histo/pathogensis of perio diseas :) Flashcards
normal periodontoum
bone
PDL
Gingiva
cementum
what lines the root surace
cementum
gingival epithelium histology
long rate ridges
junctional epithelium
thinner and more porous
forms barrier against dentinal plaque
attaches at the CEJ
healthy periodontium
junctional epithelium attaches at the ACJ
PDL attaching to alveolar bone
protective features of the host against PDD
barrier effect of intact junctional epithelium
factors in saliva
gingival crevicular
activation of T/B cells
gingival crevicular fluid
originates from gingival capillaries
contains neutrophils and complement
risk factors of PDD
poor oral hygiene
smoker
genetic
systemic disease
gingivitis symptoms
vasodilation increased blood flow damage to fibroblasts oedema increase in crevicular fluid still in tact at ADJ
histological changes at gingivitis
hyperplasia of JE increased inflammatory cells no migration of JE or bone loss increased blood flow loss of gingival collagen fibres development of deeper rate ridges more inflammatory cells junctional epithelium still attaches to ADJ
clinical changes of gingivitis
bleeding on probing
false pocketing
pain, redness, swelling
pre disposing factors to gingivitis
- Pregnancy/puberty
- Orthodontic appliances
- Dentures
- Restorations with overhangs
- Effects of medications
periodontist symtoms
JE has moved apically
plaque has moved more apically bone loss
more inflammatory cells
clinical changes of periodontitis
tooth mobility true pocket over 4mm bleeding on probing recession tooth loss halitosis calculus junctional epithelium may ulcerate
periodontisis histology
junctional epithelium ends more apically than at ADJ
true pockett formed
more inflammatory cells
BPE scoring
code 0-4
* furcation involvement
where can growth of plaque be
supra or sub gingival
what is growth on the tooth called
biofilm
what is a biofilm
3D structure of heterogenous bacterial and the material produced as a product of growth
subginigval plaque
heterogenous
firmly attached bacteria at tooth surface
many different cocci and bacilli
channels can run in the 3D structure allowing nutrients to flow
bacteria in a periodontal pocket
contains mainly gram positive Layer attached to hard tissue
overlying gram - layer
many motile and anaerobic bacteria
progression to periodontist
not always precede by gingivitus
early lesion can take many years to progress to advanced lesion, signifies change from gram + to gram - bacteia
what changes a quiescent site to an active one
change in host
change in microbial challenge
dysbiosis
healthy to disease