Introduction to Periodontal Disease

Question 1

what is periodontology?

Answer 1

the study of the periodontal tissues in health and disease, including the causes, prevention and treatment of diseases of the periodontal tissues

Question 2

name the periodontal tissues

Answer 2

gingiva, periodontal ligament, root cementum and alveolar bone

Question 3

where does periodontal disease start?

Answer 3

the gingival sulcus where the bacteria gathers

Question 4

what does junctional epithelium do?

Answer 4

closes the entrance of the bacteria to the epithelium and the bone

Question 5

what is periodontal disease?

Answer 5

a group of diseases affecting the periodontal tissues, representing an immune reaction to adjacent plaque

Question 6

what is gingivitis?

Answer 6

inflammation only in soft tissue - the bone is still intact

Question 7

what is periodontitis?

Answer 7

inflammation in the gingiva and the bone

Question 8

what are the cardinal signs of inflammation?

Answer 8

pain, heat, redness, swelling and loss of function

Question 9

why is periodontal inflammation not protective?

Answer 9

the phase of resolution is lacking and the inflammation destroys the periodontium with time

Question 10

what are the symptoms of periodontitis?

Answer 10

bleeding on brushing, halitosis and bad taste, recession and sensitivity, drifting teeth and mobility

Question 11

what are the signs of periodontitis?

Answer 11

bleeding on gentle probing, erythema, swelling, fibrosis, halitosis, bone loss, mobility/drifting teeth, purulence

Question 12

what factors impact the microbial biofilm to progress to periodontal disease?

Answer 12

general health e.g. stress/smoking, additional pathological conditions e.g. viral/bacterial infections, function of the immune system and genetics

Question 13

what is the keystone-pathogen hypothesis for periodontal disease?

Answer 13

certain low-abundance microbial pathogens can cause inflammatory disease by increasing the quantity of the normal microbiota and by changing its composition and by interfering with the host immune system

Question 14

how was the keystone-pathogen hypothesis developed?

Answer 14

by observing the properties of the red complex bacterium P. gingivalis

Question 15

what does porphyromonas gingivalis do?

Answer 15

manipulate the innate and adaptive immune system of the host to facilitate its own survival and multiplication

Question 16

what can keystone pathogens do with regards to inflammation?

Answer 16

they can trigger inflammation when they are present in low numbers

Question 17

what assists neutrophils in healthy periodontal tissue?

Answer 17

E-selection neutrophil, IL-8, ICAM

Question 18

what does E-selection do?

Answer 18

helps with neutrophil migration from the highly vascularised gingival tissue

Question 19

what is IL-8

Answer 19

a neutrophil chemo-attractant produced by epithelial cells

Question 20

what does ICAM do?

Answer 20

facilitate adhesion of neutrophils to the tissue allowing formation of the neutrophil wall

Question 21

what allows a large variety of cytokines to be produced in healthy gingiva?

Answer 21

the array of different TLRs in combination with the multitude of bacterial species

Question 22

what disrupts the homeostasis of the periodontium?

Answer 22

genetic conditions with the impairment of the immune system and disease leading to the impairment of the immune system

Question 23

how does P. gingivalis manipulate the host immune system?

Answer 23

it inhibits the synthesis of IL-8 local chemokine paralysis, it corrupts the complement system by avoiding detection, and it has the ability to invade keratinocytes

Question 24

what is a biofilm?

Answer 24

an aggregate of microorganisms in which cells adhere to each other on a surface. they are embedded within a self-produced matrix of extracellular polymeric substance

Question 25

where do biofilms form?

Answer 25

on living or non-living surfaces and can be prevalent in natural, industrial and hospital settings

Question 26

what type of infection is dental plaque?

Answer 26

polymicrobial

Question 27

what are the steps of biofilm formation?

Answer 27

planktonic cells, attachment to catheter surface, attached cell monolayer, cell-cell adhesion and proliferation, maturation, detachment

Question 28

what allows trailblazing bacteria to start colonies?

Answer 28

adhesion molecules

Question 29

what is a false pocket?

Answer 29

gingival swelling

Question 30

what is a true pocket?

Answer 30

loss of attachment

Question 31

what forms when bone is lost between the tooth?

Answer 31

a furcation