Introduction to Periodontal Disease Flashcards
what is periodontology?
the study of the periodontal tissues in health and disease, including the causes, prevention and treatment of diseases of the periodontal tissues
name the periodontal tissues
gingiva, periodontal ligament, root cementum and alveolar bone
where does periodontal disease start?
the gingival sulcus where the bacteria gathers
what does junctional epithelium do?
closes the entrance of the bacteria to the epithelium and the bone
what is periodontal disease?
a group of diseases affecting the periodontal tissues, representing an immune reaction to adjacent plaque
what is gingivitis?
inflammation only in soft tissue - the bone is still intact
what is periodontitis?
inflammation in the gingiva and the bone
what are the cardinal signs of inflammation?
pain, heat, redness, swelling and loss of function
why is periodontal inflammation not protective?
the phase of resolution is lacking and the inflammation destroys the periodontium with time
what are the symptoms of periodontitis?
bleeding on brushing, halitosis and bad taste, recession and sensitivity, drifting teeth and mobility
what are the signs of periodontitis?
bleeding on gentle probing, erythema, swelling, fibrosis, halitosis, bone loss, mobility/drifting teeth, purulence
what factors impact the microbial biofilm to progress to periodontal disease?
general health e.g. stress/smoking, additional pathological conditions e.g. viral/bacterial infections, function of the immune system and genetics
what is the keystone-pathogen hypothesis for periodontal disease?
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
how was the keystone-pathogen hypothesis developed?
by observing the properties of the red complex bacterium P. gingivalis
what does porphyromonas gingivalis do?
manipulate the innate and adaptive immune system of the host to facilitate its own survival and multiplication
what can keystone pathogens do with regards to inflammation?
they can trigger inflammation when they are present in low numbers
what assists neutrophils in healthy periodontal tissue?
E-selection neutrophil, IL-8, ICAM
what does E-selection do?
helps with neutrophil migration from the highly vascularised gingival tissue
what is IL-8
a neutrophil chemo-attractant produced by epithelial cells
what does ICAM do?
facilitate adhesion of neutrophils to the tissue allowing formation of the neutrophil wall
what allows a large variety of cytokines to be produced in healthy gingiva?
the array of different TLRs in combination with the multitude of bacterial species
what disrupts the homeostasis of the periodontium?
genetic conditions with the impairment of the immune system and disease leading to the impairment of the immune system
how does P. gingivalis manipulate the host immune system?
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
what is a biofilm?
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
