L11&12-Periodontitis Flashcards
LETS GET IT SHAWTY: What are the 10 Major Risk Factors for Periodontitis?
1.Tobacco 2.Systemic Diesases 3.Medications 4.Crooked Teeth 5.Prego 6.More Red Complex Bugs 7.Heredity 8.Age 9.Poverty 10. Poor Oral Hygiene
What are the three events that DEFINE periodontitis? How is it distinguished from gingivitis?
1.destruction of PDL 2.Loss of alveolar bone 3.Migration of junctional epithelium…it is IRREVERSIBLE
Does attachment loss indicate if disease is ongoing?
NO it might not be active at that time
Which age group is most affected by peroidontitis?
Older individuals
What is usually the cause of Perio in young children less then 10 years old?
Neutrophil genetic defects
What are 6 proposed mechanisms explaining why perio disease happens?
1.Bacterial products distroy tissue 2.host inflammatory factors destroy tissue 3. too many bacteria/too few host 4.no single bug to blame 5.most bad guys still uncharacterized 6.Most popular idea: unique bacterial combinations and MALFUNCTIONING host immunity
What are the 3 hypotheses for explaining perio disease? (think general).. What is the most likely?
1.A specific bacterium 2. Specific Mechanism, multiple bacterial…3..MOST likely-Multiple Machanisms, multiple bacteria
What are the two competing theories about the root of perio disease? Which one is clinically used more?
1.All plaque is bad 2.Only certain plaque is pathogenic
What are the three DAMAGING MICROBE PRODUCTS? (general)
Exoenzymes, Exotoxins, and Toxic Metabolites
What are the two DEFENSE INHIBITORS?
lowered PMN migration and lowered T and B cell function
What is the main INFLAMMATORY AGENT found in Perio?
LPS!!!(massive potential)
Whats causing Type I-TypeIV Hypersensativity to go on in periodontitis?
unknown antigens and known complexes
What are the 5 MAJOR pathogens in Periodontitis?
1.Porphymonas Gingivalis 2.Prevotella Intermedia 3.Aggregatibacter Actinomycetemcomitans 4.Tannerella Forsythia 5.Treponema Denticola
What are the 7 topics to know about AA?
1.Gram - Rod 2.Capnophilic 3.Facultative 4.Catalase 5.pH 7.5 optimum 6.Saccharolytic (ODD!) 7.Grows w/ steroids! (cool!)
What are the two MAJOR virulence factors for AA?
- LPS BLEBS! 2. Fimbrae binding
What are the three features of the nasty LPS Blebs?
1.activates Macrophages (for more inflammation) 2.KILLS Macrophages and PMNs with LeukoToxin! 3.Stimulates osteoclasts!
What % of aggressive adult perio and what % of aggressive juvenile perio is associated with AA?
30-50% aggressive adult……..freaking 90% aggressive juvenile!
What are the 5 topics to know about Porphymonas Gingivalis?
- Gram - rod 2.Anaerobic 3.Needs Haemin 4.pH 7.5-8.5 5. Asaccharolytic
What is stealthy about P. Gingivalis?
Its LPS is 100 to 1000x LESS inflammatory!
What are the 5 virulence factors for P. Gingivalis?
1.CHO capsule 2.Toxic Products 3.UNIQUE LPS (in blebs too!) 4.Fimbrae 5. Many secreted enzymes and proteases
When looking at AA and PG, when in life do they show up in a healthy mouth?
AA-at a young age, then they go away…PG-slowly build as age progresses
Which one (PG or AA) is constant across all areas of the mouth and which one lives in specific neighborhoods?
PG is everywhere….AA only lives in little pockets/neighborhoods
What is the major leukocyte doing battle with AA, PG and PI ?
the PMN
What happens to oxygen that reaches a gingival pocket in perio disease?
reacts with organic molecules to get rid of it and make an anaerobic environment!
Why must perio bugs use protein for food? (2)
No saliva, no food residue down there!
What is a major colonization factor for perio bugs?
absence of saliva washing
What are the different surfaces of a perio pocket? (3)
- pellicle 2.leaky epithelium 3. wall of neutrophils
What removes the MASSIVE amount of LPS in a perio pocket?
PMN!
What is the MAIN culprit/the genesis of collagen degradation and bone resorption in the perio pocket?
LPS! (stimulates cytokine release by Macrophages)
Which immune cell has an end goal of GETTING RID of the threat? (e.g. get RID of the TOOTH!)
The Helper T cell…get rid of the tooth to keep the infection localized at all costs!
What does LPS from bacteria and Cytokines from Helper T cells do to the Macrophages?
Turns them in to ‘super macs’
Periodontal treatment strives to eliminate, or more correctly greatly reduce, ___________, thus reducing the immunologic stimulus.
the bacterial load
__________ (____) might be added after periodontal surgeries to encourage osteoblast activity so that supporting bone structure might regenerate.
Bone Morphogenic Proteins (BMPs)
Which mechanism attributes about 1/3 of the assault during perio disease? Which is the other 2/3s?
1/3-the bacterial assault….2/3s the host immune response
