L27: Oral Infections - Pathology

Question 1

Which pathogen can cause dental carries?

Answer 1

S. mutans
- The type that can ferment sugars and make organic acids

Question 2

True or False: For dental carries (attack on tooth enamel by metabolic byproducts of microbial flora) to occur, requires cariogenic bacteria

Answer 2

True

Question 3

How do dental carries arise?

Answer 3

Question 4

True or False: If left untreated, dental carries can become dentoalveolar infections

Answer 4

True!

Question 5

What are two features of peridontitis?

Answer 5

1. Bone destruction
2. Pocket

Question 6

What are two features of ginvigitis?

Answer 6

1. Calculus
2. Inflammation

Question 7

True or False: All of the bacterium that lead to gingivitis are gram (-) rods

Answer 7

True

Question 8

Which condition is characterized by plaque build-up on necks of teeth, as well as calcification, leading to gum inflammation?

Answer 8

Gingivitis

Question 9

In ginigivitis, what causes the vasodilation (gum redness)?

Answer 9

Metabolic products of bacteria

Question 10

In gingivitis, which complement pathway is activated, leading to edema/puffy gums?

Answer 10

Alternative pathway

Question 11

In gingivitis, bacteria activate ___ receptors and induce pro-inflammatory ___

Answer 11

TLR; cytokines

Question 12

In gingivitis, airway epithelial cells make ___ to induce neutrophil infiltration
A. IL-1
B. IL-9
C. IL-8
D. IL-2

Answer 12

C. IL-8

Question 13

Is gingivitis reversible? How?
What happens if it isn’t treated?

Answer 13

Yes - removal plaque and tartar
- Lack of treatment = periodontitis (irreversible)

Question 14

Loss of bone and alveolar tissue is a feature of
A. Gingivitis
B. Periodontitis

Answer 14

B. Periodontitis

Question 15

_____: Inflammation of the tissue around teeth, often causes shrinkage or gums, loosening of teeth, or loss of teeth

Answer 15

Periodontitis

Question 16

What is an etiological agent that is likely to cause Adult Periodontitis?

Answer 16

Keystone pathogen
- P. gingivalis

Question 17

____: Commensal organisms that, under disrupted homeostasis, have the potential to deregulate inflammatory response and cause disease

Answer 17

Pathobionts

Question 18

True or False: Formation and composition of biofilm are very important in promoting periodontitis

Answer 18

True

Question 19

Influx of neutrophils and inflammation WITHOUT significant tissue loss suggests ____

Chronic inflammation, more macrophages, activation of osteoclasts suggests ____

Answer 19

Gingivitis; Periodontitis

Question 20

In periodontitis, which cells of the adaptive immune response recruit additional PMN’s and IL-17 to promote osteoclast activation?

Answer 20

Th17

Question 21

In periodontitis, neutrophils release ____, which break down CT and are pro-inflammatory cytokines

Answer 21

metalloproteases

Question 22

True or False: In periodontitis, macrophages and neutrophils release ROS

Answer 22

True

Question 23

True or False: In periodontitis, cells produce RANKL, which promotes bone resorption

Answer 23

True

Question 24

What are thee pathophysiological mediators responsible for tissue and bone loss in periodontitis?

Answer 24

1. Matrix metalloproteases
2. ROS
3. RANKL

Question 25

___ cells, produced by PMN's and fibroblasts, lead to degradation of collagen and elastin in periodontitis; also cleaves and activates pro-infl proteins A. Matrix metalloproteases B. ROS C. RANKL

Answer 25

A. Matrix metalloproteases (Periodontitis)

Question 26

____ made by neutrophils and macrophages increase MMP activation and pro-inflammatory secretion, decrease proteinase inhibitors, as well as osteoblast differentiation (by increasing RANKL) A. Matrix metalloproteases B. ROS C. RANKL

Answer 26

B. ROS

Question 27

RANKL is produced by innate immune cells like ___ and ___ as well as adaptive immune cells like B and T cells

Answer 27

macrophages/neutrophils

Question 28

___ promotes differentiation of precursor to osteoclasts that degrade bone

Answer 28

RANKL

Question 29

True or False: Net loss of alveolar bone, as in periodontitis, is largely controlled by production of RANKL and OPG

Answer 29

True

Question 30

True or False: RANKL promotes bone loss in periodontitis

Answer 30

True

Question 31

Although bone loss is not reversible in periodontitis, which two anti-inflammatory cytokines can slow it down? what other molecule?

Answer 31

IL-4/IL-10 OPG - If OPG>RANKL

Question 32

True or False: Chronic periodontitis has been linked to increased circulation of oral flora (P. gingivalis) -- can lead to local inflammatory response and promote platelet.thrombus formation

Answer 32

True

Question 33

Individuals with severe periodontitis demonstrate increased levels of pro-inflammatory cytokines + CAD. How?

Answer 33

- High inflammatory cytokines - IFN-gamma inhibits collagen production of VSM - TNF-a increased IL-6, which increases CRP