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BDS 2: Pathology and Microbiology > L5 Aetiology of Periodontal Disease > Flashcards

L5 Aetiology of Periodontal Disease Flashcards

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1
Q

What disease types affect the periodontium?

A
  • Developmental
  • Inflammatory
  • Metabolic
  • Disorders of growth
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2
Q

What is chronic periodontal disease?

A

Destruction of the gingiva and periodontal tissues by an inflammatory reaction to dental bacterial plaque products.
Divided into chronic gingivitis (only marginal gingiva involved) and chronic periodontits (PDL, alveolar bone and cementum involved).

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3
Q

Describe the appearance of healthy gingiva.

A
  • Pink
  • Stippled
  • No swelling
  • Knife edge gingival margin
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4
Q

Describe the appearance of gums with chronic gingivitis.

A
  • Redness
  • No stippling
  • Swelling of interdental papillae
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5
Q

Describe the appearance of gums with chronic periodontitis.

A
  • Flattening of interdental papillae
  • Gingival recession exposing more crown and small part of root
  • Plaque and calculus deposits present
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6
Q

Describe the appearance of gums with adavnced chronic periodontitis.

A
  • Large amount of gingival recession indicating loss of alveolar bone and damaged periodontium
  • Extensive plaque and calculus deposits
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7
Q

How can chronic periodontal disease be prevented and treated?

A

Prevented by oral hygiene measures.
Treated by improved oral hygiene, chemical antibacterial treatment e.g. chlorhexidine, surgery to allow better tooth cleaning

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8
Q

What is the prevalence of gingivitis and periodontitis?

A

Gingivitis: up to 95%
Periodontitis: 12-15%

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9
Q

Is periodontitis a continually progressive disease?

A

No. Shows periods of activity and quiescence.

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10
Q

What model describes the progress of periodontal disease?

A

Asynchronous random burst model of periodontal breakdown:

  • Active bursts followed by inactivity
  • Some areas of the mouth affected at one time whilst others aren’t
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11
Q

How do we know that dental plaque plays a role in periodontal disease?

A
  • Epidemiological studies show strong relationships between dental plaque and periodntal disease severity
  • Clinical observations: more dental plaque = more gingivitis, severity of gingivitis related to quantitiy and distribution of dental plaque, removal of plaque causes resolution of gingivitis
  • Human experiments, e.g. Birmigham Uni students ceased tooth brushing, gingivitis developed- relationship between plaque index and gingival bleeding index
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12
Q

Is plaque capable of causing tissue damage?

A

Yes, bacteria from human plaque induces gingivitis in gnotobiotic animals, plaque products damage cells in tissue culture

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13
Q

What local plaque retentive factors are associated with increased gingivitis severity?

A
  • Overcrowding of teeth
  • Dental appliances e.g. braces, dentures
  • Overhanging restorations
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14
Q

How does diabetes affect periodontal disease?

A
  • Periodontal disease is said to be more severe and progresses faster
  • Inconclusive evidence
  • Vascular changes and defects in cellular immunity suggested to be responsible
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15
Q

How does pregnancy affect periodontal disease?

A
  • Pre-existing gingivitis will become more severe from the second to the eighth month of pregnancy
  • Increased levels of sex hormones implicated (progesterone)
  • Resolves with OH
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16
Q

How does nutrition affect periodontal disease?

A
  • Nutrition can modify but not initiate periodontal disease
  • Protein deficiency in Nigerians associated with advanced perio disease
  • Severe, prolonged vitamin C deficiency causes scurvy gingivitis
17
Q

How do blood diseases affect periodontal disease?

A
  • Chronic neutropenia: can cause advanced bone destruction
  • Leukaemia: associated with gingivitis and periodontitis
  • Functional neutrophil disorders: implicated in juvenile periodontitis
18
Q

How do certain drugs affect periodontal disease?

A
  • Immunosuppressants: possible reduction in disease activity
  • Calcium channel blockers: gingival hyperplasia
  • Sex hormones: exacerbation of pre-existing gingivitis
  • Phenytoin: gingival hyperplasia
  • NSAIDs: pssible reduction in disease activity
19
Q

How does AIDS affect periodontal disease?

A
  • Can cause severe gingivitis and periodontitis

BDS 2: Pathology and Microbiology (14 decks)

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