L6.Periodontal Disease

Question 1

Define Gingivitis

Answer 1

Inflammation of the gingiva

Question 2

Define Periodontitis

Answer 2

Inflammation AND destruction of the attachment apparatus

Question 3

Why might smoking lessen the visual affects periodontitis?

Answer 3

Smoking constricts blood vessels in the mouth leading to decreased bleeding and swelling

Question 4

Briefly describe Necrotizing Ulcerative Gingivitis

-Not that important

Answer 4

• Acute onset w/ characteristic “punched out,” crater like depressions at the apex of the interdental papillae.
• Pseudomembrane forms over involved tissue.
• Constant gnawing pain & metallic-foul taste.
• Commonly seen in patients under some form of emotional stress.

Question 5

What 4 specific bacteria are associated w/ Necrotizing ulcerative Gingivitis?
-Hint: 1 shape, 2 species, & 1 bacteria

Answer 5

Spirochetes

1. Fusobacteria spp
2. Selenomonas spp
3. Prevotell intermedia

Question 6

Briefly describe Localized Aggressive Periodontitis

-Not that important

Answer 6

• Rapid rate of progression
• circumpubertal onset
• Typically involves permanent incisors & 1st molars
• Progression of disease may self arrest and amounts of microbial deposits are often inconsistent with the extent of attachment loss

Question 7

What is the major bacteria associated w/ Localized Aggressive Periodontitis? Give 4 traits of this bacteria

Answer 7

Aggregatibacter actinomycetemcomitans (Aa)

1. Gram-negative coccobacillus
2. Microaerophilic (capnophilic)
3. Non-encapsulated
4. Non-motile

Question 8

Is early supragingival plaque associated w/ gingivitis?

Answer 8

NO

Question 9

What 3 bacteria were found to be in the “Red” group that is suspected to be the cause of periodontal disease?

Answer 9

1. P. gingivalis
2. T. forsythensis
3. T. denticola

Question 10

What are the 3 virulence factors of Aa that were mentioned in class that play important roles in increasing the virulence of Aa? Briefly describe each

Answer 10

1. Endotoxin LPS - Elicits Bone Resorption & Inflammation
2. Leukotoxin - Kills leukocytes
3. Cytolethal Distending Toxin - Causes cellular distension & death of epithelial cell. This breaks down the epithelial barrier allowing microbes to enter gingiva.

Question 11

What are the 3 bacteria considered periodontal pathogens by the Academy of Periodontists?

Answer 11

1. Porphoromonas gingivalis
2. Tannerella forsythia
3. Aa

Question 12

What 3 bacteria are considered part of the RED Complex as determined by Sokransky?

Answer 12

1. P. gingivalis
2. T. forsythia
3. T. denticola

Question 13

Of the following 4 bacteria which 3 are part of the RED Complex and which 3 are considered perio pathogens by the academy?
1. P. gingivalis
2. T. forsythia
3. Aa
4. T. denticola
Which, if any, of these 4 are associated w/ Chronic Periodontitis?

Answer 13

RED
1. P. gingivalis
2. T. forsythia
3. T. denticola
Perio Paths
1. P. gingivalis
2. Aa
3. T. forsythia
All 4 are associated w/ chronic periodontitis

Question 14

What is a Dysbiotic mechanism of disease initiation? (Dysbiosis)

Answer 14

A dysbiotic mechanism of disease initiation states that disease results from a shift in the resident microflora of a body compartment. i.e. a shift from gram-positive, facultative anaerobe cocci to gram-negative anaerobe spirochetes, filaments or rods.