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perio > lecture 2: etiology > Flashcards

lecture 2: etiology Flashcards

1
Q

what are the 3 components that lead to the development of periodontal disease

A
  • environmental factors
  • microbial factors
  • host factos
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2
Q

smoking makes the environment __ favorable to periodontal ds

A

more

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3
Q

periodontal pathogenesis

A
  1. overgrowth of gram + bacteria in susceptible host
  2. leads to inflammation
  3. get gingivitis
  4. the gingival inflammation alters sub gingival microenvironment
  5. this makes the environment favorable for perio pathogens
  6. leads to overgrowth of periodontal pathogens in biofilm which can lead to
    7a. more gingivitis, and able to contain the infection
    or 7b. unable to contain the infection and lead to periodontitis
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4
Q

the structurally and functionally organized, species-rich microbial biofilms that form on teeth

A

dental plaque

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5
Q

what is materia alba

A
  • white cheeselike accumulation
  • soft accumulation of salivary proteins, bacteria, desquamated epithelial cells and food debris
  • not organized
  • easily displaced with water
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6
Q

what is dental plaque

A
  • resilient clear to yellow/gray color
  • mostly made of bacteria in a matrix of salivary glycoproteins and bacterial products
  • a biofilm
  • impossible to remove with water
  • use disclosing agent to see plaque
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7
Q

what is calculus

A
  • mineralized dental plaque forms the hard deposit
  • generally covered by a layer of unmineralized dental plaque
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8
Q

what is the composition of dental plaque

A

70% water
30% Microorganisms (70% of the 30)
and intracellular matrix

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9
Q

what do we see here

A

materia alba

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10
Q

what do we see here

A

calculus

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11
Q

organic components of the intracellular matrix

A

polysaccharides

proteins

glycoproteins

lipids

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12
Q

inorganic component of the intracellular matrix

A

CALCIUM PHOSPHOROUS

other minerals like sodium, potasisum and fluoride

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13
Q

sites of accumulation of dental plaque

A
  • gingival thirds
  • cracks, pits and fissures
  • under overhanging restorations
  • around malaligned teeth
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14
Q

dental plaque classification are based on ..

A

the position on the tooth surface towards the gingival margin

supragingival, marginal and subgingival plaque

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15
Q

tooth attached plaque, unattached plaque and epithelial associated plaque are

A

subgingival plaque

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16
Q

supragingival plaque is made up of what rods

A

gram + cocci and short rods

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17
Q

subgingival plaque is made up of

A

gram - rods and spirochete

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18
Q

once calculus is forming and we have root caries this is what type of plaque

A

supragingival plaque

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19
Q

direct contact with gingival margin, initiation and development of gingivitis is what type of plaque

A

marginal plaque

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20
Q

once there is tissue destruction what type of plaque is there

A

subgingival plaque

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21
Q

the 3 steps of the formation of dental plaque

A
  1. formation of the pellicle
  2. initial colonization of bacteria
  3. secondary colonizers and plaque maturation
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22
Q

step 1: formation of the pellicle

A
  1. the pellicle is formed
  2. transport - passive
  3. REVERSIBLE attachment to the pellicle
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23
Q

step 2: initial colonization of bacteria

A
  1. the adhesin receptor binds which is IRREVERSIBLE and specific
  2. co adhesion ocurs with secondary colonizers
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24
Q

step 3: secondary colonization and plaque maturation

A

attracts more bacteria

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25
Q

an organic material layer coated on all surfaces in the oral cavity, including hard and soft tissues

A

acquired pellicle.

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26
Q

the inital stage of the development of plaque and length

A

acquired pellicle

27
Q

formation of the pellicle and length

A
  • REVERSIBLE adhesion between adhesins and receptors
  • forms a protective barrier
  • ~2 hours
28
Q

intial colonization and length

A
  • occurs with coadhesion
  • primary and secondary colonizers
  • there is an alteration in the oxygen gradient ANAEROBIC CONDITIONS emergy

4-8 hours

29
Q

what are the primary colonizers (5)

A

streptococcus

hemophilus

neisseria

actinomyces

veillonella

  • think in primary school we wear vans.*
  • “VANHS”*
30
Q

what are the secondary colonizers

A

prevotella intermidia

capnocytophaga

fusobacterium nucleatum

porphyromonas gingivalis

  • think @ secondary school, we begin to cuss at pigs.*
  • “FnC PiPg”*
31
Q

colonization and maturation and length

A
  • occurs through coaggregation with the secondary colonizers

~4-8 hours

  • maturation occurs through furthur colonization and growth
  • there is quorum sensing to improve conditions of the environment

~12 hours

32
Q

quorum sensing results in

A

bacterial resistance

33
Q

the structure of dental plaque

A
  • open fluid-filled channels runing through plaque mass
  • have a distinct microenvironment produced by matrix
  • steep chemical gradients (oxygen, pH)
34
Q

a patient should brush bid (12 hours apart) becauseee

A

that is about howlong colonization and maturation take so you should brush around every 12 hours to disrup this.

35
Q

nonspecific plaque hypothesis

A
  • all plaque are NOT equally pathogenic

not all gingivitis develops into destructive periodontitis, and there is some site specificity.

36
Q

specific plaque hypothesis

A

the pathogenicity depends on the presence of or increase in specific microorganisms

A.a in localized aggresive periodontitis

  • have targeted treatment strategies.
37
Q

which microorg is localized in aggresive periodontitis

A

a. actinomicetemcomitans

A. a

38
Q

ecologic plaque hypothesis

A

both the total amount of dental plaque and specific microbial composition is important.

it is based on the mirobial homeostasis and the state of dynamic equilibrium

39
Q
A
40
Q

do we use kochs postulates or socransky’s criteria for microbiologic specificity

A

socransky’s criteria

41
Q

A. a. association

Agrrebacter actinomycetemcomitans

A

Increased in localized aggresive periodontitis lesions.

Some in chronic periodontitis lesions.

42
Q

A. a. eliminations

(Agrrebacter actinomycetemcomitans)

A

suppresed or eliminated in sucessful therapy, can be found in recurrent lesions too

43
Q

A. a. host responose

(Agrrebacter actinomycetemcomitans)

A

increased serum and local antibody levels

44
Q

A. a. animal sutdies

(Agrrebacter actinomycetemcomitans)

A

was capable of inducing disease in gnotobiotic rats

45
Q

A. a. virulence factors

(Agrrebacter actinomycetemcomitans)

A

host tissue cell adherence and invasion

trypsin-like enzyme, collagenase, fibrinolysis, phopholipase A, endotoxin, ginigpains, factors that affect PMN function

46
Q

P. gingivalis association

A

increased in periodontitis lesions, found associated with the crevicular epithelium (especially at the sulcus)

why its important to remove as much calculus as possible in SRP

47
Q

P. gingivalis elimination

A

supressed or eliminated in successful therapy, can be found in recurrent lesions

48
Q

P. gingivalis host response

A

increased systemic and local antibody levels

49
Q

P. gingivalis animal studies

A

important in experimental mixed infections

50
Q

P. gingivalis virulence factors

A

host tissue cell adherence and invasion, endotoxin, gingipains, trypsin-like enzyme, collagenase, fibrinolysis, phospholiipase A, factors that affect PMN formation

51
Q

bacteria in the red complex

A
  1. P. gingivalis
  2. T. forthysia
  3. T. denticola
52
Q

virulence factors:

toxins and enzymes that help promote tissue destruction

A
  • LPS
  • leukotoxin
  • gingipains
  • collagenase
  • protease
53
Q

virulence factors

adhesins that help promote colonization

A
54
Q

virulence factors

evading mechanisms

A
  1. invasion of gingival epithelial cells: LPS
  2. modulate host response: bind serum components
  3. proteolytic degradation: gingipains
55
Q

what are the bacteria of gingivitis

A
  1. actinomyces spp
  2. capnocytophaga spp
  3. campylobacter spp
  4. streptococcus spp
  5. parvimonas spp
  6. fusobacterium nucleatum
  7. preotellla intermedia
  8. treponema spp
56
Q

bacteria of necrotizing periodontal ds

A
  1. fusobacterium nucleatum
  2. prevotella intermedia
  3. treponema spp
  4. spirochetes
57
Q

bacteria associated with pregnancy and puberty

A
  1. prevotella intermedia
  2. capnocytophaga spp
58
Q

bacteria in abscess of the periodontium

A
  1. fusobacterium nucleatum
  2. parvimonas micra
  3. prevotella intermedia
  4. porphyromonas gingivalis
  5. spirochetes
59
Q

specific bacteria in ds for healthy sites

A
  • more gram +
  • cocci
  • nonmotile
  • facultative anaerobes (they like O2)
  • fermenting
60
Q

specific bacteria in diseased sites

A
  1. gram -
  2. rod
  3. motile
  4. obligate anaerobes (no O2)
  5. proteolytic
61
Q

order of complexes from best to worst

A

yellow –> green –> purple –> orange –> red

62
Q

transmission of periodontal pathogens, which ones?

A

A. a (A. actinomycetemcomitans) AND P. gingivalis

source: saliva

donor-recipient: parent/child, spouse/spouse

63
Q

are the peridontal pathogens transmissible?

A

periodontal pathogens are communicable but not readily transmissible

64
Q

goals of plaque control

A
  1. disrupt ecological succession
  2. reduce degree of organization (those red and orange complexes)
  3. “heathy plaque” (gram +, aerobic bacteria)
  4. Shift in flora compatible with health

perio (9 decks)

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