Lecture 3

Question 1

pathogenesis

Answer 1

disease progression
the sequence of events that occur during the development of a disease or abnormal condition

Question 2

three basic states of the periodontium

Answer 2

health
gingivitis
periodontitis

Question 3

the term periodontal disease should not be confused with

Answer 3

periodontitis

Question 4

gingivitis and periodontitis are both

Answer 4

bacterial infections

Question 5

difference between gingivitis and periodontitis

Answer 5

gingivitis:
confined to the gingiva
damage is reversible
probing depths 1-3mm

periodontitis:
affects all parts of the periodontium
damage is irreversible
probing depths 4mm+

Question 6

histological periodontium in health

Answer 6

JE coronal to CEJ
gingival fibers intact
alveolar bone intact
periodontal ligament intact
cementum normal

Question 7

gingivitis

Answer 7

a type of periodontal disease/bacterial infection characterized by changes in color, contour and consistency of the gingival tissue

4-14 days after biofilm accumulation

Question 8

clinical characteristics of gingivitis

Answer 8

increased # of bacteria from plaque biofilm
gingival tissues are: red (erythema), enlarged tissues (edema), spongy, IDP bulbous, probing depths 1-3mm, bleeding on probing

Question 9

histological characteristics of gingivitis

Answer 9

JE coronal to CEJ (epithelial ridge formation)
some gingival fiber destruction
alveolar bone intact
periodontal ligament intact
cementum normal

Question 10

clinical signs of inflammation

Answer 10

erythema/redness
edema/swelling
bleeding on probing

Question 11

duration of acute gingivitis

Answer 11

sudden onset/short lasting
red
swollen gingiva due to increased fluid in CT
professional/self-care returns to health

Question 12

duration of chronic gingivitis

Answer 12

long lasting/typically painless
body forms new collagen fibers in CT resulting in enlarged, fibrotic appearance
may conceal the redness caused by increased bloodflow

Question 13

key points if diagnosis is gingivitis

Answer 13

there is no apical migration of the junctional epithelium
tissue damage of the CT fibers is reversible
with good patient self-care, the body can repair the damage

Question 14

how can edema/swelling affect probing depths

Answer 14

pseudopocket or gingival pocket
probing depth that is greater than 3mm but is from swelling of the gingiva
look at radiographs

Question 15

clinical characteristics of periodontitis

Answer 15

vast numbers of bacteria
gingival tissues are: red-bluish-red-purplish, gingival margin swollen/fibrotic/non-adaptation to tooth, blunted IDP, recession, edematous (spongy), BOP, probing depths equal or >4mm, radiographic bone loss

Question 16

histological characteristics of periodontitis

Answer 16

JE is apical to CEJ
epithelial ridges present
gingival fiber destruction
PDL fiber destruction
alveolar bone destruction
cementum exposed to biofilm

Question 17

intermittent disease progression theory

Answer 17

periodontal disease is characterized by periods of disease activity and inactivity
destruction does not occur in all parts of the mouth at the same time

Question 18

immunity and inflammation systems

Answer 18

a complex system of protective responses against foreign substances
-infections by bacteria
-viruses
-fungi
-toxins
-parasites

Question 19

host response

Answer 19

the manner in which the human body reacts to an infection

Question 20

components of the immune system

Answer 20

cellular defenders
1. leukocytes 2. lymphocytes

compliment system
- circulating proteins

Question 21

phagocytosis

Answer 21

the process by which leukocytes engulf and digest microorganisms

Question 22

complement system

Answer 22

circulating proteins in the bloodstream that work to facilitate phagocytosis

Question 23

inflammatory response

Answer 23

part of the immune response
a bodily reaction to injury or pathogenic organisms
eliminate these microorganisms and heal tissue

Question 24

biochemical mediators in periodontitis

Answer 24

cytokines: initiate tissue destruction and bone loss
chemokines: attract additional immune cells
prostoglandins: cause bone destruction
metalloproteinases: cause collagen destruction of periodontal tissue

Question 25

stages of inflammation

Answer 25

acute: short term, normal process that protects/heals the body, warning signs present

chronic: long lived/uncontrolled, warning signs are absent

Question 26

chemotaxis

Answer 26

leukocytes attracted to the infection site/invading microorganisms