microbiology of periodontal disease 3 Flashcards
what are the classifications of periodontal disease?
gingival diseases
chronic periodontitis
aggressive periodontitis
periodontitis as a manifestation of systemic diseases
necrotizing periodontal diseases
abscesses of the periodontium
periodontits associated with endodontic lesions
developmental or acquired deformities and conditions
what is a longer term gingivitis?
plaque-induced chronic gingivits
microorganisms associated with chronic gingivits?
gram-positive:
streptococcus sanguis, mitis, intermedius, oralis
actinomyces viscosus, naeslundii
peptostreptococcus micros
microorganisms associated with chronic gingivits?
gram-negative : fusobacterium nucleatum prevotella intermedia veillonella parvula camylobacter species
Bacteria most often cultivated and in high levels in C. Periodontitis
porphyromonas gingivalis tannerella forsythia prevotella intermedia campylobacter rectus eikenella corrodens fusobacterium nucleatum aggregatibacter actinomycetemcomitans serotype a
bacteria associated with chronic periodontitis?
peptostreptococcus micros
treponema species
eubacterium species
what can be a modifying factor for periodontitis?
diabetes, type 2 diabetes
microbiota associated with LAP (localized aggressive periodontitis)?
A. actinomycetemcomitans serotype b (90% of the total cultivable microbiota) P. gingivalis E. corrodens C. rectus F. nucleatum Capnocytophaga species spirochetes
bacteria associated with necrotizing ulcerative gingivitis?
P. intermedia
Spirochetes
what is tannerella forsythia?
non-motile, spindle-shaped, highly pleomorphic rod
gram-negative obligate anaerobe
produces several proteolytic enzymes capable of destroying immunoglobulins and factors of the complement system
what are spirochetes
spiral, motile organisms
helical rods
cell wall is gram negative but spirochetes stain poorly
penetrate both the epithelium and connective tissue
some have the capacity to degrade collagen and dentin
T. denticola produces proteolytic enzymes that can destroy immunoglobulins (Ig A, IgM, IgG) or complement factors
what is the intial lesion like in gingivitis?
plaque biofilm, early signs of inflammatory respnse; not yet evident visually, migration of polymorphs toward sulcus in response to biofilm and its products
gingival tissues appear firm and pink, no response is evident to probing.
what is the early lesion in early gingivitis?
pathogens from plaque biofilm traverse sulcular epithelium into connevtive tissue
release of inflammatory mediators by epithelial cells
continued migration/recruitment of polymorphs, cytokines, antibodies, PGE, LPS
increased blood flow and vascular permeability
gingival margin shows change form pink to red Early signs of edema are evident. Slight bleeding response to gentle probing.
established lesion in established gingivitis what is it like?
increased number of polymorphs and other defense cells, greater presence of pathogens in host tissue, release of MMPs, cytokines, LPS, and PGE2.
Gingival fibers damaged and destroyed.
Marked immune response leads to host cell damage.
Significant edema and redness of gingival margin evident. Faster and more profuse bleeding in response to probing.
Patient should be aware of bleeding during oral hygiene.
what is the advanced lesion like in periodontitis?
plaque biofilm becomes more gram negativ and anaerobic
epithelial attachment migrates apically
destruction of connective tissue
resorption-bone loss
Lesion is no longer limited to gingival tissue. Bone and periodontal ligament fibers are damaged and destroyed. Host is overwhelmed by pathogenic insult and collateral damage from immune and inflammatory response. Host tissue is not replaced. Resolution results in changed architecture.
