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TEXTBOOK FALL EXAM 2021 > Pathogenesis > Flashcards

Pathogenesis Flashcards

1
Q

What is pathogenesis`

A

Origin and development of a disease

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2
Q

What is periodontal disease?

A

Chronic disease that is multifactorial between the biofilm, host and inflammation

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3
Q

What is the relationship between bacteria and inflammation?

A

Bacteria - Initiates

Inflammation - Perpetuates

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4
Q

What is gingival health? (5)

A
  1. Minimal to no bleeding on probing
  2. Pink gingiva
  3. Firmly attached
  4. Shallow probing depths
  5. Minimal to no bone loss
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5
Q

What are the epithelial portions in gingiva?

A
  1. Oral
  2. Sulcular/ Crevicular
  3. Junctional
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6
Q

How does gingiva stay healthy (5)

A
  1. Maintains epithelial barrier
  2. Sloughing/Turnover of epithelium
  3. Antibodies
  4. Neutrophils
  5. Macrophages
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7
Q

Where are antibodies found? (3)

A
  1. Saliva
  2. GCF
  3. Capillaries
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8
Q

What is the histopathology of gingivitis?

A
  1. Tissue infiltrated by defense cells
  2. Release of enzymes
  3. Causes collagen depletion
  4. Reversible
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9
Q

How did Page and Schroder describe gingival inflammation

A

Initial
Early
Established
Advanced

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10
Q

What happens in the Initial Stage of gingival inflammation?

A
  1. Neutrophils dominant
  2. Increased vascular permeability
  3. Increased vasodilation

Appears in 2-4 days

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11
Q

What happens in Early Stage of gingival inflammation? (4)

A
  1. T cells dominate the lesion
  2. Increased GCF
  3. Degeneration of fibroblasts– loss of CT
  4. Collagen fibroblasts– loss of collagen

Appears in 4-7 days

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12
Q

What happens in the Established Stage of gingival inflammation? (5)

A
  1. Chronic Gingivitis
  2. Plasma Cells–> B cells dominate the lesion
  3. Increased CT breakdown
  4. Increased Collagen depletion
  5. JE proliferate in apical direction

Appears in 2-3 weeks

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13
Q

What happens in the Advanced Stage of gingival inflammation?

A
  1. Transition to perio dx
  2. B- cell predominates still
  3. Bone loss occurs by osteoclast resorbing alveolar bone
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14
Q

What are the specific virulence factors (5)

A
  1. LPS
  2. Protease – Bacterial Enzyme
  3. Fimbriae
  4. Microbial Invasion
  5. Bacterial DNA
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15
Q

What are the Host derived inflammatory mediators? (3)

A
  1. Cytokines
  2. Prostaglandin
  3. MMP (matrix metalloproteinases)
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16
Q

What are cytokines?

A

Locally acting soluble messengers that amplify immune response and induce their own expression

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17
Q

What are prostaglandins?

A
  1. Lipid compound from arachadonic acid
  2. Metabolized by COX1 & 2
  3. Increase vasodilation/ inflammation
  4. Induce MMP and Bone Resorption
18
Q

What are MMPs?

A

Enzymes that break down structural proteins like collagens

Matrix metalloproteinases

19
Q

What are the Inflammatory mediators in perio disease? (4)

A
  1. Interleukin (IL-1, IL-6)
  2. TNF Alpha
  3. Prostaglandin (PGE2)
  4. Chemokines - Direct migration of WBCs
20
Q

What are Interleukins?

A

Type of cytokines linked to innate immune response (they stimulate the immune response)

21
Q

What is TNF alpha?

A
  1. Inflammatory mediator
  2. Increases neutrophil activity
    (TNF Alpha - Neutrophils)
22
Q

What cells makes/secretes prostaglandin?

A
  1. Macrophages

2. Fibroblasts

23
Q

What are chemokines?

A
  1. Chemotactic molecules (Direct WBC to inflammation)

2. Leukocyte migration role

24
Q

How does a pocket develop?

A
  1. Biofilm causes inflammation which causes sulcus to deepen

2. Defense cells cause CT breakdown –> apical movement of JE

25
Q

What is RANKL?

A

Pro osteoclast that regulates bone formation

26
Q

Discuss the resolution of inflammation?

A

ACTIVE process

  1. Lipoxins
  2. Resolvins
  3. Protectins
27
Q

What is innate immunity

A
  1. Non specific barrier to infection
  2. Lysozyme
  3. Mucin
  4. Peroxidase
  5. Phagocytic cells (monocytes, macrophages, neutrophils
28
Q

What are the defensive components of saliva? (5)

A
  1. Antibodies
  2. Lactoferrin
  3. Mucin
  4. Lysozyme
  5. Perioxidase
29
Q

What are GCF defensive functions? (3)

A
  1. Antibodies
  2. Neutrophils
  3. Flushing action
30
Q

What is in epithelium to make it a defensive tissue?

A

Keratin is the barrier

31
Q

What are senteniel cells?

A
  1. Macrophage and dendritic cells (Antigen Presenting Cells and Phagocytic)
  2. Provide innate and adaptive immunity
32
Q

What are neutophils?

A

Type of White Blood Cell

  1. Phagocytic Cells
  2. Low grade defense- First line of defense in innate immunity
33
Q

What is adaptive immunity?

A
  1. Later immune response with plasma cells/B Cells
  2. Slower and more complex
  3. Antigen specific
  4. Chronic periodontitis is adaptive
34
Q

What are the 3 types of Antigen Presenting Cells and what do they do?

A
  1. B Cell
  2. Macrophage
  3. Dendritic Cell

Go to the lymph node to present to the T Cell

35
Q

REPEAT CARD- IGNORE

how do antigen presenting cells function

A

Go to lymph node and react with T Cells

36
Q

What are T cells?

A

Cells in adaptive immunity- Develop in the bone marrow and go to the Thymus

37
Q

What are antibodies?

What is the most common type?

A
  1. Made by B cells
  2. Immunoglobulin for specific antigen

Most common is IgG

38
Q

Discuss Host susceptbility

A
  1. Complex immune and inflammatory process
  2. Some patients hyper respond
  3. Response can be disproportionate
39
Q

What is the role of Toll like Receptors?

A

proteins on sentinel cell (Macrophages and Dendritic Cells) that recognize pathogens

40
Q

What are NETS?

A

Neutrophil extra cellular traps

41
Q

What are the main Antibodies to perio disease?

A

Mainly IgG

some IgA and IgM

42
Q

What antibody is present in saliva?

A

IgA

TEXTBOOK FALL EXAM 2021 (11 decks)

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