Pathogenesis Flashcards
What are the 5 components of Microbial Plaque?
Bacteria Fungus Protozoa Virus Microplasm
What are the two types of plaque?
Subgingival
Supragingival
What are components of the supragingival plaque?
Coronal plaque
Marginal Plaque
What are the components of the subgingival plaque?
Attached plaque
Unattached
Where do you find the attached plaque?
Tooth
Epithelium
Connective Tissue
What are the five cardinal signs of inflammation?
Redness (rubor) Swelling (tumor) Heat (calor) Pain (dolor) Loss of function (functiolaesa)
Is supragingival plaque aerobic or anaerobic?
aerobic
Is subgingival plaque aerobic or anaerobic?
anaerobic
What can increase the subgingival plaque if it accumulates?
Supragingival plaque
What can cause the pain from the five cardinal signs of inflammation?
Abcesses
If you have an increased number of blood vessels in the gingiva what might that be a sign of?
Periodontal disease
Inflammation
What happens to the epithelial ridges (rete pegs) when you have periodontal disease or inflammation?
They extend deep into the connective tissue
T/F Probing depth increase during inflammation or periodontal disease.
True
T/F You have decreased vascular permeability during inflammation/ periodontal disease?
False
You have increased permeability
What happens to the collagen fiber network in periodontitis?
It goes through destruction
Loss of attachment to root surface
What happens to the epithelial cell junctions with inflammation?
They get disrupted
What does the gingiva look like clinically with inflammation?
Erythematous tissue
Spongy
Edematous
When does the initial lesion occur?
2-4 days
When do you first see the loss of perivascular collagen?
Initial lesion
What happens to the junctional epithelium during the initial lesion?
Alteration of the most coronal portion
When do you find increased migration of leukocytes into the junction epithelium and gingival sulcus?
Initial lesion
Where do you find classic vasculitis of vessels in the initial lesion?
subjacent to the junction epithlium
When do you find the presence of serum proteins, especially fibrin?
Initial lesion
When clinically will you find these symptoms?
Appear clinically Healthy
No periodontal Pocket
No radiographic evidence of bone loss
Initial lesion
When does the early lesion occur?
4-7 days
If you have: Acute form Gingivitis Changes in gingival color, contour, consistency No periodontal pocket No radiographic bone loss
Early lesion
When do you find the accumulation of lymphoid cells subjacent to the Junctional epithelium?
early lesion
When do you find the cytopathic alterations of fibroblast?
early lesion
When do you find the beginning of proliferation of basal cells in the junctional epithelium?
early lesion
If you have: Chronic gingivitis Changes in gingival color, contour, consistency No periodontal pocket No radiographic bone loss
Established lesion
When does the established lesion occur?
2-3 weeks
When do you find proliferation, apical migration and lateral extension of the junctional epithelium?
Established lesion
When do you find the predominance of plasma cells without appreciable bone loss?
Established lesion
When do you find the presence of immunoglobulins extravascularly in the connective tissue and the junctional epithelium?
Established lesion
When do you find histologic evidence that early pocket formation may or may not be present?
Established lesion
When do you find the advanced lesion?
Greater than 3 weeks
If you have: Periodontitis changes in gingival color, contour, consistency and bleeding on probing Periodontal pocket formation Alveolar bone loss shown on radiographs
Advanced lesion
When do you find the conversion of distant bone marrow into fibrous connective tissue?
Advanced lesion
When do you find cytopathically altered plasma cells?
Advanced lesion
When do you find the extension into alveolar bone and PDL with significant bone loss?
Advanced lesion
When do you find widespread manifestations of inflammatory/immunopathologic reaction?
Advanced lesion
What three diagnoses will you find the periodontal connective tissue attachment intact?
Normal
Early gingivitis
Chronic gingivits
When do you find that the periodontal connective tissue attachment is lost?
Adult periodontitis
When do you find the alveolar process intact?
Normal
Early gingivitis
Chronic gingivitis
What stage of diagnosis do you find few bacteria in the gingival crevice or pocket?
Normal
What stage of diagnosis do you find complex flora fills in the gingival pocket with calculus possibly present?
Chronic gingivitis
What stage of diagnosis do you find complex flora filling the gingival pocket?
Early gingivitis
When do you find subgingival flora containing specific pathogens with calculus to the bottom of the pocket?
Adult periodontitis
When do you find tight intercellular junction and the JE at the CEJ?
Normal
When do you find widened intercellular spaces containing leukocytes and the JE at the CEJ?
Early gingivitis
When do you find greater leukocytic infiltrate of JE but the JE is still at the CEJ?
Chronic gingivitis
When do you find the JE apical to the CEJ and converted to pocket epithelium?
Adult periodontitis
When do you find the supracrestal attachment intact?
Normal
When do you find the loss of attachment of the CT, Ct infiltrated by round cells mainly lymphocytes?
Early gingivitis
When do you find the loss of attachment: CT infiltrated by round cells, mainly plasma cells?
Chronic gingivitis
When do you find the loss of attachment: plasma cells predominant in the CT?
Adult periodontitis
Is the innate immune system specific or nonspecific?
Non-specific
Is the acquired response Specific or non specific?
Specific (adaptive)
What cell causes the most damage in the acute phase (gingivitis)?
Neutrophil
What cell causes the most damage in periodontitis?
Fibroblast
What are some important immune cells that are involved in plaque accumulation and initiation of gingivitis?
Mast Cells Acute phase proteins Complement PMN antibodies
What histologic state are you in if you have Slightly elevated vascular permeability and vasodilation?
Initial lesion
What histologic state are you in if you have gingival crevicular fluid flowing out of the sulcus?
Initial lesion
What histologic state are you in if you Migration of leukocytes, primarily neutrophils, in relatively small numbers though the gingival connective tissue across the JE and into the sulcus?
Initial lesion
