Pathogenesis

Question 1

What is pathogenesis`

Answer 1

Origin and development of a disease

Question 2

What is periodontal disease

Answer 2

Chronic disease with interplay between biofilm, host and inflammation

Question 3

What is the relationship between bacteria and inflammation

Answer 3

Bacteria - Initiate

Inflammation - Perpetuates

Question 4

Whatis gingival health

Answer 4

Not bleed on probing
Pink
Firmly attached

Question 5

What are the epithelial portions in gingiva

Answer 5

1. Oral
2. Sulcular
3. Junctional

Question 6

How does gingiva stay healthy

Answer 6

Maintains epithelial barrier
Sloughing of epithelium
Antibodies
Neutrophils
Macrophages

Question 7

Where are antibodies found

Answer 7

Saliva
GCF
Capillaries

Question 8

What is the histopath of gingivitis

Answer 8

Tissue infiltrated by defence cells
Release of enzymes
Causes collagen depletion
Reversible

Question 9

How did Page and Schroder describe gingival inflammation

Answer 9

Initial
Early
Established
Advanced

Question 10

What happens in Stage 1

Answer 10

Increased vascular permeability
Increased vasodilation
Increased GCF
Neutrophil and leukocyte in CT

Question 11

What happens in stage 2

Answer 11

Increase vascular permeability
Increased vasodilation
Increased GCF
Neutrophil
Degeneration of fibroblast
Collagen fibroblasts

Question 12

What happens in stage 3

Answer 12

Chronic Gingivitis
Dense inflammation
Plasma Cells
Increased MMP
Increased Collagen depletion

Question 13

What happens in stage 4

Answer 13

Transition to perio dx
Apical migration of JE
Increased collagen breakdown
Osteoclast resorb alveolar bone

Question 14

What are the specific virulence factors

Answer 14

1. LPS
2. Protease
3. Fimbriae
4. Bacterial DNA

Question 15

What are the host derived mediators

Answer 15

Cytokines
Prostaglandin
MMP

Question 16

What are cytokines

Answer 16

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

Question 17

What are prostaglandins

Answer 17

Lipid compound from arachadonic acid
Metabolized by COX
Increase vasodilation
Induce MMP and bone resorption

Question 18

What are MMP

Answer 18

Enzymes that break down structural proteins like collagens

Question 19

What are the inflamm mediators in perio disease

Answer 19

Interleukin
TNF Alpha
Prostaglandin
Chemokines

Question 20

What are interleukins

Answer 20

Family of cytokines linked to innate immune response

Question 21

What is TNF alpha

Answer 21

Inflamm mediator
Increases neutrophil activity
TNF Alpha - Neutrophils

Question 22

What makes prostaglandin

Answer 22

Macrophage

Fibroblast

Question 23

What are chemokines

Answer 23

Chemotactic molecules

Leukocyte migration role

Question 24

How does a pocket develop

Answer 24

Biofilm causes inflamm which causes sulcus to deepen

Defense cells cause CT breakdown apical movement of JE

Question 25

What is RANKL

Answer 25

Pro osteoclast that regulates bone formation

Question 26

Discuss the resolution of inflammation

Answer 26

Active process Lipoxins Resolvins Protectins

Question 27

What is innate immunity

Answer 27

Non specific barrier to infection Lysozyme Mucin Peroxidise

Question 28

What are the defensive components of saliva

Answer 28

``` Antibodies Lactoferrin Mucin Lysozyme Perioxidase ```

Question 29

What is GCF defensive function

Answer 29

Antibodies Neutrophils Flushing action

Question 30

What is epithelial defensive tissue

Answer 30

Keratin is the barrier

Question 31

What are senteniel cells

Answer 31

Macrophage and dendritic cells | Provide immediate and adaptive immunity

Question 32

What are neutophils

Answer 32

Professional phagocyte | Low grade defense

Question 33

What is adaptive immunity

Answer 33

Focused intense defence Slower and more complex Anti gen specific Chronic perio is adaptive

Question 34

What are antigen presenting cells

Answer 34

B Cell Macro Dendritic Go to T Cell inlymph node

Question 35

how do antigen presenting cells function

Answer 35

Go to lymph node and react with T Cells

Question 36

What are T cells

Answer 36

Adaptive immune cells in bone marrow to thymus

Question 37

What are antibodies

Answer 37

Endpoint in B cell activation | Mostly IgG

Question 38

Discuss Host susceptbility

Answer 38

Complex immune and inflamm process Some pt hyper respond Response can be disproportionate

Question 39

What is the role of Toll like Receptors

Answer 39

proteins on sentinel cell that recognizes pathogens

Question 40

What are NETS

Answer 40

Neutrophil extra cellular traps

Question 41

Antibodies to perio dx

Answer 41

IgG | some IgA and IgM

Question 42

What antibody in saliva

Answer 42

IgA