Pathogenesis of Periodontal Disease (9/20) Flashcards
What are 5 components of microbial plaque?
- bacteria
- fungus
- protozoa
- virus
- mycoplasm
What 3 factors contribute to periodontal disease?
- microbial plaque
- genetics/host factors
- acquired/environmental factors
What are the 2 types of supragingival plaque?
- coronal plaque
- marginal plaque
What are the 2 types of subgingival plaque?
- attached plaque
- unattached
What are the 3 types of attached plaque?
- tooth
- epithelium
- connective tissue
What are the 5 cardinal signs of inflammation?
- redness (rubor)
- swelling (tumor)
- heat (calor)
- pain (dolor)
- loss of function (functiolaesa)
What are the 5 cardinal signs of inflammation?
- redness (rubor)
- swelling (tumor)
- heat (calor)
- pain (dolor)
- loss of function (functiolaesa)
What are the underlying host response events that are the basis for the clinical findings seen in gingivitis and periodontitis?
-
What is the relationship between periodontal disease and systemic effects?
-
T/F: Increased epithelial turnover rate may result in a lack of keratinization.
True.
What is the major cell type found in inflammatory cell infiltrate?
PMNs
When does the initial lesion occur?
2-4 days
What are the histologic features of an initial lesion?
- vasculitis of vessels in JE
- exudate from gingival sulcus
- increased leukocytes into JE & gingival sulcus
- presence of serum proteins (fibrin)
- increased vascularity
- alteration to coronal JE
- loss of perivascular collagen
What is the clinical appearance of the initial lesion?
- appears clinically healthy
- no periodontal pocket
- no radiographic evidence of bone loss
When does the early lesion occur?
4-7 days
What are the histologic features of the early lesion?
- accentuation of initial lesion
- lymphoid cells in JE
- further loss of collagen fiber network of marginal gingiva
- beginning proliferation of basal cells of JE
What are the clinical features of the early lesion?
- gingivitis (acute)
- changes in gingival color, contour, and consistency
- bleeding on probing
- no pocket
- no bone loss
When does the established lesion occur?
2-3 weeks
What are the histologic features of an established lesion?
- predominance of plasma cells without bone loss
- immunoglobulins in CT & JE
- continuing loss of CT
- proliferation, apical migration, and lateral extension of JE
- early pocket formation may or may not be present
What are the clinical features of the established lesion?
- gingivitis
- changes in color, contour, and consistency of gingiva
- bleeding on probing
- no pocket
- no bone loss
When does the advanced lesion occur?
> 3 weeks
What are the histologic features of the advanced lesion?
- significant bone loss
- loss of collagen in pocket epithelium
- cytopathically altered plasma cells
- formation of periodontal pockets
- periods of quiescence and exacerbation
- conversion of distant bone marrow into fibrous CT
- widespread manifectations of inflammatory/immunopathologic reactions
What are the clinical features of the advanced leasion?
- periodontitis
- changes in gingival color, contour, and consistency
- pocket formation
- alveolar bone loss
What is the innate immune response?
non-specific
