Pathogenesis of Periodontal Disease

Question 1

Socransky et. al (1984) proposed 3 different models to describe possible patterns and rate of progression of perio disease. What are they?

Answer 1

Continuous Rate Theory Random burst Theory Asynchronous multiple bust theory

Question 2

What is the Continuous rate theory?

Answer 2

• Sites are either active or inactive
• At active sites the progression continues at a constant rate over time unless treatment is carried out
• Different active sites in a patient may be progressing at different rates

Question 3

What is Random Burst Theory?

Answer 3

• Sites can be active or innactive
• At active sites there are random bursts of periodontal destruction followed by periods of no activity with possible periods of repaid

Question 4

What is Asynchronous Multiple Burst Theory?

Answer 4

• Similar to Rnadom Burst Theory except that multiple active sites breakdown within a short defined periods of time. e.g period of stress
• Activity followed by long periods of no activity

Question 5

As plaque biofilm accumulates & matures evidence of gingival inflammation increases with evidence of …

Answer 5

1. Increased gingival crevicular fluid (GCF) flow
2. Increase in inflammatory & immune cellular infiltrate in the connective tissue underlying Junctional Epithelium
3. Fewer fibroblasts in the gingival connective tissue underlying the Junctional Epithelium
4. Reduction in the collagen contenet in the inflamed connective tissue under the Junctional Epithelium

Question 6

Kinane et al. (2008) Divided progressing lesion into 4 phase, what are they?

Answer 6

Initial & Early Lesions : early stages of gingivitis (no clinical signs)

Established Lesion : clinically obvious gingivitis

Advanced Lesion : periodontitis