Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

perio exam 1 > pathogenesis of periodontitis > Flashcards

pathogenesis of periodontitis Flashcards

1
Q

in healthy gingiva, the _______ appears to be continuous with the junctional epithelium (JE)

A

oral epithelium (OE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the tissue volume ratios for healthy gingiva?

A

10% JE

30% OE

60% CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the characteristic of connective tissue in healthy patients? Do they have epithelial ridges (rete pegs) in their JE?

A

CT is dense with prominent collagen fiber bundles

Epithelial ridges (rete pegs) absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the reasons for stability in Clinically healthy gingiva

A 
Shedding of epithelial cells
Intact epithelial barrier
Positive flow of GCF
Complement system
PMNs and macrophages
Protective effects of antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the Histopathological stages in the development of gingivitis and periodontitis?

A

1) initial lesion
2) early lesion
3) established lesion
4) advanced lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when does the initial lesion occur?

A

Occurs within 1 to 4 days of plaque development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

t/f: Increased permeability is seen during the initial lesion stage

A

TRUE

Increased permeability (carbon particles and serum proteins leak out of vessels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens during infiltration in the initial lesion stage?

A

PMNs and monocytes in the Junctional Epithelium

lymphocytes in Connective Tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

during the initial lesion, there will be a decrease in __________ collagen

A

perivascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

t/f: the symptoms associated with the initial lesion can be seen clinically

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dilation of vessels of the dentogingival plexus is induced by ________ mediators

A

vasoactive mediators (histamine, IL-1, TNF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gaps form between what cells to result in increased permeability

A

capillary endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the 2 types of gingival crevicular fluid (GCF)?

A 
GCF is a:
plasma transudate (health)

or

inflammatory exudate (disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what can GCF constituents indicate?

A

inflammatory changes and bacterial colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

does GCF flow rate increase or decrease with clinical inflammation?

A

increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what kind of stain for protein indicates GCF volume?

A

Ninhydrin stain for protein indicates GCF volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the cellular events associated with the INITIAL lesion? (theres 4 of them)

A

Cytokine-mediated up-regulation of adhesion molecules on endothelial cells

PMNs adhere to post-capillary venules and begin to migrate

PMNs migrate through JE into gingival sulcus

Chemotaxis induction by PMNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

chemotaxis induction by PMNs is mediated by what?

A

host factors (IL-8, C5a)

molecules released by bacteria (fMetLeuPhe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

during the initial lesion, there is a migration of PMN’s toward where?

A

toward the sulcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

the initial lesion is an early response to ________ _________

A

plaque accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

in the initial lesion, there is vasculitis subjacent to the ____

A

junctional epithelium (JE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what portion of the JE is altered in the initial phase?

A

the most coronal portion of JE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when does the EARLY lesion occur?

A

Occurs within 4 to 7 days of plaque development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what immune cells are found subjacent to JE in the EARLY lesion?

A

Lymphocytes and PMNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are Fibroblasts undergoing during an early lesion?

A

Fibroblasts undergoing cytopathic alterations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

when is clinical inflammation FIRST present during periodontitis?

A

during the early stage

NOT the initial

27
Q

what occurs during the early stage to allow space for infiltrate?

A

Collagen destruction occurs, which creates space for infiltrate

28
Q

during the early stage, ______ cells of JE and SE proliferate

A

basal cells

29
Q

in the early stage, Epithelial rete pegs invade what?

A

invade the coronal portion of the lesion

30
Q

t/f: during the EARLY lesion, the dentogingival plexus (dp) remains dilated

A

true

31
Q

t/f: the dp (dentogingival plexus) is only extremely permeable following inflammation

A

false

dp is extremely permeable following minor trauma or inflammation

32
Q

what happens as the As JE invades CT during the early stage?

A

As JE invades CT, the previously inactive capillary bed opens up and proliferates into the CT papillae

33
Q

what are the characteristics of an ESTABLISHED lesion?

A

A) increase in: swelling clinically, fluid exudation, leukocyte migration

B) Plasma cells increase around blood vessels and in coronal CT

C) Collagen loss continues as infiltrate expands

34
Q

when looking at an established lesion: In addition to macrophages and serum proteins, what other cells are present?

A

T and B cells and plasma cells are present

35
Q

what are the Activated T cells produce cytokines found in an established lesion?

A

IL-2, 3, 4, 5, 6, 10 and 13, TNF-

36
Q

name the chemotactic substances produced by T-cells in an established lesion:

A

MCP, MIP and RANTES

37
Q

Plasma cells in an established legion produce ___ and ______

A

produce Ig and cytokines

38
Q

________ produce MMPs and TIMPs in established lesions

A

Fibroblasts

39
Q

what happens to the sulcus during established lesion?

A

The sulcus deepens and the coronal portion of the JE is converted into permeable pocket epithelium (PE)

40
Q

characteristics of pocket epithelium (PE)

A

The PE is not attached to tooth surface

The PE is loaded with PMNs

41
Q

T/F: although there is no bone loss at the established stage, there is an apical migration of JE

A

FALSE:

No apical migration of JE and no bone loss at this stage

42
Q

what occurs to the shape of the JE during the established stage?

A

Proliferation and lateral extension of JE

43
Q

T/F: Advanced stage periodontitis occurs 1-2 years after the initial onset of gingivitis

A

FALSE: Beginning and duration are not known

44
Q

in an advanced stage, there will be a switch from ______ to ______ immune cells

A

Switch from T-cells to B-cells

45
Q

what signals the conversion from gingivitis to periodontitis?

A

Switch from T-cell to B-cell predominance

46
Q

what indicates first clinical sign of periodontitis?

A

Destruction of CT attachment to root surface and apical migration of epithelial attachment

47
Q

during an advanced lesion, Bone destruction begins where?

A

begins around communicating blood vessels along crest of septum

48
Q

as advanced periodontitis proceeds, there will be an Apical proliferation of _____ into deep connective tissue

A

PE

pocket epithelium

49
Q

during the advanced stage, there will be an extension of the lesion into where?

A

into alveolar bone and PL (with significant bone loss)

50
Q

what are the Common modifying factors of periodontitis?

A

Diabetes

Pregnancy, puberty and menopause

Smoking

51
Q

what can the “Modifying factors” influence?

A

Susceptibility to gingivitis and periodontitis

Plaque growth and composition

Clinical presentation

Disease progression

Response to periodontal therapy

52
Q

name the Oral and periodontal effects of Diabetes Mellitus

A

Xerostomia

Candida (yeast) infections

Periodontitis

Multiple periodontal abscesses

53
Q

T/F: Incidence and severity of periodontitis greater in poorly controlled diabetes

A

true

54
Q

what are the Effects on bacteria due to diabetes?

A

Spirochetes increase in poorly controlled diabetes

P.intermedia, C.rectus, P.gingivalis in Type 2 diabetes

Capnocytophaga predominance seen in Type 1diabetes

(you’re increasing the disease-causing bacteria)

55
Q

what are the effects on host response due to diabetes?

A

A) PMN function and chemotaxis impaired

B) Cytokines, monocytes and macrophages increase

C) Connective tissue synthesis declines

56
Q

T/F: perio treatment of controlled diabetics will still yield lower results than a non-diabetic

A

FALSE: Stable diabetics same as non-diabetics

57
Q

Gingivitis seen in ______% of pregnancies

A

seen in 35-88% of pregnancies

58
Q

Gingival inflammation highest during which trimesters?

A

2nd and 3rd trimesters

59
Q

when is Periodontal treatment best during pregnancy?

A

Best during 2nd trimester

Best to avoid use of antibiotics during pregnancy

60
Q

T/F: Osteoporosis in post-menopausal pts may not cause periodontal disease, but may affect the severity of pre-existing disease

A

true

61
Q

Deeper probe depths and larger number of deep pockets

are typically found in what patient group?

A

smokers

62
Q

effect of smoking on periodontal health:

A

More attachment loss, including recession

More alveolar bone loss

More tooth loss

63
Q

_________ is associated with poorer reduction in probing depth and poorer attachment gain in nonsurgical treatment

A

smoking

64
Q

what causes the lowered BOP (bleeding on probing) in smokers?

A

decrease in inflammation

decrease in blood vessels

decrease in keratinization

perio exam 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions