Pathogenesis of Periodontitis Flashcards
Healthy gingiva is reflective of superb ___, the ___ epithelium is attached to enamel, and the ___ epithelium appears to be continuous with the JE. Inflammation is virtually ___.
hygiene; junctional; oral; absent
What are the tissue volume ratios in gingival health?
10% juncitonal epi
30% oral epi
60% CT
T/F. In gingival health, there are many PMNs present in the outer portion of the JE.
False, In gingival health, there are FEW PMNs present in the outer portion of the JE.
The JE is ___ (thin/thick), epithelial ridges (rete pegs) are ___ (present/absent), and ___ tissue is dense with prominent collagen fiber bundles.
thin; absent; connective
The ___ plexus with capillary ___ provides nutrients to the oral epi and the ___ of loops is constant.
subepithelial; loops; number
What does the supepithelial anastomose with?
supraperiosteal blood vessels from bone and PDL
T/F. Dentogingival plexus venules have no loops in health.
True.
What defense factors are in place that allows clinically healthy gingiva to avoid becoming clinical ginigvitis?
- intact barrier provided by junctional epi
- regular shedding of epi cells into oral cavity
- positive flow of fluid to the gingival crevice, which may wash away unattached microorganisms and noxious products.
- the presence in GCF of antibodies to microbial products
- the phagocytic function of neutrophils and macrophages
- Protective effect of Ab (detrimental effect of complement on the microbiota_
What are the four histopathological stages in the development of gingivitis and periodontitis?
- initial lesion
- early lesion
- established lesion
- advanced lesion
Match the lesion stage with its diagnosis.
- initial lesion
- early lesion
- established lesion
- advanced lesion
A. subclinical stage of gingivitis
B. clinical early stage of gingivitis
C. chronic gingivitis
D. progression to periodontitis
- -A
- -B
- -C
- -D
The initial lesion occurs within ___-___ days of inflammation.
1-4
Explain how increased permeability causes carbon particles and serum proteins to leak out of vessels.
When carbon particles are injected intravenously they become trapped in the open endothelial junctions due to increased permeability.
Decreased perivascular collagen in the basement membrane around venules allows venules to be leaky
Increased permeability causes an infiltration of ___ and ___ in the JE and ___ in CT.
JE - PMNs; monocytes (5%)
CT- lymphocytes (5%)
Dilation of vessels of the ___ plexus is induced by vasoactive mediators (___, ___, ___). ___ form between capillary endothelial cells resulting in increased permeability. Increased ___ ___ fluid will make the tissue edematous and swollen.
dentogingival; histamine; IL-1; TNF; Gaps; gingival crevicular
T/F. The initial lesion is visible clinically.
False, this stage is NOT detectable clinically.
GCF is a plasma ___ (health) or inflammatory ___ (disease).
transudate; exudate
How is GCF collected? Why would you want to collect it?
GCF passes through the periodontal tissues and can be collected from within or at the orifice of the gingival crevice.
GCF constituents indicate inflammatory changes and bacterial colonization.
GCF flow rates ___ during clinical inflammation.
increases