Perio and Systemic Health Flashcards

1
Q

The ________ reaction cascade is a mechanism by which periodontitis could potentially influence systemic disease (which gives some truth to the Focal Infection Concept).

A

acute-phase

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2
Q

What is the “focal infection concept?”

A

spread of bacteria from the oral cavity causes many chronic diseases

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3
Q

What 3 problems were found with the Focal Infection Concept?

A
  1. extracting teeth didn’t necessarily cure disease
  2. People with good oral health/no infection still developed systemic disease
  3. People with no teeth still developed systemic disease
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4
Q

What are the steps involved in an Acute-Phase Reaction cascade?

A

Triggering factors –> Local Reaction –> Mediators(cytokines) –> Secondary Systemic Reaction

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5
Q

Infection, necrosis, radiation, neoplasia, and surgery are all examples of ______ in the Acute-Phase Reaction Cascade.

A

Triggering Factors

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6
Q

Macrophages, Fibroblasts, and endothelial cells are ______ factors in the Acute-Phase Reaction.

A

Local Reaction

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7
Q

Mediators of the Acute-Phase Reaction Cascade involve the production/release of _______ _______ such as TNFalpha, IL-1, IL-6, and IFNgamma.

A

inflammatory cytokines

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8
Q

Fever, serum, complement, and alternative synthesis of proteins describe the ________ phase of the Acute-Phase Reaction Cascade.

A

Secondary Systemic Reaction

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9
Q

What are the five important “acute phase proteins?”

A
  1. Complement components (lysis, chemotaxis, opsonize)
  2. Protease Inhibitors (alpha1 macroglobulin)
  3. C-reactive Protein (opsonization)
  4. Fibrinogen (coagulation, chemotaxis)
  5. Plasminogen (breaks down clots)
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10
Q

In addition to complement components, which Acute-Phase protein is involved in chemotaxis?

A

fibrinogen

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11
Q

How does periodontitis result in systemic exposure to bacteria and inflammatory cytokines?

A
  • Periodontal pockets = LARGE SURFACE AREA exposed to gram negative bacteria
  • infection results in INCREASED INFLAMMATION
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12
Q

What are the seven conditions that define a risk factor?

  1. Consistency of _____
  2. Strength of _______
  3. Correct _______
  4. Specificity of ______
  5. Degree of ______
  6. Biological ______
  7. Support from ________
A
  1. consistency of association
  2. strength of association
  3. correct time sequence
  4. specificity of association
  5. degree of exposure
  6. biological plausibility
  7. support from experimental evidence
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13
Q

True or False: The potential factor relating periodontitis must precede the occurrence of systemic disease, it cannot be coincident.

A

True

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14
Q

What are the four systemic diseases that are associated with periodontitis?

A
  • Atherosclerotic Vascular Disease
  • Adverse Pregnancy Outcomes (low birth weight)
  • Diabetic complications
  • Respiratory complications (pneumonia, COPD)
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15
Q

What are the three layers that are present in healthy elastic arteries?

A

intima
media
adventitia

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16
Q

Atherosclerosis is a progressive disease in which large to medium sized muscular and large elastic arteries become occluded with fibro-lipid lesions termed ______.

A

atheromas

17
Q

What are the two complications commonly related to atherosclerosis?

A
  • coronary thrombosis

- acute myocardial infarction

18
Q

In atherosclerosis, there is a/an _______ in the blood supply surrounding the adventitia.

A

increase (need more blood to overcome lipid accumulation)

19
Q

True or False: Periodontitis and AVD share common risk factors or etiological pathways.

A

True

20
Q

Because there are _______ _______ between AVD and periodontitis, studies must be adjusted to account for these factors.

A

confounding factors

21
Q

What are the four major confounding factors relating AVD to periodontitis?

A
  1. Smoking
  2. Age
  3. Diabetes
  4. Education/SES
22
Q

True or False: Although it is not extremely strong, the evidence is predominantly positive and consistent in relating periodontitis to AVD.

A

True

23
Q

There are three biological pathways that explain the link between periodontitis and CVD:

  1. effect of periodontal bacteria on ______
  2. Invasion of _____ cells and _____ by perio bacteria
  3. ______-like effects of pro-inflammatory mediators
A
  1. platelets
  2. endothelial, macrophages
  3. endocrine
24
Q

Gingipains from P.g will upregulate expression of ______ which is pro-inflammatory and will downregulate _______ which is anti-inflammatory inhuman aortic smooth muscle.

A

angiopoetin 2 = pro-inflammatory

angiopoetin 1 = anti-inflammatory

25
Q

The increase in angiopoetin 2 and decrease in angiopoetin 1 in smooth muscle cells will increase migration of cells and promote ______.

A

atherosclerosis

26
Q

True or False: The association between periodontal disease and C-reactive Protein doubles when adjusted for age.

A

True

27
Q

True or False: Studies support a causal relationship between periodontitis and AVD.

A

False: studies support an association NOT causation

28
Q

True or False: There is strong evidence of association between adverse pregnancy outcomes and periodontitis.

A

False, modest association

29
Q

True or False: Periodontal therapy appears to significantly reduce overall rates of PTB or LBW.

A

False

30
Q

True or False: Poorly controlled diabetics of both Type 1 and Type 2 tend to have more periodontal attachment loss than non-diabetics.

A

True

31
Q

Evidence for the link between diabetes and periodontitis shows ________.

A

association not causality

32
Q

True or False: Systemic reviews detected conclusive evidence of an association between periodontitis and COPD.

A

False

33
Q

True or False: The evidence of an association between dental plaque and COPD is stronger than that for pneumonia.

A

False

association of plaque with pneumonia >COPD