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Hygiene Sem 1 > Perio Final > Flashcards

Perio Final Flashcards

1
Q

Define systemic risk factors in regards to perio

A

Disorders, diseases or conditions that increase an individuals susceptibility to periodontal infection

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2
Q

Systemic risk factors can be (2)

A

Modifiable
Nonmodifiable

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3
Q

Modifiable risk factor

A

Smoking

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4
Q

Example of nonmodefiable risk factor

A

Genetic factors, age, gender

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5
Q

Characteristics of diabetes mellitus

A

Chronic, lifelong metabolic disorder in which body fails to produce sufficient amounts of insulin or use it properly

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6
Q

What is the primary purpose of the immune system

A

Defend the life of the individual by identifying foreign substances in the body and developing defense against them

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7
Q

What are the 2 subdivisions of the immune system

A

Innate and adaptive

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8
Q

Innate immune system is present at birth, is is NOT ____ specific.
And it does not?

A

Not antigen specific
Does not improve with repeated exposure to infectious agent

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9
Q

Adaptive immune system develops?
It is _____ specific ?
What develops that may provide lifelong immunity to reinfection

A

Throughout life
Antigen specific
Memory develops

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10
Q

The way an individuals body responds to the infection is known as the

A

Host response

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11
Q

How does host response work/ the body responds by?

A

Sending certain cells to the infection
Producing biochemical substances to counteract foreign invaders

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12
Q

Loss of immune function is

A

Deadly to the body

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13
Q

The immune system can become so intense in its response that it begins to

A

Harm the body that it is trying to protect

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14
Q

Components of the immune system that play an important role in combating periodontal diseases are

A

Cellular defenders
The complement system

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15
Q

Leukocytes act like independent single cell organisms. They can move

A

Through tissues and capture MO’s on their own

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16
Q

2 types of leukocytes important in periodontal diseases are

A

Polymorphonuclear leukocytes (PMNs)
Monocytes/macrophages

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17
Q

Phagocytosis is the process by which leukocytes

A

Engulf and digest microorganisms

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18
Q

Polymorphonuclear leukocytes (PMNs) are also called

A

Neutrophils

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19
Q

PMNs are rapid responders that provide the _____
PMNs are ____ lived cells (hint die when they become engulfed w bacteria)

A

First line of dense
Short lived cells

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20
Q

PMNs are attracted to bacteria by a process called

A

Chemotaxis

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21
Q

Periodontal pathogens are most effectively destroyed by

A

PMNs

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22
Q

Called monocytes when?
Called macrophages when?

A

Called monocytes when in bloodstream
Called macrophages when in tissue

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23
Q

Macrophages/monocytes are slower to arrive at site of infection than PMNs. They are ____lived cells seen in chronic inflammation

A

Long lived cells

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24
Q

Lymphocytes are small leukocytes that help defend the body. What are the 2 main types

A

B lymphocytes (B cells)
T lymphocytes (T cells)

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25
Q

B lymphocytes, once activated, makes millions of ? Pours them into where?

A

Millions of antibodies and pours them into the bloodstream

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26
Q

B cells can differentiate into 2 types which are

A

Plasma b cells and memory b cells

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27
Q

What shape are b lymphocytes antibodies and how do they bind to a MO

A

Y shaped proteins
One end of y binds to outside of B cell and other end of y binds to MO

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28
Q

Antibodies are known collectively as

A

Immunoglobulins

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29
Q

5 major classes of immunoglobulins are
Hint * my dad got an exorcism

A

Immunoglobin M, D, G, A, E

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30
Q

Main function of t lymphocytes is to

A

Intensify the response of other immune cells to bacterial invasion

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31
Q

What to t lymphocytes produce

A

Substances called cytokines that further stimulate immune response

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32
Q

Cytokine is a general name for any

A

Protein that is secreted by cells and affects the behaviour of nearby cells

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33
Q

The complete system is a

A

Complex series of proteins circulating in the blood

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34
Q

Functions of the complement system (4)

A

Destruction of pathogens
Opsonization of pathogens
Recruitment of phagocytes
Immune clearance

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35
Q

Components of complement system can destroy certain MO’s directly by forming pores in their cell membranes. What protein is created to do this and what can it do

A

Membrane attack complex
It can puncture cell membranes of certain bacteria (lysis)

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36
Q

The complement system facilitates the capture and destruction of bacteria by phagocytes. What is this process called

A

Opsonization

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37
Q

Opsonization is the

A

Most important action of the complement system

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38
Q

To fight infection, leukocytes travel through

A

The bloodstream

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39
Q

The thin layer of epithelial cells that line the interior surface of blood vessels is called

A

Endothelium

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40
Q

Near the infection site, leukocytes push their way between the endothelial cells and enter connective tissue. This process is called

A

Trans endothelial migration

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41
Q

Chemotaxis is the process whereby leukocytes

A

Enter the CT

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42
Q

Leukocytes are attracted to the site of the infections in response to

A

Biochemical compounds released by the invading bacteria

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43
Q

The body’s response to inflammation focuses host defense components at

A

The site of an infection to eliminate MO’s and heal damaged tissue

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44
Q

Inflammatory biochemical mediators are biologically active compounds secreted by cells that

A

Activate body’s inflammatory response

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45
Q

Biochemical mediators of importance in periodontitis include

A

Cytokines
Prostaglandins
Matrix metalloproteinases (MMPs)

46
Q

What are chemokines

A

Subgroup of cytokines
Cause additional immune cells to be attracted to the site of an infection of injury

47
Q

2 stages of inflammation

A

Acute and chronic

48
Q

Short term, normal process that protects and heals the body

A

Acute inflammation

49
Q

Acute inflammation process is achieved by the increased movement of

A

Plasma and leukocytes from the blood to the injured tissues

50
Q

5 classic signs of acute inflammation

A

Heat
Redness
Swelling
Pain
Loss of function

51
Q

Long lived, out of control inflammatory response that continues for more than a few weeks

A

Chronic inflammation

52
Q

Chronic inflammation is a ____ condition that can destroy healthy tissue and cause more damage than ?

A

Pathological
More damage than the original problem

53
Q

The classic warning signs in acute inflammation are usually ___ in chronic inflammation

A

Absent in chronic inflammation
(Pain is often absent, may go unnoticed by the host)

54
Q

Why does chronic inflammation occur

A

Body is unable to rid itself of invading organism

55
Q

What is the hallmark of chronic inflammation

A

Tissue damage

56
Q

Chronic inflammation is characterized by an accumulation of

A

Macrophages

57
Q

Chronic inflammation is associated with a number of disease conditions like

A

Rheumatoid arthritis
Diabetes
Asthma
Gingivitis
Periodontitis

58
Q

Signs and symptoms of chronic inflammation may partially or completely disappear during a period of

A

Remission

59
Q

The signs and symptoms may recur in all of their severity in an active period of disease known as

A

Exacerbation

60
Q

Virulence factor refers to

A

All the mechanisms that enable biofilm bacteria to colonize and damage tissues

61
Q

Factors enhancing microbial challenge

A

Presence of lipolysaccharides (LPS)
Ability to invade tissues
Ability to produce enzymes

62
Q

Factors affecting host immune response

A

Genetic
Environmental (smoking)
Acquired (diabetes)

63
Q

Acute inflammation is the first

A

Line of defense against microbial invasion

64
Q

Resolution of inflammation and return to homeostasis is an actively regulated biologic process called

A

Catabasis

65
Q

Pro-inflammatory mediators (ex prostaglandins) recruit what, during what phase

A

Recruit PMNs during the acute phase

66
Q

Pro-resolving lipid mediators are produced by the body to

A

Shut down PMN function and acute inflammation

67
Q

Cytokines signal to the immune system to send

A

More phagocytes to the site of infection

68
Q

Cytokines important in periodontal disease

A

IL-1, IL-6, IL-8, and TNF-alpha

69
Q

What can cytokines initiate

A

Can initiate tissue destruction and bone loss in chronic infections such as perio disease

70
Q

Series of prostaglandins include D, E, F , G, H and I. The most important in bone destruction is

A

Prostaglandins of the E series

71
Q

Function of prostaglandins

A

Increase permeability and dilation of blood vessels
Trigger osteoclasts to destroy the alveolar bone
Promote overproduction of destructive MMP enzymes

72
Q

In health MMPs aid in

A

Normal turnover time of the periodontal connective tissue matrix

73
Q

MMPs are released in an attempt to

A

Kill invading bacteria

74
Q

Overproduction of MMPs results in

A

Breakdown of CT of the periodontium

75
Q

High MMP levels result in extensive collagen destruction in the periodontal tissues. How would this present in the mouth

A

Gingival recession
Pocket formation
Tooth mobility

76
Q

4 histological stages in development of perio disease

A

Initial lesion
Early lesion
Established lesion
Advanced lesion

77
Q

Initial lesion is characterized by how many days bacteria accumulation?
Where does bacteria colonize

A

2-4 days
Colonize teeth near gingival margin

78
Q

Describe process of bacteria accumulation

A

Initial location of plaque is at gingival margin
GCF increases in volume
CLINICALLY tissues look healthy
Host response successful if most bacteria are destroyed

79
Q

During initial lesion of bacterial accumulation, if pathogens are not controlled what develops

A

Early gingivitis

80
Q

Early lesion (early gingivitis): how many days

A

4-7days

81
Q

In early lesion biofilm maturation continues and bacterial toxins penetrate JE. PMNs move where and form what

A

PMNs move into connective tissue and form a wall between biofilm and sulcus wall

82
Q

Early gingivitis: clinically what is observed

A

Edema and redness of gingival marginal tissue is observed

83
Q

Established lesioknoccurs how many days after established gingivitis

A

21days

84
Q

Established lesion: plaque biofilm extends where and disrupts what

A

Subgingivally into sulcus
Disrupts attachment of coronal most portion of JE from tooth surface

85
Q

In established gingivitis, JE loosens attachment to root surface and start to transform into pocket epithelium which is

A

Thinner and more permeable

86
Q

Advanced lesion: periodontitis. Plaque biofilm spreads

A

Laterally and apically along root surface.

87
Q

In advanced less on the gingival pocket progresses to

A

Periodontal pocket

88
Q

Factors influencing hosts failure to control bacterial challenge

A

Abnormal PMN function
Persistence and virulence of bacteria in biofilm
Acquired and environmental factors
Systemic factors

89
Q

3 types of diabetes mellitus

A

Type 1(5-10%)
Type 2 (90-95%)
Gestational (during pregnancy)

90
Q

Does diabetes favour or influence growth of specific periodontal pathogens?

A

No

91
Q

Oral complications of poorly controlled diabetes mellitus

A

Reduced salivary flow
Multiple periodontal abscess formation
Cheilosis
Burning mouth and tongue
Rapid occurrence of deep pockets

92
Q

Defective neutrophilic function in diabetics impairs initial immune response to infection. What is not functioning properly

A

Neutrophils (PMNs)

93
Q

What is cell death called

A

Apoptosis

94
Q

Glycation is a natural metabolic process where glucose in the bloodstream irreversibly attaches to?
What does it form?

A

Attached to proteins and lipids in the blood.
Forms harmful molecules called advanced glycation end products (AGEs)

95
Q

In health, AGE is

A

At low levels and has no pathologic effect to the body

96
Q

In hyperglycaemia, AGE formation is

A

Increased beyond normal and can alter function of collagen

97
Q

In diabetes, levels of AGE can also contribute to diabetes related complications such as

A

Neuropathy
Retinal disease
Kidney failure

98
Q

Direct interaction of AGE to a cell surface receptor known as ____ triggers what?

A

RAGE (receptor for advanced glycation end product)
Triggers pathologic tissue destruction

99
Q

What is the major factors that contribute to the exaggerated periodontal and systemic inflammation and impaired tissue repair in diabetic patients with perio

A

AGE-RAGE interaction

100
Q

High financial stress and depression are significant risk factors for

A

Periodontal disease

101
Q

Levels of sex hormones/ changes in hormone levels may have an effect on

A

The periodontium

102
Q

Increase in hormones causes increased

A

Blood circulation to gingival tissues
Sensitivity to local irritants (ex. Plaque)

103
Q

Inflammation of gingiva increases in pregnancy even if the presence of

A

Small amounts of plaque

104
Q

Elevated progesterone levels enhance _____ resulting in increased gingival deviate and edema

A

Capillary permeability

105
Q

What is a pregnancy tumour called that is found on the interdental gingiva or gingival margin, is non cancerous and not painful

A

Pyogenic granuloma

106
Q

Menopausal gingivostomatitis is characterized by gingiva that

A

Bleeds readily, with abnormally pale, dry and shiny erythematous appearance

107
Q

Osteoporosis is a reduction in?
Making women more prone to?

A

Bone mass
More prone to bone fractures
* hallmark of osteoporosis is bone fractures*

108
Q

Osteopenia is a condition in which there is a lower than average?

A

Bone density

109
Q

What can cause a rare disorder called MRONJ (medication induced osteonecrosis of the jaw)

A

Biophosphonates

110
Q

MRONJ is characterized by

A

Painful exposed bone in the mouth that fails to heal after extraction or oral surgery

Hygiene Sem 1 (22 decks)

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