Perio Microbiology

Question 1

Are perio pathogens communicable?

Answer 1

Yes! - Lee et al. 2006 - BANA positive caregiver is strongest predictor of BANA positive plaque in child.
35x more likely than a BANA neg caregiver/child

Question 2

Do you need to brush the gums?

Answer 2

No - Desquamation (epithelial shedding) Occurs twice/day - BUT, not on tongue or under RPD - brush tongue/under RPD

Question 3

What are the different types of deposits that accumulate on teeth?

Answer 3

Materia Alba
Dental Plaque
Calculus

Question 4

What is Materia Alba

Answer 4

White - cheese like substance
Accumulation of 
Bacteria
Salivary glycoproteins
Desquamated epithelial cells
Food debris
Not as organized as Dental Plaque
Easily removed with water-spray

Question 5

What is Dental Plaque

Answer 5

Yellowish-gray resilient substance
Composed of bacteria in a matrix of salivary glycoproteins and extracellular polysaccharides
Considered a Biofilm
Cant be removed with spray

Question 6

What is Calculus

Answer 6

Mineralized Dental Plaque

covered by a layer of unmineralized

Question 7

How does plaque progress from nothing to a mature plaque?

Answer 7

Acquired Pellicle
Transport of microbes to pellicle
Adhesion (reversible)
Attachment (strong)
Co-Adhesion (micro-colonies)
Colonization (mature plaque)

Question 8

What is the acquired pellicle composed of?

Answer 8

Peptides
Proteins
Glycoproteins
Phosphoproteins
Mucins
Keratins
Statherins

Question 9

How does adhesion develop?

Answer 9

Acquired pellicle develops immidiately
After 2hrs - equilibrium of deposition/shedding bacteria
1) Transport - Brownian motion, sedimentation of bacteria on surface
2) Initial adhesion - Van der Waals forces, Hydrophobicity
3) Strong Attachment - Microbe surface Adhesins bind Glycoproteins/proteins/polysaccharides on pellicle
4) Co-adhesion and micro-colony formation

Question 10

What is the most dominant bridge bacteria? what complex is it a part of?

Answer 10

Fusobaterium Nucleatum

Orange

Question 11

What complexes are primary colonizers?

Secondary?

Answer 11

Yellow, Blue, Purple, No complex (Actinomyces Naeslundi, A. oris)

Green, Orange, Red (and Aa(b))

Question 12

What bacteria are a part of the Yellow complex?

Answer 12

Streptococcus sanguis
S. intermedius
S. mitis
S. gordonii
S. oralis

Question 13

What bacteria are a part of the Blue complex (not a defined complex in socransky)

Answer 13

Actinomyces species (naeslundii)

Question 14

What bacteria are a part of the Purple complex?

Answer 14

Villinella Parvula

Actinomyces Odontiliticus

Question 15

What bacteria are a part of the Green complex?

Answer 15

Capnocytophaga concisus
C. ochracea
C. gingivalis
C. sputigena
Eikenella corodens
A. a. (a)

Question 16

What bac. are a part of the Orange complex

Answer 16

Prevetella intermedia
Prevetella nigresens
Petpostreptococcus micros
Campylobacter rectus
C. gracilis
C. showae
Fusobacterium nucleatum
F. periodonticum
Eubacterium nodatum
Streptococcus constellatus

Question 17

What is the Red complex

Answer 17

P gingivalis
T forsythia
T. denticola

Question 18

what is the No complex?

Answer 18

A.a. (b)

S. noxia

Question 19

What bacteria is most indicated in effecting pregnancy outcomes and colorectal cancer?

Answer 19

F. nucleatum

Question 20

What things affect disease activity?

Answer 20

not just the bacteria, but individual host susceptibility and the presence of interacting bacterial species (fusobacterium)

Question 21

What is Socransky’s modified Koch’s postulates?

Answer 21

The bacteria should cause disease in animal models
Should have a virulence factor that is identifiable and found to cause periodontal destruction
Should illicit a cellular or humoral immune response
Should be found in increased quantity in diseased sites
Should be found in lower/no quantity in resolved/treated sites

Question 22

What is the Orange complex associated with clinically?

Answer 22

increasing PD

Question 23

What is the Red complex associated with clinically?

Answer 23

Deepest PD when all 3 are present
Shallowest when none are present
BOP

Question 24

Ximénez-Fyvie et al. 2000

Answer 24

With Socransky
Took supra and sub G samples
Most common in both supra and sub is actinomyces
Only difference between health and disease is the proportion of actinomyces to orange and red complex
SupraG plaque and be a reservoir to spread and re-infect subG sites

Question 25

What study described the necrotizing periodontal lesion? What are they?

Answer 25

Listgarten 1965
The Bacterial zone
The Neutrophil Rich Zone
The Necrotic Zone
The Zone of Spirochetal infiltration