Periodontal Disease

Question 1

List some of the oral defence mechanisms

Answer 1

Oral mucosa and lymphoid system
Saliva
Crevicular fluid
Chewing and swallowing
General anatomy of the tooth

Question 2

Where are lymphoid cells located?

Answer 2

Lamina propria

Question 3

What is the role of saliva in prevention of PD?

Answer 3

Prevents caries, gingivities and PD, oral homeostasis

Contains proteins, histatins, secretory immunoglobulins

Question 4

T/F:

Histatins are antibacterial and proteins are antifungal

Answer 4

False

other way round

Question 5

Define xerostomia

Answer 5

Significant salivary reduction

Question 6

What would you find in crevicular fluid?

Answer 6

Immunoglobulins
Macrophages
T cells
B cells

Question 7

How does the shape of the tooth protect it from PD?

Answer 7

Conical= less surface area for plaque

Enamel bulge pushes food away from the sulcus

Question 8

T/F:

PD symptoms consistently worsen

Answer 8

False

Periods of active inflammation and then quiescence

Question 9

Which teeth usually show more severe PD symptoms and why?

Answer 9

Maxillary teeth
they are on the outside of the mandibular teeth and therefore experience less abrasion and therefore less mechanical force to remove plaque

Question 10

List structures that can be lost in PD patients

Answer 10

Gingiva, cementum, periodontal ligament, bone

Question 11

What is a pellicle?

Answer 11

Protein film on the enamel surface

serves as an attachment site for bacteria and therefore plaque

Question 12

Distinguish between plaque and calculus

Answer 12

Plaque= mass of bacteria adherent to the enamel surface

Calculus= mineralized plaque, suitable surface for plaque to hide and survive

Question 13

Describe the 3 main steps of plaque deposition on the pellicle

Answer 13

Glycoproteins/mucopolysaccharides from saliva attach to the tooth surface
Gram positive bacteria colonise the area, migrate into GS, metabolic by-products attract WBCs= inflammation
Positive turns to gram negative

Question 14

A hallmark of PD is ______ loss

Answer 14

Attachment loss

Question 15

What is a major consequence of bone destruction esp. in the maxilla?

Answer 15

Could lead to an oronasal fistula
Hole from the oral cavity to the nasal cavity
Can cause aspiration or chronic rhinitis

Question 16

What is a consequence of some of the PD treatments?

Answer 16

Bacteraemia

Question 17

What does COHAT stand for?

Answer 17

Comprehensive Oral Health Assessment and Treatment

Combines both mechanical and chemical treatment of PD

Question 18

Where does tooth resorption usually take place?

Answer 18

Cementoenamal junction
Mostly in the mesial premolar teeth
Mostly on the buccal surface

Question 19

Which cell type is responsible for tooth resorption?

Answer 19

Odontoclasts

Question 20

List 4 potential causes/links to tooth resorption

Answer 20

Local immune response to plaque
Calcium poor diet
Calicivirus
Chronic regurgitation
Hyper-vitaminosis A/D

Question 21

What are the two phases of odontoclasts in terms of tooth resorption?

Answer 21

Resorptive Phase

Reparative Phase

Question 22

What is the main treatment for tooth resorption?

Answer 22

Extraction