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Clinical 1 > Periodontal Disease > Flashcards

Periodontal Disease Flashcards

1
Q

What is periodontology

A

The study of periodontal tissue in health and disease

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2
Q

What does the periodontal tissue consist of

A

Gingiva
Periodontal ligament
Root cementum
Alveolar bone

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3
Q

What is the gingival crevice

A

Normal space located between the wall of the unattached gum tissue and the enamel/cementum of the tooth

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4
Q

Why can the seal be described as a protective measure

A

Bacteria cannot easily enter

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5
Q

What does gingival crevice fluid provide

A

A flushing action and an isolation effect by rapidly washing out substances put into the crevice

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6
Q

What are signs of healthy gingiva

A

No bleeding

Pink

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7
Q

Why should dark gums not automatically be assumed as unhealthy gums

A

In some regions of the world, gingiva can have melanin pigmentation

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8
Q

What is present in diseased gingiva

A

Pockets

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9
Q

How can pockets be clinically assessed

A

Between the free gingiva and the surface of the tooth there is a crevice where the probe can be inserted and the probe can help determine if the gingiva is healthy

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10
Q

What is the probe measurement for healthy gingiva

A

1 - 3mm

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11
Q

What is the probe measurement for a warning

A

4mm

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12
Q

What is the probe measurement for urgent

A

5 - 9mm

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13
Q

What is periodontal disease

A

A group of diseases affecting the periodontal tissues, representing an immune reaction to adjacent microbial plaque

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14
Q

What is periodontitis characterised by

A

Irreversible, recessed gums and bone loss

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15
Q

Is gingivitis reversible

A

Yes

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16
Q

What is the treatment for periodontitis

A

It is irreversible so aim is to decrease inflammation and encourage patients to reach a non active state of disease

17
Q

What are retention factors

A 
Calculus
Dental restorations
Various cavities
Partial dentures
Orthodontic appliances 
Mal positioned teeth
18
Q

What is the main goal of treatment

A

Plaque control
Removal of plaque
Retention factors

19
Q

What does inflammation result in

A

Dilation of blood vessels
Increased permeability of vessel walls
Inflammatory exudate
Emigration of white blood cells from blood vessels into the connective tissue

20
Q

What are cardinal signs of inflammation

A 
Pain
Heat
Redness
Swelling
Loss of function
21
Q

What factors increase gingivitis

A

Neutrophil emigration

Leukocytic infiltrate

22
Q

What are factors that contribute to periodontal disease

A

General health
Additional pathological conditions
Genetics
Functions of the immune system

23
Q

What is a false pocket

A

Gingival swelling
No bone loss
Junctional epithelium still intact

24
Q

What is a true pocket

A

Loss of attachment
Tissue is destroyed
Bone loss

25
Q

What does the keystones pathogen hypothesis indicate

A

That commensal microbiota is essential in the disease process as certain microorganisms cannot colonise without their presence

26
Q

Describe how the immune system organises itself in healthy periodontal tissue

A

The periodontal tissue contains a wall of neutrophils between the plaque and the epithelial surface
The array of different TLRs in combination with the multitude of bacterial species lead to a large variety of cytokines that are expressed at health

27
Q

Why is periodontal disease so difficult to treat

A

The bacteria form a biofilm

28
Q

What is a biofilm

A

An aggregate of microorganisms in which the cells adhere to each other on a surface
These adherent cells are embedded within a self produced matrix

29
Q

What does the self produced matrix consist of

A

Extracellular polimetric substances - DNA, proteins and polysaccharides

30
Q

Why does the biofilm cause a problem when treating periodontal disease

A

It means that microorganisms in the mouth are resistant to antibiotics and they are hidden from the immune system of the host

31
Q

How is the biofilm formed

A

Pellicle is made of proteins and glycoproteins
Association and adhesion occurs
Growth of microorganisms results in micro colonies and this results in the production of the polysaccharide matrix
Mature biofilm micro colonies transition into metabolic complexes

32
Q

What are the strategies for treatment

A

Mechanical disruption - reducing the bacterial challenge by scaling and root surface debridement
Host modulation therapy

33
Q

What are the oral hygiene instructions given for treatment

A

Modified brushing techniques
Flossing when patient has good papillae
Interdental brushes for interdental space

34
Q

What are the different adhesion molecules that create the wall of neutrophils between the plaque and epithelial surface

A

E-selectin
IL-8
ICAM

35
Q

What does E-selectin do

A

Allows neutrophil migration from the highly vascularised gingival tissue

36
Q

What does IL-8 do

A

It is a key neutrophil chemo-attractant produced by epithelial cells

37
Q

What does ICAM do

A

Facilitates adhesion of neutrophils to the tissue allowing formation of this wall

38
Q

What is the seal

A

Junctional epithelium attaches the gingiva to the tooth surface preventing bacteria from getting through

Clinical 1 (12 decks)

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