periodontal disease and immunology (complete) Flashcards
what are the components of the periodontium
gingiva gingival attachement cementum periodontal ligament alveolar bone
which parts of the periodontium are tooth supporting structures
cementum
periodontal ligament
alveolar bone
what are the cells surrounding the periodontal ligament
connective tissue cells
epithelial rest cells
immune system cells (Neutrophils, lymphocytes, macrophages, mast cells, eosinophils)
what is periodontal disease
a broad group of pathological alterations to the periodontal tissue
what is the only etiology of periodontal disease
bacterial plaque
what is bacterial plaque
the colonization of subgingival regions by specific groups of organisms (bacterial mass)
where does bacterial plaque attach
tooth surface above and below the gingival margin
what are the direct effects of bacterial plaque on the periodontium
invasion
release of exotoxins
cell constituents
enzymes (proteases)
what are the indirect effects of bacterial plaque on the periodontium
immunological and other host responses (often destructive)
loss of periodontal tissue
what are the two types of periodontitis
chronic and aggressive
what is periodontitis
an inflammation based infection to the supporting structures of the teeth
what effect do systemic diseases have on periodontitis
they modify it
which type of periodontitis is most common in adults
chronic
is the severity of chronic periodontitis consistent with the plaque and calculus formation
yes
what happens to the tissues in chronic periodontitis
they may be red or purplish
you may lose attachment and bone
how quickly does chronic periodontitis progress
slowly or moderately
is the severity of aggressive periodontitis consistent with the plaque and calculus
nope
how fast is the destruction of tissue progression in aggressive periodontitis
rapid
are there genetic factors involved in aggressive periodontitis
yes
what bacteria is most commonly associated with aggressive periodontitis
actinobacillus actinomycetemcomitans
what is the activity of PMNs and macrophages like in aggressive periodontitis
abnormal PMN function and hyperresponsive macrophages
what are the two kinds of aggressive periodontitis
Localized (LAP)
generalized (GAP)
which type of aggressive periodontitis has a strong Ab response, which type has a poor Ab response
localized has a strong Ab response
generalized has a weak Ab response
what are the characteristics of localized aggressive periodontitis
- early onset
- associated with actinobacillus actinomycetemcomitans
- abnormal neutrophil function
- destroys around 1st molars and incisors
- AKA juvenile periodontitis
what are the characteristics of generalized aggressive periodontitis
- rapid attachment and bone loss
- no obvious symptoms of systemic disease
- destruction isn’t proportional to plaque
- genetic factor
- specific bacteria
- early onset
are all bacterial plaque equally pathogenic
nope
what are the bacteria associated with periodontitis
Porphyromonas gingivalis
Prevotella intermedia
Bacteroides forsythus
Campylobacter rectus
what bacteria is associated with aggressive periodontitis
Actinobacillus actinomycetemcomitans (Aa)
what are the virulence traits of periodontal pathogens,
proteases hemagglutinins LPS Fimbriae Polysaccharide capsule
what do proteases do for periodontal pathogens
degrade host proteins
what do hemagglutinins do for periodontal pathogens
they are responsible for bacterial binding to the host cell receptors
what does LPS do for periodontal pathogens
slightly endotoxic
what does Fimbriae do for periodontal pathogens
helps in adherence, colonization, and periodontal destruction
what does the polysaccharide capsule do for periodontal pathogens
inhibit phagocytosis and MAC medaited cytolysis
how does P. gingivalis induce inflammation and bleeding and why
hemagglutinins and proteases lyse RBCs and extract the nutrients for rapid growth
what do the proteases of periodontal pathogens lyse
RBCs
serum Abs
complement proteins
cytokines
what is responsible for bone resorption
PGE2
how do you combat PGE2 and bone resorption
NSAIDs and dexamethasone
early periodontal lesions are characterized by
T-cells and macrophages
established and advanced periodontal lesions are characterized by
B cells and plasma cells
what controls the progression from T-cells and macrophage in early periodontal lesions to B-cells and plasma cells in advanced periodontal lesions
host Th-derived cytokines
early clinical gingival lesions correlate with which type of immune response and which cytokines
TH1 type response
with IL-12 and IFN-y
protective immunity
established gingival lesions correlate with which type of immune response and which cytokines
TH2 response
IL-4, IL-10, IL-13
chronic periodontitis
what type of immune response leads to aggressive periodontitis
TH-1 dependent Ab type
high IgG2
