periodontal disease SDL

Question 1

what features and signs may be associated with periodontal disease

Answer 1

• gingivitis (red swollen gums that bleed)
• periodontitis (receding gums, pockets, loose teeth, infection, bone loss)

Question 2

what is plaque and how does it form

Answer 2

soft sticky film made from leftover food particles and saliva

Question 3

what is the difference between plaque and calculus

Answer 3

Plaque: a biofilm covering the teeth including bacteria.
Calculus: Mineralised phosphates deposited around the bacteria

Question 4

which change in plaque make it a potential cause of periodontal features

Answer 4

• when the plaque hardens and goes under the gum line forming infections in the mucosa lining
• ongoing inflammation can put a strain on the immune system
• unresolved plaque build up

Question 5

what micro-organisms are involved in plaque

Answer 5

• streptococcus spp (early colonizer)
• actinomyces spp (ec)
• fusobacterium
• porphyromonas
• neisseria

Question 6

how does osteoclast formation occur and why is it important in periodontal disease

Answer 6

Inflammation leads to recruitment of immune cells
Cells in the periodontal tissues (e.g., osteoblasts) produce RANKL (cytokine)
RANKL binds to RANK on the surface of osteoclast precursor cells which stimulates differentiation into mature osteoclasts
if not regulated leads to bone resorption which weakens the bone around the tooth

Question 7

what other disease of similar pathophysiology result from osteoclastogenesis and bone loss

Answer 7

any disease with excessive bone loss like osteoporosis

Question 8

describe the stages and pathological changes of periodontal disease

Answer 8

stage 1: gingivitis (reversible)
stage 2: early periodontitis = gingival pocket formation, inflammation of gingive extends deeper into roots
bacteria and plaque accumulates in pockets, early bone loss
stage 3: moderate periodontitis = increased pocket depth, further bone loss and formation of periodontal abscess in pockets
**stage 4: advanced periodontitis **= severe pocket formation, extensive bone loss, tooth mobility and loss, soft tissue/gum recession

Question 9

what factors may predispose cats to periodontal disease

Answer 9

• cat fights
• eating raw foods/catch prey harvesting bacteria
• hard to brush cats teeth
• groom themselves bringing bacteria into the mouth
• immune system health
• age
• breeds

Question 10

list the symptoms of periodontal disease in companion animals

Answer 10

• Discoloured gums
• bleeding/inflamed gums
• loose or missing teeth
• halitosis
• irritability
• blood/’ropey’ saliva
• inappetance

Question 11

what is FORL

Answer 11

feline odontoclastic resorptive lesions
dental condition characterised by resorption of tooth structure due to odontoclast overactivity

Question 12

how does FORL occur

Answer 12

• Initiation and stimulation of odontoclastic activity
• stem cells attracted to the sulcus area by cytokines
• instead of forming into macrophages , the stem cells become clast cells
• the clast cells(multinucleated) dissolve mineralised tissue
• dissolve the tooth tissue

Question 13

what is the pathogenesis behind gingivitis

Answer 13

Dental plaque → periodontal disease → plaque retentive factors, eg pockets → environment conducive to further multiplication of pathogenic plaque bacteria → inflammatory response in gingiva and other periodontal tissues.
caused by the microbial plaque deposits located in or close to the gingival sulcus.