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Periodontology > Periodontal Medicine > Flashcards

Periodontal Medicine Flashcards

1
Q

what is periodontal medicine

A

systemic conditions that increase susceptibility to periodontal disease

periodontal infections that are risk factors for systemic conditions

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2
Q

what is the ‘focal infection theory’

A

states that infectious agents from a central focal infection - such as teeth, roots, inflamed gum tissues or perhaps tonsile, metastasize to the heart, the eyes, the kidneys, lungs or other organ/tissues, establishing the same infection in new, distant sites

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3
Q

4 major common infections in the oral cavity

A
  1. caries
  2. periapical lesions- nonvital teeth
  3. fungal and viral infections
  4. periodontitis
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4
Q

what we look at for the potential link of perio and overall health

A

RISK FACTORS

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5
Q

the challenge to the potential link

A

NOT CAUSE AND EFFECT MECHANISM

- someone may have both perio disease and systemic disease but how do yo know if one caused the other

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6
Q

describe two faced neutrophil

A
  1. harmful
    - excessive release of noxious copounds that cause tissue damage
    - PMN mediated destruction
  2. protective
    - phagocyte function/ clearance of microbes
    - increase intracellular killing of microbes via controlled release of ROS
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7
Q

why is there so much variability

A

there are different kinds of plaque

  • patients respond differently
  • genetics may play a factor; susceptibility to perio diseases and variance in response to treatment
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8
Q

potential risk factors

A
  1. systemic conditions
    - like DM
  2. local anatomy
  3. medications
  4. genetics
  5. smoking
  6. stress/ SES
  7. all are yet to be indentified and understood
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9
Q

perio disease needs to be viewed as what (either __ or ___)

A
  1. consequence of underlying hyperinflammatory trait
    OR
  2. as a facotr contributing to systeic inflammation
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10
Q

implication of interleukin 1 (IL-1) gentotye being + or -

A

individuals who are genotype positive roduce two to four times more IL-1beta than individual who are genotype negative

  • if positive produce more IL-1 as a response to plaque – more heightened response – more bone loss potential?
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11
Q

5 major complications of DM

A
  1. blindness
  2. kidney disease
  3. nerve disease
  4. heart disease and stroke
  5. PERIODONTAL DISEASE
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12
Q

Oral manifestations of DM in the oral cavity

A
  1. burning mouth syndrome
  2. candidiasis
  3. dental caries
  4. glossodynia
  5. lichen planus
  6. neurosensory dysesthesias
  7. periodonttitis
  8. salivary dysfunctino
  9. taste dysfunction
  10. Xerostomia
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13
Q

major connection between DM and perio

A

Diabetic patients who have perio are more susceptible to devloping recurrent and multiple periodontal abscesses

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14
Q

studies show an increase in what with diabetic patients and perio disease

A

GREATER

  • prevalence
  • incidence
  • severity
  • extent
  • progression

dose response - so as diabetic situation worsens - perio worsens and likley because these patients cannot fight infections as well

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15
Q

study with pima indians was which type

A

epidemiological study

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16
Q

epidemiological study with pima indians showed?

A

diabetics had more severe perio than non

destructive perio occured earlier in life than non

diabetics were 15 x more likely to lose teeth

17
Q

epidemiological study with pima indians major finding? supported by?

A

finding
- when perio was treaed the management of their diabetes improved

supported by JOurnal of Perio in 1997 with the 113 Pima indians with both perio and diabetes

18
Q

what is the mechanism of adjunctive diabetic therapy with periodontal patietns?

A

as a consequence of perio disease - the pateitn has reduced glycolyated hemoglobin and thus require less insulin

if this is verified, physicians may consider perio therapy a needed adjunctive therapy in the treatment of certain diabetic patients whom are struggling with glycemic control

19
Q

what can we say and not say about relationship between DM and perio?

A

CANNOT SAY perio tx will improve glycemic control in all patients

CAN SAY
- with good certaintiy that DM is a contributing factor to the severity of perio disease and evidence is showing that perio is a contributing factor to impaired glycemic control

MAY NOT BE TRUE FOR ALL INDIVIDUALS

20
Q

potential link between CVD and perio

A
  1. perio organisms have been found in atheromas
  2. both diseases have nearly identical risk factors
    - age, male gender, smoking, and diabetes
  3. both involve the inflammaotry processes- perio disease could be stimulating immune mediators that affect the heart
  4. involve same inflammatory mediators and mechanisms
21
Q

what are increased in CD and Perio?

A
  1. fibrinogen
  2. WBC
    - contributed by genetics, cytokines, LPS, Smoking

INCREASES PLATALET aggregation and fibrinogen levels initiate thrombus formation

22
Q

describe c-reactive protein

A
  1. produced by the liver
  2. produced in the normal immune response
  3. also elevated during injury, inflammation and infection
    * 4. elevated CRP levels are associated with negative CV outcomes
23
Q

CRP levels in periodonotitis

A
  1. Perio disease increases CRP levels
    - stastically significant increases in CRP levels were observed in subjects with perio disease when compared to healthy controls
  2. perio treatment can decrease CRP levels
    - clinical perio control accompanied by significant reductions in CRP
24
Q

CRP relationship with atherosclerosis

A

CRP participates in development of clots and plaques

  • CRP involved in blot clots - causing MI stroke and other vascular diseases
  • CRP is mediator in the inflammation of arteries, resulting in formation of clots and plaques that lead to CVD
25
Q

major findings from studies that look at Cardio disease and Perio?

A

support AN ASSOCIATION
- DO NOT SUPPORT A CAUSATIVE EFFECT

ASSOCIATION IS REAL- AND INDEPENDENT OF SHARED RISK FACTORS

no known evidence that perio therapy can prevent ASVD or modify outcomes

26
Q

pregnancy and risk for Perio? there is increased?

A

Pre-term, low birth weight infants
- less than 37 weeks and weight less than 5lbs 8 oz

  1. vascular permeability
  2. GCF flow
  3. GI scores
  4. PMN’s in the sulcus
  5. PGE2
  6. Bacteriocides species
27
Q

conclusion with pregnancy and risk for perio

A

PREGNANCY MAY ACCELERATE ATTACHMENT LOSS

- those with moderate to severe perio were more likely to have perio progress versus those that were initially healthy

28
Q

major biological mechanism associated with pregnancy and perio

A

PGE2 levels increased in mothers with LBW infants that in controls

  • the lower the birth weight the higher the PGE2 - which is a prostagladin
  • may interfer with fetal growth and trigger preterm labor

Periodontology (20 decks)

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