Periodontal Microbiology Flashcards
The Periodontium
Periodontal Diseases
____ and___ of ___ ___and___associated with the tooth
______trauma
_____trauma
____ (___ associated)
¡Most common etiology is the presence of ___ ssociated with the________
____/____
_____ ____ ______
___ ____ ____ _____
¡Chronic Periodontitis is a major cause of ___ ___ in ___ populations.
¡LAP and ANUG are found in ______populations.
¡
¡
¡Inflammation and destruction of connective tissue and bone associated with the tooth
▪Physical-occlusal trauma
▪Thermal/chemical trauma
▪Microbial (plaque associated)
¡Most common etiology is the presence of bacteria associated with the subgingival crevice
§Gingivitis /Chronic Periodontitis
§Localized Aggressive Periodontitis (LAP)
§Acute Necrotizing Ulcerative Gingivitis (ANUG)
¡Chronic Periodontitis is a major cause of tooth loss in aging populations.
¡LAP and ANUG are found in immuno-compromised populations.
¡
¡
Quantitative clinical changes=
changes in microbial habitat
Factors in Disease
Periodontal disease is multifactorial
¡
¡Simple diseases
§Condition is ___ or ___, ______factors influence
___ ___: sickle-cell anemia, cystic fibrosis
___ ____: Small-pox, Anthrax
¡
¡Complex diseases
___ of ___ ( ___ ___)
____ factors influence the diagnosis
____
___
§Large numbers subjects are affected “__ ___ ___”
Periodontal disease is multifactorial
¡
¡Simple diseases
§Condition is present or absent, one (or few) factors influence
§Host genetics: sickle-cell anemia, cystic fibrosis
§Infectious disease: Small-pox, Anthrax
¡
¡Complex diseases
§Spectrum of severity (Bell Curve)
§Many factors influence the diagnosis
▪Host
▪Environment
§Large numbers subjects are affected “to some degree”
¡
▪
▪
Periodontal Disease Factors
¡Host
- ____
- ___ ___
- ___ ___ ___
- __ __ ___
- ____
- ___ ___
- ___
- ___
¡Environment
- §Bacterial flora
- ____
- ___
- ____
- ▪
¡Host
§Genetics
▪Immune response
▪Connective tissue healing
▪Type 2 Diabetes
§Habits
▪Oral hygiene
▪Smoking
▪Diet (diabetes)
▪
¡Environment
§Bacterial flora
▪Composition
▪Load of pathogenic species
▪Virulence potential of strains
▪
Natural History of Periodontal Disease in Man
¡J Clin Periodontol. 1986 May;13(5):431-45.
¡480 male laborers at two tea plantations in Sri Lanka
___ oral hygiene
¡Oral examinations in ___ 1973, 1977, 1982,1985,___
¡Aggregates of ___ ,___ and ___ on their teeth
¡Based on ____ ____ of ___ and tooth ___ rates, three subpopulations were identified:
__ ___ of ___ ___ beyond ____ (___ )
___ ___ ( )
___ ____of periodontal disease ( )
¡J Clin Periodontol. 1986 May;13(5):431-45.
¡480 male laborers at two tea plantations in Sri Lanka
¡No oral hygiene
¡Oral examinations in 1971, 1973, 1977, 1982,1985, 1990
¡Aggregates of plaque, calculus and stain on their teeth
¡Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified:
§no progression (NP) of periodontal disease beyond gingivitis (~ 11%)
§moderate progression (MP) (~ 81%)
§rapid progression of periodontal disease (RP) (~ 8%)
CDC’s Healthy Aging Data Portfolio
¡The percentage of older adults who have retained their natural teeth (i.e., lost _ or fewer teeth) has ____ steadily over the past few decades.
¡Reflects a change in treatment philosophy, from___ teeth to making efforts to ____ natural teeth and supporting structures.
¡
¡This is significant as the mouth reflects a person’s___ and ___ ___ throughout life.
¡From a dental perspective, more elderly adults with natural dentition requires___ ____ of ___ ___
¡
¡The percentage of older adults who have retained their natural teeth (i.e., lost 5 or fewer teeth) has increased steadily over the past few decades.
¡
¡Reflects a change in treatment philosophy, from extracting teeth to making efforts to preserve natural teeth and supporting structures.
¡
¡This is significant as the mouth reflects a person’s health and well-being throughout life.
¡From a dental perspective, more elderly adults with natural dentition requires greater management of periodontal health.
¡
¡
Biofilms as Dental Plaque
- ¡The ___________ link has been investigated over centuries
- ¡Plaque in health and disease has ____ composition
- §“___ ___ __ ___”
- §Gingivitis (___complex) and Periodontitis (___ complex)
- ¡Dental plaque biofilms form in an ___ fashion
- ____/____
- §Driven by ____/____ relationships
- §Local changes in the____
- ¡Pioneer bacteria ___ the ___ for the ___ colonizers
- ¡Biofilm growth is restricted by __ ___
Biofilms as Dental Plaque
¡The plaque-oral health link has been investigated over centuries
§Microscopy
§Molecular techniques
§
¡Plaque in health and disease has different composition
§“Experimental gingivitis in man”
§Gingivitis (orange complex) and Periodontitis (red complex)
¡Dental plaque biofilms form in an orderly fashion
§Structurally/temporally
§Driven by adhesion/coaggregation relationships
§Local changes in the environment
§
¡Pioneer bacteria prepare the environment for the late colonizers
¡
¡Biofilm growth is restricted by host factors
§
¡
Health- Clinical parameters
Gingiva is ___ AND ___
No ___ on ___
Probing depth =______
___ plaque at___ ____
Genus:
____
___
____
Gingiva is firm and tight
No bleeding on probing
Probing depth = 0-3 mm
Little plaque at gingival margin
Streptococci
Actinomyces
Veillonella
Streptococcus salivarius group
Streptococcus oris group
Complex?
O2?
+/-
Shape?
Form _____
Comments: ___ on the ___, __ ___. ____ ___ of the ___ ___
Streptococcus salivarius group
Streptococcus oris group
Yellow
Facultative anaerobes
G+ cocci
Long chains
Pioneers on the pellicle, mucosal surfaces. Largest component of the oral flora.
Actinomyces spp.
Complex?
O2?
+/-
Shape?
Form ____ ___
_____ numbers in ____ and ___ dental plaque.
Actinomyces spp.
Blue
Facultative anaerobes
G+ bacilli
Branching rods
High numbers in approximal and marginal dental plaque.
Veillonella spp.
Complex?
O2?
+/-
Shape?
___ numbers from __ ___ and __ ___
Veillonella spp.
Purple
Obligate anaerobes
G- cocci
High numbers from dental plaque and mucosal surfaces.
Capnocytophaga spp.
complex?
O2?
+/-
shape ___ ___
Comments
_____________
Capnocytophaga spp.
Green
Capnophilic anaerobe
Gram - filamentous
bacilli
Gliding motility
Aggregatibacter actinomycetemcomitans serotype a
Complex
O2
Gram ___
Shape?
Comment:
Aggregatibacter actinomycetemcomitans serotype a
Green
Capnophilic facultative anaerobe
Gram – short bacilli
Internal “star” in colonies
Eikenella corrodens
Complex?
O2
Gram ___
Shape?
Comments: _____
Eikenella corrodens
Green
Facultative anaerobe
Gram - bacilli
Microaerophilic
¡Capnocytophaga spp.
§Gram negative
§Filamentous ___
§Capnophilic anaerobe
§Gliding motility
§Grooms ___ from cell surfaces
§
¡Aggregatibacter actinomycetemcomitans serotype a
§Gram negative
§Short ___
§Capnophilic facultative anaerobe
______
§Internal “star” in colonies
§
¡Capnocytophaga spp.
§Gram negative
§Filamentous rod
§Capnophilic anaerobe
§Gliding motility
§Grooms glycan from cell surfaces
§
¡Aggregatibacter actinomycetemcomitans serotype a
§Gram negative
§Short rod
§Capnophilic facultative anaerobe
§Non-motile
§Internal “star” in colonies
§
¡Eikenella corrodens
§Gram negative bacillus
§Facultative anaerobe
Found in ___ __ and ___ ___
§Can be elevated in ___
___ ___ __
▪
▪
▪
___ and ____ lesions
§
¡Eikenella corrodens
§Gram negative bacillus
§Facultative anaerobe
§Gingival margin and Subgingival plaque
§Can be elevated in gingivitis
§Human bite infections
▪Clenched fist
▪Occlusal bite
▪Other saliva-associated wounds
§painful and necrotic lesions
§
Gingivitis\
Gingiva ___ , ____
___ on ___
PD =_____
Increased plaque at ___
___ complex
Gingiva red, swollen
Bleeding on probing
PD =2 - 5 mm
Increased plaque at margin
Orange complex
Gingivitis
¡An ___ process limited to the ___ ___ ___ around the ___ potion of the tooth
¡
¡Classifications
§Etiology
▪___ induced, ____, ___ , ___ induced
¡Most common form of gingivitis is ___, __ induced
¡
¡Inflammation begins with ___ ___ ____ (aging plaque)
___ ___and ___ ____ increase
§Tissue bleeds when disturbed.
§
¡
▪
¡An inflammatory process limited to the mucosal epithelial tissue around the cervical potion of the tooth
¡
¡Classifications
§Etiology
▪Drug-induced, hormonal, nutritional, plaque induced
¡
¡Most common form of gingivitis is chronic, plaque induced
¡
¡Inflammation begins with undisturbed plaque accumulation (aging plaque)
§GCF flow and neutrophil infiltration increase
§Tissue bleeds when disturbed.
§
¡
▪
