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Perio #2 > Periodontist and the Risk for Systemic Disease 10/29/15 > Flashcards

Periodontist and the Risk for Systemic Disease 10/29/15 Flashcards

1
Q

What is the Focal infection theory?

A

System disease are often caused by oral infections or tooth problems. Also stated that lessening systemic diseases, should take precedence over preserving teeth (1910-1950)

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2
Q

What are the problems with the Focal Infection Theory?

A
  • Extracting teeth didn’t necessarily cure disease
  • People with good oral health and no infection still develop systemic diseases.
  • People with no teeth still develop systemic diseases.
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3
Q

By what mechanism could Periodontitis influence systemic disease?

A

Through the Acute phase reaction cascade:

Triggering factors –> Local Reactions —> Mediators —-> Secondary systemic reactions.

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4
Q

What are the Triggering factors of the Acute phase rxn?

A
  • Plaque
  • Infection
  • Surgery
  • Nercorsis
  • NEoplasia
  • Radiation
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5
Q

What are the Local rxns of the Acute Phase run.

A
  • Macrophages
  • Fnrboblasts
  • Endothelial cells
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6
Q

What are the mediators?

A
  • TNF-A
  • Il-1
  • IL-6
  • INF-y
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7
Q

What are the Secondary systemic rxns?

A
  • Fever
  • Complement activation
  • Serum Glucocorticoids
  • altered synthesis of acute phase proteins
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8
Q

What are the important acute phase proteins?

A
  • Complement components: opsonization, lysis, chemotaxis.
  • Protease inhibitors
  • C-reactive protein
  • Fibrinogen
  • Plasminogen
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9
Q

_____% of americans 30 yrs and older have periodontitis?

A

47%

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10
Q

What are the sources of risk for systemic disease from periodontitis?

A
  • Inflamed and infected tissues

- Periodontal pockets provide environment for gram negative biofilm.

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11
Q

What Defines a Risk factor?

A
  • Consistency of association
  • Strength of Associations
  • Correct time sequence
  • Specific Associations
  • Degree of exposure (degree of exposure correlates with occurrence of disease)
  • Biological plausibility (associations make sense)
  • Support from experimental evidence (animals who are episode to risk factors get the disease)
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12
Q

Name 4 systemic disease associated with Periodontitis?

A
  1. Atherosclerotic vascular disease AVD (heart disease)
  2. Adverse pregnancy outcomes (low birthweight, Preterm birth)
  3. Diabetic complications
  4. Respiratory infections
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13
Q

What is AVD?

A

Common disorder in larger arteries where lumen becomes occluded by plaque and less capable of passing blood through.

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14
Q

What are the 2 common complications of AVD?

A
  • Coronary Thrombosis

- Acute Myocardial infarction

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15
Q

Both Periodontitis and AVD are more common in what groups of People?

A
  • Older
  • Male
  • Smokers
  • Lower income
  • hypertensive
  • Under stress
  • diabetics
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16
Q

What pathways explain the link between periodontitis and Cardiovascular disease?

A
  • effect of Periodontal bacterial on platelets
  • Invasion of endothelial cells and macrophages by periodontal bacteria
  • Endocrine-like effects of pro-inflammatory mediators
17
Q

______ and _____ can produce proteins that stress collagen and can cause a blood clot/Thrombo-embolic events.

A

S. Sanguis and P. Gingivalis

18
Q

_________ Enhances foam cell formation by macrophages.

A

A.a LPS

19
Q

____ and _____ increase the coagulation effect.

A

C-reactive protein and fibrinogen (Acute phase response)

20
Q

What is the effect of Periodontal therapy on Cardiovascular disease Biomarkers?

A

Studies have NOT shown that Cardiovascular disease Biomarkers are consistently reduced by periodontal therapy. * Yet successful therapy made it 4x more likely to have a decrease in serum C-reactive proteins.

21
Q

However, A recent study suggest that treatment of mild to moderate periodontitis in otherwise healthy patients may significantly decreases carotid artery intimal-medial thickness.

A

Cool.

22
Q

Does treatment of periodontitis reduce the risk of Atherosclerotic vascular disease?

A

There is currently a lack of strong evidence, but it would make sense…….whatever that means.

23
Q

Does periodontitis meet the requirement of Specificity? (Strength of evidence)

A

Not fully

24
Q

What are some reasons for Plausibility of Periodontitis being associated with AVD?

A
  • Periodontal pathogens have been isolated form human carotid atheromas.
  • P. gingivalis can induce platelet aggregation
  • Systemic pro-inflammatory mediators CSRP and Fibrinogen are elevated in subjects with periodontitis.
25
Q

What are the Adverse Pregnancy outcomes associated with periodontitis?

A
  • low birth weight (less than 2.5 kg)
  • Preterm birth (less than 37 wks)
  • Intrauterine growth constriction
  • These can result in longterm disability
26
Q

How does Periodontitis influence Pregnancy outcomes?

A
  • Through translocation of bacteria and endotoxin into the systemic circulation.
  • Inflamed tissues produce significant quantities of inflammatory mediators (IL-1B, IL-6, TNF-a and PGE-2), These cytokines may have systemic effects.
27
Q

Mothers with Periodontitis are ____ to ____ times more likely to deliver a preterm infant than healthy mothers.

A

4 to 7 times more likely

28
Q

Does Periodontal treatment decrease the likelihood of PLBW or PTB?

A

Not statistically significant, but yes it appears to…….man this lecture is ridiculous…

29
Q

Does Periodontitis predispose to poor diabetic control?

A

Yes (type 2)

Perio #2 (11 decks)

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