Periodontitis and the risk for systemic disease part 1&2 Flashcards
acute phase reaction cascade
triggering factors–> local reaction–>mediators –> secondary systemic reaction
what could be triggering factors of the acute phase reaction cascade
infection necrosis surgery neoplasia radiation
cells of local reaction
macrophages
fibroblasts
endothelial and other cells
mediators that are produces by local reactors
TNF-alpha
IL-1
IL-6
IFN-y
secondary systemic rxn effects
fever and leukocytosis
complement activation
serum glucocorticoids increased
altered synthesis of acute phase proteins
important acute phase proteins
complement: opsonization, lysis, chemotaxis
protease inhibitors (a2-macroglobulin)
C-reactive protein (CRP): opsonization
Fibrinogen: coag factor
Plasminogen: degrades clots
what defines a risk factor?
consistency of assoc.
strength of assoc.
correct time seq.
specificity
degree of exposure
biological pausability
support from experimental evidence
2 systemic diseases that have the strongest association with periodontitis
athersclerotic vascular disease
adverse pregnancy outcomes
diabetic complications
respiratory infections
both AVD and periodontitis share several factors, for example patients with these diseases all tend to…
be older
male
lower SES
smokers
HTN
under psych. stress
diabetic
what are the 4 major confounding factors in studies of association of periodontitis with AVD?
smoking
age
diabetes
education/SES
S. sanguis and P. gingivalis can induce …. events. This action is mediated by collagen-like platelet aggregation associated proteins made by bacteria
thrombo-embolic
AVD and Perio:
DNA from periodontal pathogens was found in …. in a study
atheromas
macrophages incubated with in vitro P. gingivalis and LDL take up bacteria and transform into … cells similar to those observed in the vessel intima during formaion of atherosclerotic lesions
foam
A.a. LPS enhances foam cell formation by macrophages incubated in vitro with …
LDL
Gingipains from P. gingivalis up-regulate expression of ….. and down regulate …. in human aortic smooth muscle cells. this change in gene expression increases migration of smooth muscle cells and promotes atherosclerosis
angiopoetin 2
antiopoetin 1
studies show that CRP and fibrinogen are … in periodontally diseases subjects
elevated
periodontal patients treat with SRP did show a reduction in …. but other studies have shown this is not consistent. There also may be a trend toward treatment-induced suppression but the effects are not consistent or sustainable
CRP
a recent study suggested that treatment of mild-mod periodontitis in other wise healthy patients may result in a significant decrease in carotid artery….
intimal-medial thickness
the consistency of study finding suggest the observed assoc. between periodontitis and AVD is not a ….
false finding
the strength of reported associations btn periodontitis and AVD is …
modest
does periodontitis fully meet the criterion of specificity?
no
T/F P. gingivalis can induce platelet aggregation
true
is there enough support to show a causal relationship of periodontitis and AVD
no
is there anough evidence to show that perio therapy will prevent AVD
no
inflamed periodontal tissues produce significant quantities of inflammatory mediators including…
IL-1b
IL-6
TNF-a
PGE2
inflammatory mediators from periodontal tissues can cause placental tissues to release… causing myometrial contraction which contributes to LBW and preterm labor
PGE2
inflammatory mediators from periodontal tissues can cause increased …. which can cause weakening of the placental membrane leading to preterm labor
MMPs
