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Periodontics > Periodontitis as a Manifestation of a Systemic Disease > Flashcards

Periodontitis as a Manifestation of a Systemic Disease Flashcards

1
Q

periodontitis as a manifestation of a systemic disease

A

“Diseases and conditions
that can affect the
periodontal tissues by
influencing the course
of periodontitis.

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2
Q

Major impact

A

Severe/early-onset
periodontitis

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3
Q

Moderate impact
(2)

A

Increase prevalence
No otherwise different
clinical presentations of
chronic periodontitis

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4
Q

Systemic disorders
Loss of
periodontal
tissue
Influence (2)

A

Influence periodontal inflammation
Influence the pathogenesis of periodontal diseases

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5
Q

Influence periodontal inflammation
(3)

A

Genetic Disorders
Acquired Immunodeficiency Diseases
Inflammatory Diseases

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6
Q

Genetic Disorders
(4)

A

Diseases associated with immunologic disorders
Diseases affecting the oral mucosa and gingival tissue
Diseases affecting the connective tissues
Metabolic and endocrine disorders

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7
Q

Down Syndrome
(5)

A

Trisomy 21 or mongolism
Characteristic physical appearance
Mental deficiency and growth retardation
Moderate to severe periodontitis with rapid progression
Local factors alone failed to explain the severity of
periodontal destruction

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8
Q

Down Syndrome
Predispose to infections:

A

intrinsic immune system defects Poor PMN chemotaxis, phagocytosis, intracellular killing

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9
Q

Leukocyte Adhesion
Deficiency
(2)

A

Mutation in beta-2 integrin (ITGB2) gene Lack of
Neutrophils are confined to blood vessels and
absent from the periodontium

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10
Q

skipped
Mutation in beta-2 integrin (ITGB2) gene
(2)

A

Lack of beta-2 integrin mRNA in leukocytes
Low integrin (CD18 or CD15) expression on neutrophils

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11
Q

Neutrophils are confined to blood vessels and
absent from the periodontium
(4)

A

Leukocytosis is common
History of severe recurrent infection but no pus
Disruption of neutrophil-associated homeostasis
Lack of neutrophil immune surveillance

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12
Q

Leukocyte Adhesion
Deficiency
dental (3)

A

Severe gingival inflammation, acute gingival lesions
Early-onset and rapidly progressive alveolar bone loss
Early loss of the primary and permanent teeth

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13
Q

Papillon–Lefèvre
Syndrome
(3)

A

Mutations in the cathepsin C gene (CTSC)
Compromised neutrophil function, not the quantity
Hyperkeratotic lesions

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14
Q

Mutations in the cathepsin C gene (CTSC)

A

Chromosome 11q14

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15
Q

Compromised neutrophil function, not the quantity

A

Decreased phagocytosis (Rathi, 2002)

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16
Q

Hyperkeratotic lesions

A

Palms, soles of the feet, elbows, knees

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17
Q

Papillon–Lefèvre
Syndrome
dental (3)

A

Severe gingival inflammation, pocket formation
Early-onset and rapidly progressive alveolar bone loss
Early loss of the primary and permanent teeth

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18
Q

Chediak-Higashi
Syndrome
(4)

A

Mutations in CHS1, LYST gene
Partial oculocutaneous albinism
Recurrent pyogenic infections
Varying neurologic problems

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19
Q

Mutations in CHS1, LYST gene

A

Lysosomal trafficking defect

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20
Q

Partial oculocutaneous albinism

A

Defects in melanin granules

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21
Q

Recurrent pyogenic infections

A

Circulating leukocytes exhibit defective lysosomes
Decrease in phagocytosis

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22
Q

Varying neurologic problems

A

Intellectual deficit and dementia

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23
Q

Chediak-Higashi
Syndrome
dental (4)

A

Severe gingival inflammation
Early-onset and rapidly progressive alveolar bone loss
Early loss of the primary and permanent teeth
Poor response to dental treatment

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24
Q

Congenital Neutropenia
(3)

A

Mutations in the ELANE (50%), HAX1(10%) gene
Decrease in number of neutrophils
Deficiency in the immune response

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25
Mutations in the ELANE (50%), HAX1(10%) gene
1/3 causes remain unknown
26
Decrease in number of neutrophils
ANC < 500 cell/uL and static
27
Deficiency in the immune response
Severe and recurrent infections
28
Congenital Neutropenia dental (3)
Severe periodontitis is common Higher risk for tooth loss Oral ulcerations
29
Epidermolysis Bullosa Kindler syndrome (3)
Mutation in the fermitin family homologue 1 gene (kindlin-1; FERMT1) Photosensitivity Recurrent blister formation
30
Kindler syndrome Mutation in the fermitin family homologue 1 gene (kindlin-1; FERMT1) (3)
Imparied keratinocyte cell adhesion Molecular defects in basement membrane zone Reduced resistance at the junctional epithelium
31
Epidermolysis Bullosa Kindler syndrome dental (3)
Oral blisters formation Severe periodontitis Need immunofluorescence to confirm diagnosis
32
Severe periodontitis
Alveolar bone loss that progress rapidly
33
Need immunofluorescence to confirm diagnosis
Skin biopsy of an included blister
34
Ehlers-Danlos Syndrome (3)
Mutations in genes encoding fibrillar collagens or enzymes involve in the biosynthesis of these proteins Affecting collagen production and composition Joint hypermobility, skin extensibility, and tissue fragility
35
Affecting collagen production and composition Mainly involves
joint, skins and walls of the blood vessels
36
Ehlers-Danlos Syndrome EDS type VIII have
gingival recession and generalized severe periodontitis that often leads to loss of all teeth.
37
EDS type IV and, to a lesser extent, in EDS type I may also demonstrate the
periodontitis as oral manifestation
38
Ehlers-Danlos Syndrome dental (2)
Generalized, early-onset severe periodontitis and gingival recession Early loss of the primary and permanent teeth
39
Hypophosphatasia (3)
Alcaline phosphatase (ALPL) gene mutation Mild form and severe form Dentin is not affected with defective cementum
40
Hypophosphatasia dental (3)
Impaired bone/tooth mineralization Defects in root cementum Alveolar bone loss and premature loss of teeth
41
Defects in root cementum (2)
Compromised periodontal attachment, reduction in alveolar bone height The teeth are not adequately anchored to the alveolar bone via the PDL
42
Osteoporosis
Postmenopausal women with osteoporosis or osteopenia exhibit greater loss of periodontal attachment compared with women with normal bone mineral density.
43
Osteoporosis
Estrogen withdrawal Increased bone turnover Net systemic bone loss Decrease in bone mineral density Weaken bone microarchitecture High risk of bone fracture
44
Periodontitis
Bacterial infection Local inflammatory insult Initial cortical bone compromise Bone loss
45
Shared Risk Factors
Age, vitamin D and calcium deficiency, and smoking
46
Osteoporosis, Periodontitis Homeostasis Both are bone resorptive diseases Higher prevalence and severity of
radiographic alveolar bone loss No clear association with probing depth or clinical attachment loss
47
Diabetes Mellitus (3)
An important risk factor for periodontal diseases Associated with significantly higher prevalence and severity of periodontitis. A disorder of glucose metabolism
48
Diabetes Mellitus Chronic status of
elevated blood glucose level Accumulation of AGEs AGEs - RAGE (Receptor of AGEs) interaction
49
Diabetes Mellitus dental (2)
Diabetes as a risk factor for periodontal disease Periodontal abscess may be a common complication
50
Diabetes as a risk factor for periodontal disease
Increased prevalence and severity of attachment loss
51
Periodontal abscess may be a common complication 58.6% of patients having periodontal abscesses had HbA1c ≥
6.5%
52
Diabetes Mellitus Periodontal disease as a complicating factor for
Diabetes Periodontitis ALSO affects glycemic control
53
Diabetes Mellitus Monitor
fasting plasma glucose level and HBA1c
54
Obesity (3)
Metabolic syndrome: Adipose tissue is a complex organ secrets numerous endocrine mediators Rather than the amount of fat mass, adipose tissue dysfunction may be the key factor in pathophysiology
55
Metabolic syndrome: (4)
Hypertension, Hyperglycemia, Obesity, and dyslipidemia
56
Rather than the amount of fat mass, adipose tissue dysfunction may be the key factor in pathophysiology (4)
Cross-talk between T cells and adipose tissue Increased releasing myriad proinflammatory cytokines and chemokines Decreased phagocytic activity Impaired antigen presentation
57
Acquired Immunodeficiency Diseases (2)
Acquired neutropenia HIV infection
58
Inflammatory Diseases (3)
Epidermolysis bullosa acquisita Inflammatory bowel disease Reumatoid arthritis
59
Epidermolysis Bullosa Acquisita (4)
The presence of autoantibodies against type VII collagen Recurrent blister formation Generalized gingival inflammation and enlargement, gingival recession, alveolar bone loss, and mobile teeth Immunofluorescence on basement membrane zone - split skin
60
Epidermolysis Bullosa AcquisitaThe presence of autoantibodies against type VII collagen (2)
Mechanobullous type Inflammatory form (mimic pemphigoid)
61
Inflammatory Bowel Disease dental (3)
Hypersensitivity of immune response Inflammation and alveolar bone loss in a susceptible host Increased prevalence and severity of periodontitis
62
Rheumatoid Arthritis (3)
Chronic auto-inflammatory disease Increased risk for loss of periodontal attachment, alveolar bone Biological link between rheumatoid arthritis and periodontitis
63
Influence the pathogenesis of periodontal diseases (3)
Stress/depression Smoking Medications for malignancies, anti-inflammatory agents, bisphosphonates
64
Smoking (2)
Chronic nicotine exposure Immunosuppression
65
Chronic nicotine exposure (2)
Impairment of antigen-mediated T cell signaling Inhibits antibody-forming cell response
66
Immunosuppression (1)
The inflammation in response to plaque accumulation is reduced
67
Bisphosphonates (3)
Treat cancer (IV administration) Treat osteoporosis (oral administration) Inhibit osteoclast activity and interfere with bone turnover
68
Bisphosphonates Not currently used to prevent further
alveolar bone loss
69
Independent etiology Neoplasms Other disorders
langerhans cell histiocytosis, giant cell granuloma, hyperparathyroidism, systemic sclerosis
70
Neoplasms (2)
Neoplastic diseases of periodontal tissue Secondary metastatic neoplasms of periodontal tissue
71
Neoplastic diseases of periodontal tissue (3)
Oral squamous cell carcinoma Odontogenic tumors Other primary neoplasms of periodontal tissue
72
Other Disorders Langerhans cell histiocytosis (4)
Peripheral small vessel necrotizing vasculitis Respiratory and renal impairment Characteristic fiery and hyperplastic gingival inflammation Alveolar bone loss
73
Other Disorders Giant cell granuloma (2)
Reactive proliferation, benign lesion No systemic features
74
Peripheral giant cell granuloma (2)
*Expanding epulis-like gingival swelling *Occasional loss of periodontal supporting tissue
75
Central giant cell granuloma (2)
*Loss of periodontal supporting tissue *May expand toward marginal periodontal tissue
76
Other Disorders Hyperparathyroidism Primary : Secondary: Tertiary:
benign adenoma of parathyroid glands result of hypercalcemia parathyroid hypertrophy following 2o type
77
Other Disorders Systemic sclerosis (scleroderma) (3)
Autoimmune disease of the connective tissues Many different systemic presentations Widening PDL and higher prevalence of periodontitis

Periodontics (13 decks)

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