periodontitis- risk for systemic disease

Question 1

what were the problems with the focal infection concept

Answer 1

• Extracting teeth didn’t necessarily cure disease
• People with good oral health and no infection still developed systemic diseases
• People with no teeth still developed systemic diseases

Question 2

list the steps of the acute-phase reaction cascade

Answer 2

Triggering factors

Local reaction

Mediators

Secondary systemic reaction

Question 3

what are the “triggering factors” of the acute-phase reaction cascade?

Answer 3

– Infection
– Necrosis 
– Surgery
– Neoplasia
 – Radiation

Question 4

list the cell types involved in the “local responses” during the acute-phase reaction cascade

Answer 4

– Macrophages
– Fibroblasts
– Endothelial and other cells

Question 5

_________ are responsible for the production and release of inflammatory cytokines

Answer 5

mediators

Question 6

what inflammatory mediators are involved in the acute-phase reaction cascade?

Answer 6

– TNF-alpha
– IL-1
– IL-6
– IFN-gamma

Question 7

what are the characteristics of a secondary systemic reaction?

Answer 7

– Fever and leukocytosis
– Complement activation
– Serum glucocorticoids increased
– Altered synthesis of acute phase proteins

Question 8

opsonization, lysis, and chemotaxis (CTX) are all _______ components

Answer 8

compliment

Question 9

what does alpha2-macroglobulin inhibit?

Answer 9

protease

inhibits enzyme

Question 10

what are C-reactive proteins involved in?

Answer 10

opsonization

Question 11

T/F: fibrinogen and plasminogen are important in the acute phase

Answer 11

true

Question 12

_____% of Americans 30 yrs and older (64.7 million total) have periodontitis

Answer 12

47

Question 13

Periodontal pockets provide a significant surface area exposed to ________ biofilm

Answer 13

gram-negative

Question 14

during periodontitis, there is a systemic exposure to what?

Answer 14

– Bacteria and bacterial products

– Inflammatory cytokines

Question 15

what systemic conditions can be caused by periodontitis?

Answer 15

• Atherosclerotic vascular disease
• Adverse pregnancy outcomes
• Diabetic complications
• Respiratory infections

Question 16

Atherosclerosis leads to fibro-lipid lesions called ________

Answer 16

atheromas

Question 17

what are the common complications of atherosclerosis?

Answer 17

Coronary thrombosis and acute myocardial infarction

Question 18

what 2 things can cause an Acute phase reaction?

Answer 18

Systemic Inflammation & Bacterial Translocation

Question 19

what are the major confounding factors associating periodontitis with AVD?

Answer 19

• Smoking
• Age
• Diabetes
• Educational and socioeconomic status

Question 20

T/F: DeStafano found that periodontitis is associated with a small increase in risk for coronary heart disease in men

Answer 20

true

Question 21

what did the matilla study find?

Answer 21

it showed a significant association between poor oral health and MI (myocardial infarction)

Question 22

the ______ study revealed a small association between tooth loss and coronary heart disease.

Answer 22

Joshipura

Question 23

the study by _______ found that periodontitis can influence atheroma formation

Answer 23

Beck

Question 24

what study found no link between periodontal disease and CHD risk

Answer 24

Hujoel

Question 25

Periodontal patients treated with Sc/RP experienced significant reductions in serum _____ and ____

Answer 25

CRP and IL-6

Question 26

T/F: There is currently a lack of strong evidence that treatment of periodontitis reduces the risk of atherosclerotic vascular disease.

Answer 26

true

Question 27

Periodontal pathogens have been isolated from human carotid _______

Answer 27

atheromas

Question 28

the bacterial species _________ can induce platelet aggregation

Answer 28

P. gingivalis

Question 29

T/F: According to the AHA, there is evidence to indicate that perio treatments can prevent AVD

Answer 29

FALSE

there is not enough evidence to indicate that it can prevent AVD or modify its outcomes

Question 30

T/F: Poorly controlled diabetics of both types tend to have more periodontal attachment loss than non-diabetics

Answer 30

true

Question 31

T/F: there is conclusive evidence for an association between periodontal disease and COPD, probably due to inhaled oral bacteria

Answer 31

false

we have yet to establish a link

Question 32

It is likely that well-controlled ___________ studies will provide the strongest evidence of periodontitis as a risk factor for systemic health

Answer 32

intervention