Quiz 2

Question 1

What are the 4 stages of chronic periodontitis?

Answer 1

Initial

Early

Established

Advanced

Question 2

How many days of plaque accumulation does it take to histologically see an early inflammatory response within the initial lesion?

Answer 2

2 - 4 days

Question 3

Identify what prevents invasion of the Junctional Epithelium in the initial lesion?

Answer 3

Neutrophils

Question 4

Discuss what happens to the crevicular fluid in the initial lesion?

Answer 4

It increases

Question 5

Histologically identify what happens in the Junctional Epithelium in the initial lesion?

Answer 5

It becomes hyperplastic

Question 6

What can be seen after 7 – 14 days of plaque accumulation in the early lesion?

Answer 6

Vascular changes are more pronounced

Increase in extra-vascular neutrophils

Question 7

Name the most prominent type of lymphocyte present beneath the Junctional Epithelium in the early lesion?

Answer 7

T-Lymphocyte/Cells

Question 8

How are rete ridges and dermal papillae formed in the early lesion?

Answer 8

The basal layer of the JE proliferates

Question 9

What effect does collagenase have in the early lesion?

Answer 9

Destroys the collagen fibres

Affects the fibroblasts to stop them producing more collagen

Question 10

Identify why PMNs arrive to the early lesion?

Answer 10

The attracted by chemotaxis from the leucotoxin

Question 11

Within the established lesion what is the main histological factor?

Answer 11

Plasma cells

Question 12

When the JE becomes hyperplastic and ulcerated discuss what exits and enters it in the established lesion?

Answer 12

Neutrophils – exit

Exudate – enters

Question 13

Within the established lesion, complement becomes present. Define ‘complement’?

Answer 13

Part of the innate immunity. It is a system of plasma proteins activated bypathogens.

Question 14

As further sub-gingival plaque accumulates describe the appearance of the gingiva within the established lesion

Answer 14

It ‘hangs’ off the tooth due to the reduction and destruction of collagen fibres, allowing plaque to enter more easily. No stippling evident

Question 15

Clinically an established lesion may be present in Established Chronic Gingivitis or Early Periodontitis. What is this known as?

Answer 15

Transition Phase

Question 16

Name OAF and describe its function?

Answer 16

Osteoclast Activating Factor – osteoclasts remove the alveolar bone (bone loss)

Question 17

In the advanced lesion discuss what happens to the JE?

Answer 17

It migrates down the tooth surface to form periodontal (true) pockets

Question 18

Where does the legion extend to in the final stage?

Answer 18

Extends into the periodontal ligament and alveolar bone

Question 19

Define ‘quiescence’

Answer 19

Quietness/no activity in the progression of the disease

Question 20

What effect does the formation of granulation tissue have on the advanced lesion?

Answer 20

Reattachment cannot occur if granulation tissue is present.