QUIZ 4 Regeneration and Repair Flashcards

1
Q

what are the 4 phases of tissue repair?

A
  • hemostasis: clot formation
  • inflammatory: infilatration of immune cells, initiation of repair
  • reparative phase (proliferative): migration of cells, formation of granulation tissue
  • wound contraction and scarring (not always)
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2
Q

what is the difference between regeneration and repair?

A
  • regeneration - complete restoration of tissue architecture and function (good as new)
  • repair - restoration of function but altered architectures (scars)
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3
Q

what is hemostasis?

A

transition of blood from liquid to a fibrillar gel

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4
Q

what are the primary and secondary goals of hemostasis?

A
  • primary: stop the bleeding
  • secondary: initiation of healing
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5
Q

in hemostasis, disruption of platelets leads to ___. the clot unites the edges of the wound, and the ___ provides a scaffold for future ___

A
  • coagulation cascade
  • fibrin
  • cell migration and repair
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6
Q

how is a clot different in the oral cavity than other areas of the body?

A

it is softer and more easily detached

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7
Q

what is primary hemostasis?

A
  • vascular spasm (constriction) and initial platelet plug in a damaged vessel
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8
Q

primary hemostasis is initiated by exposure of ___ in subendothelium (normally separate from the lumen) to circulating ___

A
  • collagen
  • von willebrand factor
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9
Q

what is von willebrand factor?

A

causes platelet aggregation by interacting with platelet surface proteins (GP1b-IX-V receptor complex)

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10
Q

platelets can also bind collage directly by ___ and ___

A
  • GPVI (glycoprotein VI)
  • alpha-2-beta-1 integrin
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11
Q

in primary homeostasis, platelets activate and dump out tons of preformed cytoplasmic vesicles containing what?

A
  • more von willebrand factor
  • fibrinogen
  • coagulation factors V and XIII
  • platelet agonists serotonin and ADP
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12
Q

in primary hemostasis, ___ anchors platelets together

A

fibrinogen

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13
Q

what is secondary hemostasis?

A
  • blood coagulation
  • occurs simultaneously with or just after primary hemostasis
  • complex cascade of extrinsic and intrinsic pathways
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14
Q

what is the extrinsic pathway of secondary hemostasis?

A
  • factor VII and tissue factor interactions (found around, often on fibroblasts) initiate the cascade
  • called extrinsic because it requires tissue factor which is normally not found in blood
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15
Q

what is the intrinsic pathway of secondary hemostasis?

A
  • initiated by damaged endothelium (collagen exposure)
  • called intrinsic because it involves factors found in the blood (ie. not tissue factor)
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16
Q

the main point of secondary hemostasis is the conversion of ___ into ___ which in turn converts soluble ___ into insoluble ___.

many of these steps require ___

A
  • prothrombin
  • thrombin
  • fibrinogen
  • fibrin
  • calcium
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17
Q

in secondary hemostasis, ___ cross-links and forms a mesh, trapping red and white cells, resulting in a ___

A
  • fibrin
  • blood clot
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18
Q

what is inflammation?

A

tissue injury and leakage of plasma proteins attracts macrophages and lymphocytes

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19
Q

what types of cells are involved in inflammation?

A
  • inflammatory cells
  • neutrophils
  • macrophages
  • leukocyte involvement - particularly T cells
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20
Q

describe inflammatory cells involved in inflammation

A

resident cells, circulating cells from disrupted blood vessels, cells infiltrating from intact local blood vessels (diapedesis)

21
Q

describe neutrophils involved in inflammation

A
  • first on the scene, activated by antibody-antigen interactions, LPS, complement system
  • bacterial destruction, also damages surrounding tissues
22
Q

describe macrophages involved in inflammation

A

second to arrive (after neutrophils), clear damaged tissue remnants and foreign material

23
Q

which phase involves the mobilization of adjacent cells (epithelium) and endothelial cell proliferation and angiogenesis?

A

reparative/proliferative phase

*there are obviously steps in between*

24
Q

what is the result of epithelial cell migration in the reparative/proliferative phase?

A
  • formation of new basal lamina, redistribution of integrin receptors, and formation of new hemidesmosomes (cells lay their own track)
  • eventually forms a thin cover over the wound
25
what is the result of fibroblast recruitment after endothelial cell migration in the reparative/proliferative phase?
* after fibroblasts are recruited, they proliferate in the wound * both resident fibroblasts and new ones from mesenchymal progenitor cells * collagen production begins to fill the defect, forming a scaffold
26
in the reparative/proliferative phase, which cause endothelial cell proliferation and angiogenesis?
TGF-beta, VEGF, and FGF-2
27
describe the process of wound contraction
* specialized fibroblasts - myofibroblasts, increased actin/myosin * align around wound, form cell junctions and attach to CT fibril around wound * draw wound edges together * initial collagen deposition by fibroblasts: immobile scar tissue, can be remodeled
28
what is describe as bacterially induced inflammation at gingival margins, causing destruction of connective tissues?
periodontal disease
29
in periodontal disease, how is pocket epithelium formed?
via apical migration of junctional epithelium
30
\_\_\_ can arrest the spread of infection into periodontal tissues
fibrosis
31
in periodontal disease, if the source of inflammation is removed,
32
compare repair after gingivitis vs. periodontal disease
* gingivitis - repair will occur once infection is removed * periodontal disease - involvement of alveolar bone, much less chance of successful repair
33
the repair mechanism of the ___ is broadly the same as in skin
periodontal ligament the difference is that in repair of the periodontal ligament, there is immedate remodeling of collagen by ligament fibroblasts = no scar
34
periodontal repair can result in significant implacations for \_\_\_
tooth movement
35
what can provide a membrane to prevent epithelial invasion during periodontal repair?
root planing and guided tissue regeneration
36
in periodontal repair, the addition of which growth factors can encourage ligament reattachment?
PDGF, FGF, EGF, and many others
37
what are the 3 primary zones of dental caries, from outer to inner?
1. surface and body - surface zone re-mineralizes, body is the primary zone of demineralization 2. dark zone - zone of increasing demineralization 3. translucent zone - leading edge, caused by micro-pores which form in the enamel rod boundaries
38
in the formation of dental caries, there is continual ___ and \_\_\_, with a net \_\_\_
* demineralization * remineralization * loss
39
describe repair of enamel
repair vs. remineralization - recreation of enamel scaffold, 3D printing
40
describe repair of dentin
* odontoblasts, reactionary vs. reparative dentinogenesis * tertiary (sclerotic) dentin formation
41
what is the dentin bridge?
dentin formed between surviving dentin and restorative material, preventing microleakage
42
how can a more rapid dentin bridge be achieved?
biomaterials, which induce odontoblast differentiation and dentin production
43
describe the process of cavity prep and dentin bridge formation
* cavity prep: removal of destroyed enamel/dentin * healing: no epithelium migration as in soft tissues * placement of dental restorative materials * formation of dentin bridge
44
\_\_\_ is a discipline which seeks to encourage the restoration of function and structure to pre-injury state
tissue engineering
45
what are bioactive materials?
materials which are designed to drive repair/regeneration through the use of bioactive factors
46
what are the 3 traditional key components in tissue engineering?
* cell source * material * bioactive component
47
describe cellular vs acellular approaches
addition of material containing cells vs. application of materials to existing tissues there are advantages and disadvantages of each
48
describe the repair of tooth associated tissues
* dental pulp supplies mesenchymal cells, which migrate, proliferate, and differentiate in response to odontoblast death/pulp damage * implications: mineralization vs. soft tissue repair * even after significant damage, the pulp remains partially vital, leaving a reservoir of tissue to work with * importance of selecting scaffolds/materials and delivering them into the correct regions of the tooth