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Oral Biology > QUIZ 4 Regeneration and Repair > Flashcards

QUIZ 4 Regeneration and Repair Flashcards

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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
Q

what is the result of fibroblast recruitment after endothelial cell migration in the reparative/proliferative phase?

A
  • 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
Q

in the reparative/proliferative phase, which cause endothelial cell proliferation and angiogenesis?

A

TGF-beta, VEGF, and FGF-2

27
Q

describe the process of wound contraction

A
  • 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
Q

what is describe as bacterially induced inflammation at gingival margins, causing destruction of connective tissues?

A

periodontal disease

29
Q

in periodontal disease, how is pocket epithelium formed?

A

via apical migration of junctional epithelium

30
Q

___ can arrest the spread of infection into periodontal tissues

A

fibrosis

31
Q

in periodontal disease, if the source of inflammation is removed,

A
32
Q

compare repair after gingivitis vs. periodontal disease

A
  • gingivitis - repair will occur once infection is removed
  • periodontal disease - involvement of alveolar bone, much less chance of successful repair
33
Q

the repair mechanism of the ___ is broadly the same as in skin

A

periodontal ligament

the difference is that in repair of the periodontal ligament, there is immedate remodeling of collagen by ligament fibroblasts = no scar

34
Q

periodontal repair can result in significant implacations for ___

A

tooth movement

35
Q

what can provide a membrane to prevent epithelial invasion during periodontal repair?

A

root planing and guided tissue regeneration

36
Q

in periodontal repair, the addition of which growth factors can encourage ligament reattachment?

A

PDGF, FGF, EGF, and many others

37
Q

what are the 3 primary zones of dental caries, from outer to inner?

A
  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
Q

in the formation of dental caries, there is continual ___ and ___, with a net ___

A
  • demineralization
  • remineralization
  • loss
39
Q

describe repair of enamel

A

repair vs. remineralization - recreation of enamel scaffold, 3D printing

40
Q

describe repair of dentin

A
  • odontoblasts, reactionary vs. reparative dentinogenesis
  • tertiary (sclerotic) dentin formation
41
Q

what is the dentin bridge?

A

dentin formed between surviving dentin and restorative material, preventing microleakage

42
Q

how can a more rapid dentin bridge be achieved?

A

biomaterials, which induce odontoblast differentiation and dentin production

43
Q

describe the process of cavity prep and dentin bridge formation

A
  • 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
Q

___ is a discipline which seeks to encourage the restoration of function and structure to pre-injury state

A

tissue engineering

45
Q

what are bioactive materials?

A

materials which are designed to drive repair/regeneration through the use of bioactive factors

46
Q

what are the 3 traditional key components in tissue engineering?

A
  • cell source
  • material
  • bioactive component
47
Q

describe cellular vs acellular approaches

A

addition of material containing cells vs. application of materials to existing tissues

there are advantages and disadvantages of each

48
Q

describe the repair of tooth associated tissues

A
  • 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

Oral Biology (19 decks)

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