Relevance of Microbiology in Managing Periodontal Diseases Flashcards
Why is it important to understand the microbial aetiology of periodontal conditions?
Because it’s important for:
-Prevention
-Risk assessment
-Diagnosis
-Communication
-Treatment planning
-Monitoring treatment outcomes
What is the primary aetiological factor of periodontal disease?
Dental plaque
Compare the gingival sulcus with the gingival/periodontal pocket.
-In the gingival/periodontal pocket, you can always find more of the anaerobic species (Bcs deeper areas= less O2)
-more motile bacteria & more Gram -ve bacteria
-GCF present in both
look at the slides
When is there increased production of GCF (gingival crevicular fluid) and what is the effect of this?
During inflammation
Since there are more proteins in inflamed GCF, it provides the periopathogenic bacteria with nutrients because the bacteria are proteolytic
It also provides the bacteria with novel substrates for their metabolism like proteins, iron & haem
What are most of the bacteria that are found in the deep periodontal/gingival pockets?
Asaccharolytic bacteria, meaning they can’t metabolise sugars.
What bacteria is gingivitis usually caused by?
Gram negative obligate anaerobes
look at the slides
What is the pH of the subgingival area?
Slightly higher than that of the saliva, in the region of 6.9-7.8.
What will the predominant cultivable microflora of the healthy gingival crevice look like?
Predominantly Gram +ve
look at the slides
What can gingivitis be exaggerated by?
Hormonal disturbances & some drugs
Doesn’t always progress to periodontitis though.
What are the most important bacterial species involved in the development of periodontitis?
-Porphyromonas gingivalis
-Tannerella forsythia
-Treponema denticola
-Fusobacterium nucleatum
look at the slides
What are necrotising periodontal diseases characterised by?
These are acute conditions characterised by: pain, bleeding, halitosis, necrotising inflammation of dental papillae, grey pseudomembranes, lymph nodes
In terms of the microbiology, they are characterised by specific complexes called fuso-spirochaeta complexes
What are some risk factors for necrotising periodontal diseases?
-Dental plaque
-Smoking
-Poor oral hygiene
-Immunosuppression
-Emotional stress
-Poor diet
What bacterial species form the fuso-spirochaeta complex?
-Treponema spp.
-Fusobacterium spp.
-Prevotella intermedia
-Borrelia vincentii
How can antibiotics be used in periodontal therapy?
Either locally or systemically, and the 3 main groups are:
Penicillin- inhibition of cell wall synthesis
Tetracyclins- inhibition of protein synthesis
Metronidazole- inhibition of nucleic acid synthesis
