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Perio Final > Sweep 1.1 > Flashcards

Sweep 1.1 Flashcards

1
Q

Mediators of innate immunity:

A

Prostaglandins
Matrix metalloproteinases
Proteinase inhibitors
Antimicrobial peptides

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2
Q

Prostaglandins (especially PGE2) induce

A

vasodilation and cytokine production

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3
Q

PGE2 induces

A

production of matrix metalloproteinases by fibroblasts and osteoclasts, which damage periodontal tissues

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4
Q

Mediators of innate immunity: Matrix metalloproteinases

A

Degrade extracellular matrix
Example: PMN collagenase (degrades the major structural protein in gingiva)
Concentrations are higher in inflamed gingiva than in healthy gingiva

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5
Q

Mediators of innate immunity: Proteinase inhibitors

A

Antagonize inflammation
Inhibit degradation of matrix proteins
Alpha-2 macroglobulin: broad spectrum proteinase inhibitor
Alpha-1 antitrypsin: broad spectrum proteinase inhibitor and potent inhibitor of PMN collagenase

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6
Q

Mediators of innate immunity: Antimicrobial peptides

A

Defensins:
Calprotectin:

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7
Q

Defensins: Inhibit

A

bacteria and fungi. Produced by mucosal surfaces and salivary gland epithelium.

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8
Q

Calprotectin:

A

Inhibits bacteria and fungi by chelating zinc. Produced by epithelium, PMNS, monocytes, macrophages.

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9
Q

Acute inflammation or injury increases vascular permeability, resulting in redness, edema, and increased

A

gingival crevicular fluid flow

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10
Q

PMN deliver

A

antimicrobial substances to bacteria in the early stages of infection

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11
Q

T-cell receptor has

A

T-cell receptor has 2 glycoprotein chains ( and ) with variable segments

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12
Q

Variable segments determine the

A

type of immune response

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13
Q

TCR in periodontitis

A

different before and after therapy

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14
Q

TCR different between

A

chronic and aggressive periodontitis

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15
Q

2 types of T-helper cells -

A

differ in cytokine profiles

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16
Q

Cytokines are messenger proteins that

A

transmit signals to other cells
Th1: IL-2, IFN-gamma, TNF-alpha
Th2: IL-4, 5, 6, 10, 13

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17
Q

3Cytotoxic T cells (Tc) activated by

A

cytokines

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18
Q

Tc cells respond to

A

intracellular pathogens

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19
Q

Antigens from these pathogens bind

A

MHC I molecules

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20
Q

Tc cells recognize this antigen presentation and

A

destroy infected cells

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21
Q

Not many Tc cells are found in

A

periodontitis, suggesting that viruses and invasive bacteria are not major players

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22
Q

B cell response

Humoral immunity

A

(antibody mediated) triggered in response to soluble antigens

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23
Q

Ag-Ab complex activates

A

complement

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24
Q

Ag-Ab complex facilitates

A

opsonization

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25
Q

Th-2 cytokines activate

A

B cells to plasma cells

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26
Q

2 types of B cells-

Conventional:

A

produce antibodies against bacteria, levels decrease in healthy and treated sites

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27
Q

Autoreactive:

A

produce auto-antibodies, levels do not decrease after treatment

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28
Q

Efficacy of B cell response

Avidity:

A

Ag-binding differs among antibody subclasses. Not all are capable of effective opsonization or complement activation.

29
Q

IgG2

A

chronic periodontitis, but IgG2 predominates in aggressive periodontitis.

30
Q

Antigen recognition:

A

IgG2 recognizes carbohydrate antigens (LPS), while other subclasses mainly recognize protein Ag

31
Q

Homing of relevant immune cells takes place within the

A

periodontal lesion.

32
Q

Th2 cells outnumber

A

Th1 cells in chronic periodontal lesions.

33
Q

Plasma cells are among the most predominant and active

A

secretory cells in advanced periodontal lesions.

34
Q

The ratio of IgG subclasses are similar in

A

serum and GCF.

35
Q

An individual’s ability to mount a specific

A

Ab response to bacteria in the subgingival biofilm may indicate a patient’s susceptibility to the disease and ability to respond to treatment.

36
Q

Stomadeal epithelium releases factors which initiate

A

epithelial-ectomesenchymal interactions.

37
Q

Dental lamina forms

A

Bud stage
Cap stage
Bell stage

38
Q

Ectomesenchyme condenses around

A

dental organ (DO)

39
Q

Forms dental follicle (DF)

Gives rise to

A

periodontium

Dental papilla determines shape and form of tooth

40
Q

Embryogenesis

A

Crown forms first
Outer and inner enamel epithelium proliferate apically
Hertwig’s epithelial root sheath(RS)
Odontoblasts (OB) form dentin
Inner cells of RS secrete enamel-related proteins (amelogenins)
RS fenestrates
Ectomesenchymal cells of follicle contact root surface
Amelogenin induces differentiation of these cells into cementoblast (**remember this for later)
Cementoid forms
Fibers of cementoid intermingle with immature dentinal fibres

41
Q

Limits of free (marginal) gingiva

Macroscopic

A

Extends from FGM to FGG

42
Q

Limits of free (marginal) gingiva

Microscopic

A

Extends from FGM to JE

43
Q

No MGJ on

A

palate

44
Q

Interdental papilla

Shape depends on

A

the contact relationships between adjacent teeth
width of approximal tooth surfaces
course of CEJ

45
Q

Col – central zone that curves down. Turns over VERY quickly.

A

Concavity seen in contact areas of premolar / molar region
Non-keratinized epithelium (similar to junctional epithelium), will stay this way as long as two teeth are in contact (protected from friction).

46
Q

Oral epithelium
Keratinized, stratified, squamous epithelium (keratinocytes).
Layers

A

1- basal layer (stratum basale or stratum germinativum)
2- prickle cell layer (stratum spinosum)
3- granular cell layer (stratum granulosum)
4- keratinized cell layer (stratum corneum)

47
Q

Orthokeratinized

A

(no nucleus)

48
Q

Parakeratinized

A

(nuclear remnants)

49
Q

From the basal layer to the
granular layer:
Cytoplasmic tonofilaments and
number of desmosomes

A

increase.

The number of organelles decreases.

50
Q

Cells of oral epithelium

A 
Keratinocytes (90%) 
Clear cells (arrows)
-melanocytes (synthesize melanin pigment)
-Langerhans cells (defense cells)**		
-Merkel’s cells (sensory
51
Q

Basement membrane

2 layers

A

Lamina lucida(LL) -adjacent to basal cells (400 A)
Lamina densa(LD)- adjacent to connective tissue
Hemidesmosomes(HD)- dense plaques that attach epithelium to the basement membrane.
Desmosomes: Pairs of hemidesmosomes

52
Q

Lamina densa(LD)-

A

adjacent to connective tissue

Anchoring fibers project from LD into connective tissue

53
Q

Microscopic anatomy of stippling

Boundary between

A 
OE and underlying CT: 
CT projects into epithelium CT papillae
epithelial ridges or rete pegs intervene
When rete pegs fuse it is seen as stippling
Rete pegs are missing at JE site.
54
Q

JE does not correspond to Free Gingival groove until

A

tooth reaches final position, and as person ages, this relationship stops (recession). NOTE: the above is an unerupted tooth.

55
Q

Differences between JE and OE

A

Size of the cells-JE>OE – means metabolically active.
Size of intercellular space- JE>OE – allows fluid and neutrophils to flow. GCF = gingival cravicular fluid
Number of desmosomes- JE

56
Q

Collagen

A

Characteristic cross-banding
Produced by fibroblasts, cementoblasts and osteoblasts
Most abundant

57
Q

Reticulin

A

Numerous adjacent to basement membrane

Around blood vessels

58
Q

Oxytalan

A

mostly in pdl
Run parallel to long axis of tooth
Keep things from collapsing

59
Q

Elastic

A

around blood vessels

60
Q

Fibroblasts-

A

aligned along principal fibres

61
Q

Osteoblasts-

A

line bone surface

62
Q

Cementoblasts-

A

line cemental surface

63
Q

Osteoclasts-

A

multinucleated, crete ruffled surface of bone
epithelial cells
nerve fibers

64
Q

epithelial cell rests of Mallassez:

A

remnants of the Hertwig’s epithelial root sheath.

65
Q

Cementum thickness increases by gradual apposition throughout life.

Cementum thickness in cervical portion of the root:

A

20-50 m

66
Q

Cementum thickness in apical portion of the root:

A

150-250 m

67
Q

Alveolar bone Consists of bone formed both by

cells from the

A

dental follicle

cells independent of tooth development.

68
Q

Alveolar bone

A 
Cancellous bone 
Cortical bone –hard flat bone
Bone marrow
adipocytes 
vascular structures 
undifferentiated mesenchymal cells
Remodels in response to forces and tooth movement

Perio Final (8 decks)

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