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Perio Final > Sweep 2 > Flashcards

Sweep 2 Flashcards

1
Q

Most common breakdown enzyme

A

MMP - break down collagen.

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2
Q

Largest size implant

A

5mm - need 1mm all the way around with 2 mm on each side.

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3
Q

Localized CAL in

A

first molars/incisors (at least 1 first molar must be affected).
Distribution: no more than 2 teeth other than first molars and incisors are affected .

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4
Q

: AT least 3 permanent teeth other than

A

1st molars & incisors.

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5
Q

P gingivalis inhibits

A

Inibits IL-8: ↓ chemotaxis of PMNs

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6
Q

P gingivalis

A

Proteinases: Gingipains, Collagenases
LPS: activates cells to produce PGs, IL-1β, TNF-α

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7
Q

LAP host responses

A

Impaired neutrophil function (chemotaxis and phagocytosis.)
Significantly higher levels of prostaglandin E2 in GCF.
Antibody against A.a is extremely high(Levels in sulcus fluid higher than in peripheral blood)
High titers and high avidity of IgG2 in LAP.
Low levels of Ab against P.g in GAP patients .

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8
Q

Ascorbic acid-deficiency gingivitis

A

Malnourished individuals have a compromised host defense system which may make individuals susceptible to infectious diseases
The precise role of nutrition in periodontal diseases remains to be elucidated.
Human studies have failed to show a relationship between nutrition and periodontal diseases

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9
Q

Ehlers-Danlos syndrome (types IV & VIII)

autosomal ———– hereditary disorder

A

dominant

aggressive periodontitis (primary and permanent dentitions); fragility of gingiva, excessive hemorrhage

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10
Q

NPD advanced lesion

A

Lack of deep pockets
Merging of papillary and marginal involvement
Characteristic foetor
Central necrosis results in crater formation
Involvement of periodontal ligament and alveolar bone (NUG  NUP)

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11
Q

NUP

Involvement of palatal mucosa —->

A

necrotizing stomatitis

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12
Q

NUP

Involvement of

A

regional lymph nodes

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13
Q

Predictive Value Positive (PVP)

A

The probability of disease in a subject with a positive test result
PVP = Pr(D+/T+)

A/A+B (yes for positive/ yes+ yes for neg)

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14
Q

Predictive Value Negative (PVN)

A

The probability of not having the disease when the test is negative
PVN = Pr(D-/T-)

D/C+D (no/no+no for yes)

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15
Q

Thrush

A 
Candida albicans
Acquired during birth
Pseudomembranous / erosive lesions
Predisposing conditions
-Antibiotics  
-Immunosuppression
-Malnutrition
-HIV
-Diabetes
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16
Q

Lichen Planus

A 
Oral involvement alone is common.
Premalignant potential (0.5-2%).
Characteristic skin lesions (Wickham striae).
Varied clinical appearances.
Any area of the oral mucosa
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17
Q

Lichen planus

A

Subepithelial band-like accumulation of lymphocytes
characteristic of a type IV hypersensitivity reaction.
Fibrin in the basement membrane.
Deposits of IgM, C3, C4, and C5.

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18
Q

Pemphigoid

A

Autoantibody reactions against hemidesmosome and lamina lucida components.

Detachment of the epithelium from the connective tissue.
Complement-mediated cell destructive processes may be involved in the pathogenesis.

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19
Q

Pemphigus

Formation of ——– in skin and mucous membranes.
Strong genetic background (Jewish and Mediterranean)
Painful desquamative lesions, erosions or ulcerations.
Chronic course with recurrent bulla formation

A

intraepithelial bullae

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20
Q

Canthus layer- another name for

A

stratum spinosum

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21
Q

Acantholysis-breakdown of the

A

spinous bridges

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22
Q

Periapical cemental dysplasia:

A

Fibrous-osseous cemental lesions.
Tooth is usually vital.
Usually no symptoms.
Periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase.
Differential diagnosis: Cemento-ossifying fibroma and fibrous dysplasia.

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23
Q

Herpes zoster-

A

Latent in the dorsal root ganglion.

- Unilateral lesions.
- 2nd and 3rd branch of the trigeminal ganglion
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24
Q

Linear gingival erythema-

A
  • Distinct linear erythematous band limited to the free gingiva.
  • Lack of bleeding.
    Positive for C.albicans by culture:
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25
Q

Hereditary gingival fibromatosis-

Possible mechanism(s):

A

TGF-beta1 favor the accumulation of ECM.

May be located on chromosome 2 in human.

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26
Q

Lupus erythematosus-

A

Autoimmune connective tissue disorders in which autoantibodies form to various cellular constituents.
Central atrophic area with small white dots surrounded by irradiating fine white striae with a periphery of telangiectasia
(vascular lesion formed by dilatation of a group of small blood vessels).
Lesions can be ulcerated and cannot be differentiated from leukoplakia or atrophic oral lichen planus.
Together with characteristic skin lesions (butterfly).

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27
Q

Fibroma/ focal fibrous hyperplasia:

► Differential diagnosis:

A

Giant cell fibroma.

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28
Q

Often reddish and ulcerated reactive lesion
Fibrous proliferation in which bone- or cementum
like hard tissue is formed
► Highly cell-rich areas below ulcerated sites.

A

Calcified fibroblastic granuloma:

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29
Q

Calcified fibroblastic granuloma:

►Differential diagnosis:

A

Pyogenic granuloma

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30
Q

► Ulcerated (may resemble purulence).
► gingival margin.
► Reddish or bluish, sometimes lobulated, sessile or pedunculated. Bleeding is common.
► Highly vascular with chronic inflammatory cells.

A

Pyogenic granuloma:

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31
Q

Pyogenic granuloma:

► Differential diagnosis:

A

Pregnancy tumor.

32
Q

Anywhere on the gingival mucosa.
- Pedunculated (has a stalk), sessile (broad base),
red or purple, commonly ulcerated.
- Focal collection of multi-nucleated osteoclast-like
giant cells with a richly cellular and vascular stroma separated by collageneous septa.
- Probably originated from periodontal ligament.

A

Peripheral giant cell granuloma

33
Q

Peripheral giant cell granuloma

Differential diagnosis:

A

focal fibrous hyperplasia.

34
Q

► Fibrous-osseous cemental lesions.
► Tooth is usually vital.
► Usually no symptoms.
► Periapical bone is replaced by cellular fibroblastic tissue through a cementoblastic phase.

A

Periapical cemental dysplasia:

35
Q

Periapical cemental dysplasia:

Differentialdiagnosis:

A

Cemento-ossifying fibroma and fibrous dysplasia.

36
Q
  • Rather frequent tumors of oral mucosa.
  • Flat or raised, sometimes lobulated, soft lesions of blue to red color.
  • Asymptomatic but may bleed. - They blanch on pressure.
  • Capillary and cavernous types.
A

Hemangioma-

37
Q

Hemangioma-

Differential diagnosis:

A

Mucous cysts, pyogenic granuloma.

38
Q

► Pigmented lesion containing melanocytes in CT. ► rare in the oral mucosa, mostly seen in palate. ► Flat, slightly raised lesions or a tumor.
► Brown or black or no pigmentation.
► Nevocellular or brown nevus located along the basal layer of epithelium.

A

Nevus:

39
Q

Nevus: Diff diagnosis:

A

Amalgam tattoo

40
Q

► Four or five different types of papilloma are present.
► Exophytic, pedunculated or sessile lesions. Reddish/normal or whitish/gray color.
► A granular/moruloid or filiform/digitated surface. ► Human Papilloma Virus is commonly found.

A

Papilloma:

41
Q
  • Is less common in oral mucosa compared to skin.
  • Lips and palate are main locations.
  • Sessile, exophytic or raised lesion with a whitish surface. - Papillomatous surface with hyperkeratinization
    and elongated rete ridges.
  • Associated with HPV type 2 and 4.
A

Verruca vulgaris (one type of papilloma):

42
Q

► Non-ulcerated sessile or pedunculated gingival lesions.
► Generally detected in the soft tissue around unerupted
teeth.
► Histopathology is similar to intraosseous forms of the tumors.

A

Peripheral odontogenic tumors:

43
Q

► Derived from odontogenic epithelium. ► Well-circumscribed radiolucency

A

Ameloblastoma:

44
Q

► Derived from pdl, presumably from epithelial rests of Malassez.
► Often associated with lateral root surface. ► Rarely seen.

A

Squamous odontogenic tumor:

45
Q

► Slow-growing neoplasm forming hard tissue around the apex of a tooth.
► Radiopacity typically surrounded by a radiolucent margin.

A

Benign cementoblastoma:

46
Q

Metastasis to the gingiva:
► The majority are ———–.
► Soft tissue metastasis from lung cancer.
► Most of the metastasis cases are ——— and not ———-.

A

intraosseous

carcinoma

sarcoma

47
Q

► Skin lesion followed by oral lesions.
► Gingiva is the second mostly detected site after
palate.
► Re-occurrence with AIDS.

A

Kaposi’s sarcoma:

48
Q

► Widening of pdl is common with

A

Osteosarcoma

49
Q

Induces bacterial lysis
Promotes phagocyte recruitment (chemotaxis)
Promotes phagocytosis by opsonization of bacteria
Helps activate mast cells, which increases vascular permeability

A

Complement system

50
Q

Major role in induction of innate immune response
Recognize conserved microbial-associated molecular patterns (including LPS, lipoteichoic acid and flagellae)
Expressed by all cells, including epithelial cells, PMNs, monocytes and macrophages
——- signal for cells to produce cytokines, chemokines, antimicrobial peptides, nitric oxide and eicosanoids

A

TLRs

51
Q

Prostaglandins (especially PGE2) induce

A

vasodilation and cytokine production

52
Q

PGE2 induces

A

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

53
Q

Innate immunity:

A

inherent biological responses – many different, all capable and all nonspecific

54
Q

Adaptive or acquired immunity:

A

based on recognition of antigens, immune memory and clonal expansion

55
Q

2 types of B cells-

A

Conventional: produce antibodies against bacteria, levels decrease in healthy and treated sites
Autoreactive: produce auto-antibodies, levels do not decrease after treatment

56
Q

Avidity:

A

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

57
Q

IgG2

A

IgG2 predominates in aggressive periodontitis.

Disease due to less effective antibody?

58
Q

Antigen recognition:

A

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

59
Q

Resorption at the cortical bone.
Woven bone formation in the spongious bone.
Blood clot formation.
Proliferation of vascular structures into newly
forming granulation tissue.

A

24 hours

60
Q

Reparative macrophage and undifferentiated
mesenchymal cells.
Modeling at the apical trabecular region and
at the “furcation sites” of a screw-shaped
implant.

A

1 week-

61
Q

New bone formation can be detected at

the “furcation sites” of the implant surface

A

2 weeks –

62
Q

Callus formation and lamellar

compaction within woven bone.

A

Up to 6 weeks –

63
Q

An implant should be surrounded with a minimum of

—— alveolar bone thickness.

A

1 mm

64
Q

Minimum bone thickness between 2 implants should
be ——-(implant surface to implant surface) and
minimum bone thickness between an implant and
a tooth should be ——- (from root surface to implant
surface).
Coronal part of an implant should be placed
approximately ——— apical to the adjacent CEJ

A

3 mm

4 mm

5 mm

65
Q

A biological width exists around unloaded and loaded
nonsubmerged one-part titanium implants.
It is approximately ——–

A

3 mm.

66
Q

RFA (Resonance Frequency Analysis)

A

Mechanically, the resonance frequency of an object

is strongly correlated to the boundary constrains of the structure.

67
Q 
Lamina lucida(LL) -adjacent to ------ (400 A)
Lamina densa(LD)- adjacent to ------
A

basal cells

connective tissue

68
Q

– Reticulin

A
  • Numerous adjacent to basement membrane

* Around blood vessels

69
Q

Oxytalan

A
  • mostly in pdl

* Run parallel to long axis of tooth

70
Q

The dental tissue that most closely resembles bone is

A

cementum

71
Q

Epithelial cells – need to guide the tissue. ——— – done with stem cells)

A

GTR (guided tissue regen.

72
Q

Lactose (increase lactose,

A

decrease in co-adhesion)

73
Q

S. sanguis is found in large numbers in deep, active
periodontal pockets. Thorough scaling and root planing
of a deep periodontal pocket will most likely result in
increased numbers of A. actinomycetemcomitans.

A

false, false

74
Q

Facultative species, Can live w/ or w/o O2

Uses up O2 when available

A

Streptococcus cristatus

75
Q

Robust anaerobe

Binding to strep improves survival when O2 is present

A

Fusobacterium nucleatum

76
Q

Microaerophilic, obligate anaerobe

Coaggregation essential to survival when O2 is present

A

Porphyromonas gingivalis

Perio Final (8 decks)

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