Test 4 Flashcards
Undermines the enamel and can eventually involve the pulp, causing pulpal necrosis if left unchecked, is what dental disease
dental caries
where do dental caries form
anywhere plaque forms
term for the subjective symptom of dryness in the mouth, which may be associated with a change in the composition of saliva or reduced salivary flow
xerostomia
layer remains almost unaffected, intact and in place for some time: important feature of
early enamel lesion is which zone of enamel caries 1-5% mineral loss
Surface zone
Largest area, region in which bulk of mineral is lost 5-20% mineral loss
body of the lesion
Appears as band on deep aspect of the body, Dense, brown opaque zone in which little structure can be seen, is which zone of enamel caries, Mineral loss of 2-4%
Dark Zone
First recognizable alterations in enamel structure observable by light microscopy: large pores created by demineralization at the prism junctures and at cross striations
Translucent Zone
No evidence of decalcification clinically or radiographically, consistent of translucent zone is which stage
stage 1
Still clinically and radiographically undetectable
Developing dark zone located centrally is which stage
stage 2
Breakdown in the center of the dark zone Formation of body of lesion
Clinically appears as a white spot is which stage
stage 3
Beginning of dentin involvement, Increase in size of lesion body is which stage
stage 4
Earliest stages of cavity formation Dentin involvement Remineralization of the defect is unlikely at this point, is which stage
stage 5
Clinical cavity formation is which stage
stage 6
First change seen histologically is the for smooth surface caries is
loss of inter-rod substance of enamel with increased prominence of the rods.
accentuated incremental lines of Retzius as seen when
smooth surface caries are beginning to form
Describe the shape of the enamel lesion on smooth surfaces
is cone-shaped, with the apex towards DEJ and base towards the tooth surface.
what type of caries begin with decalcification of enamel
pit and fissure
Caries follows the direction of what in pit and fissure caries
enamel rods
pit and fissure caries frequently involve what because the enamel is very thin
dentin
describe the shape of pit and fissure caries
it has a triangular shape, with its base toward the DEJ and the apex facing the surface of the tooth
Greater number of dentinal tubules are affected when lesion reaches DEJ, so there is greater cavitation than the smooth surface caries with more undermining of enamel. True or false
True
manage non-cavitated caries non-invasively via remineralization is what
the goal of modern dentistry
management of non-cavitated caries non-invasively is done how
by calcium and phosphate ions being supplied from external sources
Probably plays a special role as a precursor to bioapatite and as a transient phase in biomineralization, Approved use as abrasive prophylaxis pastes and for treatment of tooth
sensitivity is what
Recaldent
Involves filling and reinforcing the pore system of a noncavitated white spot, or incipient proximal lesions, with a light-curable resin. is seen in what tooth reparative drug
Icon
Caries infiltration works by capillary action, whereas sealants only cover incipient caries lesions at the surface of the tooth. T/F
TRUE
In early stages of caries, surface enamel may still be intact, but there is increased permeability of enamel to acid and other chemical stimuli, is seen in what type of caries
dentin caries
In response to low level stimulation of odontoblasts, there is formation of what? which is seen as a glossy transparent appearance
sclerotic dentin
If dentin is damaged the odontoblastic processes retract or die leaving empty dentinal tubules which form areas of
dead tracts
Dead tracts become filled with mineral and are called
blind tracts
which forms faster secondary or tertiary dentin
tertiary
which dentin is regarded as an important defense mechanism of the pulp-dentin complex in response to either pathological or physiological insults
tertiary
as caries reach dentin how do they spread
laterally along the DEJ
during dentin cavities Dentin is involved before breakdown or cavitation of the
enamel surface True or false
True
what act as paths for bacteria leading to the pulp
dentin tubules
Bacteria proliferate and form colonies that dilate the tubules called
liquefaction foci
Invading bacteria secrete a large amounts of what into the fluid in dentinal tubules
hydrolytic enzymes
may play a role in destruction of dentin organic matrix following demineralization by bacterial acids.
MMPs
which MMPs are involved in dentin caries/dentin caries
Collagenases Gelatinases Stromelysin
Acids demineralize the tissue and bacterial and host enzymes destroy the
collagen matrix
caries progression is slower in what and faster in what
slower in enamel and faster in dentin
The destruction of dentin can occur by what two mechanisms
decalcification and proteolysis
decalcification and proteolysis lead to dentin becoming of what consistency
necrotic mass of dentin of a leathery consistency.
the reason dentin when removed comes out in layers is due to the formation of what in dentin, spaces or gaps in carious dentin
clefts
zone of fatty degeneration, next to pulp
zone 1
Zone of dentinal sclerosis (protective)
zone 2
Zone of decalcification of dentin
zone 3
Zone of bacterial invasion
zone 4
Zone of decomposed dentin due to acids and enzymes.
zone 5
soft, progressive lesion found anywhere on the root surface that has lost its connective tissue attachment and is exposed to the environment. is what type of caries
root caries
lactobacillus and actinomyces are involved in what type of caries
root caries
what are essential for the cause and progression of the lesion,
plaque and micro organisms
Bacteria invade the cementum either along what or what
Sharpey’s fibers or between the bundles of fibers.
Root surfaces have greater what uptake than
enamel
flouride
what is the most cariogenic dietary constituent because it is fermentable and serves as a substrate for bacterial synthesis of extracellular (EPS) and intracellular (IPS) polysaccharides in dental plaque
sucrose
what does sucrose fermentation cause
low pH
Cariogenic flora is predominated by
Streptococcus mutans
what promotes bacterial adherence to tooth and contributes to the structural integrity of the biofilm
extracellular polysaccharides
what are the three products of neutrophils
lactoferrin, lactoperoxidase, lysozyme
what is a critical nutrient for periodontal pathogens
iron
what is a chronic inflammation disease of oral cavity
periodontitis
what is one of the transferrin proteins that transfer iron to the cells and control the level of free iron in the blood and external secretions
lactoferrin
what bacteria use free iron
porphyromonas gingivalis
Binds to iron (competition with bacteria for a required growth factor)
lactoferrin
Catalyzes the oxidation of thiocyanate ion (SCN-) and hydrogen peroxide
lactoperoxidase
which neutrophil product can be bactericidal
lactoperoxidase
Prevents the accumulation of lysine and glutamic acid required for bacterial growth
lactoperoxidase
Hydrolytic enzyme that cleaves the linkage between structural components of cell wall
lysozyme
hydrolyzing beta 1-4 glucosidic linkages between N-acetylmuramic and N- acetylglucosamine peptidoglycan
lysozyme
which neutrophil is effective against gram positive and gram negative bacteria
lysozyme
what functions in lubrication, buffers bicarbonate and phosphate and has Antibacterial action containing sIgA, lysozyme, lactoferrin
saliva
what are common mucins in saliva
MG1 and MG2
viscoelastic properties that aid in mastication and swallowing of food bolus
MG1 and MG2 Mucins
high molecular weight glycoproteins found in saliva
mucins
can bind calcium and have a high affinity for hydroxyapetite and compose part of the acquired enamel pellicle
Proline rich proteins
Neutral pH (7) is not conducive to the growth of ‘aciduric’ what type of bacteria
Streptococcus mutans
family of small basic peptides that display bactericidal and fungicidal activity
histatins
what is an example of a bacteria histatins combat
candida albicans
histatins does what for the host
provides protection
what are the main immunoglobulins that function in salivary antibodies
IgG, IgA, IgM
what antibody is more prevalent in gingival crevicular fluid (GCF)-serum
IgG
What is a secretory antibody that is synthesized in the salivary glands
IgA
what antibody is most common in serum
IgG
due to modified structure it is more resistant to bacterial proteolytic enzymes
sIgA
what component of sIgA facilitates transport into secretions and protects it against proteolytic attack
secretory
what is most common in saliva
sIgA
what is predominant Ig in seromucous secretions including saliva, colostrum, milk, and tracheobronchial and genitourinary secretions
sIgA
Bacteria found in saliva are coated with sIgA promoting phagocytosis True or false
True
which antibody Inhibit attachment of oral Streptoccocus species to epithelial cells
sIgA
Impair the ability of bacteria to attach to mucosal or dental surfaces
sIgA
is a protein film that forms on the surface enamel by selective binding of glycoproteins from saliva that prevents continuous deposition of salivary calcium phosphate
dental pellicle
what is also protective to the tooth from the acids produced by oral microorganisms after consuming the available carbohydrates.
dental pellicle
Strep and Actinomyces possess what that bind to pellicle glycoproteins
lectins
what are carbohydrate binding proteins
lectins
what is another function of MG2
bind to early colonizing bacteria leading to additional bacterial interaction, growth and maturation
Microbial succession evolves depending upon what two things
available nutrients and the formation of extracellular and intracellular polysaccharides
which mutans has acid tolerance and can thrive in acidic environment
streptococcus mutans
enzyme utilized to metabolize sucrose and maintain low pH
glucosyl transferase
if you boost igA what else is boosted
immunotherapy
Utilize which immune system for route of vaccine immunization
secretory immune system
the STAMP caries vaccine stands for
specifically targeted antimicrobial peptides
what are two parts of STAMP
a specific homing sequence for targeting specific bacteria, and a anti microbial bomb to kill bacteria on delivery
what helps Porphyromonas gingivalis to adhere to RBC and to evade host response by degrading Ig and impairing neutrophil function
gingipains
what is main defense against caries
fluoride treatment
what is major issue with periodontal disease vaccine
there are many different organisms to attack
In the progression of dental caries, the most superficial zone of enamel demineralization consisting of unaffected and usually intact enamel
stage/zone 4
◦ Erythritol ◦ Sorbitol (sorbit_ ◦ Mannitol (mannit) ◦ Xylitol (xylit) ◦ Maltitol ◦ Lactitol
What are these
sugar alcohols
which sugar alcohol is not metabolized to acids by flora, Non-cariogenic
xylitol
what is not fermented by any bacteria in the oral cavity
xylitol
what is an advantage to polyols
they do not promote tooth decay
Incomplete absorption of large amounts of polyols(sugar alcohols) consumed at one time may cause what effects, give example
GI tracts such as flatulence and diarrhea
what is the recommended daily amount of sugar
7.5-9 teaspoons
The most important goal of preventive dentistry is to reduce the consumption of
sweet products to a minimum.
enamel demineralization occurs at what pH
5.5
Dental plaque must be about_____ ____ old before the acid formation in response to sucrose is sufficient to cause enamel demineralization.
two days
