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Periodontics > Periodontitis as a Manifestation of a Systemic Disease > Flashcards

Periodontitis as a Manifestation of a Systemic Disease Flashcards

1
Q

periodontitis as a manifestation of a systemic disease

A

“Diseases and conditions
that can affect the
periodontal tissues by
influencing the course
of periodontitis.

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2
Q

Major impact

A

Severe/early-onset
periodontitis

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3
Q

Moderate impact
(2)

A

Increase prevalence
No otherwise different
clinical presentations of
chronic periodontitis

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4
Q

Systemic disorders
Loss of
periodontal
tissue
Influence (2)

A

Influence periodontal inflammation
Influence the pathogenesis of periodontal diseases

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5
Q

Influence periodontal inflammation
(3)

A

Genetic Disorders
Acquired Immunodeficiency Diseases
Inflammatory Diseases

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6
Q

Genetic Disorders
(4)

A

Diseases associated with immunologic disorders
Diseases affecting the oral mucosa and gingival tissue
Diseases affecting the connective tissues
Metabolic and endocrine disorders

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7
Q

Down Syndrome
(5)

A

Trisomy 21 or mongolism
Characteristic physical appearance
Mental deficiency and growth retardation
Moderate to severe periodontitis with rapid progression
Local factors alone failed to explain the severity of
periodontal destruction

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8
Q

Down Syndrome
Predispose to infections:

A

intrinsic immune system defects Poor PMN chemotaxis, phagocytosis, intracellular killing

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9
Q

Leukocyte Adhesion
Deficiency
(2)

A

Mutation in beta-2 integrin (ITGB2) gene Lack of
Neutrophils are confined to blood vessels and
absent from the periodontium

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10
Q

skipped
Mutation in beta-2 integrin (ITGB2) gene
(2)

A

Lack of beta-2 integrin mRNA in leukocytes
Low integrin (CD18 or CD15) expression on neutrophils

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11
Q

Neutrophils are confined to blood vessels and
absent from the periodontium
(4)

A

Leukocytosis is common
History of severe recurrent infection but no pus
Disruption of neutrophil-associated homeostasis
Lack of neutrophil immune surveillance

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12
Q

Leukocyte Adhesion
Deficiency
dental (3)

A

Severe gingival inflammation, acute gingival lesions
Early-onset and rapidly progressive alveolar bone loss
Early loss of the primary and permanent teeth

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13
Q

Papillon–Lefèvre
Syndrome
(3)

A

Mutations in the cathepsin C gene (CTSC)
Compromised neutrophil function, not the quantity
Hyperkeratotic lesions

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14
Q

Mutations in the cathepsin C gene (CTSC)

A

Chromosome 11q14

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15
Q

Compromised neutrophil function, not the quantity

A

Decreased phagocytosis (Rathi, 2002)

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16
Q

Hyperkeratotic lesions

A

Palms, soles of the feet, elbows, knees

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17
Q

Papillon–Lefèvre
Syndrome
dental (3)

A

Severe gingival inflammation, pocket formation
Early-onset and rapidly progressive alveolar bone loss
Early loss of the primary and permanent teeth

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18
Q

Chediak-Higashi
Syndrome
(4)

A

Mutations in CHS1, LYST gene
Partial oculocutaneous albinism
Recurrent pyogenic infections
Varying neurologic problems

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19
Q

Mutations in CHS1, LYST gene

A

Lysosomal trafficking defect

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20
Q

Partial oculocutaneous albinism

A

Defects in melanin granules

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21
Q

Recurrent pyogenic infections

A

Circulating leukocytes exhibit defective lysosomes
Decrease in phagocytosis

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22
Q

Varying neurologic problems

A

Intellectual deficit and dementia

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23
Q

Chediak-Higashi
Syndrome
dental (4)

A

Severe gingival inflammation
Early-onset and rapidly progressive alveolar bone loss
Early loss of the primary and permanent teeth
Poor response to dental treatment

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24
Q

Congenital Neutropenia
(3)

A

Mutations in the ELANE (50%), HAX1(10%) gene
Decrease in number of neutrophils
Deficiency in the immune response

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25
Q

Mutations in the ELANE (50%), HAX1(10%) gene

A

1/3 causes remain unknown

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26
Q

Decrease in number of neutrophils

A

ANC < 500 cell/uL and static

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27
Q

Deficiency in the immune response

A

Severe and recurrent infections

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28
Q

Congenital Neutropenia
dental
(3)

A

Severe periodontitis is common
Higher risk for tooth loss
Oral ulcerations

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29
Q

Epidermolysis Bullosa
Kindler syndrome
(3)

A

Mutation in the fermitin family homologue 1 gene (kindlin-1; FERMT1)
Photosensitivity
Recurrent blister formation

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30
Q

Kindler syndrome
Mutation in the fermitin family homologue 1 gene (kindlin-1; FERMT1)
(3)

A

Imparied keratinocyte cell adhesion
Molecular defects in basement membrane zone
Reduced resistance at the junctional epithelium

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31
Q

Epidermolysis Bullosa
Kindler syndrome
dental (3)

A

Oral blisters formation
Severe periodontitis
Need immunofluorescence to confirm diagnosis

32
Q

Severe periodontitis

A

Alveolar bone loss that progress rapidly

33
Q

Need immunofluorescence to confirm diagnosis

A

Skin biopsy of an included blister

34
Q

Ehlers-Danlos Syndrome
(3)

A

Mutations in genes encoding fibrillar collagens or
enzymes involve in the biosynthesis of these proteins
Affecting collagen production and composition
Joint hypermobility, skin extensibility, and tissue fragility

35
Q

Affecting collagen production and composition Mainly involves

A

joint, skins and walls of the blood vessels

36
Q

Ehlers-Danlos Syndrome
EDS type VIII have

A

gingival recession and generalized
severe periodontitis that often leads to loss of all teeth.

37
Q

EDS type IV and, to a lesser extent, in EDS type I may
also demonstrate the

A

periodontitis as oral manifestation

38
Q

Ehlers-Danlos Syndrome
dental (2)

A

Generalized, early-onset severe periodontitis and
gingival recession
Early loss of the primary and permanent teeth

39
Q

Hypophosphatasia
(3)

A

Alcaline phosphatase (ALPL) gene mutation
Mild form and severe form
Dentin is not affected with defective cementum

40
Q

Hypophosphatasia
dental
(3)

A

Impaired bone/tooth mineralization
Defects in root cementum
Alveolar bone loss and premature loss of teeth

41
Q

Defects in root cementum
(2)

A

Compromised periodontal attachment, reduction in alveolar bone height
The teeth are not adequately anchored to the alveolar bone via the PDL

42
Q

Osteoporosis

A

Postmenopausal women with osteoporosis or osteopenia
exhibit greater loss of periodontal attachment compared
with women with normal bone mineral density.

43
Q

Osteoporosis

A

Estrogen withdrawal
Increased bone turnover
Net systemic bone loss
Decrease in bone mineral density
Weaken bone microarchitecture
High risk of bone fracture

44
Q

Periodontitis

A

Bacterial infection
Local inflammatory insult
Initial cortical bone compromise
Bone loss

45
Q

Shared Risk Factors

A

Age, vitamin D and calcium deficiency, and smoking

46
Q

Osteoporosis, Periodontitis
Homeostasis
Both are bone resorptive diseases
Higher prevalence and severity of

A

radiographic alveolar bone loss
No clear association with probing depth or clinical attachment loss

47
Q

Diabetes Mellitus
(3)

A

An important risk factor for periodontal diseases
Associated with significantly higher prevalence and
severity of periodontitis.
A disorder of glucose metabolism

48
Q

Diabetes Mellitus
Chronic status of

A

elevated blood glucose level
Accumulation of AGEs AGEs - RAGE (Receptor of AGEs) interaction

49
Q

Diabetes Mellitus
dental (2)

A

Diabetes as a risk factor for periodontal disease
Periodontal abscess may be a common complication

50
Q

Diabetes as a risk factor for periodontal disease

A

Increased prevalence and severity of attachment loss

51
Q

Periodontal abscess may be a common complication 58.6% of patients having periodontal abscesses had HbA1c ≥

A

6.5%

52
Q

Diabetes Mellitus
Periodontal disease as a complicating factor for

A

Diabetes
Periodontitis ALSO affects glycemic control

53
Q

Diabetes Mellitus
Monitor

A

fasting plasma glucose level and HBA1c

54
Q

Obesity
(3)

A

Metabolic syndrome:
Adipose tissue is a complex organ secrets numerous
endocrine mediators
Rather than the amount of fat mass, adipose tissue
dysfunction may be the key factor in
pathophysiology

55
Q

Metabolic syndrome: (4)

A

Hypertension, Hyperglycemia,
Obesity, and dyslipidemia

56
Q

Rather than the amount of fat mass, adipose tissue
dysfunction may be the key factor in
pathophysiology
(4)

A

Cross-talk between T cells and adipose tissue
Increased releasing myriad proinflammatory cytokines and chemokines
Decreased phagocytic activity
Impaired antigen presentation

57
Q

Acquired
Immunodeficiency
Diseases (2)

A

Acquired neutropenia
HIV infection

58
Q

Inflammatory Diseases
(3)

A

Epidermolysis bullosa acquisita
Inflammatory bowel disease
Reumatoid arthritis

59
Q

Epidermolysis Bullosa
Acquisita
(4)

A

The presence of autoantibodies against type VII collagen
Recurrent blister formation
Generalized gingival inflammation and enlargement, gingival
recession, alveolar bone loss, and mobile teeth
Immunofluorescence on basement membrane zone - split skin

60
Q

Epidermolysis Bullosa
AcquisitaThe presence of autoantibodies against type VII collagen
(2)

A

Mechanobullous type
Inflammatory form (mimic pemphigoid)

61
Q

Inflammatory Bowel
Disease
dental (3)

A

Hypersensitivity of immune response
Inflammation and alveolar bone loss in a susceptible host
Increased prevalence and severity of periodontitis

62
Q

Rheumatoid Arthritis
(3)

A

Chronic auto-inflammatory disease
Increased risk for loss of periodontal attachment, alveolar bone
Biological link between rheumatoid arthritis and periodontitis

63
Q

Influence the pathogenesis of periodontal diseases
(3)

A

Stress/depression
Smoking
Medications for malignancies, anti-inflammatory agents, bisphosphonates

64
Q

Smoking
(2)

A

Chronic nicotine exposure
Immunosuppression

65
Q

Chronic nicotine exposure
(2)

A

Impairment of antigen-mediated T cell signaling
Inhibits antibody-forming cell response

66
Q

Immunosuppression
(1)

A

The inflammation in response to plaque accumulation is reduced

67
Q

Bisphosphonates
(3)

A

Treat cancer (IV administration)
Treat osteoporosis (oral administration)
Inhibit osteoclast activity and interfere with bone turnover

68
Q

Bisphosphonates
Not currently used to prevent
further

A

alveolar bone loss

69
Q

Independent etiology
Neoplasms
Other disorders

A

langerhans cell histiocytosis, giant cell granuloma,
hyperparathyroidism, systemic sclerosis

70
Q

Neoplasms
(2)

A

Neoplastic diseases of periodontal tissue
Secondary metastatic neoplasms of periodontal tissue

71
Q

Neoplastic diseases of periodontal tissue
(3)

A

Oral squamous cell carcinoma
Odontogenic tumors
Other primary neoplasms of periodontal tissue

72
Q

Other Disorders Langerhans cell histiocytosis
(4)

A

Peripheral small vessel necrotizing vasculitis
Respiratory and renal impairment
Characteristic fiery and hyperplastic gingival inflammation
Alveolar bone loss

73
Q

Other Disorders Giant cell granuloma
(2)

A

Reactive proliferation, benign lesion
No systemic features

74
Q

Peripheral giant cell granuloma
(2)

A

*Expanding epulis-like gingival swelling
*Occasional loss of periodontal
supporting tissue

75
Q

Central giant cell granuloma
(2)

A

*Loss of periodontal supporting tissue
*May expand toward marginal
periodontal tissue

76
Q

Other Disorders Hyperparathyroidism
Primary :
Secondary:
Tertiary:

A

benign adenoma of parathyroid glands
result of hypercalcemia
parathyroid hypertrophy following 2o type

77
Q

Other Disorders
Systemic sclerosis
(scleroderma)
(3)

A

Autoimmune disease of the connective tissues
Many different systemic presentations
Widening PDL and higher prevalence of periodontitis

Periodontics (13 decks)

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