(3) Histology of periodontal Disease - Advanced Lesion

Question 1

Is this periodontitis?

Answer 1

Yes

Transition from gingivitis to periodontistis

Bone loss

Question 2

What location is the inflammation?

Answer 2

Extension of the inflammation into the supra-alveolar connective tissue

Periodontal ligament and alveolar bone

Question 3

Where does the destruction of the collagen fibres extend to?

Answer 3

Periodontal ligament

Question 4

What is the effect of the destruction of collagen fibres and the periodontal ligament

Answer 4

Lead to loss of attachment to the cementum and/or bone

Question 5

What happens once there is less of attachment of the periodontal ligament to cementum/bone?

Answer 5

Apical migration of the JE

Question 6

What type of pocket forms in the advanced lesion?

Answer 6

True pocket

Due to to bone loss and apical migration of the je

Question 7

Where do neutrophils infiltrate?

Answer 7

The Pocket

Question 8

Where do plasma cells infiltrate?

Answer 8

Connective tissue

Adaptive immune response

Question 9

What is the effect of ROS production?

Answer 9

Activate osteoclasts and resorption

Apoptosis of fibroblasts

Destruction of collagen fibres

= ulceration and destruction of tissues

Question 10

Why does inflammation not go away on its own?

Answer 10

The patient cannot remove the plaque themselves and need to be removed by a dentists

If it is above 3.5mm below the gingival margin

Question 11

Name structure A-C

Answer 11

A = dentin
B = cementum
C = enamel space

Question 12

What is noticeable about the JE here?

Answer 12

Passes the CEJ, apical along the root

And much thicker

Question 13

What shows the inflammatory infiltrate here?

Answer 13

The white lines show infiltrate

Question 14

Where do the immune cells lie?

Answer 14

All the dots adjacent to the sulcular and junctional epithelium

Question 15

What side is the deeper pocket on?

Answer 15

Left

Question 16

What bone is involved at the advanced lesion stage?

Answer 16

Alveolar Bone

Osteoclasts resorption of the bone

Question 17

Is there variation in pocket size for the same tooth?

Answer 17

Yes variation at different sites

Question 18

Where is the gingival margin/gun line in this histogram?

Answer 18

Question 19

What do the dark cells represent here?

Answer 19

Inflammatory cells

Question 20

Where is the plaque and calculus in this histogram?

Question 21

Where is the proliferative epithelium in this histogram?

Answer 21

Question 22

Does this show serve pockets?

Answer 22

Yes

Question 23

Does this how severe pockets?

Answer 23

Shows pockets but not too severe

Question 24

What are the 2 types of bone loss?

Answer 24

Vertical bone loss
Horizontal pattern of Bone loss

Question 25

What does vertical bone loss lead to?

Answer 25

Infra-bone pockets

Question 26

What does horizontal pattern of Bone loss lead to?

Answer 26

Supra-bony pockets

Question 27

What type of bone loss is shown here?

Answer 27

Supra-bony pocket Horizontal bone loss

Question 28

What type of bone loss is shown here?

Answer 28

Infra-bony pocket Vertical bone loss

Question 29

How do you measure loss of attachment?

Answer 29

Go from the cemento-enamel junction to the pocket floor (junctional epithelium)

Question 30

What type of pocket is shown here?

Answer 30

Supra-bony pocket

Question 31

Name A-E

Answer 31

Question 32

What do you call the gingiva between 2 teeth?

Answer 32

Interdental papilla

Question 33

What antibodies are present?

Answer 33

IgG IgA More IgM than the established lesion