5. Periodontal Pathogenesis

Question 1

5

Inflammation is linked to most chronic diseases of ____ and _______.

Question 2

9

What is the etiologic role of bacterial plaque in periodontitis?

Question 3

10

What determines susceptibility to periodontal disease?

Question 4

10

What is the paradox with the role of inflammation that is seen in clinical manifestations of periodontitis?

Question 5

11

Is periodontal disease caused by a single organism?

Question 6

11

Is the bacteria that colonizes the subgingival sulcus found inside or outside the body?

Question 7

12

What are 3 types of cells that are seen in clinically healthy gingiva that have protective features?

Question 8

12

In clincially healthy gingiva, there is a steady state between ______ and _____.

Question 9

14

The initial lesion develops within ______ of plaque accumulation and corresponds to __________.

Question 10

14

The initital lesion shows slightly _____ vascular permeability.

Question 11

14

What are two protective features that are starting to go to work when the initial lesion develops?

Question 12

15

What does the early lesion correspond to?

Question 13

15

What three things increase in the early lesion?

Question 14

15

What two cells will be active when the early lesions develops?

Question 15

15

Where does collagen destruction occur with the early lesion?

Question 16

15

What percent of collagen destruction occurs in the early lesion?

Question 17

15

What epithelium is proliferating during the early lesion?

Question 18

16

What does the established lesion correspond to?

Question 19

16

What are three cells involved in the established lesion?

Question 20

16

There is elevated release of ____ and ______ from PMNs in the established lesion.

Question 21

17

The advanced lesion corresponds to ______.

Question 22

17

What are two cells involved in the advanced lesion?

Question 23

17

What does the JE do in the advanced lesion?

Question 24

17

In the advanced lesion, where does the collagen destruction extend into?

Question 25

18 What does the majority of tissue destruction result from in periodontitis and what drives and perpetuates that inflammation?

Question 26

19 What are the two components of LPS?

Question 27

19 Where is LPS found in gram negative bacteria?

Question 28

19 What kind of toxin is LPS?

Question 29

19 What receptor recognizes LPS?

Question 30

19 What is the TLR receptor that recognizes microbe-associated molecular patterns (MAMPs) and is found on innate immune cells like macrophages and dendritic cells?

Question 31

20 ________ has an atypical LPS that is recognized by both _____ and ______.

Question 32

21 What are the two host responses to LPS?

Question 33

22 Does lipotechoic acid (LTA) stimulate the immune response more or less potently than the LPS?

Question 34

22 What is LTA a component of?

Question 35

22 What receptor recognizes LTA?

Question 36

23 What are 3 bacterial enzymes and noxious products that act as microbial virulence factors?

Question 37

24 What is a bacterial enzyme produced by P. gingivalis?

Question 38

25 What two bacteria invade gingival epithelium and connective tissue?

Question 39

25 What bacteria invades oral epithelial cells?

Question 40

25 Is bacteria in tissue removed by scaling and root planing?

Question 41

26 What are three host-derived inflammatory mediators?

Question 42

28 Which cytokine is elevated in gingivitis and periodontitis, correlates with diseases severity, and exacerbates inflammation and bone resorption?

Question 43

28 What three molecules does IL-1B stimulate the production of?

Question 44

28 IL-1B is mainly produced by what three molecules?

Question 45

28 What two cytokines is IL-6 stimulated by?

Question 46

28 Which cytokine is produced by T cells, B cells, macrophages, dendritic cells, fibroblasts, and osteoblasts?

Question 47

28 What two things does IL-6 stimulate?

Question 48

29 What cytokine is secreted by macrophages in response to LPS?

Question 49

29 What does TNF-a stimulate development of?

Question 50

29 TNF-a causes apoptosis of what cells?

Question 51

29 TNF-a causes upregulation of what?

Question 52

30 What are prostaglandins derived from?

Question 53

30 What two things metabolize arachidonic acid?

Question 54

30 Is PGE-2 a vasodilator or constrictor?

Question 55

30 What 3 things does PGE2 stimulate?

Question 56

30 PGE2 is produced by what two things?

Question 57

30 What inhibits PGE2?

Question 58

31 MMPs are a family of proteolytic enzymes that degrade what three things?

Question 59

31 MMP-8 and MMP-9 are produced by PMNs. What do these two enzymes degrade?

Question 60

31 What cell produces MMP-1?

Question 61

32 What two things inhibit MMPs?

Question 62

32 What are three cells that produce tissue inhibitor of metalloproteinases (TIMP)?

Question 63

33 How far from bone must inflammatory mediators be to stimulate bone resorption?

Question 64

34 What are the relative levels of RANKL and OPG with sites that have active periodontitis?

Question 65

34 What prevents binding of RANKL to RANK?

Question 66

35 What are three cells that resolve inflammation?

Question 67

35 Protectins are produced by what fatty acids?

Question 68

36 What are the two anti-inflammatory cytokines?

Question 69

38 Is the innate immune response improved as a result of previous exposure to pathogen in perio?

Question 70

40 Peripheral dendritic cells reside in the _____ and ingest antigen and transport it to the ______.

Question 71

40 What is the difference between monocytes and macrophages?

Question 72

40 What two cells orchestrate the chronic immune response?

Question 73

41 NK cells recognizes changes in which MHC class?

Question 74

43 Which lymphocyte is involved in stable (not progressing) periodontitis?

Question 75

43 What 2 adaptive immune cells are involved in active periodontits?

Question 76

45 CD4+ T cells help the immune response by providing proliferation and differentiation signals through ________.

Question 77

45 TH1 secretes _____ and activates ______.

Question 78

45 TH2 secretes what three cytokines?

Question 79

45 What type of immunity does TH2 regulate?

Question 80

47 B cells express ___ in the BCR before exposure to antigen.

Question 81

47 What do B cells differentiate to form in the absence of T cells?

Question 82

47 What do B cells differentiate into in the presence of T cells?

Question 83

47 Memory B cells give rise to plasma cells that secrete what three antibodies?

Question 84

49 What class of MHC do antigen presenting cells express?

Question 85

50 Complement is produced in the _____ and by ______.

Question 86

50 Complement enables leukocytes to recognize and bind foreign substances for which they _______.

Question 87

51 What is the name for the complement intracellular effector system?

Question 88

52 What complement component increases vascular permeability and dilation?

Question 89

52 What are the two complement components that are anaphylotoxins that induce mast cell secretion and chemotaxins that attract leukocytes?

Question 90

52 What complement component is involved in opsonization?

Question 91

54 Defects in transendothelial migration are associated with ______.

Question 92

55 What are the 9 general steps of transendothelial migration?

Question 93

56 What is the molecule that is found on leukocytes and interacts with the endothelial surface to cause rolling of leukocyte along endothelium?

Question 94

56 What are the two molecules found on endothelial cells that bind leukocyte resulting in increased time that the leukocytes remain associated with the endothelium?

Question 95

56 What molecule binds ICAAM-2 (intracellular adhesion molecule) found on the endothelium to arrest leukocyte rolling?

Question 96

57 Which complement component is involved in chemotaxis to attract neutrophils?

Question 97

59 Which stages and grade of periodontitis have dysfunctional neutrophils?

Question 98

60 -Defect in neutrophil transendothelial migration -Lack of extravascular neutrophils in periodontal tissues -affects primary and permanent dentitions -bacteria destroy host tissue unimpeded by normal host immune response

Question 99

62 What is the term for cyclic reduction in circulating neutrophils?

Question 100

64 What drug is used in sub-antimicrobial doses as an adjunct to treat periodontitis?