aetiology and pathogenesis of periodontal disease Flashcards Preview

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Flashcards in aetiology and pathogenesis of periodontal disease Deck (27)
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1

describe gingvival health

clearly defined gingival margin, knife edge, scalloped
possible stippling
pink

2

what is the clinical definition of gingival health?

absence of bleeding on probing, erythema and edema, patient symptoms, attachment and bone loss, bone level range from 1-3mm apical to ACJ
<10% bleeding sites w/ probing depths

3

describe plaque induced gingivitis (intact periodontium)

red margin
rolled
-lost knife edge

4

what are the local plaque retention factors?

calculus
restoration margins
crowding
mouth breathing

5

what are the systemic modifying factors?

sex hormones
medication

6

what happens to neutrophils, lymphocytes etc. gin gingiivitis?

influx higher than normal

7

is periodontitis reversible?

no

8

is gingivitis reversible?

yes

9

what is periodontitis?

inflammation
loss of periodontal attachment
bone >3mm away from ACJ

10

describe a periodontal pocket

probe disappears
bleeding

11

what is a false pocket?

proliferation of sulcular epithelium leads to enlarged gingivae
probe disappears but no loss of attachment

12

in what group are pockets without inflammation common?

smokers

13

what is the normal bone level from the ACJ?

1-2mm

14

how do you determine if there has been bone loss?

check if bone level consistent on radiographs
how much bone loss relative to root length
-apex -> ACJ
-give %

15

what determines horizontal vs vertical bone loss?

how thick alveolar bone is between teeth

16

describe the progression from gingivitis -> periodontitis

once initiated, progression of attachment loss may be episodic, different sites may be affected differently
generally very slow but variable
2mm loss over 5 years = rapid progression

17

what happens when the biofilm migrates apically?

severe inflammation
bone loss

18

what is the host immune response?

saliva
epithelium
-physical barrier
-shedding of cells
-production of inflammatory mediators
GCF
inflammatory and immune responses

19

describe connective tissue matrix degradation

matrix malloproteinases are a family of zinc & ca dependent proteolytic enzymes which include collagenases
matrix degradation largely a result of MMP's secreted by host inflammatory cells
immune cell activation of osteoclasts via RANK/RANKL/ other cytokine

20

what are anatomical risk factors?

enamel pearls/projections
grooves
furcations
gingival recession

21

what are tooth position risk factors?

malalignment
crowding
tipping
migration
occlusal forces

22

what are iatrogenic risk factors?

restoration overhangs
defective crown margins
poorly designed partial dentures
orthodontic appliances

23

why is smoking a risk factor?

vasoconstriction of gingival vessels and increased gingival keratinisation
impaired antibody production
depressed numbers of Th lymphocytes
impaired PMN function
increased prod. pro-inflammatory cytokines

24

what are environmental risk factors?

local risk factors
local microbiome
stress

25

what is the impact of periodontitis?

most common cause of bone loss
50% population affected

26

what is the extent and severity dependant on?

interaction between microbiome and host

27

what is the primary aetiological agent?

microbial plaque