Flashcards in Aggressive Periodontitis Deck (35):
What are four important features of aggressive periodontitis?
-Patient is otherwise HEALTHY clinically
-Characteristic RAPID bone and attachment loss
-INCONSISTENCY with plaque and calculus
What are the two sub-classifications of Aggressive Periodontitis?
LAP most frequently occurs in patients between _____ and _____ years old.
puberty-->20 years old
GAP affects patients under the age of _______ but may occur in older patients also.
In localized aggressive periodontitis, at least ______ _____ must be affected and no more than two teeth other than _____ and _____.
at least one first molar
no more than 2 other teeth besides molars/incisors
In GAP, there must be at least _____ permanent teeth other than ______ and ______ that are affected.
at least 3 teeth other than first molars and incisors
Which form of aggressive periodontitis (LAP or GAP) is characterized by a robust serum antibody response?
LAP = serum antibody response
True or False: GAP has a moderate serum antibody response.
False...POOR serum antibody response
Which form of aggressive periodontitis is characterized by intense gingival inflammation and which has relatively less gingival inflammation?
Intense inflammation: GAP ("inflammation causes gaps")
Less inflammation: LAP
True or False: Localized Aggressive Periodontitis is characterized by episodic destruction of attachment and bone.
False, GAP has episodic nature
How do you determine rate of bone loss?
Comparison of serial radiographs (aggressive is 3-4 times faster than chronic)
True or False: Prevalence of Aggressive Periodontitis in the primary dentition is 0.9% to 4.5%
True or False: Prevalence of Aggressive Periodontitis in the United States is 5%
False, below 1% in the U.S.
True or False: Both types of Aggressive Periodontitis are more prevalent among African Americans (2.6%)
There is a direct link between ______ ______ microbes and localized aggressive periodontitis.
A.a and, more particularly, the _____ clone or serotype ____ is highly associated with LAP.
JP2 clone (high in African American populations)
True or False: A.a is motile.
True or False: A.a in anaerobic.
False, it's a facultative anaerobe
What are the 4 virulence factors associated with A.a?
4. Immunosuppressive Factors
A.a will translocate across the _____ and invade the _____.
What is the action of leukotoxin?
kills PMNs and macrophages
Which two host responses are suppressed by A.a's immunosuppressive factors?
P.gingivalis is a gram___ microbe that is ______ and _______. P.gingivalis is associated with _____ aggressive periodontitis.
What are the three virulence factors associated with P.gingivalis?
1. Proteinase (gingipains and collagenase)
2. LPS (activates PGs, TNFalpha, and IL-1beta)
3. Inhibition of IL-8 (decreases chemotaxis of PMNs)
=inhibition of host responses
True or False: LAP is most likely a genetic polymorphism.
What is the proposed inheritance mode for LAP?
There are significantly higher levels of _______ in gingival crevicular fluid in patients with LAP
True or False: There are high titers and high avidity of IgA in localized aggressive periodontitis.
False, high titers of IgG2
True or False: GAP patients have high levels of antibodies against P.gingivalis.
False, LOW levels of antibodies against P.g
LAP is associated with impaired ______ function.
Diagnosing AP: If there is high A.a? If there is high P.g?
A.a = LAP
P.g = GAP
Diagnosing AP: High crevicular PGE2 levels? High titers of IgG? Low levels of P.g antibody?
high PGE2 = LAP
high IgG2 = LAP
low P.g Ab = GAP
Levels of antibody against A.a are higher in ______ than in blood.
sulcular fluid > peripheral blood
What are the two antibiotic cocktails that are prescribed for aggressive periodontitis?
Amoxicillin + Metranidazole (500mg 3x per day)
Ciprofloxacin + Metranidazole