Chapter 3 Flashcards

1
Q

risk factors for periodontal disease

A
  • poor oral hygiene
  • tobacco smoking
  • genetics/heredity
  • advanced aging
  • stress
  • past history of perio
  • systemic disease
  • male gender
  • compromised host defense
  • race, ethnicity
  • regularity of dental care
  • interleukin-1 production
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2
Q

what are local factors

A
  • environmental
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3
Q

what are systemic factors

A
  • medical conditions
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4
Q

what are host factors

A
  • own body

- susceptibility of disease

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5
Q

what is inflammatory periodontal disease the result of

A
  • accumulation of dental plaque (microorganisms are part of the plaque)
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6
Q

what is microbial biofilm

A
  • gelatinous matrix-enclosed bacterial populations
  • bacteria adhere
  • must disrupt biofilm
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7
Q

what is extracellular matrix

A
  • protects from external sources such as antibiotics/antimicrobials
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8
Q

how many different species of bacteria are present in oral biofilms and how many are pathogenic

A
  • more than 700 bacterial species in oral biofilm

- less than 10% are pathogenic

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9
Q

what type of morphology of bacteria are there in oral biofilms

A
  • wide variety of shapes
  • aerobic vs nonaerobic
  • motile vs nonmotile
  • gram + vs gram -
  • saachrolytic vs asaachrolytic (capable or non capable of metabolizing sugar)
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10
Q

describe bacteria present in healthy mouths

A
  • gram-positive
  • aerobic
  • nonmotile
  • saachrolytic
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11
Q

describe bacteria present in diseased mouths

A
  • gram-negative
  • anaerobic
  • motile
  • asaachrolytic
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12
Q

2 types of bacteria found in health

A
  • streptococcus species

- actinomyces species

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13
Q

3 main types of bacteria associated with periodontal disease

A
  • AA (stages I-IV)
  • PG (stages I-IV)
  • Tannerella forsynthesis (stages I-IV) not as important as the other 2
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14
Q

what is acquired pellicle

A
  • first few hours after laid down contains proteins and glycoproteins
  • saliva and crevicular fluid
  • provides specific receptors for bacterial attachment
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15
Q

what are adhesions

A
  • bacterial adherence to surface proteins
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16
Q

when is phase I/initiation for oral biofilms formation and what is it

A
  • 1-2 days
  • individual clones and layers
  • gram + cocci
  • streptococcus mutans
17
Q

when is phase II for oral biofilms formation and what is it

A
  • 2-4 days
  • gram + rods
  • gram - cocci
  • some anaerobes: anaerobic environment between layers
18
Q

when is phase III for oral biofilms formation and what is it

A
  • 4-7 days, 7-11 days
  • plaque thickens coronally
  • more filamentous bacteria (spirochetes and gram negative rods)
  • new plaque layer on top
  • PMNs (neutrophils) in gingival crevicular fluid
    after 7-11 days
  • gingival enlargement, clinical gingivitis
  • spirochetes multiply
  • increase in anaerobic and gram -
  • move subgingival
19
Q

what are sub gingival biofilms

A
  • live as strict or obligate anaerobes (can’t live with O2)

- multiplication - increasing thickness

20
Q

what are the 3 types of sub gingival bacterial biofilms

A
  • tooth associated (attached)
  • tissue associated (attach to tissue increase swelling, causing more room to descend and penetrate and grow)
  • unattached (mobile organisms that are unattached producing toxins, enzymes causing damage)
21
Q

what are tooth associated bacteria

A
  • gram + facultative aerobes
  • removed by scaling and root planing
  • less virulent
22
Q

what are tissue associated bacteria

A
  • gram -, anaerobic, motile
  • not removed by scaling or root planing
  • more virulent
23
Q

what are unattached bacteria

A
  • gram -, anaerobic, motile
  • removed by flushing
  • more virulent
24
Q

how do subgingival biofilms get their nutrients

A
  • provided by gingival crevicular fluid
  • compounds in GCF enhance the growth of porphyromonas and prevotella species
  • antimicrobial properties (immunoglobulins) prevents bacteremia and infections
25
what happens during bacterial tissue invasion
- subgingival AA, PG and spirochetes invade into the lamina propria - cannot eliminate with scaling - contributes to aggressive periodontitis
26
microorganisms in dental implants
- same as with teeth | - important not to scratch implants as this will cause more sport for bacteria to attach
27
components of plaque (biofilms)
- bacteria | - cells: epithelial white and red blood cells, ghost cells, all filled with bacteria
28
what are tooth accumulated materials (TAMs)
- loosely adhere - no major impact on perio - mostly food bacterial mixture (like materia alba)
29
3 types of mechanisms of bacterial action: direct effect
1. cytotoxic agents (endotoxins) 2. enzymes 3. host derived enzymes
30
what are cytotoxic agents
- lipooligosaccharide (LOS) - previously termed lipolysaccharide - gram - found in cell wall - toxins released when cells die - initiates inflammation and bone destruction - LOS found in root cemetum
31
what are enzymes
- produced and released by subgingival bacteria within the periodontal pocket - destroys connective tissue: collagen, ground substance - matrix metalloproteinases (MMPs) (host derived), collagenases
32
what are host derived enzymes
- same or very similar to bacterial enzymes | - matrix metalloproteinases (MMPs); collagenases, gelatinases, common enzymes that break down periodontal tissues
33
what are immunopathologic mechanisms
- indirect mechanisms of bacterial action - bacterial antigens stimulate inflammatory response - destructive as well as protective