Clinical Correlates-Inflammation

Question 1

Inflammation-define

Answer 1

Body’s attempt at self protection

Inflammation is the body’s attempt at self-protection;
the aim being to remove harmful stimuli, including
damaged cells, irritants, or pathogens - and begin the
healing process.

Question 2

Causes of Inflammation (3)

Answer 2

Physical, Biological, Chemical

Question 3

Physical, Biological, Chemical-examples of each cause of inflammation

Answer 3

Physical
-temp, injury, foreign bodies

Biological
-infection, hyperinsensitivity, stress

Chemical
-toxins and alcohol

Question 4

Inflammation = infection?

Answer 4

NO

Question 5

infection causes

Answer 5

inflammation

Question 6

Infection is the ____ and inflammtion is the

Answer 6

reason, inflammation is body’s response

Question 7

Inducers/infection –> tissue damage –>

Answer 7

Sensors which release mediators to the target tissue

Question 8

Inducers can be one of two classes

Answer 8

Exogenous

• PAMP, virus
• Allegens, toxin,

Endogenous

• Stress signal
• Products of ECM breakdown

Question 9

What triggers the production of numerous inflammatory mediators

Answer 9

inducers of inflammation

Question 10

Alters the functional states of tissues and organs

Answer 10

Mediators

Question 11

Inflammatory mediators are classified into seven groups

according to their biochemical properties:

Answer 11

1. Vasoactive amines
2. Vasoactive peptides
3. Complement components
4. Lipid mediators
5. Cytokines
6. Chemokines
7. Proteolytic enzymes

Question 12

Vasoactive amines function/effect

Answer 12

increased vascular permability,

vasodilatation, vasoconstriction

Question 13

Vasoactive peptides effect

Answer 13

Vasodilation and pain

Question 14

Lipid mediators effect

Answer 14

fever

Question 15

Proteolytic enzymes effect

Answer 15

tissue degradation, leukocyte migration

Question 16

Cardinal signs of inflammation (5)

Answer 16

Heat
Redness
Swelling
Pain
Loss of Function

Question 17

Key steps of inflammatory process (~4)

Answer 17

Pathogens invade and release toxins/enzymes –> tissue injury and cell death which causes inflammation and immune cell recruitment (host response) –> Phagocytosis/killed/removed –> side effect (5 signs)

Question 18

Systemic effects of inflammation (6)

then there are two others which could be results

Answer 18

★ Acute-phase proteins (e.g. CRP)
★ Fever
★ Increased blood pressure
★ Malaise
★ Loss of appetite
★ Somnolence
★ Leukocytosis

Also shock and sepsis

Question 19

If pathogens are not killed/persist

Answer 19

chronic

Question 20

biggest problem with chronic inflammation

Answer 20

continued cell damage with some evidence of healing

Question 21

Outcomes of inflammation (4)

Answer 21

★ Resolution (Regeneration)
Cells Removed-Complete restoration/regeneration of the inflamed tissue back to a normal status.

★ Fibrosis (Repair)
Tissue destruction cannot be regenerated by the body. Fibrous scar
composed primarily of collagen.

★ Abscess Formation
Defensive reaction of the tissue to prevent the spread of infectious
materials to other parts of the body.

★ Chronic inflammation
If the injurious agent persists, then chronic inflammation will ensure.

Question 22

Initial gingavitis

• plaque?
• vasculature?
• Immune cells?
• Tissue description?
• Clinical change?

Answer 22

★ Accumulation of plaque biofilm in sulcus
★ Slight increase in vascular permeability
★ Migration of PMNs towards biofilm (across
connective tissue, junctional epithelium, and
into the sulcus)
★ Firm, pink tissue
★ No bleeding upon probing
★ No change in clinical presentation as
compared to health

Question 23

Clinical presentation of initial gingivitis?

Answer 23

None- appears as health

Question 24

Early gingivits

• plaque? migration?
• vasculature?
• Immune cells?
• Tissue description
• Color?
• Tissue destruction?
• Clinical change?

Answer 24

★ Biofilm more mature; increased pathogenicity
★ Some pathogens migrate into connective tissue
★ Increased vascular permeability and vasodilation
★ Release of inflammatory mediators by epithelial
cells
★ Cytokines, LPS, and PGE2 and antibodies present
★ Continued migration of PMNs
★ Collagen destruction and proliferation of epithelium
★ Gingival margin changes from pink to red
★ Early sings of edema

★ Bleeding upon probing is likely
★ May not be a distinct clinical entity, but clinical
changes are beginning to manifest

Question 25

Clinical appearance of early gingavitis

Answer 25

★ Bleeding upon probing is likely ★ May not be a distinct clinical entity, but clinical **Also maybe pain

Question 26

collagen depleted in initial gingivitis? Early?

Answer 26

In early, yeah

Question 27

Clinical signs of health to inflammed ``` Color Size and shape Position Consistency/Texture BOP? ```

Answer 27

``` Color -pink to red Size/shape -flat thin/knife --> rolled margins Position -normal vs hyperplasia Consistency & texture -firm/stippled vs smooth glassy and soft BOP ```

Question 28

BEST clinical sign of gingivitis

Answer 28

BOP

Question 29

Key for long term success

Answer 29

maintenance

Question 30

Lack of space of mucosa during 3rd molar eruption causes inflammation of mucosa called

Answer 30

pericoronitis

Question 31

Apthous stomatitis

Answer 31

swelling of the oral mucosa such as an ulcer or canker sore

Question 32

Contact stomatitis

Answer 32

Tongue inflammation

Question 33

To remove inflammation, you must do what

Answer 33

remove the cause