Etiology Flashcards by Michael McMahan

What are the 3 major factors of periodontal pathogenesis?

Environmental factors
Host factors
Microbial factors

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The structurally and 
functionally organized,  
species-rich  
microbial biofilms  
that form on teeth

Dental plaque

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What is the main etiology for periodontal disease and dental caries?

Dental plaque

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•White cheeselike 
accumulation 
•A soft accumulation of 
salivary proteins, 
bacteria, desquamated 
epithelial cells, and food 
debris 
•No organized structure 
•Easily displaced with a 
water spray

Materia Alba

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•Resilient clear to yellow-
grayish substance 
•Primarily composed of 
bacteria in a matrix of 
salivary glycoproteins 
and bacterial products 
•Considered to be a 
biofilm 
•Impossible to remove by 
rinsing or spraying

Dental plaque

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•Mineralized dental 
plaque forms the hard 
deposit 
•Generally covered by a 
layer of unmineralized 
dental plaque

Calculus

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What accounts for 70% of plaque?

Water

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What accounts for 70% of dry weight of plaque (30%)?

Microorgs

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What accounts for 30% of dry weight of plaque (30%)?

INtracelluluar matrix

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Organic component
Dental Plaque
Polysaccharides 
Proteins 
Glycoproteins 
Lipids

Inorganic component
Calcium Phosphorous 
Other minerals 
Sodium 
Potassium 
Fluoride

Intracellular matrix

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More than ___ distinct microbial species
can be identified with highly sensitive
molecular techniques

500

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What is dental plaque?
A. It is a non organized structure with soft accumulation of salivary
proteins, bacteria, desquamated epithelial cells, and food debris.
B. It is the structurally and functionally organized, species‐rich
microbial biofilm that form on teeth.
C. It is the hard deposit on the teeth surface which can be formed
by the mineralization of the matrix of salivary glycoproteins and
bacterial products.
D. It is the ornamental tablet in commemoration of the contribution
of the dentistry.

B. It is the structurally and functionally organized, species‐rich
microbial biofilm that form on teeth.

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______ plaque
Gram+ cocci and short rods
Aerobic environment
Slight diversity

Supragingival plaque

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_____ plaque
Gram- rods and spirochete
Anaerobic environment
Great diversity

Subgingival plaque

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What are the 3 steps of formation of dental plaque?

Formation of Pellicle
Initial colonization of bacteria
Secondary colonization and plaque maturation

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Adsorption of a conditioning film
- An organic material layer coated on all surfaces in
the oral cavity, including hard and soft tissues.
- Components derived from saliva and crevicular
fluid.
- Gram+ facultative microorganisms are involved

Initial stage of the development of the plaque

•Acquired pellicle:

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What are the 5 bacterial species seen as primary colonizers?

Streptococcus spp.
Hemophilus spp.
Neisseria spp.
Actinomyces spp.
Veillonella spp.

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What are the 4 bacterial species seen as Secondary colonizers?

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Prevotella intermidia.
Capnocytophaga spp.
Fusobacterium nucleatum
Porphyromonas gingivalis

Secondary colonizers adhere to the bacteria that
are already in the plaque mass
A significant feature can be seen by naked eye

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Coaggregation

- Through further colonization and growth of 
additional species 
- Quorum sensing: cell-cell signaling 
- Environment modification 
- metabolic interaction

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Maturation

__________ results in bacterial resistance

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Quorum sensing

Quorum sensing results in _______

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bacterial resistance

Direct relationship between the total amount of plaque and the amplitude of the pathogenic effect
Concept inherited: Control of periodontal disease depends on control of plaque accumulation
Standard of care: oral hygiene measures, non-surgical/ surgical debridement
All plaque are not equally pathogenic
- Not all Gingivitis develop into destructive periodontitis
- Site specificity in the pattern of disease was demonstrated in some individuals with periodontitis

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Non-specific plaque hypothesis

- The pathogenicity depends on 
the presence of or increase in 
specific microorganisms 
- A. Actinomicetemcomitans 
in localized aggresive 
periodontitis 
- Targeted treatment strategies 
aim to control or eliminate the 
particular pathogenic 
organisms

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Specific plaque hypothesis

``` - Both the total amount of dental plaque and the specific microbial composition of plaque may contribute - Microbial homeostasis: the state of the dynamic equilibrium ```

Ecologic plaque hypothesis

What are the 3 pathogenic bacteria that play a large role in periodontal disease?

P. gingivalis B. forsthus (T. forthysia) T. denticola

``` Criteria for Identification of Periodontopathogens •Be routinely isolated from diseased individuals •Be grown in pure culture in lab •Produce a similar disease when inoculated into susceptible lab animals •Be recovered from lesions in a diseases lab animal ```

Kochs Postulates

``` Criteria for Identification of Periodontopathogens •Be associated with disease •Be eliminated or decreased in sites that demonstrate clinical resolution •Demonstrate a alteration in host cellular or immune response •Be capable of causing disease in experimental models •Demonstrate virulence factors ```

Socransky's criteria

_____ bacteria Association -Increased in localized aggressive periodontitis lesions. Some in chronic periodontitis lesions. Elimination - Suppressed or eliminated in successful therapy, can be found in recurrent lesions Host response -Increased serum and local antibody levels Animal studies -Capable of inducing disease in gnotobiotic rats Virulence factors -Host tissue cell adherence and invasion, leukotoxin, protease, collagenase, epitheliotoxin, FIF, bone resorption inducing factors

AA: A. Actinomycetemcomitans

______ bateria Association -Increased in periodontitis lesions, found associated with the crevicular epithelium Elimination -Suppressed or eliminated in successful therapy, can be found in recurrent lesions Host response -Increased systemic and local antibody levels Animal studies -Important in experimental mixed infections Virulence factors -Host tissue cell adherence and invasion, trypsin-like enzyme, collagenase, fibrinolysis, phospholipase A, endotoxin, gingipains, factors that affect PMN function

Pg: P. gingivalis

(virulence factors) • Bacterial products that promote tissue destruction: lipopolysaccharides(LPS), leukotoxin, gingipains, collagenase, protease

Toxins and enzymes

(virulence factors) • Factors that promote colonization: fimbria, gingipains

Adhesins

(virulence factors) * The production of an extracellular capsule * Proteolytic degradation of host immunity components: gingipains * Modulate host response: bind serum components on bacterial cell surface * Invasion of gingival epithelial cells: lipopolysaccharides(LPS)

Evading mechanisms

``` Bacteria of _______ Actinomyces spp. Capnocytophaga spp. Campylobacter spp. Streptococcus spp. Parvimonas micra Fusobacterium nucleatum Prevotella intermedia Treponema spp. ```

Gingivitis

``` Bacteria of ________: Specific Bacteria in Disease Aggregatibacter actinomycetemcomitans (Type b) Porphyromonas gingivalis Prevotella intermedia Parvimonas micra Fusobacterium nucleatum Tannerella forsythia Treponema denticola Spirochetes ```

Periodontitis

``` Bacteria of _________: Fusobacterium nucleatum Prevotella intermedia Treponema spp. Spirochetes ```

Necrotizing Periodontal DIsease

Bacteria Associated with ______ and _______ Prevotella intermedia Capnocytophaga spp.

Pregnancy and Puberty

``` Bacteria in ________: Fusobacterium nucleatum Parvimonas micra Prevotella intermedia Porphyromonas gingivalis Spirochetes ```

Abscess of the Periodontium

``` Do the following characteristics describe healthy or disease state bacteria? Gram +ve Cocci Nonmotile Facultative anaerobes Fermenting ```

Health

Do the following characteristics describe healthy or disease state bacteria? ``` Gram -ve Rod Motile Obligate anaerobes Proteolytic ```

Disease

Which one is correct for the specific bacteria observed in correlated periodontal disease? A. In diseased sites, more gram positive, nonmotile cocci are observed B. In healthy sites, more orange and red complex bacteria are observed C. A. actinomycetemcomitans and P. gingivalis are highly related to periodontitis D. Capnocytophaga spp. is usually found in periodontal abscess

C. A. actinomycetemcomitans and P. gingivalis are highly related to periodontitis

``` P. gingivalis is known as a notorious periodontal pathogen. Which complex of color does it belong to? A. Yellow complex B. Green complex C. Orange complex D. Red complex ```

D. Red complex

Periodontal pathogens are _______ but not readily ________

communicable; transmissible

Etiology Flashcards

(43 cards)