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Periodontics I > Etiology > Flashcards

Etiology Flashcards

1
Q

Can you cure periodontal disease?

A

No- you can treat it and reduce its chance of progression but not cure it

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2
Q

Periodontal pathogenesis involve:

A
  1. environmental factors
  2. host factors
  3. microbial factors
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3
Q

Regarding periodontal pathogenesis, smoking would be considered:

A

an environmental factor

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4
Q

Regarding periodontal pathogenesis, immune system/immune factors would be considered:

A

Host factors

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5
Q

Regarding periodontal pathogenesis, plaque/biofilm would be considered:

A

microbial factors

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6
Q

When overgrowth of gram positive bacteria in susceptible individuals leads to gingival inflammation:

A

gingivitis

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7
Q

Gingivitis is a reaction limited to:

A

soft tissue area

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8
Q

The gingival inflammation ini gingivitis alters:

A

subgingival microenvironment

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9
Q

What occurs in patients with gingivitis when the gingival inflammation alters the subgingival microenvironment?

A

Overgrowth of “perriodontal pathogens” in the biofilm which may stay at gingivitis or progress to periodontitis

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10
Q

When plaque causes a host immune and inflammatory reactions together with genetic predisposition and environmental influences are able to “contain” infection:

A

gingivitis

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11
Q

When plaque causes a host immune and inflammatory reactions together with genetic predispositions and environmental influences unable to “contain” infection:

A

periodontitis

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12
Q

If gingivitis progresses to causing attachment loss or bone loss it is considered:

A

periodontitis

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13
Q

If you are unable to see if there is plaque or not, what should you do?

A

have patient use disclosing agent

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14
Q

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

A

Dental plaque

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15
Q

Main etiologic agent for periodontal disease and dental caries:

A

dental plaque

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16
Q

Dental plaque is the man etiologic agent for:

A
  1. periodontal disease
  2. dental caries
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17
Q
  • White cheeselike accumulation
  • a soft accumulation of salivary proteins, bacteria, desquamate epithelial cells, and food
  • No organized structure
  • easily displaced with a water spray:
A

Materia alba

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18
Q

What components comprise materia alba?

A

accumulation of
1. salivary proteins
2. bacteria
3. desquamated
4. epithelial cells
5. food debris

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19
Q

Describe the structural makeup of material alba:

A

NOT organized

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20
Q

Describe the removal or materia alba:

A

easily displaced with a water spray

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21
Q
  • 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 and spraying
A

dental plaque

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22
Q

What components comprise dental plaque?

A

bacteria in a matrix of salivary glycoproteins and bacterial products

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23
Q

Describe the structural makeup of dental plaque:

A

a biofilm

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24
Q

Describe the removal of dental plaque:

A

impossible to remove by rinsing or spraying- requires mechanical removal

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25
Q
  • mineralized dental plaque forms the hard deposit
  • generally covered by a layer of unmineralized dental plaque
A

calculus

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26
Q

Describe the structural makeup of calculus:

A

mineralized

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27
Q

Composition of dental plaque:

A
  • water
  • microorganisms
  • intracellular matrix
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28
Q

What percentage of dental plaque is comprised of water?

A

70%

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29
Q

What makes up the “dry weight” of dental plaque?

A

microorganisms & intracellular matrix

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30
Q

What makes up the ORGANIC component of intracellular matrix?

A
  1. polysaccharides
  2. proteins
  3. glycoproteins
  4. lipids
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31
Q

What makes up the INORGANIC component of dental plaque?

A
  1. Calcium
  2. Phosphorus
    (main components)
  3. other minerals
  4. sodium
  5. potassium
  6. fluoride
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32
Q

What are the main two components that make up the inorganic portion of dental plaque?

A

calcium & phosphorus

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33
Q

___ grams of dental plaque contain approximately 10^11 bacteria (and the human body has approximately 10^12 bacteria)

A

1 gram

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34
Q

More than ___ distance microbial species can be identified in dental plaque with highly sensitive molecular techniques

A

500

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35
Q

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 teeth surface with 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 dentistry

A

B

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36
Q

Sites of plaque accumulation in the oral cavity include: (4)

A
  • gingival thirds
  • cracks, pits, fissures
  • under overhanging restorations
  • around maligned teeth
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37
Q

Why does plaque accumulate in:
- gingival thirds
- cracks, pits, fissures
- under overhanging restorations
- around maligned teeth

A

because these areas are harder to keep Clea with brushing and flossing

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38
Q

Dental plaque classification is based on:

A

position on the tooth surface (toward the gingival margin)

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39
Q

What are the three classifications (based on location) of dental plaque?

A
  1. supragingival plaque
  2. marginal plaque
  3. subgingibal plaque
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40
Q

Describe subgingival plaque: (3)

A
  1. tooth attached plaque
  2. unattached plaque
  3. epithelial associated plaque
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41
Q

How may unattached plaque be removed?

A

by brushing

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42
Q

What type of bacteria make up supra gingival plaque?

A

gram + cocci and short rods

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43
Q

What is the oxygen requirement for supra gingival plaque (bacteria comprising = gram + cocci and short rods)?

A

aerobic environment

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44
Q

Describe the diversity of the bacteria comprising supra gingival plaque:

A

Slight diversity

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45
Q

What type of bacteria comprise subgingival plaque?

A

gram - rods and sprirochete

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46
Q

What is the oxygen requirement for subgingival plaque (bacteria comprising = gram - rods and spirochetes)?

A

anaerobic environment

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47
Q

Describe the diversity of the bacteria comprising subgingival plaque:

A

greater diversity

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48
Q

Type of plaque associated with calculus formation & root caries:

A

supragingival plaque

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49
Q

Type of plaque that is in direct contact with the gingival margin and associated with the initiation and development of gingivitis:

A

marginal plaque

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50
Q

Type of plaque that is associated with tissue destruction:

A

subgingival plaque

(made of spirochetes that can swim from subgingival space and into the tissue)

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51
Q

Steps involved in the formation of dental plaque (3):

A
  1. formation of the pellicle
  2. initial colonization of bacteria
  3. secondary colonization and plaque maturation
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52
Q

What type of attachment is seen with formation of the pellicle (Step 1) in dental plaque formation?

A

reversible attachment

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53
Q

What type of attachment is seen with initial colonization of bacteria (Step 2) in dental plaque formation?

A

irreversible, specific, short range

54
Q

How do the secondary colonizer attach to the primary colonizers in dental plaque formation?

A

co-adhesion

(initial colonizers used adhesion receptor attachments, and these guys use co-adhesion)

55
Q

List some of the processes that occur during the secondary colonization and plaque maturation (Step 3) of dental plaque formation: (6)

A
  1. metabolic interactions
  2. environment modification
  3. gradient formation
  4. matrix synthesis
  5. cell-cell signaling
  6. bacterial growth
56
Q

List the 6 steps of formation of the dental plaque (further broken down steps 1-3):

A
  1. pellicle formation
    2a. passive transport
    2b. reversible attachment
  2. adhesin-receptor (primary colonizers)
  3. co-adhesion (secondary colonizers)
  4. biofilm maturation
  5. detachment
57
Q

Adsorption of a conditioning film:

A

acquired pellicle

58
Q

An organic material layer coated on all surfaces in the oral cavity, including hard and soft tissues:

A

acquired pellicle

59
Q

The acquire pellicle is a ___ layer coated on ___ surfaces in the oral cavity, including ____ tissues

A

organic; all; hard & soft

60
Q

Components of the acquired pellicle are derived from:

A

saliva and crevicular fluid

61
Q

What type of bacteria are involved with the formation of the acquired pellicle?

A

gram + facultative microorganisms

62
Q

What is considered the INITIAL stage of development of the plaque?

A

formation of acquired pellicle

63
Q

During formation of the pellicle, there is reversible adhesion between the ____ and the ___.

A

microbial cell surface (adhesins); conditioning film (receptors)

64
Q

During formation of the pellicle, there is ____ adhesion between microbial cell surface (adhesins) and the conditioning film (receptors)

A

reversible

65
Q

The reversible adhesion between the microbial cell surface (adhesins) and the conditioning film (receptors) alters the charged and the free energy of the surface which:

A

increase efficiency of bacterial adhesion

66
Q

During initial colonization, the primary colonizers and secondary colonizers attach via:

A

co-adhesion

67
Q

During initial colonization after co-adheison of the primary & secondary colonizers, there is alteration in the:

A

oxygen gradient

68
Q

Describe the alterations in the oxygen gradient seen during the initial colonization after co-adhesion of the primary and secondary colonizers:

A

anaerobic conditions emerge in the deeper layers of deposits

69
Q

List the bacterial species that are considered PRIMARY colonizers in the formation of dental plaque:

A
  1. Streptococcus spp.
  2. Hemophilus spp.
  3. Neisseria spp.
  4. Actinomyces spp.
  5. Veillonella spp.
70
Q

List the bacterial species that are considered SECONDARY colonizers in the formation of dental plaque:

A
  1. Prevotella intermedia
  2. Capnocytophaga spp.
  3. Fusobacterium nucelatum
  4. Porphyromonas gingivialis
71
Q

What the term for secondary colonizers adhering to the bacteria that are already in the plaque mass during formation of dental plaque?

A

coaggregation

72
Q

T/F: Coaggregation with the secondary colonizers adhering to the bacteria that are already in the plaque mass can be seen by the naked eye

A

true

73
Q

Following colonization, this process occurs through further colonizations and growth of additional species during formation of dental plaque:

A

maturation

74
Q

During maturation in the formation of dental plaque, bacteria use quorum sensing (cell-cell signaling) to:

A
  1. modify the environment
  2. metabolic interactions
75
Q

Regarding the structure of dental plaque:

  1. Open ____ running through plaque mass
  2. Distinct ___ produced by matrix (steep chemical gradients)
  3. Quorum sensing results in ___.
A
  1. fluid-filled channels
  2. microenvironment
  3. bacterial resistance
76
Q

In periodontal microbiology, what results in “Corn-cob formation”?

A

coccal-shaped cells attach along the tip of gram negative filamentous organisms

77
Q

In periodontal microbiology, “corn-cob formation” is an example of:

A

inter-bacterial adherence or coaggregation

78
Q

List the microbiologic specificity hypothesis’ for the time period given:

A) 1900s
B) 1960s
C) 1990s

A

A) non-specific plaque hypothesis
B) specific plaque hypothesis
C) ecologic plaque hypothesis

79
Q

Hypothesis that states “direct relationship between the total amount of plaque and the amplitude of the pathogenic effect”

A

Non-specific plaque hypothesis

80
Q

According to the non-specific plaque hypothesis, the control of periodontal disease depends on:

A

control of plaque accumulation

81
Q

According to the non-specific plaque hypothesis, what standard of care was developed?

A
  • Oral hygeine measures
  • non-surgical/ surgical debridement
82
Q

The non-specific plaque hypothesis states that all plaque are:

A

Not equally pathogenic

83
Q

According to the non-specific plaque hypothesis “not all plaque are equally pathogenic”

Describe what this means regarding gingivitis:

A

Not all gingivitis develop into destructive periodontitis

84
Q

T/F: The specific plaque hypothesis states that not all gingivitis develops into destructive periodontitis

A

false- this is what the non-specific hypothesis states

85
Q

According to the non-specific plaque hypothesis “not all plaque are equally pathogenic”

_____ in the pattern of disease was demonstrated in some individuals with periodontitis

A

site specificity

86
Q

The hypothesis that states “the pathogenicity depends on the presence of or increase in specific microorganisms”

A

Specific plaque hypothesis

87
Q

The Specific plaque hypothesis states that the pathogenicity depends on the presence of or increase in:

A

specific microorganisms

88
Q

According to specific plaque hypothesis, _____ is localized in aggressive periodontisis

A

A. Actinomicetemcomitans

89
Q

What was developed from the information of specific plaque hypothesis?

A

Targeted treatment

90
Q

Strategies that aim to control or eliminate the particular pathogenic organisms (Specific plaque hypothesis)

A

targeted treatment

91
Q

T/F: Pathogens may be presence at the absence of disease

A

true

92
Q

According to the Specific plaque hypothesis, what bacteria are found in the “yellow complex”?

A
  1. S. mitis
  2. S. oralis
  3. S. sanguis
93
Q

According to the Specific plaque hypothesis, what bacteria are found in the “purple complex”?

A
  1. V. parvula
  2. A. odontolyticus
94
Q

According to the Specific plaque hypothesis, what bacteria are found in the “orange complex”?

A

P. intermedia

95
Q

According to the Specific plaque hypothesis, what bacteria are found in the “red complex”?

A
  1. P. gingivalis
  2. B. forsythus
  3. T. denticola
96
Q

According to the Specific plaque hypothesis, what bacteria are found in the “green complex”?

A
  1. E. corrodens
  2. C. gingivalis
  3. C. sputigena
  4. C. ochracea
  5. C. condcisus
  6. A. actino. a
97
Q

Hypothesis that states “both the total amount of dental plaque and the specific microbial composition of plaque may contribute:

A

Ecologic plaque hypothesis

98
Q

The ecologic plaque hypothesis describes ____ meaning the state of the dynamic equilibrium

A

Microbial homeostasis

99
Q

What criteria for identification of periodontopathogens was formed during the nonspecific plaque hypothesis (1900s)

A

Kochs postulates

100
Q

What criterial for identification of periodontopathogens was formed during the ecologic plaque hypothesis (1990s)

A

Socransky’s Criteria

101
Q

What criteria for identification of periodontopathogens is being described below?

  • 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 diseased lab animals
A

Kochs Postulates

102
Q

What criteria for identification of periodontopathogens is being described below?

  • be associated with disease
  • be eliminated or decreased in sites that demonstrate clinical resolution
  • demonstrate an alteration in host cellular or immune response
  • be capable of causing disease in experimental models
  • demonstrate virulence factors
A

Socransky’s Criteria

102
Q

P. gingivalis is known as a notorious periodontal pathogen. Which complex of color does it belong to?

A

Red complex

103
Q

What are the virulence factors of bacteria that contribute to microbiologic specificity?

A
  1. Toxins & Enzymes
  2. Adhesins
  3. Evading mechanisms
104
Q

Bacterial products that promote tissue destruction:

A

Toxins and enzymes

105
Q

What are some specific toxins and enzymes that serve as virulence factors?

A
  • LPS
  • Leukotoxin
  • Gingipains
  • Collagenase
  • Protease
106
Q

Factors that promote colonization:

A

Adhesins

107
Q

List some specific adhesins:

A
  • fimbria
  • gingipains
108
Q

The production of an extracellular capsule is an example of:

A

Evading mechanism

109
Q

What evading mechanisms is functions in proteolytic degradation of host immunity components?

A

gingipains

110
Q

Modulating the host response via binding serum components on the bacterial cell surface is an example of:

A

Evading mechanism

111
Q

Evading mechanisms that contributes to the invasion of gingival epithelial cells:

A

LPS

112
Q

Specific bacteria of gingivitis (8):

A
  1. Actinomyces spp.
  2. Capnocytophaga spp.
  3. Campylobacter spp.
  4. Streptococcus spp.
  5. Parvimonas micra
  6. Fusobacterium nucleatum
  7. Prevotella intermedia
  8. Treponema spp.
113
Q

The following bacteria are associated with:

  1. Actinomyces spp.
  2. Capnocytophaga spp.
  3. Campylobacter spp.
  4. Streptococcus spp.
  5. Parvimonas micra
  6. Fusobacterium nucleatum
  7. Prevotella intermedia
  8. Treponema spp.
A

Gingivitis

114
Q

Specific bacteria of periodontitis (8):

A
  1. Agreggatibacter actinomycetemcomitans (type B)
  2. Porphyromonas gingivalis
  3. Prevotella intermedia
  4. Parvimonas micra
  5. Fusobacterium nucleatum
  6. Tannerella forsythia
  7. Treponema denticola
  8. Spirochetes
115
Q

The following bacteria are associated with:

  1. Agreggatibacter actinomycetemcomitans (type B)
  2. Porphyromonas gingivalis
  3. Prevotella intermedia
  4. Parvimonas micra
  5. Fusobacterium nucleatum
  6. Tannerella forsythia
  7. Treponema denticola
  8. Spirochetes
A

Periodontitis

116
Q

Specific bacteria of necrotizing periodontal disease: (4)

A
  1. Fusobacterium nucleatum
  2. Prevotella intermedia
  3. Treponema spp.
  4. Spirochetes
117
Q

The following bacteria are associated with:

  1. Fusobacterium nucleatum
  2. Prevotella intermedia
  3. Treponema spp.
  4. Spirochetes
A

Necrotizing Periodontal Disease

118
Q

Specific bacteria associated with pregnancy and puberty: (2)

A
  1. Prevotella intermedia
  2. Capnocytophaga spp.
119
Q

The following bacteria are associated with:

  1. Prevotella intermedia
  2. Capnocytophaga spp.
A

pregnancy & puberty

120
Q

Specific bacteria associated with periodontal abscesses: (5)

A
  1. Fusobacterium nucleatum
  2. Parvimonas micra
  3. Prevotella intermedia
  4. Pophyromonas gingibalis
  5. Spirochetes
121
Q

The following bacteria are associated with:

  1. Fusobacterium nucleatum
  2. Parvimonas micra
  3. Prevotella intermedia
  4. Pophyromonas gingibalis
  5. Spirochetes
A

periodontal abscesses

122
Q

Specific bacteria of peri-implantitis is comparable to:

A

microbiota to that of periodontitis

123
Q

In a healthy site we see gram ___ bacteria; In a diseased site we see gram ___ bacteria

A

health: positive
disease: negative

124
Q

In a healthy site we see ___ bacteria; In a diseased site we see ___ bacteria (shape)

A

health: cocci
disease: rod

125
Q

In a healthy site we see ___ bacteria; In a diseased site we see ___ bacteria (movement)

A

health: nonmotile
disease: motile

126
Q

In a healthy site we see ___ ; In a diseased site we see ___ (oxygen requirement)

A

health: facultative anaerobes
disease: obligate anaerobes

127
Q

Fermenting bacteria are in ____ sites; while proteolytic bacteria are seen in ___ sites

A

healthy; diseased

128
Q

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

A

C

129
Q

List the donor to recipient transmission of periodontal pathogens:

A
  1. parent-to-child
  2. spouse-to-spouse
130
Q

T/F: Periodontal pathogens are communicable but not readily transmissible

A

True

131
Q
A

Periodontics I (18 decks)

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