Etiology of Periodontal Diseases

Question 1

‘Pathogenesis’ is

Answer 1

the step-by-
step process that leads to the
development of disease

Question 2

Pathogenesis of periodontal
disease is the

Answer 2

series of
structure changes and
function within the
periodontium

Question 3

What is Gingivitis

Answer 3

• Inflammatory response only
affecting the gingiva

Question 4

Gingivitis
• Occurs as a results of

Answer 4

biofilm
(plaque) accumulation that is
not removed

Question 5

Gingivitis
reversible?

Answer 5

yes

Question 6

Gingivitis
• Precedes — but does
not always progress to
—

Answer 6

periodontitis

Question 7

Sri Lankan Tea
Worker Study
1978

Answer 7

Results published May 1986 in the Journal of Clinical Periodontology
2 groups, approximately 500 healthy Norwegian men and
approximately 500 Sri Lanken tea workers had oral evaluations
Findings concluded that although plaque/calculus accumulation was
significant in the Sri Lanken group, periodontitis did not affect all

Question 8

Gingivitis
Characterized by:
(2)

Answer 8

• Inflammation of gingival
margins and interdental papilla,
redness, bleeding on probing
• NO attachment loss

Question 9

Periodontitis
Characterized by:
(2)

Answer 9

• Bone loss
• Apical migration of the Junctional
  Epithelium

Question 10

What is
Periodontal
Disease??
(3)

Answer 10

• A chronic inflammatory disease affecting the periodontium
• Complex and multifactorial
• Initiated by a dysbiosis of biofilm (plaque) and modulated by the host
response

Question 11

Dysbiosis-

Answer 11

an imbalance between the types of organism present in a person’s
natural microflora thought to contribute to a range of conditions of ill health.

Question 12

Differences between Gingivitis & Periodontitis
GINGIVITIS
(4)

Answer 12

• Inflammatory response only
affecting the gingiva
• Occurs as a results of biofilm
(plaque) accumulation that is not
removed
• Reversible
• Precedes periodontitis but does
not always progress to
periodontitis

Question 12

Differences between Gingivitis & Periodontitis
PERIODONTITIS
(3)

Answer 12

• Follows gingivitis
• Not reversible
• Inflammatory process extends to
affect the PDL and alveolar bone,
resulting in clinical attachment loss
(CAL)

Question 13

1. Initial Lesion
   (2)

Answer 13

• Clinically healthy gingival tissues
• Develops within 2-4 days of the accumulation of plaque

Question 14

2. Early Lesion
   (2)

Answer 14

• Early gingivitis that is clinically evident
• Develops approximately 1 week of continued plaque
accumulation

Question 15

3. Established Lesion
   (2)

Answer 15

• Established chronic gingivitis
• Progression to this stage dependent on many factors

Question 16

4. Advanced Lesions
   (2)

Answer 16

• Transition from gingivitis to periodontitis
• Progression to this stage dependent on many factors

Question 17

*periodontitis, although irreversible, can be brought to a state of stable
periodontal health, however, on a

Answer 17

reduced periodontium

Question 18

Stages of Gingivitis & Periodontitis (4)

Answer 18

health teeth and gums
gingivitis
periodontitis
advanced periodontitis

Question 19

Gingival Pocket(pseudo-pocket/false pocket)
(3)

Answer 19

Pocket caused by hyperplasia;
coronal movement of the gingival
margin
• No apical migration of the
junctional epithelium
• No bone loss

Question 20

Periodontal Pocket (true pocket)
(3)

Answer 20

pocket cause by bone loss associated with apical migration of the junctional epithelium

suprabony
infrabony

Question 21

suprabony

Answer 21

bottom of the pocket is coronal to the crest of the alveolar bone

Question 22

infrabony

Answer 22

bottom of the pocket is apical to the crest of the alveolar bone

Question 23

pseudo pockets are always

Answer 23

suprabony

Question 24

Complete Periodontal Assessment Requires: (5)

Answer 24

• Description of the clinical appearance of the soft tissues • Probing depths • Plaque and bleeding index • Recession/ Clinical Attachment Loss (CAL) • Radiographs

Question 25

Causative Factors of Periodontal Disease Primary etiology:

Answer 25

plaque in a susceptible host

Question 26

Causative Factors of Periodontal Disease Secondary etiology:

Answer 26

local/environmental factors

Question 27

Etiologic Factors (3)

Answer 27

• Gingival diseases are initiated primarily by plaque on tooth and gingival surfaces • Plaque initiates inflammation, which leads to pocket formation, and the pocket provides shelter for more plaque • Removal of subgingival plaque and calculus constitutes the cornerstone of periodontal therapy

Question 28

skipped Local Contributing Factors: (10)

Answer 28

* Calculus * Carious lesions * Overhangs * Malpositioned teeth * Xerostomia * Furcations * Food impaction * Occlusal trauma * Orthodontics * Poor crown margins

Question 29

skipped Systemic Factors: (10)

Answer 29

* Medication * Stress * Diabetes * Obesity * Cardiovascular disease * Immuno-compromised * Smoking * Nutritional deficiencies * Age * Genetics

Question 30

skipped Primary Bacterium Associated with Periodontitis (5)

Answer 30

* Aggregatibacter actinomysetemcomitan (Aa) * Porphyromonas gingivalis (Pg) * Prevotella intermedia (Pi) * Tannerella forsythia (T. forsythia) * Treponema denticola (T. denticola)