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Patient Care 3 > Etiology of Periodontal Diseases > Flashcards

Etiology of Periodontal Diseases Flashcards

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1
Q

describe gingival health

A
  • coral pink in color
  • free from inflammation/edema
  • firm and resilient
  • scalloped gingival margin that envelopes the teeth
  • peaked and pointed interdental papilla
  • stippled surface texture
  • no bleeding upon probing
  • consistent with good oral hygiene
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2
Q

how is gingival health achieved

A
  • plaque free tooth surfaces
  • healthy diet
  • regular dental visits
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3
Q

what is plaque biofilm’s affect on healthy gingiva

A
  • lingering biofilm on a clean tooth results in inflammatory process
  • local inflammation persists as long as biofilm is present around gingival tissues
  • inflammation resolves after removal of biofilm
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4
Q

describe gingivitis

A

-inflammation of the gingival tisues
- reversible

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5
Q

what is the primary etiologic factor of gingivitis

A

plaque

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6
Q

what percentage of the population is affected by plaque

A

more than 82% of adult population

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7
Q

what is gingivitis characterized by

A

-inflammation of gingival margins and interdental papilla, redness, bleeding on probing
- no attachment loss
- healthy bone levels

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8
Q

what is the most common form of gingival disease

A

dental plaque induced gingival disease

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9
Q

describe dental plaque induced gingival disease

A
  • may occur without attachment loss or on a reduced periodontium
  • inflammatory lesion is within the gingiva
  • not associated with progressive attachment loss
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10
Q

what is gingivitis associated with dental plaque only a result of

A

microbial challenge between bacteria in plaque biofilm and host responses

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11
Q

how long does it take for gingivitis to ensue with cessation of oral hygiene

A

2-3 weeks

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12
Q

what is gingivitis associated with dental plaque histologically characterized by

A
  • dense infiltrate of lymphocytes
  • mononuclear cells fibroblast alterations
  • increased vascular permeability
  • continuing loss of collagen in response to the microbial challenge
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13
Q

what is the primary etiologic factor for gingivitis

A

plaque

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14
Q

how is the severity and duration of inflammatory response of gingivitis altered

A

modifying local or systemic factors

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15
Q

how is gingivitis reversible

A

in healthy people once local factors and decrease of the microbial load around teeth reduced

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16
Q

what systemic factors effect gingival diseases

A
  • endocrine changes: puberty, menstrual cycle, pregnancy, diabetes
  • results from effects of systemic conditions on host’s cellular and immunologic functions
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17
Q

what percentage of pregnancies get gingivitis

A

more than 30% of pregnancies

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18
Q

what is gingivitis in pregnancy characterized by

A

mild to severe gingival inflammation and pain
- some can have significant hyperplasia and bleeding

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19
Q

what bacteria is increased in pregnancy and why

A

P. intermedia because progesterone causes its growth

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20
Q

how long does gingivitis with pregnancy last

A

resolves itself after delivery

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21
Q

what drugs cause gingival enlargement

A
  • phenytoin
  • immunosuppressive drugs (cyclosporin)
  • calcium channel blockers: nifedipine, verapamil, dilitiazem, sodium valproate
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22
Q

what does vitamin C deficiency cause

A
  • bright red, swollen, bleeding gingiva
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23
Q

what part of the diet increases gingivitis

A

increased carbohydrate intake

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24
Q

what do non - plaque induced gingival diseases encompass

A

lesions of autoimmune or idiopathic etiology manifesting on the gingiva

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25
what are examples of non plaque induced gingival diseases
benign mucous membrane pemphigoid
26
what viral diseases can cause gingivitis
gonorhhea synphilis herpetic stomatitis
27
what fungal diseases can cause gingivitis
candidiasis
28
what systemic diseases can cause gingival enlarment
DM or allergies
29
what traumatic origin can cause gingivitis
toothbrush or flossing trauma, fingernail biting
30
what is localized gingivitis
confined to the gingiva of single tooth or group of teeth affecting less than 30% of remaining teeth
31
what is generalized gingivitis
more than 30% of remaining teeth
32
what is marginal gingivitis
involves the gingival margin
33
what is papillary gingivitis
involves interdental papillae, often extending into adjacent portion of gingival margin
34
where do earliest signs of gingivitis occur
in the papillae
35
what is diffuse gingivitis
affects gingival margin, attached gingiva and interdental papillae
36
what are the 2 earliest signs of gingival inflammatino that precede established gingivitis
- increased GCF - increased bleeding from the gingival sulcus on gentle probing
37
what appears earlier BOP or color change or visual signs of inflammation
BOP
38
what does BOP indicate
inflammatory lesion in the epithelium and connective tissue
39
what type of sign is BOP
objective
40
what does absence of BOP imply
low risk of attachment loss
41
how does cigarette smoke affect BOP
supressess gingival inflammation and BOP
42
what medications affect gingival bleeding
antiplatelet medications (aspirin) - anticoagulatns (warfarin, eloquis) - oral contraceptives
43
where is gingivitis common in mouth breathers
in maxillary buccal area
44
what does gingiva look like in mouth breathers
red, shiny, edematous
45
what is fibrosis
pathologic process in which disrupted wound healing is associated with defective cell proliferation
46
describe gingivitis compared to periodontitis
- inflammatory response only affecting gingiva - occurs becuase of biofilm accumulatino that is not removed - reversible -precedes periodontitis but does not always progress to periodontitis
47
describe periodontitis compared to gingivitis
- follows gingivitis - not reversible - inflammatory process extends to affect the PDL and alveolar bone, resulting in clinical attachment loss - can be stabilizied and maintained with gingival health on a reduced periodontium
48
describe periodontitis
- chronic inflammation of the gingival tissues resulting in breakdown of surrounding periodontal tissues - complex and multifactorial - initiated by a dysbiosis of biofilm and modulated by the host response
49
what is periodontitis characterized by
- bone loss - apical migration of the JE
50
what are the steps involved in transitioning from gingival health to periodontitis
- plaque around gingival tissues cause microbial challenge for healtghy tissues - inflammatory change of the gingival sulucs begins - cellular and fluid inflammatory exudate causes degeneration of surrounding connective tissues including gingival fibers - apical to JE, collagen fibers are destroyed and area if occupied by inflammatory cells and edema
51
what are the stages of periodontitis and decribe each
1: initial lesion: clinically healthy gingival tissues, develops within 2-4 days of accumulation of plaque 2: early lesion: early gingivitis, develops 1-2 weeks of continued plaque accumulation 3: established lesion: established chronic gingivitis, progression to this stage dependent on many factors 4: advanced lesion: transition from gingivitis to periodontitis, progression to this stage dependent on many factors
52
what are the features of the JE
- acts as physical barrier against plaque bacteria - stratified squamous nonkeratinized in nature - attached to the tooth by internal basal lamina and to the CT by external basal lamina - exhibits higher permeability to cells, gingival fluid and host defense molecules to flow through - high rate of cellular proliferatino and turnover
53
what is a periodontal pocket cause dby
bone loss associated with apical migration of the JE
54
what is a suprabony perio pocket
bottom of pocket is coronal to the crest of the alveolar bone
55
what is a infrabony pocket
bottom of pocket is apical to the crest of the alveolar bone
56
pseudo pockets are always"
suprabony
57
complete periodontal assessment requires:
- description of the clinical appearance of the soft tissues - probing depths - plaque and bleeding index - recession/CAL - radiographs
58
what are the causative factors for periodontal disease
primary etiology: plaque in a susceptible host - secondary etiology: local/environmental factors
59
what are the local factors contributing to perio
- calculus - carious lesions - overhands - malpositioned teeth - xerostomia - furcations - food impaction - occlusal truama - orthodontics - poor crown margins
60
what are the systemic factors with perio
- medication - stress - diabetes - obesity - CVD - immunocompromised -smoking - nutrional deficiencies - age - genetics
61
what are the primary bacteria associated with periodontitis
- Aa - P. gingivalis - P. intermedia - T. forsythia - T. denticola
62

Patient Care 3 (22 decks)

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