Exam 1 C Flashcards
(27 cards)
What do T-lymphocytes and B-lymphocytes do in pockets?
T-cell = lymphokines and delayed hypersensitivity B-cell = turn into plasma cells to make antibodies
Describe pathogenesis initial?
2-4 days, acute inflammation, vasculitis, PMNs, macrophages, subclinical (no gingivitis), increased flow of gingival crevicular fluid
Describe pathogenesis early?
4-7 days, T-cell lesion, clinical signs of gingivitis, redness, bleeding, edema
Describe pathogenesis established?
2-3 weeks, B-cell lesion; plasma cells, chronic gingivitis
Describe pathogenesis advanced?
undetermined time, bone loss, pocket formation, B-cell lesion, periodontitis
What cytokine causes bone resorption?
IL-1 beta
TNF-alpha (with PGE2)
Cytokine IL-1 beta associated with what?
polymorphisms that do not cause disease, but makes individual response more severe
What proteinase breaks down collagen and is found with cytokines?
MMP (1&8)
What cells are involved in advanced lesions of Paige and Schroder?
B-cells/plasma cells
How does smoking affect PD treatment?
less clinical inflammation (decrease immune response) increases pathogens decreased response to Tx greater recurrence risk more tooth loss
What does smoking cause?
localized attachment loss
leathery gingiva
How much does smoking raise PD risk?
4x more for current smokers
1.6x more for former smokers
True/False Smoking has a huge effect on rate of plaque accumulation?
False - no effect
What is smoker recurrence?
relapse
What is smoker refractory?
non-responsive to Tx modalities
Smokers are good candidates for what?
PerioStat drug therapty (antibiotics)
What is host modulatory therapy?
normal host response does a significant portion of damage seen in PD
How does host modulatory response work?
MMPs break down collagen
Prostaglandins produce bone resorption
Osteoclasts produce bone resorption
Types of host modulation with Tx?
stop smoking, improve oral hygiene, reduce stress, control systemic disease
Host modulation by Tx?
PerioStat which inhibits MMP
When we collect data, what is most important in all the data we collect when diagnosing PD?
CAL
How can we tell PD is continuing?
CAL and probing depth increasing
What does healthy gingiva look like?
scalloped gingival margin
knife-like papillas
pink (salmon) color
What does diseased gingiva look like?
blunted/bulbous/rounded interproximally engorged vasculature red color bleeding by probing CAL fibrotic tissue - if smoker
