host responce in PDD/aetiolgy in PDD

Question 1

what do rete ridges do

Answer 1

prevent mobiltiy

Question 2

junctional epitheliumis suceptible to

Answer 2

bacterial infection

bacterial produces can get access inaide tissue

Question 3

why is junctional epithelium permeable

Answer 3

we need to secrete out into the OC

Question 4

flattened cells

Answer 4

contain hemidesmosomes (contact BM)

Question 5

pathologu of periodontal disease

Answer 5

saliva
epithelium
inflammatory responce

Question 6

which antibody is found in saliva

Answer 6

secrety IgA

Question 7

IgA

Answer 7

secreted as a dimer into OC through epithelial cells

- when being secreted a J chain attatches to it which links th emonomers together to form a dimer

Question 8

what does IgA do to bacteria

Answer 8

bind to bacteria or products to stop its function
4 potential contact points
aggregates bactera

Question 9

what does bacteria need to grow

Answer 9

iron

Question 10

lactofrrin

Answer 10

compeititve inhbitor
binds to and sequesters free ion
binds LPS leading to formation of perioxide, increases bacterial membrane permeability

Question 11

salivary thiocynate

Answer 11

enzyme
NADPH converted to hydrogen perioxoide, converted to HOSCN
is then coverted to hypothiocyanous acid in low amounts

Question 12

types of antimicrobial proteisn

Answer 12

Defensins
Catholicidin peptides
Cathepsi C

Question 13

Defensins

Answer 13

• Highly cationic membranes that insert into the bacterial membrane to create pores and bacterial cell lysis

Question 14

catholicidin peptides

Answer 14

• punches holes in bacteria membranes in particular lipoprotein membranes(gram -)

Question 15

cathepsin C roles

Answer 15

• serine protease released mainly by neutrophils
• degrades the outer membrane protein of bacteria
• activates other proteases via cleavage
• cleaves ECM components

Question 16

role of eptihelum

Answer 16

desquamation means any bacteria is shed
permability barrier
junctional epithelium more permeable, sulcus bactera trapped
epithelum can stimulate immune responce and release cytokines

Question 17

what is secreted from JE

Answer 17

gingival crevicular fluid

Question 18

gingival crevicual fluid contains

Answer 18

C1-9

Question 19

role of c3b

Answer 19

• inserts itself into the membranes of the bacteria

- leukocytes phagocytose it

Question 20

C5-9

Answer 20

• membrane attack complex
• destroys microorganisms
• forms a channel pore to lyse the bacteria

Question 21

C3a-C5a

Answer 21

• attract neutprhils and macrophages to the area(if complement is activated)
• vascular changes (increase permeability by the histamine)
• stimulate histamine release
• promote formation of leukotrienes and prostaglandins (pro inflammatory molecules)
• attract phagocytes by chemotaxis and aid phagocytosis via opsonisation

Question 22

clotting cascade purpose

Answer 22

prevent spread to blood

fibrin forms a barrier to spread of infection

Question 23

kininogens

Answer 23

• converted to kinins by proteases eg brady kinin
• acts very similar to histamine, promotes inflammatory respnce
• more serum and leukocytes into the OC due to vasodialtion

Question 24

gingival crevicualr fluid limiatiosn

Answer 24

• bacteria in plaque can metabolise some components

- complement, immunoglobulin and other components partly consumed and degraded in crevice

Question 25

how do neutrophils leave the blood stream

Answer 25

via extravasion and migrate towards site | attracted by chemokines

Question 26

functions of neutrophils

Answer 26

phagocytosis bind to complement receptors (opsonisation) (if macrophage present will use MHC class II)

Question 27

neutrophil function in PDD

Answer 27

production of Neutrophil extracellular traps | kill microbes by antimicrobial peptides

Question 28

how do NETs work

Answer 28

- neutrophil will pick up and phagocytose as many bacteria as it can - as they die (eaten as many bacteraia as possibke)they throw DNA strands, this will capture bacteria on the outside - bacteria caught in the DNA strands - macrophage can recognise and eat it

Question 29

how do neutrophils attempt to remove biofilm

Answer 29

- secrete enzymes and NETS - Kill bacteria and solublise plaque - Washed out by GCF

Question 30

chemokines funciton

Answer 30

- stimulate immune response - release cytokines (drives inflammatory reponnsce) - phagocytose - stimulate healing (helps epithelium) if there is no permanet damage at this stage/no periodontits

Question 31

tissue macrophages

Answer 31

Surveillance macrophages - once the microbial load is too great they’ll respond - secrete factors that recruit monocytes (blood) to the tissue - then turn into macrophages into the tissue

Question 32

what can macrophages do

Answer 32

- phagocytose - antigen presenting - secrete factors - secrte factors which increase inflame repsonce

Question 33

adaptive immune repsonce

Answer 33

1) Humoral immunity - B cells - Production of antibody by plasma cells 2) Cell mediated immunity - T cells - immune regulation and cytotoxic T cell killing of virally infected and neoplastic cells

Question 34

what happens to bacteria which has been swallowed

Answer 34

- can be then associated with mucosal associated Lymphoid tissue - Degraded in the stomach - if not, in the intestines there are immune patches that have lymphoid tissue - bacteria antigens can get taken up by the MALT^ - presented by dendritic cells/macrophages - can then get B cell production of antibodies - antibodies enter the serum and come out of the JE as the blood vessels there are very leaky

Question 35

roles of antibodies in defence

Answer 35

- acts an opsonin - activates neutrophil enzyme secretion (neutrophil degranulation) - prevents bacterial attachment - activates complement

Question 36

antibodies and soluble factors

Answer 36

- neutralises toxins by binding to the active site | - inhibits enzymes (by binding to its active site)

Question 37

chronic marginal gingivitus and characteristics

Answer 37

caused by expansion of the biofilm Some of the enzymes attack the biofilm so much the tissue begins to be damaged) Bleeding on probing (due to fragile tissue) False pocketing - due to swollen gingiva but functional epithelium still attached Junctional epithelium still attached - Gingivitis is reversible - alveolar bone is still intact

Question 38

destructive periodonttis

Answer 38

Complete breakdown - alveolar bone broken down - not reversible

Question 39

periodontal pocket

Answer 39

- pathologically deepened gingiva sulcus that may occur by coronal movement of the gingiva margin apical displacement of gingiva attachment or both

Question 40

cause of tissue damage and bone loss in periodotnal disease

Answer 40

bacteria products | host products

Question 41

bacteria products which damage bone and tissue

Answer 41

1) Endotoxins - may damage epithelium - fibroblasts 2) Bacterial enzymes - collagenase - hyaluronidase - gingipains break down the connective tissue 3) Lipopolysaccharide, capsular material, peptidoglcans,muramyl dipeptide, proteases may cause bone resorption

Question 42

host products which cuase tissue and bone loss

Answer 42

1) Release of enzymes from neutrophils - damaging cell tissues - negative feedback tissues on our own issues 2) complement 3) production of IL-1, IL-6 by macrophages - stimulates bone resorption and epithelial proliferation - tries to drive an inflammatory responce 4) Inflammatory mediators - prostaglandins - other cytokines - leukotrienes also stimulates bone resorption