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Biochem Final > Oral Tissues II > Flashcards

Oral Tissues II Flashcards

(93 cards)

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1
Q

What are some functions of saliva?

A

buffering
maintenance of tooth integrity
antimicrobial
digestion
taste

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2
Q

what are the three major salivary glands?

A

parotid, sunmand and sublingual

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3
Q

what does each parotid gland secrete?

A

serious fluid
amylase

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4
Q

what does sublingual gand secrete?

A

mucus

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5
Q

what does submand secrete?

A

both mucus and serous

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6
Q

The basic secretory structure of salivary glands is a pouchlike
structure called an ____, connected to a duct

A

acinus

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7
Q

The acini and ducts constitute a _______________ separating the extracellular matrix (outside) from the secretory lumen (inside).

A

continuous single layer of
cells

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8
Q

Stimulation of saliva results in a decrease _______, resulting in a thinner, less viscous saliva

A

in overall protein
concentration

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9
Q

electrolyte concentrations change what when stimulated

A

HCO3- is higher
*pH is higher

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10
Q

Some fluid passes directly from the ECM
into the secretory lumen,
________________________

A

through the interstitial spaces

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11
Q

Some fluid passes directly from the ECM into the secretory lumen, through the interstitial spaces between acinar cells (arrows).

Through this route, ______(what can get into saIiva) ________
In uncontrolled diabetes, glucose levels in saliva are
elevated, leading to an increased risk of dental caries

A

glucose and other small hydrophilic
molecules (including hormones and drugs) can leak
into saliva (rate ~proportional to their plasma levels).

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12
Q

Activation of acetylcholine or
adrenergic receptors on acinar cells stimulates release of _____________

A

the second messengers
cAMP or Ca2+

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13
Q

what do antichoineric drugs do?

A

drugs target salivary glands causing dry mouth

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14
Q

what is whoe saiva contain?

A

Contains components of non-glandular origin, such as
desquamated oral epithelial cells, food debris,
microorganisms, and blood-derived compounds (plasma
proteins, erythrocytes and leucocytes)

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15
Q

what is saIiva fIow important for?

A

essential for the mechanical
rinsing of the oral cavity, for dissolving taste substances and
transporting them to taste receptor sites, protection of the
taste buds, food bolus formation, clearance of food debris and
micro-organisms, and facilitation of mastication and
swallowing as well as speech

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16
Q

Salivary flow is stimulated by

A

Chewing (an adaptive response to eating)
Mechanical stimulation (for example, by dental work)
Nausea (an adaptive response to the possibility of oral exposure to regurgitated stomach acids)
Tasting or smelling foods

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17
Q

what decreases salivary flow?

A

Many types of drugs (e.g., anticholinergics)
Fear
Sleep
Xerostomia

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18
Q

what is the consequence of hyposalivation?

A

shift in the oral microbiota favoring the growth of more aciduric and acid-tolerating bacteria, especially Streptococcus mutans, Streptococcus sobrinus and lactobacilli, which through fermentation of carbohydrates
produce acids that increase the risk for dental caries

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19
Q

what is the acquired enamel pellicale?

A

layer of salivary glycoproteins
that precipitates on the enamel surface of teeth

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20
Q

The acquired pellicle is a ________________

A

very thin transparent protein sheath

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21
Q

During acid demineralization, the acquired pellicle may have what function?

A

retard the diffusion of acids into enamel and calcium and
phosphate out of enamel

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22
Q

what makes up the Enamel pellicle?

A

adsorbed salivary proteins, such as mucins, lactoferrin, lysozyme, α- amylase, and secretory IgA
that interact with several oral bacteria on adsorption to
hydroxyapatite

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23
Q

how fast do you get the thin protein sheath recovering the teeth surface?

A

2 hours

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24
Q

Saliva contribution to the acquired enamel pellicle helps to
modulate ___________

A

the initial adhesion and colonization of microorganisms

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25
Saliva facilitates clearance of
microorganisms and dietary carbohydrates from the oral cavity, but it also supplies colonizing bacteria with nutrients, i.e., through breakdown of dietary starch
26
Saliva also provides anti-microbial activity through numerous proteins including:
mucins, lactoferrin, lysozyme, lactoperoxidase, and antibodies (secretory immunoglobin A, sIgA
27
Salivary mucins have the _________________ whereby their adherence and colonization are inhibited
capacity to bind and aggregate microorganisms
28
Saliva also plays an important role in clearance of _____________ each of which carry about 100 microorganisms and for elimination of the microorganisms present in saliva
desquamated epithelial cells from the oral cavity
29
The salivary buffer capacity includes:
bicarbonate, phosphate, and proteins
30
what is the relationship between bicarbonate concentration and pH increase when salivary flow rate increases?
The bicarbonate concentration and thus the pH increase when the salivary flow rate increases and vice versa
31
The most important buffer in saliva is
bicarbonate (HCO)
32
Saliva bicarbonate protects enamel against the
demineralizing effects of acid (and proteins but not as efficient)
33
Salivary mucins are:
Are hydrophilic and contain much water, this creates protective barrier against desiccation
34
The variability of the mucins complex allows what?
oligosaccharide side chains in the mucins provides wide possibilities for interactions with oral surfaces, oral microorganisms
35
what is mucin 5B?
primary gel-forming mucin in the oral cavity, is secreted by mucous cells of submandibular and sublingual salivary glands
36
what is the primary job of mucin 5B?
--affects the interactions between microbial species by promoting attachment and biofilm formation --shifting cells from the biofilm into the single cell (planktonic or free-living versus adherent) state *stays in oral cavity
37
how is MUC7 different from MUC5?
Although less efficient as lubricant, it is notably more efficient in bacterial agglutination and clearance than MUC5B and therefore an important part of the salivary non-immune defense system * MUC7 directly binds to microorganisms to facilitate their removal by swallowing
38
what is savary amylase secreted by?
Mainly secreted from the serous acinar cells in the parotid glands
39
what does amylase do?
breaks down ingested starch, maltose can be fermented by oral bacteria resulting in lactic acid that lowers pH contributing to tooth demineralization
40
salivary Lysozyme
exerts enzymatic activity via hydrolysis of the β-1,4-glycosidic bonds between N-acetylmuramic acid and N-acetyl-d-glucosamine in the polysaccharide layer of the gram-positive bacterial cell wall
41
what is Salivary Lactoferrin?
Lactoferrin is an iron-binding glycoprotein
42
what does Salivary Lactoferrin do?
originates from neutrophil granulocytes * Lactoferrin binds and sequesters iron and consequently deprives the microorganisms of iron, which is essential for their growth
43
where does igA traveI?
dimeric IgA is produced by plasma cells in the stroma of the salivary glands and then transported through the glandular epithelial cells that are exocytosis at the apical surface of the epithelial cell
44
what does igG go?
derives from blood through passive leakage via the gingival crevicular fluid, and only a minor part originates from the salivary glands
45
what is the most important defense mech of sIgA?
binding antigens
46
SUMMARY OF ANTIBACT ACTIVITIES OF SAIVA
* Flushing of unattached bacteria from the oral cavity * Lysozyme causes lysis of bacteria by breaking down their cell walls * Lactoferrin inhibits growth by sequestering iron * Salivary antibodies cross-link and clump bacteria, making them easier to eliminate by flushing * Lactoperoxidase kills bacteria by causing oxidative damage to membranes and other cellular components * Thiocyanate ion inhibits bacterial growth
47
what maintains Hydroxyapatite of nonliving enamel as well as the living mineralized tissues?
maintained by ion exchange via percolation
48
what does the ion exchange via percolation mean for HA mineraIs?
The mineral component evolves over time by ion exchange via fluids percolating through the microporosity of the hard tissue
49
what protein starts enamel growth?
acerogenin
50
how does acidity effect apatite?
it demineralizes it making it soft reacts with PO and OH ions making them unavailable for recrystallization
51
what is the difference in solubility of fluorapatite to hydroapitite?
Compared to hydroxyapatite, the solubility of fluoroapatite is much less sensitive to pH and thus more acid resistant
52
____, ____ and ____ ions in dental enamel are constantly exchanging with free ions
Ca2+, (PO4)3– , and (OH)–
53
Ions are constantly leaving the surface of enamel crystals and entering into solution this is caled
solubilization
54
If ion concentrations in solution fall below the solubility product, the rate of recrystallization will drop below the rate of solubilization, and there will be a net loss of crystal mass (demineralization). * If ion concentrations in solution are above the solubility product, there will be net remineralization at the surface of crystals
55
what happens below pH 5.5 in mouth?
General oral acidity will produce general demineralization of all enamel surfaces Localized oral acidity will produce local demineralization of the underlying enamel surfaces, possibly leading to dental caries
56
Formation of dental plaque happens when:
Newly formed pellicle is quickly invaded by bacteria in saliva and from surrounding surfaces, which attach themselves to the pellicle
57
The initial stage of bacterial growth produces:
a thin aerobic lawn of bacteria in a protein matrix
58
how do bact make mature plaque?
A matrix is formed derived from polysaccharide polymers synthesized by bacteria, which holds the growing colony together and provides a favorable environment for continued bacterial growth
59
what happens as gel like polymers restrict movement?
The gel-like polymers restrict the movement of molecules between the plaque fluid and saliva
60
As the plaque becomes thicker, what happens?
the interior becomes increasingly anaerobic, which favors the growth of anaerobic species of bacteria,
61
Plaque polysaccharides are composed principally of
glucose, with some fructose polymers present.
62
The ____ are somewhat heterogeneous
glucose polymers
63
what is most abundant glucose polymer in plaque
dextrans
64
Bacteria in the anaerobic interior of plaque have little or no access to oxygen, so they cannot generate energy by oxidative metabolism of fuels * They have only one way to generate energy:
anaerobic glycolysis
64
why does pique cause tooth structure damage?
Salivary buffers cannot diffuse into plaque very fast, and metabolic acids cannot diffuse out quickly, so an acidic environment is produced inside plaque, at the surface of the tooth, whenever glucose is available and glycolysis occurs
65
Salivary proteins inhibit the
precipitation of calcium phosphate
66
what is the zone of demineralization
Ca2+, (PO4)3– , and (OH)– diffuse out of enamel and react with H+ ions in plaque, reducing the flow of ions back into the enamel
67
what is a white spot lesion?
An active subsurface caries process advances beneath a largely intact enamel surface because fluorapatite made it seem ike no damage
68
Consequently, calcium phosphate precipitation may occur in dental plaque, leading to the formation of
dental calculus
69
Incorporation of fluoride ion (F−) into hydroxyapatite (HA) is a substitution for OH−, what does this cause?
Since F− is smaller and more electronegative than OH−, substituting F− for OH− results in tighter packing of the ions into an apatite crystal lattice (less susceptible to acid)
69
The precipitated calcium phosphate in dental plaque is _________.
heterogeneous
70
Flouride-rich apatite is a tightly packed apatite crystal that is less susceptible to acidic attack, so it is a very important factor in :
prevention, pathogenesis, and treatment of dental demineralization
71
where do most people get oral cancer?
tongue, 50% on sides or posterior lateral tongue
72
what is the second most common place for oral cancer?
floor of mouth 35%
73
what is the make to female ratio of oral cancer?
2;1 M:F
74
who is more likely to get oral cancer?
older people, 40-60 (however do not assume that cause its a woman who is 20 there is no risk cause still is)
75
what is the major risk for OPH Ca?
tobacco smoking
76
what is the genetics of oral cancer?
daughter cells in deeper layers of mouth that divide to make new cells, if damaged and not repaired then new cells have the damage too
77
is the most common way to get oral cancer?
mutation occurs like mentioned above but new carcinogens like smoking or co-carcinogens like alcohol can transform the mutation into uncontrolled differentiation of those cells and thus cancer
78
The genetic alterations:
tumor suppressor gene inactivated by mutation or oncogene activated by mutation or amplification
79
what are some risk factors for O cancer?
tobacco (esp. smoking) Alcohol Actinic radiation Human papillomavirus infection (HPV) Iron deficiency
80
_______ of oral cancer pts smoke or have history of smoking
80% (just to understand that a majority of those with ora cancer smoke BUT NOT ALL)
81
TOBACCO & ALCOHOL
Both independent risk factors for OC --Both have dose and time dependent risk (but both at same time can increase risk, can aIso get cancer doing one not other)
82
what virus' put at risk of OC?
HPV-- 5% of OC (Herpes and Epstein barr not OC)
83
Most HPV positive Head and Neck cancers arise from _______
tonsils and back into the throat (palatine tonsils/oropharynx and beyond)
84
________ most common subtype of HPV in oropharyngeal cancers
HPV16
85
does genetics play a role in OC?
not really
86
what are some symptoms of oral precancer?
painless asymptomatic sores that do not heal
87
what are some symptoms of advanced cancers?
sore that does not heal, especially on just one side
88
what do OC look like?
white or red patches, red and white patches, chronic ulcers or tumorous mass
89
anything that persists longer than ______ should be checked out
2 weeks (most epithelium will regenerate after 1-2 weeks)
90
how do you make a diagnosis?
refer patient to someone else to get a diagnosis
91

Biochem Final (6 decks)

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