Pathogenesis Flashcards by Cutler Frandsen

What are the 5 components of Microbial Plaque?

Bacteria
Fungus
Protozoa
Virus
Microplasm

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What are the two types of plaque?

Subgingival

Supragingival

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What are components of the supragingival plaque?

Coronal plaque

Marginal Plaque

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What are the components of the subgingival plaque?

Attached plaque

Unattached

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Where do you find the attached plaque?

Tooth
Epithelium
Connective Tissue

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What are the five cardinal signs of inflammation?

Redness (rubor)
Swelling (tumor)
Heat (calor)
Pain (dolor)
Loss of function (functiolaesa)

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Is supragingival plaque aerobic or anaerobic?

aerobic

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Is subgingival plaque aerobic or anaerobic?

anaerobic

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What can increase the subgingival plaque if it accumulates?

Supragingival plaque

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What can cause the pain from the five cardinal signs of inflammation?

Abcesses

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If you have an increased number of blood vessels in the gingiva what might that be a sign of?

Periodontal disease

Inflammation

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What happens to the epithelial ridges (rete pegs) when you have periodontal disease or inflammation?

They extend deep into the connective tissue

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T/F Probing depth increase during inflammation or periodontal disease.

True

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T/F You have decreased vascular permeability during inflammation/ periodontal disease?

False

You have increased permeability

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What happens to the collagen fiber network in periodontitis?

It goes through destruction

Loss of attachment to root surface

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What happens to the epithelial cell junctions with inflammation?

They get disrupted

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What does the gingiva look like clinically with inflammation?

Erythematous tissue
Spongy
Edematous

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When does the initial lesion occur?

2-4 days

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When do you first see the loss of perivascular collagen?

Initial lesion

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What happens to the junctional epithelium during the initial lesion?

Alteration of the most coronal portion

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When do you find increased migration of leukocytes into the junction epithelium and gingival sulcus?

Initial lesion

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Where do you find classic vasculitis of vessels in the initial lesion?

subjacent to the junction epithlium

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When do you find the presence of serum proteins, especially fibrin?

Initial lesion

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When clinically will you find these symptoms?
Appear clinically Healthy
No periodontal Pocket
No radiographic evidence of bone loss

Initial lesion

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When does the early lesion occur?

4-7 days

``` If you have: Acute form Gingivitis Changes in gingival color, contour, consistency No periodontal pocket No radiographic bone loss ```

Early lesion

When do you find the accumulation of lymphoid cells subjacent to the Junctional epithelium?

early lesion

When do you find the cytopathic alterations of fibroblast?

early lesion

When do you find the beginning of proliferation of basal cells in the junctional epithelium?

early lesion

``` If you have: Chronic gingivitis Changes in gingival color, contour, consistency No periodontal pocket No radiographic bone loss ```

Established lesion

When does the established lesion occur?

2-3 weeks

When do you find proliferation, apical migration and lateral extension of the junctional epithelium?

Established lesion

When do you find the predominance of plasma cells without appreciable bone loss?

Established lesion

When do you find the presence of immunoglobulins extravascularly in the connective tissue and the junctional epithelium?

Established lesion

When do you find histologic evidence that early pocket formation may or may not be present?

Established lesion

When do you find the advanced lesion?

Greater than 3 weeks

``` If you have: Periodontitis changes in gingival color, contour, consistency and bleeding on probing Periodontal pocket formation Alveolar bone loss shown on radiographs ```

Advanced lesion

When do you find the conversion of distant bone marrow into fibrous connective tissue?

Advanced lesion

When do you find cytopathically altered plasma cells?

Advanced lesion

When do you find the extension into alveolar bone and PDL with significant bone loss?

Advanced lesion

When do you find widespread manifestations of inflammatory/immunopathologic reaction?

Advanced lesion

What three diagnoses will you find the periodontal connective tissue attachment intact?

Normal Early gingivitis Chronic gingivits

When do you find that the periodontal connective tissue attachment is lost?

Adult periodontitis

When do you find the alveolar process intact?

Normal Early gingivitis Chronic gingivitis

What stage of diagnosis do you find few bacteria in the gingival crevice or pocket?

Normal

What stage of diagnosis do you find complex flora fills in the gingival pocket with calculus possibly present?

Chronic gingivitis

What stage of diagnosis do you find complex flora filling the gingival pocket?

Early gingivitis

When do you find subgingival flora containing specific pathogens with calculus to the bottom of the pocket?

Adult periodontitis

When do you find tight intercellular junction and the JE at the CEJ?

Normal

When do you find widened intercellular spaces containing leukocytes and the JE at the CEJ?

Early gingivitis

When do you find greater leukocytic infiltrate of JE but the JE is still at the CEJ?

Chronic gingivitis

When do you find the JE apical to the CEJ and converted to pocket epithelium?

Adult periodontitis

When do you find the supracrestal attachment intact?

Normal

When do you find the loss of attachment of the CT, Ct infiltrated by round cells mainly lymphocytes?

Early gingivitis

When do you find the loss of attachment: CT infiltrated by round cells, mainly plasma cells?

Chronic gingivitis

When do you find the loss of attachment: plasma cells predominant in the CT?

Adult periodontitis

Is the innate immune system specific or nonspecific?

Non-specific

Is the acquired response Specific or non specific?

Specific (adaptive)

What cell causes the most damage in the acute phase (gingivitis)?

Neutrophil

What cell causes the most damage in periodontitis?

Fibroblast

What are some important immune cells that are involved in plaque accumulation and initiation of gingivitis?

``` Mast Cells Acute phase proteins Complement PMN antibodies ```

What histologic state are you in if you have Slightly elevated vascular permeability and vasodilation?

Initial lesion

What histologic state are you in if you have gingival crevicular fluid flowing out of the sulcus?

Initial lesion

What histologic state are you in if you Migration of leukocytes, primarily neutrophils, in relatively small numbers though the gingival connective tissue across the JE and into the sulcus?

Initial lesion