Flashcards in Perio and Systemic Health Deck (33):
The ________ reaction cascade is a mechanism by which periodontitis could potentially influence systemic disease (which gives some truth to the Focal Infection Concept).
What is the "focal infection concept?"
spread of bacteria from the oral cavity causes many chronic diseases
What 3 problems were found with the Focal Infection Concept?
1. extracting teeth didn't necessarily cure disease
2. People with good oral health/no infection still developed systemic disease
3. People with no teeth still developed systemic disease
What are the steps involved in an Acute-Phase Reaction cascade?
Triggering factors --> Local Reaction --> Mediators(cytokines) --> Secondary Systemic Reaction
Infection, necrosis, radiation, neoplasia, and surgery are all examples of ______ in the Acute-Phase Reaction Cascade.
Macrophages, Fibroblasts, and endothelial cells are ______ factors in the Acute-Phase Reaction.
Mediators of the Acute-Phase Reaction Cascade involve the production/release of _______ _______ such as TNFalpha, IL-1, IL-6, and IFNgamma.
Fever, serum, complement, and alternative synthesis of proteins describe the ________ phase of the Acute-Phase Reaction Cascade.
Secondary Systemic Reaction
What are the five important "acute phase proteins?"
1. Complement components (lysis, chemotaxis, opsonize)
2. Protease Inhibitors (alpha1 macroglobulin)
3. C-reactive Protein (opsonization)
4. Fibrinogen (coagulation, chemotaxis)
5. Plasminogen (breaks down clots)
In addition to complement components, which Acute-Phase protein is involved in chemotaxis?
How does periodontitis result in systemic exposure to bacteria and inflammatory cytokines?
-Periodontal pockets = LARGE SURFACE AREA exposed to gram negative bacteria
-infection results in INCREASED INFLAMMATION
What are the seven conditions that define a risk factor?
1. Consistency of _____
2. Strength of _______
3. Correct _______
4. Specificity of ______
5. Degree of ______
6. Biological ______
7. Support from ________
1. consistency of association
2. strength of association
3. correct time sequence
4. specificity of association
5. degree of exposure
6. biological plausibility
7. support from experimental evidence
True or False: The potential factor relating periodontitis must precede the occurrence of systemic disease, it cannot be coincident.
What are the four systemic diseases that are associated with periodontitis?
-Atherosclerotic Vascular Disease
-Adverse Pregnancy Outcomes (low birth weight)
-Respiratory complications (pneumonia, COPD)
What are the three layers that are present in healthy elastic arteries?
Atherosclerosis is a progressive disease in which large to medium sized muscular and large elastic arteries become occluded with fibro-lipid lesions termed ______.
What are the two complications commonly related to atherosclerosis?
-acute myocardial infarction
In atherosclerosis, there is a/an _______ in the blood supply surrounding the adventitia.
increase (need more blood to overcome lipid accumulation)
True or False: Periodontitis and AVD share common risk factors or etiological pathways.
Because there are _______ _______ between AVD and periodontitis, studies must be adjusted to account for these factors.
What are the four major confounding factors relating AVD to periodontitis?
True or False: Although it is not extremely strong, the evidence is predominantly positive and consistent in relating periodontitis to AVD.
There are three biological pathways that explain the link between periodontitis and CVD:
1. effect of periodontal bacteria on ______
2. Invasion of _____ cells and _____ by perio bacteria
3. ______-like effects of pro-inflammatory mediators
2. endothelial, macrophages
Gingipains from P.g will upregulate expression of ______ which is pro-inflammatory and will downregulate _______ which is anti-inflammatory inhuman aortic smooth muscle.
angiopoetin 2 = pro-inflammatory
angiopoetin 1 = anti-inflammatory
The increase in angiopoetin 2 and decrease in angiopoetin 1 in smooth muscle cells will increase migration of cells and promote ______.
True or False: The association between periodontal disease and C-reactive Protein doubles when adjusted for age.
True or False: Studies support a causal relationship between periodontitis and AVD.
False: studies support an association NOT causation
True or False: There is strong evidence of association between adverse pregnancy outcomes and periodontitis.
False, modest association
True or False: Periodontal therapy appears to significantly reduce overall rates of PTB or LBW.
True or False: Poorly controlled diabetics of both Type 1 and Type 2 tend to have more periodontal attachment loss than non-diabetics.
Evidence for the link between diabetes and periodontitis shows ________.
association not causality
True or False: Systemic reviews detected conclusive evidence of an association between periodontitis and COPD.