periodontal disease

Question 1

Periodontium

Answer 1

Tissue supporting and anchoring the tooth: Gingiva, gingival attachment, cementum, periodontal ligament, alveolar bone.

Question 2

Tooth supporting structures of periodontium

Answer 2

Cementum, periodontal ligament, alveolar bone

Question 3

What is necessary to initial periodontal disease?

Answer 3

Bacterial plaque.

Question 4

Direct effect of periodontal disease

Answer 4

Invasion of bacteria, exotoxin release, and proteases

Question 5

Indirect effect of periodontal disease

Answer 5

Immune and host response that leads to tissue destruction

Question 6

Types of periodontitis

Answer 6

Chronic, aggressive, and systemic disease periodontitis.

Question 7

Chronic periodontitis

Answer 7

Most common, from plaque/calculus formation. tissue destruction proportional to amount of plaque.

Question 8

Aggressive periodontitis

Answer 8

Not consistent with plaque/calculus, rapid, gram neg. actinobacillus actinomycetemcomitans. Abnormality PMN and hypersensitive macrophages. Increases prostaglandins and IL-1B…..two forms

Question 9

Localized aggressive periodontitis

Answer 9

strong antibody response. Associated with actinobacillus actinomycetemcomitas. Abnormal neutrophil and rapid destruction around 1st molars/incisors

Question 10

generalized aggressive periodontitis

Answer 10

poor antibody response. Genetic factor. Rapid bone/attachment loss.

Question 11

Are all bacterial plaque equally pathogenic?

Answer 11

No, specific bacteria responsible for destructive periodontitis

Question 12

Actinobacillus actinomycetemcomitans

Answer 12

Localized aggressive periodontitis…is gram negative.

Question 13

Virulent factors of periodontal disease

Answer 13

Proteases, hemagglutinin (bind host cell receptor), LPS, Fimbriae, polysaccharide capsule

Question 14

Hemagglutinins and protease

Answer 14

Used by P. gingivalis to lyse RBC to extract nutrients. Protease also degrade serum antibodies, complement, and cytokines.

Question 15

Leukotoxin

Answer 15

Secreted by Actinobacillus actinomycetemcomitans to destroy PMN and monocytes.

Question 16

Host innate response to oral infections

Answer 16

Secrete IL-1B and TNF-a and prostaglandins (PGE2). LPS bind to CD14 and TLR-4

Question 17

PGE2 (prostaglandins)

Answer 17

Found in GCF. Responsible for bone re-absorption/induction/destruction in P. gingivalis

Question 18

NSAIDS and dexamethasone

Answer 18

Decrease/complete inhibit of loss of alveolar bone.

Question 19

Early periodontal lesions

Answer 19

Cell immune response. T cells and macrophages. Th1-cell with IL-12, and INF-y. Cytokines lead to macrophage activation.

Question 20

Established and late lesions

Answer 20

B cells and plasma cells. Progression controlled by Th2-cell derived cytokines with antibody production and disease progression. Increased overproduction of cytokines IL-1 and inflammation. Chronic inflammation

Question 21

Localized aggressive periodontitis characteristics

Answer 21

Elevated levels of IgG2

Question 22

T-helper 1 antibody periodontitis

Answer 22

early Aggressive periodontitis