Tissue Damage & Disease Progression

Question 1

what’re the 4 key stages in disease development in dental biofilm induced gingivitis

Answer 1

1. initial gingivitis
2. early gingivitis
3. established gingivitis
4. periodontal breakdown

Question 2

describe the ‘initial gingivitis’ stage of disease development

Answer 2

• inflammation 24-48hrs after plaque accumulation
• increased vasodilation

Question 3

describe the ‘early gingivitis’ stage of disease development

Answer 3

• 1wk after plaque accumulation
• increased inflammation
• fibroblasts show signs of cell damage
• early loss of gingival collagen
• gingival hyperplasia (lead to false pocketing)

Question 4

describe the ‘established gingivitis’ stage of disease development

Answer 4

• increased inflammation
• plasma cells infiltrate
• fibroblasts show signs of cell damage
• early loss of gingival collagen

Question 5

describe the ‘periodontal breakdown’ stage of disease development

Answer 5

• loss of tissue attachment
• apical migration of junctional epithelium (real pocket)
• alveolar bone loss
• bone resorption

Question 6

how to the following effect tissue damage in epithelium:
- bacterial toxins
- bacterial enzymes
- complement activation

Answer 6

• prevent normal epithelial turnover
• damages keratinocytes
• caused by cell damage

Question 7

how to the following effect tissue damage in connective tissue:
- bacterial toxins
- bacterial enzymes
- complement activation

Answer 7

• toxic to fibroblasts (Decreases collagen production)
• degrade extra-cellular matrix
• damage to fibroblasts

Question 8

name some bacteria-derived bone resorbing agents (3)

Answer 8

1. A.actinomycetemcomitans
2. lipopolysccharides
3. peptidoglycan