Term
| Can the presence of periodontal pathogens alone cause tissue destruction? |
|
Definition
|
|
Term
| What works with the periodontal pathogen to cause tissue destruction? |
|
Definition
| the body's response + periodontal pathogen cause destruction seen in periodontitis. |
|
|
Term
| What type of tissue involvement is chronic inflammation? |
|
Definition
|
|
Term
| What type of tissue involvement is acute inflammation ? |
|
Definition
|
|
Term
| In Periodontal disease what is the Immune system trying to defend against? |
|
Definition
|
|
Term
| what is the main purpose of the cody's defenses (immune system)? |
|
Definition
| to save the life of the host, not to save the tooth or supporting Periodontal tissues. |
|
|
Term
| what do biochemical mediators do? |
|
Definition
| activate the inflammatory response by secreting immune cells |
|
|
Term
| what are 3 important mediators in periodontal disease? |
|
Definition
Cytokines
Prostoglandins
matrix metalloproteinases (MMP's) |
|
|
Term
| what do cytokines signal to the immune system? When are they produced? |
|
Definition
-to send more phagocytes to the site of the infection
-produced in response to tissue injury |
|
|
Term
| What are the different cells that produce cytokins? |
|
Definition
-PMN's
-macrophages
-T lymphocytes
-epilthelial cells
-gingival fibroblasts
-osteoblasts |
|
|
Term
| what are the cytokines that are important in periodontal disease? |
|
Definition
| IL-1, IL-6, IL-8, TNF-alpha |
|
|
Term
| what is the function of Cytokines? |
|
Definition
| to recruit cells to infection site |
|
|
Term
| What increases Vascular permeability that increases movement of immune cells into the tissue? |
|
Definition
|
|
Term
| what can cytokines do in periodontitis or chronic infections? |
|
Definition
| initiate tissue destruction and bone loss |
|
|
Term
| What is the name of a powerful inflammatory mediator? |
|
Definition
|
|
Term
| name the series of prostaglandins? |
|
Definition
|
|
Term
| Can most cells produce prostaglandins? |
|
Definition
|
|
Term
| what is the main function of prostaglandins (Edema)? |
|
Definition
| Increase permeability and dilation of blood vessels to premote increased movement of immune cells to the infection site |
|
|
Term
| what destroys the alveolar bone? |
|
Definition
|
|
Term
| what promotes the overproduction of destructive MMP enzymes? |
|
Definition
|
|
Term
| Which series of prostaglandins initiates most of the alveolar bone destruction in periodontitis? |
|
Definition
|
|
Term
| Matrix Metalloproteinases (MMPs) family consists of at least how many enzymes? |
|
Definition
|
|
Term
| what are some cells that produce MMPs? |
|
Definition
| PMNs, Macrophages, fibroblasts, JE cells |
|
|
Term
| Enzymes act together to do what? |
|
Definition
| breakdown connective tissue matrix |
|
|
Term
| What does a destruction of collagen fibers lead to? |
|
Definition
|
|
Term
| What is the function of MMP's in a healthy person? |
|
Definition
| MMP's facilitate normal turnover of the periodontal connective tissue matrix. |
|
|
Term
| What is released in an attempt to kill invading bacteria? |
|
Definition
|
|
Term
| what does an overproduction of MMP's result in? |
|
Definition
| the breakdown of connective tissue of the periodontium |
|
|
Term
| what type of periodontium destruction occurs with an MMP overproduction? |
|
Definition
-extensive collagen destruction
-gingival, PDL, Alveolar bone destruction via recession, pocketing, tooth mobility |
|
|
Term
| The Hypersensitive function in chronic inflammation, Cytokines initiate what kind of destruction? |
|
Definition
|
|
Term
| Prostaglandins (GGE) initiate what type of destruction? |
|
Definition
| Alveolar bone destruction |
|
|
Term
| MMP's initiate what type of destruction? |
|
Definition
|
|
Term
| if a person has periodontal pathogens will they experience periodontitis? |
|
Definition
|
|
Term
| will all intensities of immune responses be the same? |
|
Definition
| no they vary from one individual to another |
|
|
Term
| what will vary in intensity from site to sire within a patient's mouth? |
|
Definition
|
|
Term
| what type of disease may/can be exhibited with abundant bacterial plaque? |
|
Definition
|
|
Term
| what type of disease response might be seen with light bacterial plaque? |
|
Definition
|
|
Term
| Untreated gingivitis does not always lead to what? |
|
Definition
|
|
Term
| Will all people infected with pathogens get periodontal disease? |
|
Definition
|
|
Term
| What do pathogenic bacteria infect? |
|
Definition
|
|
Term
| the body responds to pathogenic bacteria by? |
|
Definition
| mobilizing defensive cells |
|
|
Term
| During periodontal disease the body's immune system causes WHAT in an attempt to stop bacterial infection? |
|
Definition
|
|
Term
| what determines the onset and severity of periodontal disease? |
|
Definition
| the interactions between periodontal pathogens and host response |
|
|
Term
| what are the 4 phases of microscopic changes in periodontal disease? |
|
Definition
accumulation
plaque overgrowth
subgingival plaque
tissue destruction |
|
|
Term
| what is early gingivitis? |
|
Definition
| plaque overgrowth phase (supra-gingival) |
|
|
Term
| what is established gingivitis? |
|
Definition
| Subgingival plaque phase (supra- and sub- gingival) |
|
|
Term
| What type of phase is periodontitis? |
|
Definition
|
|
Term
| Where do the bacterial colonize on the tooth in Early Bacterial Accumulation phase? |
|
Definition
|
|
Term
| What type of bacteria initiate host response in Early bacterial accumulation phase? |
|
Definition
|
|
Term
| where do PMN's pass from the bloodstream to? |
|
Definition
| into the gingival connective tissue. |
|
|
Term
| PMNs release what that destroys gingival connective tissue? |
|
Definition
|
|
Term
| the release of cytokines allows what? |
|
Definition
| PMNs to move quickly through the tissue |
|
|
Term
| PMNs migrate from connective tissue into the sulcus and does what? |
|
Definition
|
|
Term
| At what stage of plaque control and immune response can the body repair the destruction caused by immune system? |
|
Definition
| Early Bacterial Accumulation Phase |
|
|
Term
| What happens in the Early Gingivitis plaque overgrowth phase? |
|
Definition
| Bacteria penetrate into the connective tissue, JE cells release inflammatory mediators and attract more PMNs which would increase the localized destruction of the connective tissue |
|
|
Term
| Macrophages are recruited to the connective tissue, they release what? |
|
Definition
| cytokines, PGE2, and MMPs |
|
|
Term
| What phase, if the bacterial infection is controlled with plaque control and immune response is able to repair the destruction caused by the immune response? |
|
Definition
| Early Gingivitis plaque Overgrowth phase |
|
|
Term
| In what phase does Plaque biofilm extend subgingivally and disrupt the coronal most attachment portion of the JE? |
|
Definition
| Established Gingivitis Subgingival plaque phase |
|
|
Term
| what cells are the most numerous in connective tissue? Which are most numerous in the sulcus? |
|
Definition
-macrophages and lymphocytes
-PMN's |
|
|
Term
| The PMNs fight bacteria in the _______? |
|
Definition
|
|
Term
| what do Lymphocytes produce to fight the bacteria ? |
|
Definition
|
|
Term
| What does the Host cells produce that are toxic chemicals? |
|
Definition
|
|
Term
| What causes destruction of collagen fibers in gingival connective tissue? |
|
Definition
|
|
Term
| If the bacterial infection is controlled with plaque control and immune response, the body is able to repair the destruction caused by the immune response. But in susceptible individuals, gingivitis progresses into periodontitis is what PHASE? |
|
Definition
| Established Gingivitis Subgingival Plaque Phase |
|
|
Term
| After what stage is gingivitis irreversible? |
|
Definition
| Established Gingivitis Subgingival plaque phase |
|
|
Term
| At what stage is the bacteria challenge is not well controlled by host and tissue destruction is evident. Bacteria in biofilm flourish and are protected against host defense cells? |
|
Definition
| Periodontitis tissue destruction Phase |
|
|
Term
| In periodontitis phase how does the biofilm grow? |
|
Definition
| along the root surface laterally and apically |
|
|
Term
| A relentless bacterial challenge to host cells where more defense cells rush to the site causing more tissue damage causes the immune response to become? |
|
Definition
| Chronic, where the periodontium is harmed. |
|
|
Term
| What produces high levels of cytokines that destroy connective tissue and PDL fibers? |
|
Definition
|
|
Term
| what is present in Periodontitis and destroys connective tissue and Bone? |
|
Definition
|
|
Term
| what stimulates osteoclasts and initiates bone destruction? |
|
Definition
|
|
Term
| what happens to the JE in perodontitis? |
|
Definition
| the JE extends rete ridges into the connective tissue and migrates apically along the root surface. |
|
|
Term
| is perodontitis reversible? |
|
Definition
|
|
Term
| Macrophages Produce what 3 things? |
|
Definition
|
|
Term
| Cytokines, PGE2 and MMPs stimulate fibroblasts to secrete more _____ & ______ ? |
|
Definition
|
|
Term
| Mediators from the macrophage and fibroblast result in? |
|
Definition
| destruction of the connective tissue |
|
|
Term
| What stimulates osteoclasts to resorb the crest of the alveolar bone? |
|
Definition
|
|
Term
What Stage is ...
- Can't see
-2 to 4 days of plaque biofilm
-Gram - Bacteria trigger body's Host response
-Cytokines released
-PMN's released
? |
|
Definition
|
|
Term
| In the sub-clinical stage is the patient showing clinical signs yet? |
|
Definition
|
|
Term
What Stage is...
-4 to 7 days
- Red, swollen, edema, stippling disappears
-JE cells release cytokines
-Connective tissue destruction
-PMN's form wall to fight bacteria
-Cytokines attract more immune cells
-Macrophages release more cytokines, PGE and MMP's
? |
|
Definition
Early Gingivitis
(Plaque overgrowth Phase) |
|
|
Term
What stage is.....
- Occurs in 15-21 days or 3 weeks
- Subgingival plaque extends in sulcus
- increased pocket depth due to inflammatory response
-Macrophages and Lymphocytes(PMNs) are most numerous
-Lymphocytes produce antibodies to fight infection
-PGE and MMP cause destruction in gingival collagen fibers
-Disease is reversible
-Body can repair destruction caused by immune response
? |
|
Definition
|
|
Term
what stage is.....
-Plaque biofilm grow laterally and apically along root surface
-relentless bacterial challenge
-over reactive immune system
-Cytokines,PGE,MMPs destroy connective tissue and alveolar bone
-JE extends rete ridges into connective tissue and migrates apically along root
-Disease is Irreversible
? |
|
Definition
|
|
Term
| what is the acute inflammation process? |
|
Definition
| 2 weeks or less, heat, redness, swelling and pain |
|
|
Term
| What is the chronic inflammation process? |
|
Definition
| more than a few weeks, occurs when body is unable to fight bacteria, warning signs may not be present |
|
|
Term
| Is color, contour, consistency and texture changes obvious with Chronic inflammation? |
|
Definition
|
|
Term
| what are some key words to describe chronic inflammation? |
|
Definition
| fibrotic, less resilient, deepening redness... |
|
|
Term
| Periodontal disease is what type of infection? |
|
Definition
|
|
Term
| The body responds to periodontal pathogens by? |
|
Definition
| Mobilizing defensive cells |
|
|
Term
| Name the 4 distinct phases of microscopic changes in the periodontium ? |
|
Definition
- Early bacterial accumulation phase
-Early gingivitis- Plaque overgrowth phase
-Established Gingivitis- Subgingival plaque phase
-Periodontitis- Tissue destruction Phase |
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