Term
| What is the prime purpose of the immune system? |
|
Definition
| protect the life of the individual |
|
|
Term
| What is the term for the way in which an individuals body responds to an infection? |
|
Definition
|
|
Term
| What are the two ways the host responds to infection (forms of attack)? |
|
Definition
sending cells to infection site
producing biochemical substances to fight invading cells. |
|
|
Term
| What is an example of a systemic disease that causes loss of immune response? |
|
Definition
|
|
Term
| What immune cells are inhibited for individuals with HIV? |
|
Definition
|
|
Term
| What are the two phases of inflammation? |
|
Definition
|
|
Term
| What are the 5 signs of acute inflammation? |
|
Definition
heat
redness
swelling
pain
loss of function |
|
|
Term
| The 5 signs of acute inflammation are primarily due to what physiological response? |
|
Definition
| increase in blood flow to the area of infection |
|
|
Term
| What are the first cells to arrive at the cite of an infection"? |
|
Definition
|
|
Term
| What compound is released by PMNs when they arrive at the site of an infection |
|
Definition
| cytokines (signal more phagocytic cells to the area) |
|
|
Term
| What is a pathological condition that can destroy healthy tissue and is characterized by long term inflammatory response |
|
Definition
|
|
Term
| What stage of inflammation is usually painless and doesn't present with the typical signs of redness, swelling, etc. |
|
Definition
|
|
Term
| which inflammation phase is characterized by an accumulation of macrophages? |
|
Definition
|
|
Term
| leukocytes (PMNs and macrophages) release what compounds that are responsible for perpetuating the inflammatory response seen in chronic inflammation? |
|
Definition
|
|
Term
| What are 5 examples of conditions with chronic inflammation |
|
Definition
rheumatoid arthritis
asthma
diabetes
gingivitis
periodontitis |
|
|
Term
| what are the two leukocytes involved in periodontal disease? |
|
Definition
PMNs(neutrophils)
macrophages |
|
|
Term
| What is another name for PMNs? |
|
Definition
|
|
Term
|
Definition
short life span
die when become engorged with bacteria |
|
|
Term
| What process attracts PMNs to the cite of injury? |
|
Definition
|
|
Term
| What are the digestive enzymes within PMNs called? |
|
Definition
|
|
Term
| Which leukocytes are most effective at killing perio pathogens? |
|
Definition
|
|
Term
| Leukocytes are called monocytes when they are located where in the body? |
|
Definition
|
|
Term
| Leukocytes are called macrophages when they are located where in the body? |
|
Definition
|
|
Term
| How long to macrophages live? |
|
Definition
| long lived (seen in chronic inflammation) |
|
|
Term
| Are macrophages slow or fast to arrive at the site of inflammation? |
|
Definition
|
|
Term
| What are small leukocytes that help defend the body? |
|
Definition
|
|
Term
| What are the two classes of lymphocytes? |
|
Definition
|
|
Term
| Which lymphocytes make antibodies? |
|
Definition
|
|
Term
| What are the two forms of B cells |
|
Definition
plasma B cells
memory B cells |
|
|
Term
| what shape are antibodies? |
|
Definition
|
|
Term
| What is another name for antibodies? |
|
Definition
|
|
Term
| What are the 5 major classes of immunoglobulins |
|
Definition
M (IgM)
D (IgD)
G (IgG)
A (IgA)
E (IgA) |
|
|
Term
| What is the role of T cells in the immune response? |
|
Definition
| intensify the response of other immune cells |
|
|
Term
| What substance do T cells release to further stimulate the immune response? |
|
Definition
|
|
Term
| What is the term for compounds secreted by immune cells which activate the body's immune response? |
|
Definition
|
|
Term
| Inflammatory mediators are also known as? |
|
Definition
|
|
Term
| What are 3 inflammatory mediators important in perio disease |
|
Definition
cytokines
prostaglandins
matrix metalloproteinases (MMPs) |
|
|
Term
| What are 2 functions of cytokines in the immune response? |
|
Definition
1. signals other phagocytes (PMNs and macrophages) to the site of infection
2. increase vascular permeability |
|
|
Term
| What are 4 cytokines important in perio? |
|
Definition
IL-1 (interleukin)
IL-6
IL-8
TNF-alpha (tumor necrosis factor) |
|
|
Term
| What are two negative impacts of cytokines? |
|
Definition
| can initiate tissue destruction and bone loss in chronic infections |
|
|
Term
| What produces cytokines in response to injury? |
|
Definition
| immune cells (PMNs, macrophages, B lymphocytes, epithelial cells, osteoblasts, gingival fibroblasts) |
|
|
Term
| What are the prostaglandins produced in the immune response? |
|
Definition
|
|
Term
| What produces prostaglandins? |
|
Definition
|
|
Term
| What are 3 functions of prostaglandins? |
|
Definition
1. increase permiability of blood vessels
2. trigger osteoclasts to destroy alveolar bone
3. promote overproduction of MMP enzyme |
|
|
Term
| Which compound causes most of the alveolar bone destruction seen in perio? |
|
Definition
|
|
Term
| How many Matrix Metalloproteinases are there? |
|
Definition
|
|
Term
| Which compound in the immune response cause breakdown of the connective tissue matrix? |
|
Definition
|
|
Term
| What is the role of MMPs in healthy tissue? |
|
Definition
| regular normal turnover of periodontal CT matrix |
|
|
Term
| High levels of MMPs result in extensive collagen destruction in periodontal tissues. How does this tissue breakdown present clinically? |
|
Definition
gingical recession
pocket formation
tooth mobility |
|
|
Term
| MMPs are what type of compound? |
|
Definition
|
|
Term
| The compliment system is a series of what type of compound? |
|
Definition
|
|
Term
| What are two overall goals of the compliment system? |
|
Definition
facilitate phagocytosis of bacteria
kill bacteria directly by forming pores in the cell walls |
|
|
Term
| What are the 4 functions of the compliment system |
|
Definition
destruction of pathogens
opsonization
recruitment of phagocytes
immune clearance |
|
|
Term
| What protein of the compliment system is able to directly lyse bacteria |
|
Definition
|
|
Term
| What is the most important action of the compliment system? |
|
Definition
|
|
Term
| What is the term for the function of the compliment system that coats the surface of bacteria with compliment components which allow phagocytes to identify and destroy bacteria? |
|
Definition
|
|
Term
| What does immune clearance mean? |
|
Definition
| removing immune complexes from circulation in the body |
|
|
Term
| what are the 4 phases of microscopic changes in periodontal disease |
|
Definition
1. sub-clinical gingivitis (early bacterial accumulation phase)
2. Early gingivitis (plaque overgrowth phase)
3. Established gingivitis (subgingival plaque phase)
4. periodontitis (tissue destruction phase) |
|
|
Term
| what is the term for a specific surface of a tooth that is experiencing perio disease"? |
|
Definition
|
|
Term
| what is the term for oral conditions which increase susceptibility to perio infection? |
|
Definition
| local contributing factors |
|
|
Term
| T/F- local contributing factors initiate perio disease? |
|
Definition
|
|
Term
| What are the 3 ways local contributing factors increase the risk for disease? |
|
Definition
1. increase biofilm retention
2. increase biofilm pathogenicity
3. cause direct damage to the periodontium |
|
|
Term
| what is an example of increased biofilm pathogenecity as the result of local contributing factors? |
|
Definition
|
|
Term
| what is an example of direct damage to the periodontium as the result of local contributing factors? |
|
Definition
| heavy chewing forces on a tooth |
|
|
Term
| What are the two factors that influence biofilm retention? |
|
Definition
dental calculus
tooth morphology |
|
|
Term
| What are the 3 modes of calculus attachment to the tooth surface? |
|
Definition
1. pellicle
2. tooth irregularities
3. direct contact with tooth |
|
|
Term
| what is the most common form of attachment to the tooth surface? |
|
Definition
|
|
Term
| what are 3 morhphological factors that can increase calculus retention? |
|
Definition
poorly contoured restorations
untreated tooth decay
grooves and concavities in the tooth surface |
|
|
Term
| What is the term for a developmental groove on the palatal surface of a tooth? |
|
Definition
|
|
Term
| palatogingival grooves are common on which teeth |
|
Definition
|
|
Term
| which tooth has the most prominent root concavity? |
|
Definition
| M root of max 1st permolar |
|
|
Term
| what interdental aid is used for self care of root concavities? |
|
Definition
|
|
Term
| T/F- in chronic inflammation, the inflammatory process can become so intense that is inflicts permanent damage to body tissues |
|
Definition
|
|
Term
| Which cytokines play an important role in periodontitis? |
|
Definition
|
|
Term
| T/F- Chronic inflammation is a pathological condition characterized by tissue destruction |
|
Definition
|
|
Term
| Which phase of perio disease progression is characterized by tissue destruction? |
|
Definition
|
|
Term
| If the bacterial pathogens in early gingivitis continue to proliferate, what is the next phase of disease progression? |
|
Definition
|
|
Term
| In which phase of periodontal disease progression does the plaque biofilm extend subgingivally into the gingival sulcus? |
|
Definition
| established gingivitis phase |
|
|
Term
| what type of diabetes is caused by damage to the pancreas? |
|
Definition
|
|
Term
| What type of diabetes develops when the body does not make enough insulin or doesn't properly react to insulin? |
|
Definition
|
|
Term
| What percentage of people have type 1 diabetes? |
|
Definition
|
|
Term
| What percentage of people have type II diabetes |
|
Definition
|
|
Term
| What is diabetes that occurs during pregnancy? |
|
Definition
|
|
Term
| Do individuals with well controlled diabetes have higher rates of periodontal disease? |
|
Definition
|
|
Term
| What is the A1c and glucose level goal for diabetics? |
|
Definition
|
|
Term
| What glucose level indicates a greater risk for infection? |
|
Definition
|
|
Term
| What is an unacceptable glucose range? |
|
Definition
|
|
Term
| T/F- 6-18 year olds with diabetes showed more periodontal disease than those without diabetes? |
|
Definition
|
|
Term
| What are 3 signs of leukemia-associated gingivitis? |
|
Definition
swollen, glazed, spongy tissue
red to deep purple colored gingiva
possible gingival enlargement. |
|
|
Term
| What are the two most common HIV associated periodontal conditions |
|
Definition
LGE- linear gingival erythema
NPD- Necrotizing periodontal diseases |
|
|
Term
| What does Linear gingival erythema look like? |
|
Definition
| 2-3 mm band of erythema around the free gingiva (does not respond to periodontal instrumentation or self-care)) |
|
|
Term
| What is another condition associated with HIV that usually presents on the hard palate? |
|
Definition
|
|
Term
| Osteoporosis occurs most frequently in what 4 groups of people? |
|
Definition
postmenopausal women
sedentary individuals
bedridden individuals
long term steroid therapy |
|
|
Term
| How many people does osteoporosis affect? |
|
Definition
|
|
Term
| does osteoporosis initiate periodontitis? |
|
Definition
|
|
Term
| Is the link between skeletal osteoporosis and alveolar bone loss proven? |
|
Definition
|
|
Term
| what causes pubertal gingivitis? |
|
Definition
| hormones cause increased blood circulation in gingiva which increases sensitivity to local irritants. |
|
|
Term
| Is puberty gingivitis greated in men or women? |
|
Definition
|
|
Term
| What usually determines if a woman will develop pregnancy gingivitis? |
|
Definition
| if they had gingivitis before becoming pregnant |
|
|
Term
| What is another name for a pregnancy tumor/ |
|
Definition
|
|
Term
| Where do pregnancy tumors usually form? |
|
Definition
| interdental gingiva or gingival margin due to strong reaction to plaque |
|
|
Term
| Do pregnancy tumors hurt? |
|
Definition
|
|
Term
| What are 4 changes associated with menopause and postmenopause? |
|
Definition
dry mouth
burning sensation
altered taste
bone loss may be exacerbated |
|
|
Term
| What is the most common birth defect? |
|
Definition
|
|
Term
| In down syndrome, cells contain 3 of which chromosome? |
|
Definition
|
|
Term
| how many people have down syndrome in the united states? |
|
Definition
|
|
Term
| what is the expected lifespan of someone with down syndrome? |
|
Definition
|
|
Term
| what are 5 facial traits of down syndrome? |
|
Definition
flat facial profile
small nose
upward slant of eyes
small skin folds on inner corner of eyes
protruding tongue and open mouth |
|
|
Term
| what are 6 medical development issues for down syndrome |
|
Definition
increase risk for congenital heart defects
increased infection risk
respiratory issues
GI abnormalities
childhood leukemia
abnormal PMN function (50%) |
|
|
Term
| What is the most likely cause of higher severe periodontitis prevalence in down syndrome patients |
|
Definition
| impaired PMN chemotaxis and phagocytosis |
|
|
Term
| what is the prevalence of severe periodontitis in down syndrome patients under ago 30? |
|
Definition
|
|
Term
| where does gingival overgrowth usually begin? |
|
Definition
|
|
Term
| how many medications have the potential to cause gingival enlargement? |
|
Definition
|
|
Term
| What are the three main medications that can cause gingival enlargement? |
|
Definition
anticonvulsants
immunosuppressives
calcium channel blockers |
|
|
Term
| what is another name for dilantin? |
|
Definition
|
|
Term
| what reduces the rate of gingival overgrowth for patient's taking dilantin? |
|
Definition
|
|
Term
| What is the most immunosuppressant prescribed? |
|
Definition
|
|
Term
| what percentage of people taking cyclosporine for organ transplants experience gingival overgrowth? |
|
Definition
|
|
Term
| What calcium channel blocker is known to cause gingival overgrowth |
|
Definition
|
|
Term
| What conditions are treated with nifedipine? |
|
Definition
hypertension
angina
cardiac arrhythmias |
|
|
Term
| what percentage of people taking nifedepine experience gingival overgrowth? |
|
Definition
|
|
Term
| which immune cells secrete antibodies |
|
Definition
|
|
Term
| in what stage of inflammation is pain a common symptom? |
|
Definition
|
|
Term
| T/F- chronic inflammation is a pathological condition characterized by tissue destruction? |
|
Definition
|
|
Term
| which phase of periodontal disease progression is characterized by tissue destruction? |
|
Definition
|
|
Term
| if the bacterial pathogens in early gingivitis continue to proliferate, what is the next phase of disease progression? |
|
Definition
|
|
Term
| IN what phase of periodontal disease progressions does the plaque biofilm extend subgingivally into the gingival sulcus? |
|
Definition
| established gingivits phase |
|
|
Term
| T/F- more than half of the cases of periodontal disease among adults in the US may be caused by smoking? |
|
Definition
|
|
Term
| When a phagocyte ingests bacteria, what is the vesicle with bacteria inside called? what is it called when it fuses with digestive materials? |
|
Definition
| phagosome / phagolysosome |
|
|
Term
| The bacteria associated with periodontal disease are most effectively phagocytized by what cells? |
|
Definition
|
|
Term
| B lymphocytes are also known as? |
|
Definition
|
|
Term
| What are the 3 ways antibodies defend the host? |
|
Definition
neutralize bacteria and bacterial toxins
coat bacteria for faster phagocytosis
activate compliment system |
|
|
Term
| What is the main source of PGE in inflamed periodontal tissues? |
|
Definition
|
|
Term
| what is the protein of the compliment system that is able to directly form pores in bacterial cell membranes |
|
Definition
|
|
Term
| what percentage of calculus is inorganic? |
|
Definition
|
|
Term
| what are 3 inorganic compounds found in calculus? |
|
Definition
1. calcium phosphate
2. calcium carbonate
3. magnesium phosphate |
|
|
Term
| what is the term for newly formed crystalline calculus? |
|
Definition
|
|
Term
| what is the term for crystalline calculus less than 6 months old? |
|
Definition
|
|
Term
| What is the term for crystalline calculus more than 6 months old? |
|
Definition
|
|
Term
| what is the term for excessive occlusal forces on a healthy periodontium?> |
|
Definition
| primary trauma from occlusion |
|
|
Term
| what is the term for normal occlusal forces on an unhealthy periodontium previously weakened by periodontitis? |
|
Definition
| secondary trauma from occlusion |
|
|
Term
| what are two examples of parafunctional habits? |
|
Definition
|
|
Term
| What are 6 examples of direct damage to the periodontium? |
|
Definition
food impaction
tongue thrusting
mouth breathing
faulty crown design
improperly contoured restoration
faulty removable prosthesis |
|
|
Term
| What is the term for an improperly contoured restoration that doesn't allow enough space for the interdental papilla |
|
Definition
| encroaching on the embrasure space |
|
|
Term
| A crown margin within how many mm's of the crest of alveolar bone will result in bone resorption? |
|
Definition
|
|
Term
| What are 8 systemic risk factors for periodontitis |
|
Definition
1. tobacco
2. Diabetes
3. osteoporosis
4. hormone alteration
5. psychosocial distress
6. genetics
7. AIDS
8. systemic medications |
|
|
Term
| Do smokers have more plaque and calculus than non-smokers? |
|
Definition
| same plaque, more calculus |
|
|
Term
| what are some oral manifestations of diabetes? |
|
Definition
burning tongue
xerostomia
candidiasis |
|
|
Term
| Does puberty gingivitis occur more in boys or girls? |
|
Definition
|
|
Term
| what are 4 stress related behaviors that may increase risk of periodontal disease? |
|
Definition
neglect of plaque control
changes in diet
increase in smoking
increase in parafunctional habits (bruxism) |
|
|
Term
| What groups is NUG most commonly seen in? |
|
Definition
young adults under stress
soldiers on the front lines
smokers |
|
|
Term
| What is the term for gingivitis that involves tissue necrosis that is limited to the gingiva? |
|
Definition
| NUG (necrotizing ulcerative gingivitis) |
|
|
Term
| What is the term for periodontitis that involves tissue necrosis of gingival tissues combined with loss of attachment and alveolar bone loss? |
|
Definition
| NUP (necrotizing ulcerative periodontitis) |
|
|
Term
| What periodontal disease is characterized by severe pain, loose teeth, odor, bleeding, rapid bone loss, and is usually the result of severe immune suppression |
|
Definition
| NUP (necrotizing ulcerative periodontitis) |
|
|
Term
| what form of periodontal disease presents as a 2-3 mm red band along the gingival margin? |
|
Definition
| LGE- linear gingival erythema |
|
|
Term
| is LGE most common in anterior or posterior teeth? |
|
Definition
|
|
Term
| What group is gingival overgrowth more common in when taking dilantin? |
|
Definition
| children and young adults |
|
|
Term
| Gingival overgrowth from Nifedipine usually recurs after how many years from surgical removal? |
|
Definition
|
|
Term
| overactivity of what cells cause gingival overgrowth? |
|
Definition
| gingival fibroblasts (overproduce collagen matrix) |
|
|
