What is the main purpose of the immune response to overwhelming bacterial challenges?

   To save the host.  The immune system protects the host by eventually rejecting the infectious tooth and thereby protecting the host from a potentially life-threatening systemic infection

Non-specific:

Inflammatory response

Phagocytosis

Complement system

Interferons

Natural killers cells (NK)

Specific immunity:

T-cells…..thymus/cell-mediated immunity

B-cells….bone/(humoral immunity)/plasma cells

 What is the difference between Humoral and Cell-mediated immunity? What do T-cells and B-cells do?

a.      Humoral system.

                                                    i.      Extracellular-Regulatory materials are produced outside of the cell.

b.      Cell-Mediated.

                                                    i.      Intracellular- Regulatory materials are produced inside of the cell.

                                                  ii.      Regulated by phagocytes and t-cells.

a.      Adherence.

b.      Surround bacterium.

d.      Phagosome.

e.      Phagolysosome.

f.        Contents discharged.

   What is the complement system?

20 interactive plasma and cell membrane proteins with four basic functions:

1.) Opsonization.

2.) Mediating vascular responses (histamine release).

3.) Recruitment of phagocytic cells- chemotaxis.

4.) Membrane attack complex.

  Describe the protective mechanisms of saliva

1. Mucins – glycoproteins –interfere with bacterial attachment
2. Lactoferrin – binds iron necessary for bacterial metabolism
3. Peroxidase - Hypothiocyanate ions
4. Lysosome – attack cell walls of bacteria
5. Histadine rich proteins - antifungal
6. Immune components - IgA – specificity for bacteria, fungal, and viral pathogens

Describe the protective mechanisms of oral mucosa

Constantly sloughing cells:  Removes attached bacteria

    Describe the 5 protective mechanisms of crevicular fluid.

1.      Plasma cells contain IgG and IgA.

2.      Neutrophils.

3.     95% PMN’s.

4.    2-3% monocytes.

5.   1-2% lymphocytes

 More GCF in disease less in health

Subgingival –GCF

Supragingival- Saliva

What is the passive filter of the sulcular epithelium?

 Intact gingival tissue acts as a filter controlling the type of molecules it will allow to pass. In this way, it controls what comes in or out of the gingival tissue.

Understand the role of histamine as a chemotactic agent

  What causes the “leathery look” of the gingival in inflammation?

Due to destruction of the supragingival fibers by the bacteria:

Fibroblasts can overproduce collagen

   To understand that generative cells (ie. Fibroblasts, osteoblasts, and cementoblasts) can become degenerative.

 Begin to understand our role as hygienists in helping the junctional epithelium reconnect coronally while understanding our limitation to do so with respect to the biological width.

   What is the difference between sub and supra calculus?

a.      Supragingival calculus.

                                                    i.      Attaches to the salivary pellicle.

                                                  ii.      Influenced by salivary products.

b.      Subgingival calculus.

                                                    i.      Attaches to the cementum.

                                                  ii.      Influenced by serum products.

  What is a Class I MHC molecule and what type of cell produces it? Which type of T-cell does it attract?

Histamine:  

Diapedesis:  

Mast cell: 

 MMP:   

PGE2:   

Opsonization,