Term
| What are bacterial deposits in the oral cavity |
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Definition
| dental plaque or bacterial plaque |
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Term
Accumulation of bacteria on teeth causes _______ and plaque removal results in gingival health.
_________ has a similar cause-effect relationship |
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Definition
gingivitis
peri-implant mucositis |
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Term
Where does bacterial plaque start to accumulate?
Where does it progress? |
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Definition
gingival margin
supragingivally and subgingivally (if we can stop it at gingival margin, we can stop subgingivally) |
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Term
| Who first discovered microorganisms? |
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Definition
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Term
| What states that there must be a causative agent must be present in all cases of disease (we must be able to infect and non-infected animal with the causative agent and have animal develop disease)? |
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Definition
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Term
| Who stated that ""Pyorrhea Alveolaris is not caused by one bacteria, but various bacteria may participate in it" (First mention of the non-specific plaque hypothesis) |
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Definition
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Term
True or False:
The more plaque you have, the more disease you have. |
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Definition
False
Not true for aggressive periodontitis (only a few very virulent bacteria) |
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Term
| What is the direct relationship between amount of dental plaque and degree of periodontal disease, more plaque accumulation causes more periodontal disease, patients with a weak host resistance to bacterial plaque or poor home care are prone to develop extensive periodontal disease |
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Definition
| Non-Specific Plaque Hypothesis |
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Term
| What is a number of bacteria may cause periodontal disease, all patients with gingivitis don't develop periodontitis, specific bacterial pathogens are identified at elevated levels in progressing periodontal lesions |
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Definition
| Specific Plaque Hypothesis |
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Term
What percentage of people are non-progressors of periodontitis?
What percentage are rapid progressors (in presence of small amount of plaque tend to progress very rapidly in disease) |
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Definition
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Term
| What are the bacteria virulence factors? |
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Definition
Endotoxin (LPS in Gram neg that stimulates osteoclasts and activate tissue necrosis)
Exotoxin(metabolic end products, organic acids, amines, sulfur)
Enzymes (Increase intracellular spaces and permeability)
Bacterial capsule |
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Term
| What bacterial enzyme does P.g. and A.a. have? |
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Definition
P.g. – collagenase
A.a. – hyaluronidase |
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Term
| What theory is when resident flora overgrow and become opportunistic pathogens causing periodontal disease. |
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Definition
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Term
| What theory is when the patient must also become infected with specific periodontal pathogens that are transmitted from another source. |
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Definition
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Term
| What theory would we agree with more in regards to localized juvenile periodontitis (indigenous or exogenous infection theory) |
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Definition
exogenous
(not a lot of people who are infected LAP/LJP that do not have A.a.) |
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Term
How would you treat an endogenous infection (i.e. chronic periodontitis)
How would you treat an exogenous infection (i.e. aggressive periodontitis) |
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Definition
suppression of these microorganisms so normal host immune function can abrogate their pathogenic effects (oral hygiene, non-specific chemotherapeutic, non-surgical)
complete elimination from the oral cavity (specific antibiotics) |
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Term
| What infections are caused by the normal bacteria when they move into other anatomic regions? |
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Definition
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Term
| What infections are caused by normal bacteria and are related to change of ecologic conditions and decrease of host resistance? |
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Definition
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Term
| What infections can be viewed as opportunistic infections and exogenous infections |
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Definition
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Term
| What is formed when the proteins and glycoproteins in saliva adhere to the tooth surface within seconds of cleaning |
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Definition
| Dental Pellicle formation |
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Term
| After the dental pellicle forms, what happens next in dental plaque formation? |
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Definition
| Association of bacteria: through H+ bonds and vand der Waals forces, bacteria associate loosely with the dental pellicle |
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Term
| How do bacteria bind to pellicle receptors? |
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Definition
| Bacterial surface adhesion molecules (e.g. fimbriae, pili, adhesins-->virulence factors) |
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Term
| What 2 bacteria are the main primary colonizers? |
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Definition
| S. sanguis and A. viscous |
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Term
| What is it when bacteria can not only produce the host response, the their byproducts can leak out and produce a host response at a distance. Many secondary etiological factors change this. |
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Definition
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Term
| What are the phase of plaque development in terms of Gram + or neg, cocci and rods? |
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Definition
Facultatively anaerobic Gram-positive cocci
Gram-positive cocci and rods coaggregate and multiply
Gram-positive rods increase and outnumber the cocci
Gram-negative organisms adhere to Gram- positive through surface receptors
Plaque aging and maturation |
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Term
| **What constitutes the first layer of dental plaque? |
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Definition
| Coccoid bacteria, epithelial cells and polymorphonuclear leukocytes (1st line of defense) |
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Term
Intermicrobial matrix (sticky) makes up ___% of the plaque volume.
What is it made from? |
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Definition
25%
Plaque microorganisms
Saliva
Gingival crevicular fluid |
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Term
| ________ produced as energy storage or as anchoring material, mostly Levans (fructans) and glucans (mutans). |
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Definition
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Term
| What is the organic material interposed between tooth surface and sub gingival plaque? |
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Definition
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Term
| List the Red Complex bacteria |
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Definition
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Term
How many serotypes does A.a. have?
Which one is most associated with periodontitis?
What type of periodontitis does this cause? |
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Definition
5 serotypes
Serotype B
LJP
important in cases of chronic periodontitis with rapid alveolar bone loss such as refractory periodontitis. |
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Term
| What bacteria is associated with chronic periodontitis patients and RPP (Chronic and aggressive). Not found in all chronic periodontitis but healthy subjects don't exhibit it |
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Definition
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Term
| What is a hard concretion that forms on teeth or dental prostheses through calcification of bacterial plaque. |
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Definition
| Calculus, dental (tartar) |
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Term
Supragingival or sub gingival calculus:
Plaqued formed from salivary fluid quickly |
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Definition
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Term
What is calculus formed coronal to the gingival margin; usually formed more recently than subgingival calculus.
Where in the mouth is this mostly formed? |
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Definition
supragingival
lingual mandibular anterior teeth
buccal of maxillary posterior teeth (across parotid) |
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Term
| What is calculus formed apical to the gingival margin; often brown or black, hard, and tenacious. |
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Definition
| subgingival calculus (seruminal) |
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Term
| What is sub gingival calculus calcified by? |
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Definition
| gingival crevicular fluid / inflammatory exudate in the pocket |
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Term
| Gingival crevicular fluid is a serum ______ in health, and a serum _______ in disease. |
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Definition
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Term
| Supra- and sub- gingival calculus is mineralized plaque covered by an ______________ layer. |
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Definition
| Supra- and sub- gingival calculus is mineralized plaque covered by an unmineralized bacterial layer (why it's a secondary etiological factory- calculus not causing disease, bacteria inside of it is) |
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Term
What are the minerals present in calculus?
Which is hardest/least hard? |
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Definition
Hydroxyapatite (hardest)
•Octacalcium phosphate
•Magnesium whitlockite
•Brushite (least hard)
(all have calcium and phosphate) |
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Term
| The earliest crystals of calculus form in the _________ deep in dental plaque near the pellicle. _________ of the matrix provided by dental plaque A local saturation shift of _______ and _______ caused by a local increase in _____ leading to precipitation of mineral |
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Definition
interbacterial matrix
crystal seeding
calcium and phosphate
pH |
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Term
| What is believed to be formed by the epithelial attachment as it contacts the cementum. Exposure to saliva and microorganisms creates the calculus matrix. |
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Definition
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Term
| What are 4 ways that calculus can attach to root surfaces? |
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Definition
1. attachment by means of the secondary cuticle
2. Attachment to the microscopic irregularities of the cementum surface
3.Attachment by penetration of microorganisms making up the calculus matrix into the cementum.
4.Attachment into areas of cementum resorption. |
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Term
| What is the quantitive and qualitative change that sub gingival calculus causes? |
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Definition
Enhances/ Increases rate of plaque accumulation
– Quantitive change
Increases the radius of destruction from plaque related toxic stimulators- Qualitative change |
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Term
True or false:
Germ-free animals can be formed as a result of mineralization of salivary proteins |
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Definition
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Term
| What calculus is identified in most periodontal pockets? |
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Definition
| subgingival calculus (Extends from the Cementoenamel junction to 0.5 mm away from the base of the pocket) |
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Term
What are 2 experiments that proves that calculus is not a primary etiologic factor?
What is it considered? |
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Definition
Junctional epithelium and hemidesmosomes formed on calculus when chlorhexidine was used as an antimicrobial agent on its surface
No inflammation and no abscess formation detected when calculus incorporated into connective tissue
plaque-retaining factor |
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Term
True or False:
Open contacts are always a problem |
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Definition
false
Not a problem if they're really open (self-cleansable)
Problem when it's barely open and there's a plunger cusp impacting food into gingival attachment apparatus |
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Term
| What is a cusp of a tooth on closure is forced, in plunger fashion, into the interproximal space push food into this area and damage the periodontium |
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Definition
| Elongated or "Plunger" Cusps |
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Term
| Why are cervical enamel projections detrimental? |
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Definition
No Gingival fibers can attach to enamel
The only attachment to the enamel projection is a
"weak" epithelial one via hemidesmosomes |
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Term
What is the percent of people who have enamel pearls?
Where are enamel pearls usually (3/4) present?
Where is the 2nd sight? |
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Definition
1-10%
maxillary 3rd molars
mandiblar third molar and maxillary second molar |
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Term
| Why are enamel pearls a secondary etiologic factor? |
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Definition
difficult to clean underneath
weak attachment apparatus |
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Term
| Where are distopalatal/palatal radicular groove most found? |
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Definition
| maxillary lateral incisor |
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Term
| What is it called when there is an exchange of bacteria between the accessory (lateral) pulpal canal and periodontal pocket? |
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Definition
| Combined periodontic-endodontic lesions |
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Term
| What pulpal canal run from the main root canal to exit on the surfaces of the roots? |
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Definition
| Accessory (Lateral) Pulpal Canals |
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Term
| What is the 3rd leading cause of tooth loss? |
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Definition
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Term
| What does a cracked tooth cause? |
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Definition
Bacterial invasion through crack (pain upon release bc swelling has nowhere to go)
Localized periodontal disease (isolated periodontal pocket) |
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Term
| What happens when the buccal and lingual contours of an artificial crown is exaggerated (too much restorative material)? |
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Definition
| leaves a sheltered niche for plaque accumulation |
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Term
| Is it better to over contour or under contour a tooth in a periodontal standpoint? |
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Definition
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Term
| The dimensions of teeth at the widest point buccolingually are only ___ to ___ mm greater than at the narrowest point (the cervix |
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Definition
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Term
| How should you prep a crown for a molar that has a furcation? |
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Definition
| The crown should be fabricated so that it follows the preparation-outline (barreled) and does not leave a metal ledge at the the furcation entrance (looks like 2 premolars) |
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Term
| One reason that crowns encroach on the inter-proximal spaces is the failure to have the preparation follow the _______ of the proximal cemento- enamel junctions. |
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Definition
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Term
| What are the 2 types of occlusal trauma? |
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Definition
Primary-excessive forces on an intact periodontium
Secondary-normal or excessive forces on a reduced periodontium |
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Term
What happens when you don't replace a missing tooth?
What are the cons to this? |
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Definition
Extrusion and Shifting
1. Plaque retention-caries, periodontal inflammation
2. Plunger cusps; food impaction
3. Abnormal occlusal planes and forces
4. More difficult to clean |
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Term
True or false:
Trauma from occlusion does initiate connective tissue loss |
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Definition
False
Trauma from occlusion does not initiate connective tissue loss
(or gingivitis. In the presence of periodontitis could be an aggravating factor) |
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Term
| What are the 6 steps to dental plaque development? |
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Definition
Association
Adhesion
Proliferation
Microcolonies
Bioflim formation
Growth and Maturation |
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Term
You would treat (endogenous or exogenous) infections with specific antibiotics.
You would treat (endogenous or exogenous) infections with oral hygiene and non-specific chemotherapeutic. |
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Definition
exogenous (complete elimination from the oral cavity)
endogenous (suppression of these microorganisms so normal host immune function can abrogate their pathogenic effects) |
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|
Term
| What is the organic material interposed between tooth surface and subgingival plaque |
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Definition
|
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Term
What layer is composed of densely packed Gram-positive and Gram- negative cocci, rods and filaments.
Spirochetes and other motile organisms are located in the _____ extension.
What layer is the loose layer? |
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Definition
lower layer
apical
top layer |
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|
Term
LJP patients demonstrate high levels of antibody against what bacteria?
What are this bacteria's virulence factors? |
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Definition
A.a.
Invades gingival connective tissue
leukotoxin |
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Term
| What bacteria is found in chronic periodontitis, juvenile periodontitis, acute necrotizing ulcerative gingivitis, and also found in severe gingival inflammation without attachment loss? |
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Definition
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