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Questions and Answers

What determines whether the acute inflammatory response is beneficial or harmful to the periodontium?

  • The type of microbial challenge present
  • The presence of lipid mediators
  • The extent of the inflammatory response
  • The resolution effectiveness of the acute inflammation (correct)

    • Which statement about the resolution of inflammation is true?

  • It is an actively regulated biological process. (correct)
  • It is a purely passive process.
  • It happens regardless of microbial challenge removal.
  • It primarily occurs without any mediators.

    • What is the term used to describe the return to a noninflammatory state after inflammation?

  • Reconstitution
  • Homeostasis
  • Resolution
  • Catabasis (correct)

    • Which type of mediators are known to regulate the resolution of inflammation?

    <p>Specialized pro-resolving lipid mediators</p> Signup and view all the answers

    Which of the following is true regarding unresolved inflammation?

    <p>It is linked to periodontitis.</p> Signup and view all the answers

    What is the primary consequence of overactivity of polymorphonuclear leukocytes (PMNs) during inflammation?

    <p>Destruction of connective tissue matrix</p> Signup and view all the answers

    Which of the following lipid mediators is NOT typically associated with inflammation?

    <p>Antiinflammatory cytokines</p> Signup and view all the answers

    What is the role of catabasis in relation to inflammation?

    <p>To facilitate a return to homeostasis</p> Signup and view all the answers

    What is one of the roles of cytokines in the context of periodontitis?

    <p>Enhancing vascular permeability for immune cell migration</p> Signup and view all the answers

    Which cytokines are specifically associated with the pathogenesis of periodontitis?

    <p>IL-1, IL-6, IL-8, and TNF-α</p> Signup and view all the answers

    What is the primary source of prostaglandin E (PGE) in inflamed periodontal tissues?

    <p>Macrophages</p> Signup and view all the answers

    How do prostaglandins influence the work of osteoclasts in periodontal disease?

    <p>They trigger osteoclasts to destroy alveolar bone</p> Signup and view all the answers

    What is the role of MMPs in maintaining periodontal health?

    <p>Facilitating normal turnover of the connective tissue matrix</p> Signup and view all the answers

    Which cells are primarily responsible for producing MMPs in the context of periodontitis?

    <p>PMNs and gingival fibroblasts</p> Signup and view all the answers

    What can the imbalance of the MMP-TIMP relationship lead to in periodontal health?

    <p>Uncontrolled breakdown of the connective tissue matrix</p> Signup and view all the answers

    Which biological effects are associated with prostaglandins during inflammation?

    <p>Increasing blood vessel permeability and dilation</p> Signup and view all the answers

    What initiates the host immune response in the initial lesion of periodontal disease?

    <p>Presence of gram-negative bacteria and their metabolic products</p> Signup and view all the answers

    Which component plays a critical role in recruiting polymorphonuclear leukocytes (PMNs) to the site of bacterial infection?

    <p>Biochemical mediators like cytokines</p> Signup and view all the answers

    What consequence results from the cytokines released by PMNs during the immune response?

    <p>Destruction of healthy gingival connective tissue</p> Signup and view all the answers

    How does the inflammatory process evolve from gingivitis to periodontitis according to current theories?

    <p>The host response is modified by cytokines and genetic factors.</p> Signup and view all the answers

    What is the primary goal of PMNs infiltrating the gingival connective tissue during the initial lesion phase?

    <p>Reach and destroy bacterial pathogens</p> Signup and view all the answers

    Which histologic stage of periodontal disease follows the early lesion stage?

    <p>Established lesion</p> Signup and view all the answers

    Which of the following accurately describes a finding at the advanced lesion stage of periodontal disease?

    <p>Significant tissue destruction and tooth mobility</p> Signup and view all the answers

    What role do mediators like PGE2 and MMPs play in the pathogenesis of periodontal disease?

    <p>Facilitate tissue destruction</p> Signup and view all the answers

    What is the primary biochemical mediator responsible for recruiting additional immune cells to an infection site?

    <p>Cytokines</p> Signup and view all the answers

    Which statement accurately describes a feature of the early lesion phase of gingivitis?

    <p>Epithelial ridges begin to form in the sulcular epithelium.</p> Signup and view all the answers

    What is the expected collagen loss at the tissue level during the early lesion of gingivitis?

    <p>60% to 70%</p> Signup and view all the answers

    What role do plasma cells play in the established gingivitis stage?

    <p>They produce large quantities of antibodies.</p> Signup and view all the answers

    What happens if the host immune response fails during the early lesion phase?

    <p>The early lesion progresses to established gingivitis.</p> Signup and view all the answers

    Which cellular feature predominates during the established lesion phase of gingivitis?

    <p>Plasma cells</p> Signup and view all the answers

    Which of the following is NOT a characteristic of the gingival tissue during the early lesion phase?

    <p>Predominance of B-lymphocytes.</p> Signup and view all the answers

    What initiates the inflammatory changes observed in the early lesion of gingivitis?

    <p>Accumulation of plaque biofilm.</p> Signup and view all the answers

    What is the primary role of MMPs in periodontal tissue destruction?

    <p>They mediate the destruction of the extracellular matrix.</p> Signup and view all the answers

    What effect does PGE2 have in the context of periodontal disease?

    <p>It stimulates osteoclasts to resorb alveolar bone.</p> Signup and view all the answers

    Which of the following statements is true regarding the immune response in periodontitis?

    <p>It can cause irreversible tissue damage.</p> Signup and view all the answers

    What is a key characteristic of the advanced lesion phase of periodontal disease?

    <p>Destruction of alveolar bone.</p> Signup and view all the answers

    What primarily causes the migration of the junctional epithelium apically on the root surface?

    <p>Destruction of the gingival connective tissue.</p> Signup and view all the answers

    Which factor does NOT contribute to the host's inability to control bacterial challenges in periodontal disease?

    <p>Overactive macrophage function.</p> Signup and view all the answers

    What is a common clinical feature associated with advanced periodontal disease?

    <p>Tooth mobility.</p> Signup and view all the answers

    What is the hallmark of periodontitis due to chronic infection?

    <p>Irreversible tissue damage.</p> Signup and view all the answers

    What is a consequence of increased permeability of blood vessels during an immune response in gingival tissue?

    <p>Increased movement of PMNs into the gingival connective tissue</p> Signup and view all the answers

    How does the host response to bacterial infections affect tissue repair?

    <p>Successful host responses allow for eventual tissue repair</p> Signup and view all the answers

    What role do cytokines play during the migration of PMNs in response to bacterial challenge?

    <p>They attract additional cellular defenders to the site</p> Signup and view all the answers

    What changes occur in the initial phase of gingivitis following plaque accumulation?

    <p>Development of initial lesions within 2 to 4 days</p> Signup and view all the answers

    What happens to the junctional epithelium during the early gingivitis process?

    <p>It allows the penetration of bacterial toxins</p> Signup and view all the answers

    What is the initial location of plaque biofilm in a healthy body?

    <p>Supragingival surfaces</p> Signup and view all the answers

    What is the role of macrophages during the early gingivitis process?

    <p>They are attracted to the site and release biochemical mediators</p> Signup and view all the answers

    What occurs when bacterial pathogens are not controlled during the gingival response?

    <p>The development of early gingivitis takes place</p> Signup and view all the answers

    Study Notes

    Host Immune Response to Plaque Biofilm

    • Periodontal disease is a bacterial infection
    • Bacteria, alone are not enough to cause periodontal disease, the host response is crucial
    • Host response is the body's response to bacterial infection in the plaque biofilm, aiming to eliminate pathogens and limit infection spread
    • Virulence factors enhance microbial challenge:
      • Presence of lipopolysaccharide (LPS) from gram-negative bacteria
      • Ability to invade host tissues
      • Production of enzymes to degrade host proteins

    Host Factors Affecting Immune Response

    • Genetic factors: Contribute to periodontal disease susceptibility
    • Environmental factors: Tobacco smoking negatively impacts immune/inflammatory system
    • Acquired factors: Diabetes mellitus impacts the host response (reduced PMN function, increased inflammatory mediators)

    Inflammation as a Protective Host Response

    • Host responds to microbes by releasing biochemical mediators to fight bacteria
      • Cells involved: PMNs, antigen-presenting cells (macrophages, Langerhans cells), T- and B-lymphocytes, fibroblasts, and epithelial cells
    • Acute inflammation is protective, but must resolve efficiently
    • Unresolved, chronic inflammation can cause damage, like in periodontitis

    Inflammatory Biochemical Mediators

    • Cytokines: Secreted by immune cells, influencing other cell behavior and potential tissue destruction
      • Key ones: IL-1, IL-6, IL-8, and TNF-α
    • Prostaglandins (primarily PGE2): Increase vascular permeability, impacting bone destruction by stimulating osteoclasts
    • Matrix Metalloproteinases (MMPs): Enzymes that break down connective tissue matrix
      • MMP overactivity is negatively regulated by TIMPs (tissue inhibitors of matrix metalloproteinases)

    Histologic Stages of Periodontal Disease

    • Bacterial Accumulation (Initial):
      • Bacteria colonize the tooth surface, activating host immune response
      • PMNs are recruited, tissue looks healthy clinically
    • Early Gingivitis (Early Lesion):
      • Increased bacterial challenge leads to heightened inflammation
      • PMNs, macrophages, and other cells fight bacteria, also damaging healthy tissue
      • Sulcular epithelium changes, leading to epithelial ridges
    • Established Gingivitis (Established Lesion):
      • Biofilm extends subgingivally
      • Plasma cells (producing antibodies) and increased host response, leading to more tissue damage
    • Periodontitis (Advanced Lesion):
      • Chronic inflammation dominates, leading to periodontal pockets, alveolar bone loss, and tooth mobility
      • Tissue and cellular damage becomes irreversible

    Current Theory of Pathogenesis

    • Periodontal disease development is complex, involving microbial challenge, host response, and modifying risk factors (e.g., genetics, environment, acquired factors)
    • Imbalance between microbial challenge and host response leads to tissue destruction

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    Host Response Pathogenesis PDF

    Description

    This quiz explores the intricate relationship between host immune responses and plaque biofilm in periodontal disease. It covers the mechanisms of host response, the role of genetic and environmental factors, and how inflammation acts as a protective measure against bacterial infections. Test your understanding of how these factors contribute to periodontal health.

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