Podcast
Questions and Answers
What is the primary function of PMNs in the early lesion phase of gingivitis?
What is the primary function of PMNs in the early lesion phase of gingivitis?
Which cells are predominantly found in the early lesion of gingivitis?
Which cells are predominantly found in the early lesion of gingivitis?
What is a significant characteristic of the sulcular epithelium during the early lesion phase?
What is a significant characteristic of the sulcular epithelium during the early lesion phase?
What biochemical mediators are released by macrophages during the immune response?
What biochemical mediators are released by macrophages during the immune response?
Signup and view all the answers
How much collagen loss is typically noted in the early lesion phase?
How much collagen loss is typically noted in the early lesion phase?
Signup and view all the answers
What event can lead to the progression from early gingivitis to established gingivitis?
What event can lead to the progression from early gingivitis to established gingivitis?
Signup and view all the answers
What changes can be observed clinically during the early lesion phase?
What changes can be observed clinically during the early lesion phase?
Signup and view all the answers
What stimulates epithelial cells to secrete more cytokines in an established lesion?
What stimulates epithelial cells to secrete more cytokines in an established lesion?
Signup and view all the answers
What predominates the presence in the established lesion?
What predominates the presence in the established lesion?
Signup and view all the answers
What initiates collagen destruction in the affected tissue?
What initiates collagen destruction in the affected tissue?
Signup and view all the answers
What transformation occurs in the junctional epithelium during the established lesion phase?
What transformation occurs in the junctional epithelium during the established lesion phase?
Signup and view all the answers
How long after plaque biofilm accumulation is established gingivitis generally observed?
How long after plaque biofilm accumulation is established gingivitis generally observed?
Signup and view all the answers
What is a primary clinical feature of established gingivitis?
What is a primary clinical feature of established gingivitis?
Signup and view all the answers
What role does the immune system play during the established lesion phase?
What role does the immune system play during the established lesion phase?
Signup and view all the answers
What is the risk if the bacterial infection during established gingivitis is not controlled?
What is the risk if the bacterial infection during established gingivitis is not controlled?
Signup and view all the answers
What do gingival fibroblasts do during the established lesion phase?
What do gingival fibroblasts do during the established lesion phase?
Signup and view all the answers
What initiates the host immune response in bacterial accumulation during the initial lesion phase?
What initiates the host immune response in bacterial accumulation during the initial lesion phase?
Signup and view all the answers
What is the primary goal of PMNs during the initial lesion phase?
What is the primary goal of PMNs during the initial lesion phase?
Signup and view all the answers
How long after plaque biofilm accumulation does the initial lesion phase typically develop?
How long after plaque biofilm accumulation does the initial lesion phase typically develop?
Signup and view all the answers
What is a major clinical feature observed during the initial lesion phase?
What is a major clinical feature observed during the initial lesion phase?
Signup and view all the answers
What occurs during the early lesion phase concerning the PMNs?
What occurs during the early lesion phase concerning the PMNs?
Signup and view all the answers
What consequence might result if the bacterial infection is not controlled during the initial lesion phase?
What consequence might result if the bacterial infection is not controlled during the initial lesion phase?
Signup and view all the answers
What effect do cytokines have during the early gingivitis phase?
What effect do cytokines have during the early gingivitis phase?
Signup and view all the answers
What leads to the increased permeability of blood vessels during the early lesion phase?
What leads to the increased permeability of blood vessels during the early lesion phase?
Signup and view all the answers
What component found in the outer membrane of Gram-negative bacteria is responsible for initiating inflammation in periodontal tissues?
What component found in the outer membrane of Gram-negative bacteria is responsible for initiating inflammation in periodontal tissues?
Signup and view all the answers
Which periodontal bacteria is known for its ability to invade host tissues?
Which periodontal bacteria is known for its ability to invade host tissues?
Signup and view all the answers
How do genetic factors influence periodontal disease susceptibility?
How do genetic factors influence periodontal disease susceptibility?
Signup and view all the answers
What is a significant effect of tobacco smoking on the immune system related to periodontal disease?
What is a significant effect of tobacco smoking on the immune system related to periodontal disease?
Signup and view all the answers
What is known about the relationship between diabetes mellitus and periodontal diseases?
What is known about the relationship between diabetes mellitus and periodontal diseases?
Signup and view all the answers
Which of the following produces enzymes that can degrade host proteins in periodontal disease?
Which of the following produces enzymes that can degrade host proteins in periodontal disease?
Signup and view all the answers
Which interleukin is increased in the gingival crevicular fluid due to diabetes mellitus?
Which interleukin is increased in the gingival crevicular fluid due to diabetes mellitus?
Signup and view all the answers
What type of enzymes do several periodontal bacteria produce that contribute to destruction of periodontal tissues?
What type of enzymes do several periodontal bacteria produce that contribute to destruction of periodontal tissues?
Signup and view all the answers
What is the primary outcome of the host immune response in chronic periodontal disease?
What is the primary outcome of the host immune response in chronic periodontal disease?
Signup and view all the answers
Which cells are responsible for producing cytokines that lead to destruction of periodontal tissues?
Which cells are responsible for producing cytokines that lead to destruction of periodontal tissues?
Signup and view all the answers
What role does PGE2 play in periodontal disease?
What role does PGE2 play in periodontal disease?
Signup and view all the answers
What leads to the formation of a periodontal pocket?
What leads to the formation of a periodontal pocket?
Signup and view all the answers
Which of the following is a characteristic clinical feature of advanced periodontal lesions?
Which of the following is a characteristic clinical feature of advanced periodontal lesions?
Signup and view all the answers
What is the effect of chronic inflammation in periodontal disease?
What is the effect of chronic inflammation in periodontal disease?
Signup and view all the answers
Which of the following describes the state of gingival fibroblasts during advanced periodontal disease?
Which of the following describes the state of gingival fibroblasts during advanced periodontal disease?
Signup and view all the answers
What type of immune response occurs due to chronic infection by periodontal pathogens?
What type of immune response occurs due to chronic infection by periodontal pathogens?
Signup and view all the answers
Study Notes
Host Immune Response to Plaque Biofilm
- Periodontal disease is a bacterial infection that causes inflammation in the periodontal tissues
- Bacteria are essential for disease, but the body's response (host response) is the main cause of tissue destruction
- The body's immune system attempts to defend against bacteria in plaque biofilm
- Factors enhancing microbial challenge:
- Presence of lipopolysaccharide (LPS): a component of gram-negative bacteria that causes inflammation
- Ability to invade tissues: bacteria like Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans invade host tissues
- Ability to produce enzymes: enzymes like collagenases and proteases degrade host proteins
Factors Affecting Host Immune Response
- Genetic factors, environmental factors (like smoking), and acquired factors (like diabetes) influence host susceptibility
- Genetic factors and diseases like Papillon-Lefèvre syndrome and leukocyte adhesion deficiency (LAD) are associated with aggressive periodontal disease
- Smoking decreases polymorphonuclear neutrophil (PMN) phagocytic capacity and vascularity, impacting T and B-lymphocyte response
- Diabetes affects host response by reducing PMN function and increasing IL-1, TNF-α, and PGE2 levels.
Inflammation: A Protective Host Response
- Acute inflammation is the body's first line of defense against microbial invasion, eliminating harmful stimuli, repairing cells, and creating a favorable environment for repair
- Resolution of acute inflammation (catabasis) is important for maintaining health
- Resolution is an active process, not passive
- Failure to resolve results in chronic inflammation
Inflammatory Biochemical Mediators
- Cytokines: proteins released by immune cells, modulating other cells' behavior (e.g., IL-1, IL-6, IL-8, TNF-α)
- Important role in periodontitis, causing both protection and tissue destruction
- Prostaglandins, particularly PGE2: derived from fatty acids, increase vascular permeability, trigger osteoclast activity (bone resorption), and promote MMP overproduction
- Matrix metalloproteinases (MMPs): enzymes that break down the connective tissue matrix; their overactivity leads to tissue destruction
- Regulated by TIMPs (tissue inhibitors of MMP), balance is essential
Histologic Stages in Periodontal Disease
- Bacterial accumulation: bacteria colonize the tooth surface near the gingival margin, initiating host immune response
- Early lesion (gingivitis): increased vascular dilation, PMN migration into sulcus, and initial collagen loss
- Established lesion (gingivitis): significant collagen loss, epithelial ridges form, and plasma cells become prominent
- Advanced lesion (periodontitis): periodontal pocket formation, alveolar bone loss, and attachment loss
Current Theory of Pathogenesis
- Microbial challenge activates the host response
- Genetic and environmental factors modify the immunoinflammatory response
- Mediators (cytokines, antibodies) are produced, leading to collateral damage
- Resolution of inflammation (catabasis) is crucial, otherwise chronic inflammation develops
- Imbalance between microbial challenge and host response leads to increasing tissue damage
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz explores the intricate relationship between periodontal disease and the host immune response. It highlights how bacteria in plaque biofilm trigger inflammation and the various factors that influence the immune system's effectiveness in combating such infections. Test your knowledge on the mechanisms and implications of host responses to plaque-related bacteria.
