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Questions and Answers
What is a significant effect of lipopolysaccharide (LPS) in periodontal disease?
What is a significant effect of lipopolysaccharide (LPS) in periodontal disease?
Which periodontal bacteria are known to invade host tissues?
Which periodontal bacteria are known to invade host tissues?
How do certain periodontal bacteria hinder the host immune response?
How do certain periodontal bacteria hinder the host immune response?
What genetic factor is associated with aggressive types of periodontal diseases?
What genetic factor is associated with aggressive types of periodontal diseases?
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What impact does tobacco smoking have on periodontal disease?
What impact does tobacco smoking have on periodontal disease?
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How does diabetes mellitus affect the host response in periodontal disease?
How does diabetes mellitus affect the host response in periodontal disease?
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Which of the following factors does NOT affect the host immune response to plaque biofilm?
Which of the following factors does NOT affect the host immune response to plaque biofilm?
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What role do enzymes produced by periodontal bacteria play in disease progression?
What role do enzymes produced by periodontal bacteria play in disease progression?
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Which of the following is NOT a consequence of smoking on periodontal health?
Which of the following is NOT a consequence of smoking on periodontal health?
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What is the primary outcome of the host immune response in the context of periodontal disease?
What is the primary outcome of the host immune response in the context of periodontal disease?
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What role do macrophages play in periodontal disease?
What role do macrophages play in periodontal disease?
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Which of the following describes a significant tissue-level change observed in advanced periodontal disease?
Which of the following describes a significant tissue-level change observed in advanced periodontal disease?
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What mediates the destruction of alveolar bone in periodontal disease?
What mediates the destruction of alveolar bone in periodontal disease?
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Which clinical feature is commonly associated with advanced periodontal disease?
Which clinical feature is commonly associated with advanced periodontal disease?
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What triggers the shift of gingival fibroblasts toward tissue destruction in periodontal disease?
What triggers the shift of gingival fibroblasts toward tissue destruction in periodontal disease?
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What initiates the host immune response during the bacterial accumulation phase?
What initiates the host immune response during the bacterial accumulation phase?
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What is the primary goal of polymorphonuclear leukocytes (PMNs) in the initial lesion phase?
What is the primary goal of polymorphonuclear leukocytes (PMNs) in the initial lesion phase?
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Which cytokines are important for stimulating the immune response in the initial lesion stage?
Which cytokines are important for stimulating the immune response in the initial lesion stage?
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What clinical feature is observed during the initial lesion phase of periodontal disease?
What clinical feature is observed during the initial lesion phase of periodontal disease?
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What occurs if the bacterial infection is effectively controlled in the initial lesion stage?
What occurs if the bacterial infection is effectively controlled in the initial lesion stage?
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During early gingivitis, what changes occur in the composition of PMNs?
During early gingivitis, what changes occur in the composition of PMNs?
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What effect does increased permeability of blood vessels have during the early lesion phase of gingivitis?
What effect does increased permeability of blood vessels have during the early lesion phase of gingivitis?
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What role do bacterial toxins play in early gingivitis?
What role do bacterial toxins play in early gingivitis?
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What is a likely consequence of uncontrolled bacterial pathogens during the initial phase?
What is a likely consequence of uncontrolled bacterial pathogens during the initial phase?
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How long does it typically take for the initial lesion phase to develop following plaque accumulation?
How long does it typically take for the initial lesion phase to develop following plaque accumulation?
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What role do macrophages play in the immune response during the early lesion phase?
What role do macrophages play in the immune response during the early lesion phase?
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During the early lesion phase, what percentage of collagen loss is observed in the connective tissue?
During the early lesion phase, what percentage of collagen loss is observed in the connective tissue?
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What initiates the inflammatory changes in gingival marginal tissue?
What initiates the inflammatory changes in gingival marginal tissue?
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What happens to the sulcular epithelium during the early lesion phase?
What happens to the sulcular epithelium during the early lesion phase?
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What is a consequence if the host immune response fails to control the bacterial infection?
What is a consequence if the host immune response fails to control the bacterial infection?
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What is the primary cell type predominating in established lesions?
What is the primary cell type predominating in established lesions?
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What is primarily responsible for the excessive loss of collagen in the affected connective tissue zone?
What is primarily responsible for the excessive loss of collagen in the affected connective tissue zone?
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What role do cytokines play in the immune response to bacterial infection?
What role do cytokines play in the immune response to bacterial infection?
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What additional cellular defenders are recruited by the presence of subgingival bacteria?
What additional cellular defenders are recruited by the presence of subgingival bacteria?
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What happens to the junctional epithelium during the established gingivitis phase?
What happens to the junctional epithelium during the established gingivitis phase?
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How does good patient self-care affect plaque biofilm in the context of gingivitis?
How does good patient self-care affect plaque biofilm in the context of gingivitis?
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What is indicated by the presence of inflammatory changes such as edema and redness in gingival tissue?
What is indicated by the presence of inflammatory changes such as edema and redness in gingival tissue?
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What is a significant outcome of the host response during established gingivitis?
What is a significant outcome of the host response during established gingivitis?
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What is the expected duration for the development of the early lesion phase following plaque accumulation?
What is the expected duration for the development of the early lesion phase following plaque accumulation?
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Which of the following features is NOT associated with established gingivitis?
Which of the following features is NOT associated with established gingivitis?
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What stimulates gingival fibroblasts to produce additional PGE2 and MMPs?
What stimulates gingival fibroblasts to produce additional PGE2 and MMPs?
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What is the role of PMNs in the established lesion?
What is the role of PMNs in the established lesion?
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What is a common consequence if established gingivitis is not controlled?
What is a common consequence if established gingivitis is not controlled?
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What happens to the connective tissue during the established lesion phase?
What happens to the connective tissue during the established lesion phase?
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What occurs at the tissue level features in the established lesion phase?
What occurs at the tissue level features in the established lesion phase?
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Study Notes
Host Immune Response to Plaque Biofilm
- Periodontal disease is a bacterial infection causing inflammation in periodontal tissues.
- Bacteria are essential for periodontal disease, but the host response plays a significant role in tissue destruction.
- The host response involves the immune system's attempt to defend against invading bacteria.
- Bacteria that cause damage through virulence factors (structural properties or produced substances).
- Factors that enhance microbial challenge include lipopolysaccharide (LPS), the ability to invade tissues, and the ability to produce enzymes.
- Factors influencing the host response include genetics (Papillon-Lefèvre syndrome, leukocyte adhesion deficiency, etc.), environmental factors (e.g.,smoking), and acquired factors (e.g., diabetes mellitus)
- Inflammation is a crucial part of the host response; it's initially protective but can become harmful in periodontitis.
- Acute inflammation occurs as a first line of defense, but needs to be properly shut down for periodontal health.
- The resolution of inflammation (catabasis) is equally important for tissue health
- Chronic inflammation can lead to tissue damage if not resolved efficiently
- Inflammatory biochemical mediators include cytokines (IL-1, IL-6, IL-8, and TNF-α), prostaglandins (PGE2), and matrix metalloproteinases (MMPs).
- MMPs break down connective tissue, while TIMPs regulate their activity.
- Cytokines: regulate other cells, can be protective or destructive. IL-1, IL-6, IL-8, and TNF-α are crucial in periodontitis.
- Prostaglandins: regulate blood vessel dilation and influence osteoclast activity. PGE2 is important in bone destruction.
Histologic Stages in the Development of Periodontal Disease
- Four stages: bacterial accumulation, early gingivitis, established gingivitis, and periodontitis.
- Bacterial Accumulation (Initial Lesion): Bacteria colonize the tooth surface, initiate the host immune response, with PMN recruitment to the site. Gingival tissues appear healthy in this stage.
- Early Gingivitis (Early Lesion): Increased bacterial challenge, PMNs migrate toward bacteria, gingival tissues show early inflammation. This stage typically develops 4-7 days after plaque accumulation.
- Established Gingivitis (Established Lesion): Bacteria extends deeper into the gingival sulcus. Increased immune response, and cells like plasma cells are recruited. Epithelial ridges develop, as well as changes to connective tissue.
- Periodontitis (Advanced Lesion): The host response is overwhelmed, leading to irreversible tissue damage (pocket formation, bone loss).
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Description
This quiz explores the complex interaction between the host immune response and plaque biofilm in periodontal disease. It covers how bacterial infections trigger inflammation and the various factors influencing both microbial challenge and host defense mechanisms. Test your knowledge on the crucial elements that contribute to periodontal tissue destruction.
