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Questions and Answers
What is the primary function of antibodies in the immune response?
What is the primary function of antibodies in the immune response?
Which statement correctly describes the T-cell mediated response?
Which statement correctly describes the T-cell mediated response?
What role do TH cells play in the immune response?
What role do TH cells play in the immune response?
How do T-cells contribute to the shift from gingivitis to periodontitis?
How do T-cells contribute to the shift from gingivitis to periodontitis?
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Which mediator is known to contribute to tissue damage in periodontal disease?
Which mediator is known to contribute to tissue damage in periodontal disease?
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What is the role of matrix metalloproteinases (MMPs) in periodontal disease?
What is the role of matrix metalloproteinases (MMPs) in periodontal disease?
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What is one function of the complement system in relation to antibodies?
What is one function of the complement system in relation to antibodies?
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Which cells are responsible for antigen presentation to T-cells?
Which cells are responsible for antigen presentation to T-cells?
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What is the primary role of pro-inflammatory cytokines like IL-1 and TNF-α in periodontitis?
What is the primary role of pro-inflammatory cytokines like IL-1 and TNF-α in periodontitis?
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Which of the following is a function of prostaglandins in the context of periodontitis?
Which of the following is a function of prostaglandins in the context of periodontitis?
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In the context of periodontitis, how do matrix metalloproteinases (MMPs) contribute to tissue damage?
In the context of periodontitis, how do matrix metalloproteinases (MMPs) contribute to tissue damage?
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Which factor primarily disturbs the dynamic equilibrium in health and stable gingivitis, leading to periodontitis?
Which factor primarily disturbs the dynamic equilibrium in health and stable gingivitis, leading to periodontitis?
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What is a common misconception regarding the role of anti-inflammatory cytokines in periodontitis?
What is a common misconception regarding the role of anti-inflammatory cytokines in periodontitis?
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What aspect of the microbial factor of periodontitis is critical for the disease's initiation?
What aspect of the microbial factor of periodontitis is critical for the disease's initiation?
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Which of the following correctly identifies a supporting factor of the bacterial role in periodontal disease?
Which of the following correctly identifies a supporting factor of the bacterial role in periodontal disease?
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How does a compromised host defense contribute to periodontitis?
How does a compromised host defense contribute to periodontitis?
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How does the junctional epithelium contribute to tissue destruction in periodontal disease?
How does the junctional epithelium contribute to tissue destruction in periodontal disease?
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Which cells in the junctional epithelium are primarily responsible for secreting cytokines during inflammation?
Which cells in the junctional epithelium are primarily responsible for secreting cytokines during inflammation?
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What primary function does saliva serve in the oral cavity?
What primary function does saliva serve in the oral cavity?
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What leads to a compromised protective function of the epithelium in periodontal conditions?
What leads to a compromised protective function of the epithelium in periodontal conditions?
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Which type of macrophages are identified as responsible for releasing host defenses in the gingival tissues?
Which type of macrophages are identified as responsible for releasing host defenses in the gingival tissues?
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In what manner does the epithelium's protective function become affected during periodontal disease?
In what manner does the epithelium's protective function become affected during periodontal disease?
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What challenge does the inflammatory response create for the junctional epithelium?
What challenge does the inflammatory response create for the junctional epithelium?
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Which statement best describes the relationship between inflammation and the junctional epithelium?
Which statement best describes the relationship between inflammation and the junctional epithelium?
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What is the primary outcome of periodontitis?
What is the primary outcome of periodontitis?
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Which statement best describes plaque biofilm?
Which statement best describes plaque biofilm?
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Which of the following is NOT a component of the inorganic matrix found in dental plaque biofilm?
Which of the following is NOT a component of the inorganic matrix found in dental plaque biofilm?
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What is the first stage in the development of dental plaque biofilm?
What is the first stage in the development of dental plaque biofilm?
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Which of the following statements about cytokines is true?
Which of the following statements about cytokines is true?
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Which immune response is NOT considered a component of host defence in the oral cavity?
Which immune response is NOT considered a component of host defence in the oral cavity?
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What role do matrix metalloproteinases (MMPs) play in periodontal disease?
What role do matrix metalloproteinases (MMPs) play in periodontal disease?
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Which of the following factors is least likely to contribute to the initiation of periodontitis?
Which of the following factors is least likely to contribute to the initiation of periodontitis?
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What is the primary role of the oral epithelium in the gingival tissue?
What is the primary role of the oral epithelium in the gingival tissue?
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Which of the following correctly describes the function of the junctional epithelium?
Which of the following correctly describes the function of the junctional epithelium?
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What type of immune response is primarily activated by dental plaque?
What type of immune response is primarily activated by dental plaque?
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Which bacterium is known for producing gingipains that allow it to utilize gingival crevicular fluid as a nutrient source?
Which bacterium is known for producing gingipains that allow it to utilize gingival crevicular fluid as a nutrient source?
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Which of the following is NOT a virulence factor associated with A. actinomycemcomitans?
Which of the following is NOT a virulence factor associated with A. actinomycemcomitans?
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What characterizes the sulcular epithelium?
What characterizes the sulcular epithelium?
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Which component of the innate immune response is involved in the inflammatory process?
Which component of the innate immune response is involved in the inflammatory process?
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Which tissue of the periodontium is responsible for connecting the tooth to the alveolar bone?
Which tissue of the periodontium is responsible for connecting the tooth to the alveolar bone?
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What is the role of epithelial Langerhans' cells in the immune response?
What is the role of epithelial Langerhans' cells in the immune response?
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Which of the following correctly describes the humoral immune response?
Which of the following correctly describes the humoral immune response?
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Which type of immunity is characterized by the recognition of specific antigens and the establishment of immunological memory?
Which type of immunity is characterized by the recognition of specific antigens and the establishment of immunological memory?
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What is the primary function of antibodies IgG and IgA?
What is the primary function of antibodies IgG and IgA?
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What happens to B-cell lymphocytes during the humoral immune response?
What happens to B-cell lymphocytes during the humoral immune response?
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Which mechanism of adaptive immunity involves the activity of primarily B-cells?
Which mechanism of adaptive immunity involves the activity of primarily B-cells?
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The adaptive immune response is triggered when which situation occurs?
The adaptive immune response is triggered when which situation occurs?
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What is a unique characteristic of the adaptive immune response?
What is a unique characteristic of the adaptive immune response?
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Study Notes
Pathogenesis of Periodontitis
- Periodontitis is a microbial infection causing inflammatory response, leading to irreversible destruction of periodontal tissues.
- Plaque biofilm plays a significant role in periodontal disease development.
Defining Plaque Biofilm
- A biofilm is a community of microorganisms embedded within an extracellular matrix.
- The biofilm matrix has organic components (proteins, glycoproteins, polysaccharides, lipids) and inorganic components (calcium, sodium, phosphorus, potassium).
Stages of Biofilm Formation
- Initial attachment of bacteria to pellicle.
- Initial colonization of the tooth surface by new bacteria.
- Secondary colonization with production of extracellular slime layer.
- Mature biofilm formation (mushroom-shaped colonies).
Tissues of the Gingival Epithelium
- Oral epithelium: Keratinized stratified squamous tissue covering free and attached gingiva (protection).
- Sulcular epithelium: Non-keratinized stratified squamous tissue lining the sulcus; semi-permeable, allowing gingival crevicular fluid flow.
- Junctional epithelium: Non-keratinized stratified squamous tissue joining gingiva to tooth, with tightly packed epithelial cells and desmosomes.
Tissues of the Periodontium
- Gingiva.
- Periodontal ligament.
- Cementum.
- Alveolar bone.
Bacteria Associated with Periodontitis
- P. gingivalis: Produces gingipains for nutrient uptake; carbohydrate capsule for resistance to host defenses.
- T. denticola: Adhesion to fibroblasts; degradation of cytokines, and disruption of host defense.
- T. forsythia: Production of proteases and apoptotic factors causing cell death to immune cells; leukotoxin destroys white blood cells.
- A. actinomycetemcomitans: Leukotoxin destruction of white blood cells and immune response inhibition; production of proteases and toxins damaging epithelial cells.
Subgingival Environment
- The subgingival environment primarily supports anaerobic bacteria.
Host Defenses
- The innate/primary immune response is the initial response to plaque, involving inflammation, epithelium, and saliva.
- Cellular response involves PMNs (neutrophils, mast cells, basophils), macrophages for attacking and removing invading microorganisms.
- The adaptive immune response (specific/acquired) involves antibodies (IgG and IgA) produced by B-cells.
- Cell-mediated responses use T-cell receptors and involve T-helper (TH) cells producing cytokines to assist B-cell differentiation into plasma cells, activating macrophages and neutrophils.
Host Response
- The adaptive immune response involves specific responses to pathogens.
- Components include humoral immunity (antibody production) and cell-mediated immunity.
- Humoral immunity involves antibody production against extracellular pathogens.
- Cell-mediated immunity involves activation of macrophages and neutrophils using T-cell receptors.
Keystone Pathogen Hypothesis
- Keystone species in biofilms greatly influence communities, regardless of numbers.
- Their presence triggers a shift in the biofilm community toward a dysbiotic one.
- Uncontrolled host response leads to periodontal tissue damage.
Factors Contributing to Periodontitis
- Microbial factors: Increased microbial presence and virulence factors.
- Host factors: Compromised host defenses.
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Description
This quiz explores the pathogenesis of periodontitis, focusing on the role of plaque biofilm in the disease's development and the stages of biofilm formation. Additionally, it covers the structure and function of gingival tissues affected by this microbial infection.