Pathogenesis of Periodontal Disease Part 2
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Questions and Answers

What are the four stages of gingivitis to periodontitis?

  • Initial lesion, Late lesion, Established lesion, Terminal lesion
  • Initial lesion, Early lesion, Established lesion, Advanced lesion (correct)
  • Early lesion, Established lesion, Advanced lesion, Chronic lesion
  • Initial lesion, Established lesion, Advanced lesion, Critical lesion

Which of the following factors contribute to the progression of periodontal disease?

  • Poor oral hygiene, Smoking, Genetic factors, Dietary choices (correct)
  • Daily flossing, Use of mouthwash, Regular professional cleanings, Good nutrition
  • High sugar intake, Limited dental care, Sedentary lifestyle, Stress management
  • Fluoride exposure, Vitamin D, Proper brushing, Regular dental visits

What is the primary role of the host immune system in periodontal disease?

  • To prevent any bacterial colonization
  • To initiate inflammation and respond to pathogens (correct)
  • To produce enamel on teeth
  • To eliminate the need for dental hygiene

What best describes 'biofilm' in the context of periodontal disease?

<p>A collection of microorganisms adhering to surfaces (C)</p> Signup and view all the answers

Which type of lesion is characterized by the earliest changes in gingival histology?

<p>Initial lesion (C)</p> Signup and view all the answers

What distinguishes an established lesion from an early lesion in periodontal disease?

<p>Enhanced immune response and tissue destruction (D)</p> Signup and view all the answers

What role do virulence factors play in periodontal disease?

<p>They contribute to the pathogenicity of bacteria involved in periodontal disease (B)</p> Signup and view all the answers

Which statement accurately reflects the impact of the patient’s general health on periodontal disease management?

<p>The overall health status can influence treatment outcomes and plans (C)</p> Signup and view all the answers

What initiates the initial lesion in periodontitis?

<p>Plaque accumulation (B)</p> Signup and view all the answers

Which stage of periodontitis follows the early lesion?

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

At what time frame does the early lesion occur relative to plaque accumulation?

<p>4-7 days (C)</p> Signup and view all the answers

What is primarily observed in the advanced lesion of periodontitis?

<p>Severe tissue destruction (A)</p> Signup and view all the answers

Which immune response component is crucial in the pathogenesis model of periodontal disease?

<p>T cells (C)</p> Signup and view all the answers

Which of the following is not a feature of the initial lesion?

<p>Chronic inflammation (B)</p> Signup and view all the answers

What is a characteristic feature of bacterial biofilm in the established lesion?

<p>Stable mass of bacteria (A)</p> Signup and view all the answers

Which host response mechanism is associated with connective tissue destruction in periodontitis?

<p>Release of cytokines (D)</p> Signup and view all the answers

Which stage of periodontitis is most likely to exhibit clinical features such as pocket formation?

<p>Advanced lesion (C)</p> Signup and view all the answers

What bacterial feature is critical for the virulence in periodontitis?

<p>High levels of LPS (D)</p> Signup and view all the answers

Flashcards

Initial lesion

The initial stage of gingivitis where the immune system is activated by the presence of plaque biofilm, but there are no visible changes in the gingiva.

Early lesion

The early stage of gingivitis where there are visible signs of inflammation, like redness and swelling. The immune system is actively fighting the bacteria.

Established lesion

The established stage of gingivitis where the inflammation is persistent. The immune system tries to contain the infection, but damage to the gingiva is more evident.

Advanced lesion

This stage marks the transition from gingivitis to periodontitis. The inflammation extends beyond the gingiva, affecting the supporting tissues around the teeth.

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Host immune system

The body's defense mechanism against pathogens, involving cells and molecules that identify and eliminate threats.

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Biofilm

A complex microbial community that forms on the surface of teeth. It can be harmful to the gums if not removed regularly.

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Virulence factors

Factors produced by bacteria that contribute to their ability to cause disease. These factors can trigger inflammation and tissue breakdown.

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Pathogenesis

The study of how diseases develop, focusing on the interactions between the host and the pathogen.

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Page & Korman's Pathogenesis Model

The model describes the pathogenesis of periodontitis, emphasizing the role of bacteria, host response, and risk factors in the disease progression.

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LPS, Antigens, & Virulence Factors

These molecules are released by bacteria and trigger an inflammatory response in the host.

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Cytokines

These are produced by immune cells like neutrophils and lymphocytes, and they play a crucial role in the inflammatory response.

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PMNs (Neutrophils) & T Cells

These are important immune cells that combat infection and inflammation. Neutrophils are the first line of defense, while T cells are involved in specific immune response.

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MMPs (Matrix Metalloproteinases)

These are responsible for breaking down and remodeling connective tissue, leading to periodontal destruction.

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PGE2

This is a powerful inflammatory mediator that contributes to tissue destruction in periodontitis.

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Study Notes

Pathogenesis of Periodontal Disease - Part 2

  • Learning Outcomes: Students should be able to recap gingival histology, immunology, and pathogenesis; revise chemical mediators relevant to periodontal disease and host response; describe bacterial, cellular, tissue level and clinical characteristics of gingivitis to periodontitis through the four stages (initial, early, established, advanced); and explain contributing factors impacting disease progression.

Gingival and Periodontal Disease Stages

  • Initial Lesion: Characterized by a 2-4 day period after plaque accumulation, presenting with bacterial features, cellular features (e.g blood vessels and neutrophils), tissue level features (surface inflammation), and clinical features (no symptoms).

  • Early Lesion: 4-7 days after plaque accumulation, there are more bacteria, cellular features (T-cells and lymphocytes) and tissue level features (gingival inflammation) as well as clinical features (slight inflammation).

  • Established Lesion: (21 days after plaque accumulation) exhibiting significant bacteria, cellular features (plasma cells and fibroblasts), tissue level features (bone resorption), and noticeable clinical features (advanced inflammation).

  • Advanced Lesion: Features notable bone loss, substantial bacteria, cellular features(various immune cells), tissue level features (severe connective tissue destruction), and advanced clinical features (significant periodontal damage).

Model of Periodontal Disease

  • Risk Factors: Environmental, acquired, and genetic factors contribute.

  • Pathogenesis: Specific pathogenic bacteria, antibodies, antigens, LPS, virulence factors, and host immune responses interact within the host to initiate and progress inflammatory and connective tissue destruction/bone loss.

Host Immune System Role

  • Host immune responses are crucial in the progression of periodontal disease.

GDC Learning Outcomes

  • Oral diseases' description and relevance to prevention/treatment
  • Aetiology and pathogenesis of oral disease
  • Relevant physiology for patient care
  • Periodontal and soft tissue health assessment/management considering risk and lifestyle factors
  • Patient's periodontal and general health affecting treatment plans and outcomes.

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