Podcast
Questions and Answers
What role do mast cells and neutrophils play in the initiation of the inflammatory process?
What role do mast cells and neutrophils play in the initiation of the inflammatory process?
What happens to blood vessels adjacent to the junctional epithelium during the initial inflammatory phase?
What happens to blood vessels adjacent to the junctional epithelium during the initial inflammatory phase?
Which inflammatory cells are primarily responsible for attempting to kill evading bacteria and destructing nearby tissues?
Which inflammatory cells are primarily responsible for attempting to kill evading bacteria and destructing nearby tissues?
What is the consequence of the destruction of collagen fibres in the gingivae?
What is the consequence of the destruction of collagen fibres in the gingivae?
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What clinical sign indicates increased inflammation during the early stages of the gingival lesion?
What clinical sign indicates increased inflammation during the early stages of the gingival lesion?
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Which stage of gingivitis marks the transition from initial changes to more pronounced inflammatory responses?
Which stage of gingivitis marks the transition from initial changes to more pronounced inflammatory responses?
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What is a key contributing factor that impacts the progression of periodontal disease?
What is a key contributing factor that impacts the progression of periodontal disease?
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Which chemical mediators are significant in the host response during periodontal disease?
Which chemical mediators are significant in the host response during periodontal disease?
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What is the primary feature distinguishing established lesions from early lesions in periodontal disease?
What is the primary feature distinguishing established lesions from early lesions in periodontal disease?
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What is the role of the host immune system in periodontal disease?
What is the role of the host immune system in periodontal disease?
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Which of the following factors is least likely to affect the progression of periodontal disease?
Which of the following factors is least likely to affect the progression of periodontal disease?
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During which stage of gingivitis do distinct clinical features such as tissue deepening and loss of attachment occur?
During which stage of gingivitis do distinct clinical features such as tissue deepening and loss of attachment occur?
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Which component of gingival histology is primarily affected by periodontal disease progression?
Which component of gingival histology is primarily affected by periodontal disease progression?
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What is the time frame for the onset of the initial lesion after plaque accumulation?
What is the time frame for the onset of the initial lesion after plaque accumulation?
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Which of the following factors does NOT affect periodontitis?
Which of the following factors does NOT affect periodontitis?
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What type of response occurs at the histological stage of initial lesion in periodontitis?
What type of response occurs at the histological stage of initial lesion in periodontitis?
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Which phase of periodontitis is characterized by symptoms appearing 4-7 days after plaque accumulation?
Which phase of periodontitis is characterized by symptoms appearing 4-7 days after plaque accumulation?
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What role does bacteria play in the development of the initial lesion?
What role does bacteria play in the development of the initial lesion?
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Which clinical feature is expected during the initial lesion stage of periodontitis?
Which clinical feature is expected during the initial lesion stage of periodontitis?
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What is one of the main cellular features present in the early lesion of periodontitis?
What is one of the main cellular features present in the early lesion of periodontitis?
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What type of diet is associated with an increased risk of developing periodontitis?
What type of diet is associated with an increased risk of developing periodontitis?
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What role do cytokines like Interleukin-1 beta and TNF-alpha play in periodontal disease?
What role do cytokines like Interleukin-1 beta and TNF-alpha play in periodontal disease?
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What is the primary outcome of elevated pro-inflammatory cytokines in individuals with periodontitis?
What is the primary outcome of elevated pro-inflammatory cytokines in individuals with periodontitis?
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Which of the following conditions is associated with established periodontal lesions?
Which of the following conditions is associated with established periodontal lesions?
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What is the function of macrophages in the context of periodontal disease?
What is the function of macrophages in the context of periodontal disease?
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How does vasodilation contribute to periodontal disease pathology?
How does vasodilation contribute to periodontal disease pathology?
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What are MMPs and their role in periodontal disease?
What are MMPs and their role in periodontal disease?
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Which of the following is NOT a characteristic of advanced periodontal lesions?
Which of the following is NOT a characteristic of advanced periodontal lesions?
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Which risk factors can contribute to the progression of periodontal disease pathogenesis?
Which risk factors can contribute to the progression of periodontal disease pathogenesis?
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What is primarily observed in the established lesion 21 days after plaque accumulation?
What is primarily observed in the established lesion 21 days after plaque accumulation?
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What causes the blueish appearance in established lesions of the gingiva?
What causes the blueish appearance in established lesions of the gingiva?
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Which of the following immune cells predominantly appears in the junction epithelium during advanced lesions?
Which of the following immune cells predominantly appears in the junction epithelium during advanced lesions?
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What is the consequence of neutrophils releasing matrix metalloproteins and collagenase enzymes?
What is the consequence of neutrophils releasing matrix metalloproteins and collagenase enzymes?
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Which factors primarily contribute to tissue destruction in periodontal disease?
Which factors primarily contribute to tissue destruction in periodontal disease?
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What happens to the junctional epithelium during the formation of periodontal pockets?
What happens to the junctional epithelium during the formation of periodontal pockets?
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Which inflammatory mediator is derived primarily from plasma membranes and significantly influences periodontal disease?
Which inflammatory mediator is derived primarily from plasma membranes and significantly influences periodontal disease?
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What is the primary role of B lymphocytes in the context of periodontal disease?
What is the primary role of B lymphocytes in the context of periodontal disease?
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Flashcards
Gingival Histology
Gingival Histology
The study of the microscopic structure of the gums.
Immunology in Periodontal Disease
Immunology in Periodontal Disease
The study of how the immune system responds to bacteria in the gums.
Biofilm in Periodontal Disease
Biofilm in Periodontal Disease
A complex community of bacteria that forms on the teeth and gums.
Virulence Factors
Virulence Factors
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Gingivitis
Gingivitis
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Periodontitis
Periodontitis
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Pathogenesis of Periodontal Disease
Pathogenesis of Periodontal Disease
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Host Immune System Role
Host Immune System Role
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Initial Lesion
Initial Lesion
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Plaque Accumulation
Plaque Accumulation
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Early Lesion
Early Lesion
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Bacterial features
Bacterial features
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Cellular features
Cellular features
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Tissue level features
Tissue level features
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Clinical features
Clinical features
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Host response
Host response
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Early Periodontal Lesion
Early Periodontal Lesion
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Mast cells, neutrophils role
Mast cells, neutrophils role
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Chemotaxis in gum disease
Chemotaxis in gum disease
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Advanced Periodontal Disease Character
Advanced Periodontal Disease Character
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Gingival changes in periodontitis
Gingival changes in periodontitis
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Established Periodontal Lesion
Established Periodontal Lesion
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Cytokine Role
Cytokine Role
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Advanced Periodontal Lesion
Advanced Periodontal Lesion
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Inflammation in Periodontitis
Inflammation in Periodontitis
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Periodontal Pocket Formation
Periodontal Pocket Formation
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Bone Loss Mechanism
Bone Loss Mechanism
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Immune Cell Dominance (Advanced)
Immune Cell Dominance (Advanced)
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Established Lesion
Established Lesion
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Plasma Cell Role
Plasma Cell Role
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Advanced Lesion
Advanced Lesion
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Periodontal Disease Pathogenesis
Periodontal Disease Pathogenesis
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Matrix Metalloproteins (MMPs)
Matrix Metalloproteins (MMPs)
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Prostaglandin E2 (PGE2)
Prostaglandin E2 (PGE2)
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Key Inflammatory Mediators
Key Inflammatory Mediators
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Host Immune Response role
Host Immune Response role
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Clinical Signs of Periodontitis
Clinical Signs of Periodontitis
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Study Notes
Pathogenesis of Periodontal Disease - Part 2
- Intended Learning Outcomes: Students should be able to:
- Recap gingival histology, immunology, and pathogenesis.
- Review chemical mediators relevant to periodontal disease and their role in the host response.
- Describe bacterial, cellular, tissue, and clinical features of gingivitis and periodontitis in four stages (initial, early, established, advanced).
- Explain contributing factors affecting disease progression.
GDC Learning Outcomes
- Describe oral diseases and their relevance to prevention, diagnosis, and treatment.
- Explain the etiology and pathogenesis of oral disease.
- Describe relevant physiology for patient management.
- Assess and manage the health of periodontal and soft tissues accounting for risk factors and lifestyle.
- Account for the impact of patient's periodontal and general health on treatment plans and outcomes.
Recall of Knowledge
- Include gingival histology, immunology, biofilm, virulence factors, gingivitis & periodontitis, and pathogenesis of periodontal disease.
Model of Periodontal Disease
- Highlights environmental, acquired, and genetic risk factors.
- Shows elements like antibodies, specific pathogenic bacteria, host inflammatory response, LPS, and virulence factors with their influence on the disease's clinical expression (initiation and progression).
- Connective tissue and bone metabolism are major aspects.
Histological Stages of Periodontitis
- Describes different stages of periodontal disease.
What is the role of the host immune system?
- To defend against initial disease aspects.
Stages of Periodontal Disease
- Initial Lesion (2-4 days after plaque accumulation): Characterized by early plaque accumulation with bacterial, cellular, tissue level, and clinical features leading to minimal host response.
- Early Lesion (4-7 days ): Presents with increased vascular permeability and neutrophil, lymphocyte, and macrophage infiltration. Tissue levels show changes in collagen fibers, accompanied by a noticeable increase in inflammatory cells. The early lesion starts to exhibit clinical symptoms.
- Established Lesion (21 days): Significant immune cell infiltration (predominantly plasma cells, B lymphocytes and neutrophils) in the gingival tissues. The presence of collagenase enzymes further degrades collagen fibers. Increased loss of collagen with no initial bone loss is a feature of this stage.
- Advanced Lesion (irreversible): Loss of collagen in the periodontal ligament and alveolar bone. Junctional epithelium migrates apically, creating a deeper periodontal pocket that can harbor bacteria. The host response is characterized by extensive tissue destruction. Bone loss is observed during this phase.
Additional Factors
- Factors impacting periodontitis may include smoking, dry mouth, poor oral hygiene, diet rich in carbs, hormonal shifts, and crowded teeth.
Pathogenesis Model
- A model of periodontitis pathogenesis highlights environmental, behavioral, and genetic risk factors. Factors such as antibodies, PMNs/T cells, LPS, virulence factors, antigens, cytokines influence the development of gingivitis and periodontitis.
- The model showcases the interplay between the host immune response, biofilm, and tissue damage.
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Description
This quiz focuses on the pathogenesis of periodontal disease, including gingival histology, immunology, and the role of chemical mediators. Students will explore the bacterial and clinical features of gingivitis and periodontitis across four stages, as well as the contributing factors to disease progression. It aims to reinforce understanding necessary for prevention, diagnosis, and treatment of oral diseases.