Pathogenesis of Periodontal Disease 2 medium

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What role do mast cells and neutrophils play in the initiation of the inflammatory process?

They inhibit immune responses within connective tissue.

They stimulate immune cells to enhance inflammation. (correct)

They prevent the release of pro-inflammatory cytokines.

They decrease vascular permeability in tissues.

What happens to blood vessels adjacent to the junctional epithelium during the initial inflammatory phase?

They undergo mild vasodilation. (correct)

They become impermeable to plasma fluids.

They increase in diameter but do not allow fluid to exit.

They constrict completely.

Which inflammatory cells are primarily responsible for attempting to kill evading bacteria and destructing nearby tissues?

Neutrophils and T lymphocytes. (correct)

Neutrophils and macrophages.

T lymphocytes and basophils.

Fibroblasts and lymphocytes.

What is the consequence of the destruction of collagen fibres in the gingivae?

Proliferation of junctional epithelium fills in the spaces. Signup and view all the answers

What clinical sign indicates increased inflammation during the early stages of the gingival lesion?

Bleeding on probing due to blood vessel proliferation. Signup and view all the answers

Which stage of gingivitis marks the transition from initial changes to more pronounced inflammatory responses?

Early lesion Signup and view all the answers

What is a key contributing factor that impacts the progression of periodontal disease?

Patient's lifestyle factors Signup and view all the answers

Which chemical mediators are significant in the host response during periodontal disease?

Cytokines Signup and view all the answers

What is the primary feature distinguishing established lesions from early lesions in periodontal disease?

Inflammation severity Signup and view all the answers

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

To protect against tissue damage Signup and view all the answers

Which of the following factors is least likely to affect the progression of periodontal disease?

Color of dental appliances Signup and view all the answers

During which stage of gingivitis do distinct clinical features such as tissue deepening and loss of attachment occur?

Advanced lesion Signup and view all the answers

Which component of gingival histology is primarily affected by periodontal disease progression?

Epithelial integrity Signup and view all the answers

What is the time frame for the onset of the initial lesion after plaque accumulation?

2-4 days Signup and view all the answers

Which of the following factors does NOT affect periodontitis?

High water intake Signup and view all the answers

What type of response occurs at the histological stage of initial lesion in periodontitis?

Inflammatory response Signup and view all the answers

Which phase of periodontitis is characterized by symptoms appearing 4-7 days after plaque accumulation?

Early lesion Signup and view all the answers

What role does bacteria play in the development of the initial lesion?

They release toxins damaging underlying tissues. Signup and view all the answers

Which clinical feature is expected during the initial lesion stage of periodontitis?

Tissue inflammation Signup and view all the answers

What is one of the main cellular features present in the early lesion of periodontitis?

Increased neutrophil migration Signup and view all the answers

What type of diet is associated with an increased risk of developing periodontitis?

Rich in carbohydrates Signup and view all the answers

What role do cytokines like Interleukin-1 beta and TNF-alpha play in periodontal disease?

They act as messengers to recruit immune cells. Signup and view all the answers

What is the primary outcome of elevated pro-inflammatory cytokines in individuals with periodontitis?

Activation of osteoclasts and alveolar bone loss. Signup and view all the answers

Which of the following conditions is associated with established periodontal lesions?

Signs of tissue inflammation and destruction. Signup and view all the answers

What is the function of macrophages in the context of periodontal disease?

They differentiate into osteoclasts. Signup and view all the answers

How does vasodilation contribute to periodontal disease pathology?

It enhances blood flow and facilitates immune responses. Signup and view all the answers

What are MMPs and their role in periodontal disease?

Enzymes that contribute to bone destruction. Signup and view all the answers

Which of the following is NOT a characteristic of advanced periodontal lesions?

Complete absence of immune response. Signup and view all the answers

Which risk factors can contribute to the progression of periodontal disease pathogenesis?

Genetics and smoking behavior. Signup and view all the answers

What is primarily observed in the established lesion 21 days after plaque accumulation?

A large number of infiltrating plasma cells and B lymphocytes Signup and view all the answers

What causes the blueish appearance in established lesions of the gingiva?

Reduced blood flow due to viscosity changes Signup and view all the answers

Which of the following immune cells predominantly appears in the junction epithelium during advanced lesions?

Neutrophils Signup and view all the answers

What is the consequence of neutrophils releasing matrix metalloproteins and collagenase enzymes?

Further destruction of collagen fiber bundles Signup and view all the answers

Which factors primarily contribute to tissue destruction in periodontal disease?

Host immune response and inflammatory mediators Signup and view all the answers

What happens to the junctional epithelium during the formation of periodontal pockets?

It migrates apically to fill collagen-depleted areas Signup and view all the answers

Which inflammatory mediator is derived primarily from plasma membranes and significantly influences periodontal disease?

PGE2 Signup and view all the answers

What is the primary role of B lymphocytes in the context of periodontal disease?

Produce antibodies that lead to tissue destruction Signup and view all the answers

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.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

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.