Pathogenesis of Periodontal Disease 2 hard
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Questions and Answers

What role do neutrophils play in the early inflammatory response associated with gingival lesions?

  • They attempt to kill bacteria and can damage nearby tissues. (correct)
  • They decrease vascular permeability.
  • They release pro-inflammatory cytokines.
  • They promote collagen production.

    • Which of the following changes is NOT characteristic of the early lesion phase in response to plaque accumulation?

  • Increased migration of inflammatory cells.
  • Significant clinical symptoms. (correct)
  • Increased gingival crevicular fluid.
  • Mild vasodilation of blood vessels.

    • What is the primary consequence of the destruction of collagen fiber bundles in the gingivae?

  • Formation of new fibroblasts.
  • Decreased blood flow to the area.
  • Increased bacterial resistance.
  • Proliferation of junctional epithelium filling the gaps. (correct)

    • Which immune cells are predominant in the area of insult during the exaggerated inflammatory response?

    <p>Neutrophils, T lymphocytes, and macrophages.</p> Signup and view all the answers

    What role do interleukins play during the inflammatory process in gingival tissues?

    <p>They increase vascular permeability.</p> Signup and view all the answers

    Which stage of gingivitis represents the initial immune response to bacterial invasion?

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

    What impact do virulence factors have in the progression of periodontal disease?

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

    Which of the following is a contributing factor to the progression of periodontal disease?

    <p>Genetic predisposition to inflammation</p> Signup and view all the answers

    Which immune system component primarily targets bacterial pathogens in periodontal disease?

    <p>Phagocytes</p> Signup and view all the answers

    The transition from gingivitis to periodontitis is influenced by which of the following?

    <p>Continuous bacterial biofilm formation</p> Signup and view all the answers

    What is the primary role of chemical mediators in periodontal disease?

    <p>To regulate the inflammatory response</p> Signup and view all the answers

    Which of the following factors can lead to the established lesion phase of periodontal disease?

    <p>Persistent bacterial challenge and host response</p> Signup and view all the answers

    At which stage of periodontal disease might you observe significant alveolar bone loss?

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

    What initiates the initial lesion in periodontitis?

    <p>Bacterial toxins entering the connective tissue through junctional epithelium</p> Signup and view all the answers

    Which factor is likely to influence the tissue level features of periodontitis?

    <p>Diet rich in carbohydrates</p> Signup and view all the answers

    Which stage of periodontitis begins 4-7 days after plaque accumulation?

    <p>Early lesion</p> Signup and view all the answers

    What role does the host response play in periodontitis?

    <p>It is a reaction to prevent further tissue damage</p> Signup and view all the answers

    What characterizes bacterial features during the initial lesion stage of periodontitis?

    <p>Presence of plaque bacteria releasing toxins</p> Signup and view all the answers

    What is the main clinical implication of a dry mouth in susceptibility to periodontitis?

    <p>Decreased ability to wash away food particles</p> Signup and view all the answers

    Which of the following is NOT a recognized factor influencing the development of periodontitis?

    <p>Regular dental cleanings</p> Signup and view all the answers

    What is the primary distinguishing feature of the established lesion stage in periodontitis?

    <p>Presence of deep periodontal pockets</p> Signup and view all the answers

    What is the primary consequence of the activation of neutrophils in gingival tissues?

    <p>Release of matrix metalloproteins and collagenase enzymes</p> Signup and view all the answers

    What marks the transition from established lesions to advanced lesions in periodontal disease?

    <p>Destruction of collagen fibers into the periodontal ligament</p> Signup and view all the answers

    What is the predominant cell type in the junctional epithelium during the advanced lesion stage?

    <p>Neutrophils</p> Signup and view all the answers

    Which of the following is primarily responsible for the irreversible destruction observed in advanced periodontal lesions?

    <p>Matrix metalloproteins derived from subgingival microbes</p> Signup and view all the answers

    What is indicated by the increased viscosity of blood in established lesions?

    <p>Decreased blood flow due to leakage of plasma proteins</p> Signup and view all the answers

    What is the role of B lymphocytes in the progression of periodontal disease?

    <p>Maturing into plasma cells to produce antibodies</p> Signup and view all the answers

    Which inflammatory mediator is primarily derived from plasma membranes of macrophages and fibroblasts in periodontal disease?

    <p>PGE2</p> Signup and view all the answers

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

    <p>It migrates apically to fill collagen-depleted areas</p> Signup and view all the answers

    What is one of the primary roles of Interleukin-1 beta in periodontal disease?

    <p>Acts as a messenger to transmit signals between cells</p> Signup and view all the answers

    What cellular transformation is induced by cytokines in individuals with periodontitis?

    <p>Macrophages into osteoclasts</p> Signup and view all the answers

    What is a clinical feature present in the established lesion of periodontal disease?

    <p>Increased mobility of teeth</p> Signup and view all the answers

    Which cytokine is considered to be the most important in the inflammatory response in periodontal disease?

    <p>Tumor necrosis factor-alpha (TNF-alpha)</p> Signup and view all the answers

    In the context of periodontal disease, what effect do elevated levels of pro-inflammatory cytokines have?

    <p>They promote sustained inflammation leading to bone destruction</p> Signup and view all the answers

    What is one of the risk factors contributing to the pathogenesis of periodontal disease as depicted in the model?

    <p>Genetics and systemic health</p> Signup and view all the answers

    What is the suggested role of MMPs in periodontal disease.

    <p>They contribute to connective tissue and bone destruction</p> Signup and view all the answers

    What phase follows after the established lesion in the progression of periodontal disease?

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

    Study Notes

    Pathogenesis of Periodontal Disease - Part 2

    • Intended Learning Outcomes: Students should be able to recap previous knowledge of gingival histology, immunology, and pathogenesis; revise different chemical mediators relevant to periodontal disease and their role in the host response; describe bacterial, cellular, tissue-level, and clinical features of disease and host response across four stages of gingivitis to periodontitis (initial, early, established, advanced); and explain contributing factors impacting 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 and its application to patient management.
    • Assess and manage the health of periodontal and soft tissues, considering risk and lifestyle factors.
    • Explain the impact of patient periodontal and general health on overall treatment plans and outcomes.

    Recall of Knowledge

    • Gingival histology
    • Immunology
    • Biofilm
    • Virulence factors
    • Gingivitis and Periodontitis
    • Pathogenesis of periodontal disease

    Model of Periodontal Disease

    • Risk Factors: Environmental, acquired, and genetic factors.
    • Components: Antibodies, specific pathogenic bacteria, antigens, LPS, virulence factors, host inflammatory response, cytokines, prostaglandins, connective tissue and bone metabolism, clinical expression of disease initiation and progression
    • Interactions: Factors interact to cause tissue and bone damage.

    What is the role of host immune system?

    • To defend against disease, from initial stages to destruction.

    Histological Stages of Periodontitis

    • Detailed stages of disease are described.

    We need to consider

    • Factors affecting periodontitis (smoking, dry mouth, poor oral hygiene, diet rich in carbs, hormonal shift, crowded teeth).
    • Four stages of lesions (initial, early, established, advanced) and corresponding clinical, bacterial, tissue, and host response features.

    Initial Lesion (2-4 days after plaque accumulation)

    • Bacterial: Plaque accumulation.
    • Cellular: Specific cell types (e.g., neutrophils).
    • Tissue level: Changes at the tissue level.
    • Clinical: Specific clinical characteristics.
    • Host Response: Description of the host's response.

    Early Lesion (4-7 days after plaque accumulation)

    • Bacterial: Plaque accumulation.
    • Cellular: Specific cell types (e.g., neutrophils, lymphocytes).
    • Tissue level: Changes at the tissue level.
    • Clinical: Specific clinical characteristics.
    • Host Response: Description of the host's response.

    Established Lesion (21 days after plaque accumulation)

    • Bacterial: Plaque accumulation.
    • Cellular: Specific cell types (e.g., plasma cells, B lymphocytes).
    • Tissue level: Changes at the tissue level, including tissue destruction progressing.
    • Clinical: Specific clinical characteristics; bone loss possible.
    • Host Response: Description of the host's response, including intensified inflammation and increased leakage of plasma proteins.

    Advanced Lesion

    • Irreversible: Destruction of collagen fibers and bone, with a deeper periodontal pocket and further biofilm accruement. Advanced inflammatory response.

    Pathogenesis Model of Periodontal Disease

    • Describes the pathogenesis of periodontal disease, including risk factors (environmental, genetic, behavioral), disease stages (gingivitis, periodontitis), and host responses.

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    Related Documents

    Pathogenesis of Periodontal Disease PDF

    Description

    This quiz focuses on the pathogenesis of periodontal disease, including an overview of gingival histology and immunology. Students will review the chemical mediators involved and explore the stages of gingivitis leading to periodontitis. Understanding the contributing factors to disease progression is essential for effective diagnosis and treatment.

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