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Questions and Answers
What is a primary function of saliva in relation to oral health?
What is a primary function of saliva in relation to oral health?
Which components in saliva specifically target gram-positive bacteria?
Which components in saliva specifically target gram-positive bacteria?
What defines the adaptive immune response?
What defines the adaptive immune response?
Which of the following best describes humoral immunity?
Which of the following best describes humoral immunity?
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What role does immunological memory play in the adaptive immune response?
What role does immunological memory play in the adaptive immune response?
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What is the primary function of the epithelial cells in the oral cavity?
What is the primary function of the epithelial cells in the oral cavity?
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What happens to the junctional epithelium during inflammation?
What happens to the junctional epithelium during inflammation?
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Which cells in the junctional epithelium are involved in the inflammatory response?
Which cells in the junctional epithelium are involved in the inflammatory response?
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What characterizes the pocket-lining epithelium compared to the junctional epithelium?
What characterizes the pocket-lining epithelium compared to the junctional epithelium?
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What is the role of saliva in the oral cavity?
What is the role of saliva in the oral cavity?
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What change occurs to the junctional epithelium during the initiation of an inflammatory response?
What change occurs to the junctional epithelium during the initiation of an inflammatory response?
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Which type of cells are likely to be responsible for macrophage functions in the gingival tissues?
Which type of cells are likely to be responsible for macrophage functions in the gingival tissues?
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What is a potential consequence of the protective function of epithelium being compromised?
What is a potential consequence of the protective function of epithelium being compromised?
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What is the primary characteristic of periodontitis?
What is the primary characteristic of periodontitis?
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Which of the following best describes plaque biofilm?
Which of the following best describes plaque biofilm?
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Which of the following is NOT a component of the extracellular matrix in dental plaque biofilm?
Which of the following is NOT a component of the extracellular matrix in dental plaque biofilm?
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What role do cytokines play in the host response to periodontal disease?
What role do cytokines play in the host response to periodontal disease?
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What are matrix metalloproteinases (MMPs) primarily responsible for in periodontal disease?
What are matrix metalloproteinases (MMPs) primarily responsible for in periodontal disease?
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Which of the following statements about the role of bacteria in periodontal disease is incorrect?
Which of the following statements about the role of bacteria in periodontal disease is incorrect?
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Which of the following factors may contribute to the initiation of periodontitis?
Which of the following factors may contribute to the initiation of periodontitis?
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In the context of immune responses in the oral cavity, what is true about innate immunity?
In the context of immune responses in the oral cavity, what is true about innate immunity?
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Study Notes
Pathogenesis of Periodontal Disease
- Periodontitis is a microbial infection triggering a host-mediated inflammatory response, leading to progressive and irreversible destruction of the periodontal ligament and alveolar bone.
Plaque Biofilm
- Plaque biofilm is a community of microorganisms embedded in an extracellular glycocalyx (slime layer).
- It forms on natural and restored solid surfaces in the oral cavity.
Biofilm Composition
- Organic components: Polysaccharides, glycoproteins, proteins, and lipids.
- Inorganic components: Calcium, sodium, phosphorus, and potassium.
Biofilm Formation Stages
- 1. Initial attachment of bacteria to pellicle.
- 2. Initial colonization of the tooth surface.
- 3. Secondary colonization: extracellular slime layer formation.
- 4. Mature biofilm (mushroom-shaped colonies).
Periodontal Tissues
- The periodontium consists of gingivae, periodontal ligament, cementum, and alveolar bone.
- Oral epithelium covers the free and attached gingivae.
- Sulcular epithelium lines the sulcus.
- Junctional epithelium is at the base of the sulcus.
Bacteria in Periodontal Disease
- Subgingival environment supports mainly anaerobic bacteria.
- Key bacteria species associated with periodontal disease include Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Tannerella forsythia, Prevotella intermedia, and Fusobacterium nucleatum.
Virulence Factors
- Bacteria virulence factors enable colonization, invasion, and damage to the periodontium.
- Examples include carbohydrate capsules, gingipains, lipopolysaccharide (LPS), haemagglutinins, platelet aggregators, fimbrae, tissue invasion, and proteases.
Host Defenses
- Innate and acquired immune responses are initiated in response to plaque.
- Cytokines, prostaglandins, and matrix metalloproteinases (MMPs) are important chemical mediators involved in periodontal disease.
Periodontal Disease Theories
- Non-specific plaque hypothesis proposes that stagnation of plaque leads to inflammation.
- Specific plaque hypothesis suggests a shift in microbial composition rather than amount in developing periodontal disease.
- Keystone pathogen-host response hypothesis emphasizes specific bacterial species triggering an uncontrolled host response.
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