44 Questions
What is the primary cause of periodontal infection?
Invasive oral pathogens in dental plaque biofilms
When does colonization of the sterile oral cavity typically occur?
Within hours after birth
What is the composition of the human microbial flora after weaning?
Nearly mature microbiota in the gut
How does the bacterial population in a normal, healthy human being compare to human cells?
1.3 to 10 times more bacteria than human cells
What covers the surface of subgingival calculus, making its removal difficult?
Nonmineralized layer of plaque
What is the etiologic significance of the rough calculus surface according to the text?
It acts as an irritant to the periodontal tissues
What is the positive correlation mentioned in the text regarding periodontal disease?
Correlation between plaque and gingivitis
According to the text, what is the main etiologic factor in the development of periodontal disease?
Subgingival plaque
What is the role of calculus in maintaining and accentuating periodontal disease based on the text?
Provides a fixed nidus for plaque accumulation
What does the incidence of calculus, gingivitis, and periodontal disease increase with according to the text?
Age
What constitutes the cornerstone of periodontal therapy according to the text?
Removal of subgingival plaque and calculus
Which factor is more closely related to periodontal conditions in young persons according to the text?
Plaque accumulation
Which pathogen is known for its capacity to invade soft tissues?
P. gingivalis
What is the name of the proteolytic enzyme produced by T. forsythia?
Protease
Which organisms are important bridging organisms between primary and secondary colonizers during colonization?
Fusobacteria
Which hypothesis postulates that periodontal disease results from the elaboration of noxious products by the entire plaque flora?
Non-specific plaque hypothesis
What may lead to a shift in the microbial population in plaque, resulting in a chronic disease state like periodontitis?
High gingival crevicular fluid flow
Which pathogen is a nonmotile, gram-negative obligate anaerobe that contributes to periodontal disease?
T. forsythia
What is crucial for pathogenicity according to the specific plaque hypothesis?
Composition of specific plaque
What does P. gingivalis use to adhere to hard intraoral surfaces and oral mucosae?
Fimbriae
Which group of organisms produces proteolytic enzymes that can destroy immunoglobulins and complement factors?
Fusobacteria and T. forsythia
What contributes to the shift from gram-positive to gram-negative bacteria during disease progression?
Proteolytic enzymes produced by T. denticola
Which factor is not involved in the development of periodontitis?
Viral factors
Which of the following is the first and most dominant oral microbe to colonize the oral cavity of newborn infants?
Streptococcus salivarius
What type of microbial populations are different from free-living microorganisms and often up to 1000 times more resistant to antimicrobial agents than their planktonic counterparts?
Sessile microbial populations in biofilms
What is the resilient, yellow-grayish substance that adheres tenaciously to intraoral hard surfaces and is composed of microbial cells encased within a matrix of extracellular polymeric substances?
Oral biofilms
What predominantly consists of calcium and phosphorus, with trace amounts of other minerals in the intercellular matrix of biofilms?
Inorganic constituents
What periodontopathogens find their preferred habitat in deeper periodontal pockets due to the local availability of blood products and a low reduction–oxidation potential?
Aggregobacter actinomycetemcomitans
Which of the following members colonize the subgingival sulcus first and predominate in gingival health?
Yellow, green, and purple complexes
What favors further proliferation by not only the orange and red complexes, but probably members of the early colonizing species as well?
Gingivitis
Which type of bacterial adherence is crucial for the induction of infectious diseases such as gingivitis or periodontitis?
Adherence to host cells
What are the primary constituents of the organic intercellular matrix of biofilms?
Polysaccharides, proteins, glycoproteins, and lipid material
Which bacteria predominantly exist at the tooth surface in the development of a polymicrobial biofilm?
Gram-positive cocci and short rods
What are members of the orange and red complexes predominant in, leading to a change in habitat and clinical manifestation as gingivitis?
Members of the orange and red complexes become more dominant, leading to a change in habitat and clinical manifestation as gingivitis.
What is the primary cause of periodontal tissue destruction?
Inflammatory reaction
Which of the following is not listed as a primary etiologic factor of periodontal tissue destruction?
Normal flora
Which factor contributes to progressing the periodontal disease if the initial infection is not contained?
Macrophages and neutrophils
Which of the following is not a risk factor contributing to periodontal disease?
Normal flora
What leads to systemic exposure in periodontitis?
Bacterial penetration
What is the primary source of mineralization for supragingival calculus?
Saliva
Which of the following is a major inorganic proportion of calculus?
Calcium carbonate
'Calculus becomes fully mineralized in how many days?' Which of the following is the correct answer?
$15$ days
'Calculus, a mineralized form of dental plaque, is primarily composed of?' Which of the following is the correct answer?
$70-90%$ inorganic components and $10-30%$ organic components
'Four modes of attachment of calculus to tooth surfaces make removal difficult.' Which of the following is not one of these modes?
Penetration of calculus bacteria into cementum
Study Notes
- Periodontal tissue destruction can be caused by the presence of pathogenic bacteria and risk factors leading to an inflammatory reaction.
- Primary etiologic factors include inflammatory reaction, proteolytic enzymes, and collagenases released by bacteria, neutrophils, MMP, cytokines (IL-1β and IL-6), and fibroblasts, monocytes, and epithelial cells.
- If initial infection is not contained, macrophages and neutrophils play a role in progressing the disease, leading to loss of clinical attachment, pocketing, bone loss, and inflammation.
- Poor oral hygiene, normal flora, exogenous infection, and risk factors like genetic traits, diabetes, and smoking contribute to periodontal disease.
- Monocyte lymphocyte axis and bacterial penetration lead to systemic exposure.
- Periodontitis involves a cascade of events, including calculus formation, pocketing, bone resorption, and mobility recession, leading to loss of tooth structure.
- Calculus, a mineralized form of dental plaque, is primarily composed of inorganic components (70-90%), with major inorganic proportions being calcium phosphate, calcium carbonate, and magnesium phosphate.
- Calcification of plaque occurs within 4 to 8 hours and becomes fully mineralized in 12 days, with saliva being the primary source of mineralization for supragingival calculus and gingival crevicular fluid for subgingival calculus.
- Four modes of attachment of calculus to tooth surfaces make removal difficult: attachment on organic pellicle on enamel, mechanical locking into surface irregularities, close adaptation to tooth surface depressions, and penetration of calculus bacteria into cementum.
Test your knowledge on the virulence factors of periodontal pathogens with this quiz. Identify the key factors that contribute to the aggressive nature of these pathogens and their ability to cause damage to oral tissues.
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