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What is the main function of the oral epithelium in the gingival structure?
What is the main function of the oral epithelium in the gingival structure?
Which part of the gingival epithelium is described as non-keratinised and semi-permeable?
Which part of the gingival epithelium is described as non-keratinised and semi-permeable?
Which bacteria is NOT listed as being associated with periodontal disease?
Which bacteria is NOT listed as being associated with periodontal disease?
What role do gingipains produced by P.gingivalis serve in periodontal disease?
What role do gingipains produced by P.gingivalis serve in periodontal disease?
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Which type of immune response is triggered first by dental plaque?
Which type of immune response is triggered first by dental plaque?
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What structural role do tight junctions serve in the junctional epithelium?
What structural role do tight junctions serve in the junctional epithelium?
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Which virulence factor is associated with T.denticola that helps it evade the host's immune response?
Which virulence factor is associated with T.denticola that helps it evade the host's immune response?
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What is the composition of the periodontal ligament?
What is the composition of the periodontal ligament?
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What is the primary role of the inflammatory response in host defense against periodontal disease?
What is the primary role of the inflammatory response in host defense against periodontal disease?
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Which component of the periodontium is predominantly mineralized?
Which component of the periodontium is predominantly mineralized?
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How does tissue destruction at the junctional epithelium affect its protective function?
How does tissue destruction at the junctional epithelium affect its protective function?
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What type of fluid do the semipermeable parts of junctional epithelium allow to flow?
What type of fluid do the semipermeable parts of junctional epithelium allow to flow?
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Which cells are primarily responsible for secreting cytokines during the inflammatory response in gingival tissues?
Which cells are primarily responsible for secreting cytokines during the inflammatory response in gingival tissues?
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What role does saliva play in the oral cavity?
What role does saliva play in the oral cavity?
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What are the protective functions of epithelial tissues compromised by?
What are the protective functions of epithelial tissues compromised by?
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Which of the following descriptions best fits Langerhans' cells?
Which of the following descriptions best fits Langerhans' cells?
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What happens to the protective function of epithelium during an inflammatory response?
What happens to the protective function of epithelium during an inflammatory response?
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What are micro ulcerations associated with in gingival tissues?
What are micro ulcerations associated with in gingival tissues?
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What initiates the inflammatory response in gingival tissues?
What initiates the inflammatory response in gingival tissues?
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Which of the following is NOT a characteristic of gingival crevicular fluid?
Which of the following is NOT a characteristic of gingival crevicular fluid?
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What is the primary function of pro-inflammatory cytokines like IL-1, IL-6, and TNF-α in periodontitis?
What is the primary function of pro-inflammatory cytokines like IL-1, IL-6, and TNF-α in periodontitis?
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What is the role of anti-inflammatory cytokines such as IL-4 and IL-10 in the context of periodontitis?
What is the role of anti-inflammatory cytokines such as IL-4 and IL-10 in the context of periodontitis?
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Which of the following accurately describes the action of prostaglandins such as PGE₂ in periodontitis?
Which of the following accurately describes the action of prostaglandins such as PGE₂ in periodontitis?
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What is one of the main issues with the Non-specific Plaque Hypothesis in relation to periodontal disease?
What is one of the main issues with the Non-specific Plaque Hypothesis in relation to periodontal disease?
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What factor contributes to the compromised host defense in the initiation of periodontitis?
What factor contributes to the compromised host defense in the initiation of periodontitis?
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Which statement best describes the impact of microbial factors on periodontitis?
Which statement best describes the impact of microbial factors on periodontitis?
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What is periodontitis primarily caused by?
What is periodontitis primarily caused by?
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Which of the following best defines plaque biofilm?
Which of the following best defines plaque biofilm?
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Which of the following is NOT a composition of dental plaque biofilm?
Which of the following is NOT a composition of dental plaque biofilm?
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What is the first stage in the development of dental plaque biofilm?
What is the first stage in the development of dental plaque biofilm?
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Which of the following factors does NOT contribute to the initiation of periodontitis?
Which of the following factors does NOT contribute to the initiation of periodontitis?
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What components are important in the host response during periodontal disease?
What components are important in the host response during periodontal disease?
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Which immune response is NOT typically associated with host defence in the oral cavity?
Which immune response is NOT typically associated with host defence in the oral cavity?
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What type of bacteria is closely associated with periodontal disease?
What type of bacteria is closely associated with periodontal disease?
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What is NOT a role of cytokines in the host response?
What is NOT a role of cytokines in the host response?
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What is the primary role of antibodies in the humoral immune response?
What is the primary role of antibodies in the humoral immune response?
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What type of immune response is initiated when innate immunity fails?
What type of immune response is initiated when innate immunity fails?
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Which cells present antigenic parts from pathogens to lymphocytes?
Which cells present antigenic parts from pathogens to lymphocytes?
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Which type of immunoglobulin is primarily involved in the protective function within the humoral immune response?
Which type of immunoglobulin is primarily involved in the protective function within the humoral immune response?
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What is the main outcome of clonal expansion in the adaptive immune response?
What is the main outcome of clonal expansion in the adaptive immune response?
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What does immunological memory refer to in the context of adaptive immunity?
What does immunological memory refer to in the context of adaptive immunity?
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Which of the following types of immunity involves the activation of B-cell lymphocytes?
Which of the following types of immunity involves the activation of B-cell lymphocytes?
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What is the role of plasma cells in the immune system?
What is the role of plasma cells in the immune system?
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Humoral immunity primarily targets which type of pathogen?
Humoral immunity primarily targets which type of pathogen?
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Why is it essential for antibodies to recognize specific antigens?
Why is it essential for antibodies to recognize specific antigens?
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Study Notes
Periodontitis
- Periodontitis is caused by a microbial infection that triggers an inflammatory response.
- The infection leads to irreversible destruction of periodontal tissues and supporting structures.
Dental Plaque Biofilm
- Plaque biofilm is a community of microorganisms embedded in an extracellular matrix.
- Plaque biofilm is composed of organic and inorganic substances.
- Organic substances include proteins, glycoproteins, polysaccharides, lipids, and the intracellular matrix.
- Inorganic substances include calcium, sodium, phosphorous, and potassium.
- Plaque biofilm formation occurs in four stages:
- Initial attachment of bacteria to pellicle
- Initial colonization of the tooth surface
- Secondary colonization with production of an extracellular slime layer
- Mature biofilm formation with mushroom-shaped colonies.
Tissues of the Periodontium
- The gingival epithelium comprises three parts:
- Oral epithelium: Keratinized stratified squamous epithelium covering the free and attached gingiva.
- Sulcular epithelium: Nonkeratinized stratified squamous epithelium facing the tooth but not in contact.
- Junctional epithelium: Nonkeratinized stratified squamous epithelium joining the gingiva to the tooth.
- Tissues of the periodontium include:
- Gingivae
- Periodontal ligament
- Cementum
- Alveolar bone
Bacteria Associated in the Pathogenesis of Periodontal Disease
- The subgingival environment mainly supports anaerobic bacteria.
- Bacterial species associated with periodontal disease include:
- Porphyromonas gingivalis
- Treponema denticola
- Tannerella forsythia
- Aggregatibacter actinomycetemcomitans
- Virulence factors of bacteria associated with periodontal disease enable colonization, invasion, and damage to the periodontium.
Host Defenses in the Oral Cavity
- The innate immune response is the body's first line of defense against plaque.
- Components of the innate immune response include:
- Inflammatory response: Inflammation is initiated by the presence of plaque and involves the release of cytokines and chemokines.
- Epithelium: Provides a physical barrier against infection, which is compromised by tissue destruction at the junctional epithelium.
- Keratinocytes: Cells of the junctional epithelium that secrete cytokines and tumor necrosis factor (TNF).
- Langerhans' cells: Tissue macrophages responsible for releasing host defenses.
- Saliva: Prevents drying of oral tissues, has antimicrobial properties, and influences bacteria attachment.
- The adaptive immune response is activated when the innate immune response is unsuccessful in eliminating pathogens.
- It is specific to a particular pathogen and involves immunological memory.
- Two main mechanisms are involved:
- Humoral immunity (antibody response): Antibodies are produced against agents existing extracellularly.
- Epithelial Langerhans' cells: Present antigenic parts from pathogens to circulating lymphocytes which then stimulate clonal expansion after recognizing the specific antigen.
- B-cell lymphocytes: Differentiate into plasma cells which then release antibodies against the specific antigen.
- Antibodies IgG and IgA : Provide a protective function.
- Cell-mediated immunity: Immune cells directly attack and destroy infected cells.
- Humoral immunity (antibody response): Antibodies are produced against agents existing extracellularly.
Mediators Involved in Periodontitis
- Cytokines: Small proteins that control immune cell growth and activity.
- Pro-inflammatory cytokines (IL-1, IL-6, and TNF-α) promote tissue destruction.
- Anti-inflammatory cytokines (IL-4 and IL-10) act to reduce inflammation.
- Prostaglandins: Involved in bone resorption, chemotaxis, vascular permeability, and dilation.
- PGE2 is a key prostaglandin involved in periodontitis.
- Matrix metalloproteinases (MMPs): Enzymes that degrade connective tissue, contributing to tissue destruction.
Factors Contributing to the Initiation of Periodontitis
- A dynamic equilibrium exists between dental plaque and host defenses in healthy individuals and those with stable gingivitis.
- This equilibrium is disrupted in periodontitis, leading to tissue damage. Factors contributing to this shift include:
- Increased presence of plaque
- Increased pathogenicity of microorganisms within the biofilm
- Compromised host defenses
- Theories about the role of bacteria in periodontal disease:
- Non-specific Plaque Hypothesis: Stagnation of plaque biofilm within the gingival sulcus leads to gingival inflammation, periodontal disease, and tissue destruction.
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Description
Test your knowledge on periodontitis, the microbial infection that causes permanent damage to periodontal tissues. Explore the stages of dental plaque biofilm formation and understand the anatomy of the periodontium. This quiz is essential for dental students and professionals alike.
