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Questions and Answers

What induces chronic periodontitis?

Individual host's immune response

Genetic variations

Bacteria organized in the dental biofilm (correct)

Environmental and behavioral factors

What is related to the reduced reactivity of lymphocytes?

Alterations in T-cells

Enhanced B-cell response

Alterations in peripherial monocytes (correct)

Increased activity of macrophages

What mediators are synthesized by B-cells, macrophages, and epithelial cells?

Anti-inflammatory cytokines

Growth factors

Pro-inflammatory mediators (correct)

Hormones

What is influenced by local, systemic, and immunologic factors?

Periodontal disease Signup and view all the answers

What may directly influence innate and adaptive immune responses?

Genetic variations Signup and view all the answers

What has been found among family members and across different generations within a family?

Periodontal disease Signup and view all the answers

What is a major risk factor for the development and progression of generalized chronic periodontitis?

Smoking Signup and view all the answers

What is influenced by environmental and behavioral factors?

Development of chronic periodontitis Signup and view all the answers

What is an example of an environmental and behavioral factor?

Smoking Signup and view all the answers

What is the main composition of subgingival biofilm?

Various bacterial species Signup and view all the answers

What is typically found in diseased areas?

Permanent subgingival calculus Signup and view all the answers

What initiates the disease of chronic periodontitis?

Microbial plaque Signup and view all the answers

What is a characteristic finding in patients with untreated chronic periodontitis?

Gingival swelling, redness, and loss of gingival stippling Signup and view all the answers

What is a consequence of direct exposure to subgingival plaque?

Local inflammation, pocket formation, attachment loss, and bone loss Signup and view all the answers

What is chronic periodontitis considered?

A site-specific disease Signup and view all the answers

Why do some sites in the mouth have a higher risk of chronic periodontitis?

Due to site specificity Signup and view all the answers

What is the purpose of the revised classification of periodontal diseases?

To eliminate the confusion in the current literature and research Signup and view all the answers

What is more prone to periodontal destruction?

Interproximal sites Signup and view all the answers

What can occur as a result of local inflammation and bone loss?

Root furcation involvement Signup and view all the answers

What is the primary cause of chronic periodontitis?

Plaque accumulation Signup and view all the answers

What are the clinical features of chronic periodontitis?

Supragingival and subgingival plaque accumulation, pocket formation, and attachment loss Signup and view all the answers

What can influence the host's response to plaque accumulation?

Environmental factors such as diabetes, smoking, and stress Signup and view all the answers

What is the characteristic of the gingiva in long-standing chronic cases?

Thickening and a fibrotic appearance Signup and view all the answers

What determines the extent of destruction of periodontal tissues?

All of the above Signup and view all the answers

What can be observed in chronic periodontitis patients with poor oral hygiene?

Bluish discoloration of the gingiva and swelling Signup and view all the answers

What is the purpose of the 2017 revised classification?

To establish a multidimensional staging and grading system Signup and view all the answers

What type of periodontitis is characterized by attachment and bone loss?

Chronic Periodontitis Signup and view all the answers

At what stage of life may the first signs of chronic periodontitis be detected?

Adolescence Signup and view all the answers

When does chronic periodontitis usually become clinically significant?

In mid-30s or later Signup and view all the answers

What is a characteristic of chronic periodontitis?

It progresses at a rapid rate in some areas and remains static in others Signup and view all the answers

What is a common location of rapidly progressive lesions in chronic periodontitis?

Interproximal areas Signup and view all the answers

What is the prevalence of moderate periodontal destruction in patients 50 years old or older?

40% Signup and view all the answers

What is the prevalence of severe periodontitis in patients 40 years old or older?

Up to 30% Signup and view all the answers

What percentage of the human population experiences at least one form of periodontal disease?

50% Signup and view all the answers

What is a risk factor for periodontal disease?

A part of the causal chain of a disease Signup and view all the answers

What is a characteristic of chronic periodontitis in terms of gender?

It affects both genders equally Signup and view all the answers

What is the primary criterion for establishing a rapidly progressing type of periodontitis?

Severe bone and attachment loss in patients in their 20s Signup and view all the answers

What is the minimum amount of attachment loss required to classify a patient as Stage I (Mild Disease)?

1-2 mm Signup and view all the answers

What is the characteristic of radiographic bone loss in Stage III (Severe Disease)?

Extending to the middle or apical third of the root Signup and view all the answers

What is the classification of periodontitis characterized by 3-4 mm of attachment loss?

Stage II (Moderate Disease) Signup and view all the answers

What is the characteristic of periodontitis in patients under 30 years old?

Rapidly progressing type Signup and view all the answers

What is the maximum amount of attachment loss required to classify a patient as Stage IV (Very Severe Disease)?

≥ 5 mm Signup and view all the answers

What is the characteristic of radiographic bone loss in Stage I (Mild Disease)?

Coronal third of the root Signup and view all the answers

What is the minimum amount of time required to establish a criterion for a rapidly progressing type of periodontitis?

5 years Signup and view all the answers

What is the characteristic of periodontitis in Stage II (Moderate Disease)?

Coronal triple (%15-33) Signup and view all the answers

Study Notes

Immunologic Factors

Chronic periodontitis is induced by bacteria in the dental biofilm, but its progression depends on the individual host's immune response.
Patients may show alterations in peripheral monocytes, reduced reactivity of lymphocytes, or an enhanced B-cell response.
Immune cells, such as B-cells, macrophages, periodontal ligament cells, gingival fibroblasts, and epithelial cells, synthesize pro-inflammatory mediators (e.g., interleukin-1β, interleukin-6, interleukin-8, prostaglandin E2, tumor necrosis factor-α) that modify innate and adaptive immune responses at the periodontal site.

Genetic Factors

Periodontitis is a multifactorial disease influenced by local, systemic, and immunologic factors, which are directly related to individual genetic conditions.
Genetic variations, such as single nucleotide polymorphisms (SNPs) and genetic copy number variations, may directly influence innate and adaptive immune responses and the structure of periodontal tissues.
Periodontal destruction has been found among family members and across different generations, suggesting a genetic basis for susceptibility to periodontal disease.

Environmental and Behavioral Factors

Environmental and behavioral factors, such as smoking and psychological stress, influence the development and progression of chronic periodontitis.
Smoking is a major risk factor for the development and progression of generalized chronic periodontitis.

Chronic Periodontitis

Chronic periodontitis is a disease characterized by inflammation of the tissues supporting the teeth due to plaque accumulation, leading to attachment and bone loss.
Environmental factors, such as diabetes, smoking, and stress, can influence the host's response to plaque accumulation, affecting the speed and severity of the disease.
Clinical features of chronic periodontitis include supragingival and subgingival plaque accumulation, gingival inflammation, pocket formation, alveolar bone and attachment loss, and occasionally suppuration.
Gingival pockets can vary in depth, and horizontal and/or vertical bone loss is present.
The extent of destruction of periodontal tissues is proportional to oral hygiene and plaque levels, local, predisposing factors, and systemic risk factors such as smoking and stress.

Site Specificity of Chronic Periodontitis

Not all sites in the mouth are equally prone to chronic periodontitis, and it exhibits site specificity.
Interproximal sites are more prone to periodontal destruction compared to buccal/facial sites.
Disease progression occurs in certain sites but not uniformly.

Prevalence

Chronic periodontitis increases in prevalence and severity with age, and it generally affects both genders equally.
Periodontitis is an age-associated (not an age-related) disease.
Up to 30% of patients develop severe periodontitis by the time they are 40 years old or older.
Generally, 50% of the human population experiences at least one form of periodontal disease.

Risk Factors for Disease

Risk factors can be part of the causal chain of a disease and/or make the host more susceptible to disease development.
The progression and severity of the disease are shaped by various factors, such as microbiological, immunological, genetic, environmental, and racial factors, as well as interactions with unmodifiable risk factors like age, gender, and race.

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