Pathogenesis of Periodontal Disease Part 2 PDF

13/01/2022 Pathogenesis of Periodontal Disease – Part 2 Intended Learning Outcomes By the end of this session students should be able to:  Recap previous knowledge of gingival histology, immunology and pathogenesis.  Revise the different types of chemical mediators relevant to periodontal...

13/01/2022 Pathogenesis of Periodontal Disease – Part 2 Intended Learning Outcomes By the end of this session students should be able to:  Recap previous knowledge of gingival histology, immunology and pathogenesis.  Revise the different types of chemical mediators relevant to periodontal disease and their role in the host response.  Describe bacterial, cellular, tissue level & clinical features of disease and host response in the four stages of gingivitis to periodontitis; 1. Initial lesion 2. Early lesion 3. Established lesion 4. Advanced lesion  Explain what contributing factors impact the progression of disease 2 1  13/01/2022 GDC Learning Outcomes  1.1.2 Describe oral diseases and their relevance to prevention, diagnosis and treatment  1.1.4 Explain the aetiology and pathogenesis of oral disease  1.1.6 Describe relevant and appropriate physiology and explain its application to patient management  1.11.1 Assess and manage the health of periodontal and soft tissues taking into account risk and lifestyle factors  1.11.2 Explain and take account of the impact of the patient’s periodontal and general health on the overall treatment plans and outcomes 3 Recall of knowledge Gingival histology Immunology Biofilm Virulence factors Gingivitis & Periodontitis Pathogenesis of periodontal disease 4 2 13/01/2022 6 3  13/01/2022 What is the role of host immune system? 7 Histological Stages of Periodontitis 8 4  13/01/2022 We need to consider Bacterial Cellular features features Impacting Clinical Tissue level features features factors Host response 9 4 stages/lesions Initial Early Established Advanced 10 5  13/01/2022 INITIAL LESION – commences 2-4 days after plaque accumulation Bacterial features Cellular features Tissue level features Clinical features Host response 11 12 6  13/01/2022 EARLY LESION – commences 4-7days after plaque accumulation Bacterial features Cellular features Tissue level features Clinical features Host response 13 14 7  13/01/2022 ESTABLISHED LESION – 21 days after plaque biofilm accumulation Bacterial features Cellular features Tissue level features Clinical features Host response 15 16 8  13/01/2022 ADVANCED LESION Bacterial features Cellular features Tissue level features Clinical features Host response 17 18 9  13/01/2022 Pathogenesis model of Periodontal Risk factors, genetics, smoking, Disease – Page and systemic health Korman 1997 Antibodies Cytokines PMN’s / Tcells Connective tissue / bone destruction LPS Virulence factors Antigens MMPS, PGE2, TNFa 19 A model of periodontitis pathogenesis (adapted from Meyle & Chapple) 20 10