Ccd Perio Exam 1 Ch 3

Front 1

If you have supragingival biofilm that is not coming into contact with gingiva can you have inflammation?

Back 1

No

Front 2

What must be present for inflammatory periodontal disease?

Back 2

Dental biofim in the sulcus

Front 3

Name the microorganisms in biofilm

Back 3

Bacteria, yeasts, and viruses

Front 4

The degree of tissue damage is dependent on _________.

Back 4

the interaction between plaque bacteria and host defense mechanisms as well as contributing factors.

Front 5

Name the 12 risk factors/markers and indicators for periodontal health?

Back 5

1. Poor OH, 2. tobacco smoking 3. Genetics/heredity 4. advancing aga 5. stress 6. past history of periodontitis 7. systemic diseases 8. males 9. compromised host defense 10. race, ethnicity 11. regularity of dental care 12. interleukin-1 production

Front 6

What is the only way to remove biofilm?

Back 6

Mechanically with tooth brushing or scaling

Front 7

Normally, how many kinda of bacteria are present in biofilms? How many are considered to be pathogenic?

Back 7

Over 700 kinds, <10%

Front 8

What are the different ways we classify bacteria?

Back 8

Shape, gram +/-, aerobic/anaerobic, food source, motile/nonmotile

Front 9

Health associated bacterial characteristics are

Back 9

Gram (+), aerobic (oxygen using), nonmotile, and saccharolytic (carbohydrates as food source)

Front 10

Disease associated bacterial characteristics are

Back 10

Gram (-), anaerobic (cannot tolerate any oxygen), motile, and assaccharolytic (proteins obtained in part from the tissue destruction thy cause as a substrate)

Front 11

What are the primary bacteria that live in the oral cavity in health?

Back 11

Streptococcus sanguis, Streptococcus mitis, Veillonella sp., Actinomyces naselundii, and Actinomyces viscous

Front 12

Aggregatibacter actinomycetemcomitans, what's it's evidence level and primary association?

Back 12

Strong evidence and aggressive periodontics (also in chronic periodontitis and refractory periodontitis)

Front 13

Porphyromonas gingivalis, what's it's evidence level and primary association? Gram ___, transmissible? Invade? Easy or hard to destory?

Back 13

Strong evidence and chronic periodontits, gram - anaerobic rod, can invade connective tissue, transmissible amongst family members, difficult to eradicate

Front 14

Tannerella forsythensis, what's it's evidence level and primary association? Gram ___, where is it found?

Back 14

Strong evidence and chronic periodontits, gram - and in deep pockets

Front 15

Campylobacter rectus, what's it's evidence level and primary association?

Back 15

Moderate evidence and aggressive, refractory periodontitis

Front 16

Eikenella corrodens, what's it's evidence level and primary association?

Back 16

Mod and chronic periodontits

Front 17

Eubacterium nodatum, what's it's evidence level and primary association?

Back 17

Mod and chronic periodontitis

Front 18

Fusobacterium nucleatum, what's it's evidence level and primary association?

Back 18

Mod and chronic periodontitis

Front 19

Prevotella intermedia, what's it's evidence level and primary association?

Back 19

Mod and Pregnancy gingivitis, puberty gingivitis, necrotizing ulcerative peridontal diseases

Front 20

Peptostreptococcus micros, what's it's evidence level and primary association?

Back 20

Mod and Refactory periodontitis

Front 21

Capnocytophaga species, what's it's evidence level and primary association?

Back 21

Mod and aggressive, localized periodontitis

Front 22

Treponema denticola, what's it's evidence level and primary association?

Back 22

Mod and chronic periodontitis, necrotizing ulcerative periodontal diseases

Front 23

Streptococcus intermedius-complex, what's it's evidence level and primary association?

Back 23

Mod and gingivitis

Front 24

Actinomyces species, what's it's evidence level and primary association?

Back 24

Mod and gingivitis

Front 25

Fusobacterium species, what's it's evidence level and primary association?

Back 25

Mod and gingivits

Front 26

How does bacteria attach to the pellicle?

Back 26

Through adhesions which are located on fimbriae. They are usually proteins known as lectins. They link to glycoproteins of the pellicle.

Front 27

How does saliva inhibit the attachment of bacteria to the pellicle?

Back 27

By coating the bacteria and blocking their receptors. Also through agglutinate which prevents bacteria from adhering to the pellicle.

Front 28

Explain what happens to primary colonizers during days 1 - 2 undisturbed (phase 1)

Back 28

The bacteria secrete extracellular slime layer (glycocalyx).

Front 29

Explain the extracellular slime layer

Back 29

It is protective in nature, acts like a "glue" and if it goes 2 days undisturbed it will be mainly gram + faculative (Actinomyces species, streptococci)

Front 30

Explain what happens to primary colonizers during days 2 - 4 undisturbed (phase 2)

Back 30

The 2nd "wave" of bacteria attach this is when coaggregation occurs (ability of new bacteria to attach to the established colonies). Different bacteria will like together via extracellular polysaccharides (glucans, fructans, levans)

Front 31

Explain what happens to primary colonizers during days 4 - 7 undisturbed (phase 3)

Back 31

Begin to see motile bacteria, cells begin to grow away from the surface, cell division is rapid in early development (cell divison is primarily responsible for growth once tooth has been initially covered with primary colonizes), bacterial blooms (rapid, accelerated growth of groups or specific species of bacteria), changes are subclinical

Front 32

Proliferation of bacteria, which happens during days 4 -7, is dependent upon...

Back 32

Avilability of nutrients, pH, and O2 reduction potential

Front 33

Explain what happens to primary colonizers during days 7 - 11 undisturbed (phase 3)

Back 33

Plaque matures (cell division is slower in maturity), begin to see gingival inflammatory changes (subclinical)

Front 34

What happens to undisturbed plaque?

Back 34

The gingival margin becomes inflamed, sulcus deepens, and biofilm grows deeper into the sulcus.

Front 35

What type of plaque is intiated by mature supra?

Back 35

Subgingival plaque. The microflora is more anaerobic, more gram -, more motile, and more asaccharolytic.

Front 36

What is subgingival plaques nutrient source?

Back 36

Mainly tissue breakdown and GCF
FYI supragingival plaques nutrient source is saliva

Front 37

Inflammation DOES NOT appear until....

Back 37

...biofilm changes from mainly gram + to gram - anaerobes. This usually takes 3 - 12 weeks after initial formation of supragingival plaque for subgingival infestation and inflammation

Front 38

________ biofilm is associated with gingivitis.

Back 38

Supragingival which acquires most of nutrients form the oral cavity and can come into contact with the margin

Front 39

________ biofilm is associated with periodontitis.

Back 39

Subgingival, which is is below the gingival margin.

Front 40

What role does glycocalyx play in the extracelluar slime layer?

Back 40

It is embedded in the extracellular slime layer which is secreated by the bacteria.

Front 41

True or False: Biofilm is only found in the oral cavity?

Back 41

False, it is found on any surface that is exposed to bacteria containing fluid (rocks, heart valves)

Front 42

Extracellular slime layer is _______ in nature.

Back 42

Protective

Front 43

Antibiotics that kill free-floating bacteria would need to be increassed 1500x in potency to kill biofilm bacteria because...

Back 43

DUE TO THICK SLIME LAYER, SUBSTANCES RELEASED BY LEUKOCYTES WILL DAMAGE THE HOST MORE THAN BIOFILM, The slime layer prevents penetration into the "heart" of the biofilm, bacteria become resistant to antimicrobials by producing thicker slime (glycocalyx), slime layer protects againts leukocytes

Front 44

How does biofilm communite?

Back 44

Fluid channels permeate slime layer delivering O2, nutrients, and eliminate waste. They communicate through chemotaxis (messagers)

Front 45

What is bacterial virulence?

Back 45

When bacteria comes into contact with something, what it does.

Front 46

What gereralities influence virulence factors?

Back 46

Inherent pathogenic potential or a bacterium, the environment (proximity to the tissues), interaction with the host (ability to evade host defense, ability to destory tissues)

Front 47

Virulence factors: Periodontitis specific bacteria must:

Back 47

Establish themselves near the host tissue (avoid being eliminated by saliva or exudates), Find appropriate nutrition, avoid defense mechanisms of the host and other microoganisms, and be cabable of destorying periodontal tissues.

Front 48

Name the 3 zones of subgingival biofilm

Back 48

Tooth-attached, epithelial attached (tissue attached), and unattached

Front 49

Describe tooth-attached

Back 49

Attach to the tooth from the gingival margin apically, inner core mainly gram + (streptococcus sanguis, actinomyces viscosus), less virulent, associated with calculs formation and root carries, removed by scaling and root planing (perio debridment)

Front 50

Describe epithelial-attached

Back 50

Loosely attached to epithelial wall of pocket, closest to the tissue will have gram -, anaerobic bacteria and spirochetes (P. gingivalis, A.A), most injourious to periodontal tissues (most virulent), greatest bacterial toxin levels, associated with different forms of periodontitis, and cannot be removed by scaling and root planing (perio debridement)

Front 51

Describe unattached

Back 51

Free floating, gram -, anaerobic rods and spirochetes, layer between tissues associated and tooth associated, have been found to play a role in the initiation progression of periodontitis (more virulent then supra) and easiest to remove due to no attachment (water pik)

Front 52

In gingivitis there is an increased number of bacteria seen in heath with the addition of...

Back 52

Prevotella intermedia, spirochetes (won't see in health) and Fusobacterium

Front 53

Describe Actinobacillus actinomycetemcomitans

Back 53

NKA: Aggregatibacter actinomycetemcomitans. Gram - facultative rod, aggressive/refractory periodontitis, 25% of chronic periodontitis, can evade normal host responses, difficult to eradicate, and is transmissable

Front 54

What does AA do?

Back 54

destorys connective tissue and bone, actually get into the connective tissue

Front 55

What are the direct effects of bacterial actions? (What makes them virulent)

Back 55

Endotoxins, exotoxins, enzymes (bacterial) and enzymes (host-derived)

Front 56

What are the indirect effects of bacterial actions?

Back 56

Host immune response is triggered by bacterial antigens, can be destructive as well as protective

Front 57

What are the common enzymes that break down periodontal tissue?

Back 57

Collagenese, Hyaluronidase, chondroitin sulfatase, proteases, and elastases

Front 58

What does collagenese do?

Back 58

Degrades collage fibers, this is produced in the body

Front 59

What does hyaluronidase do?

Back 59

Affects the ground substance within the connective tissue which increases tissue permeability

Front 60

What does chondroitin do?

Back 60

Destorys cementing substances of cells and tissues

Front 61

What does proteases do?

Back 61

Break down noncollagenous proteins and increase capillary permeability

Front 62

What does elastases do?

Back 62

Affect elastin fibers which reduce tissue integrity

Front 63

What do bacterial enzymes do?

Back 63

Harm or destory host cells

Front 64

The main bacterial enzymes is? What does it do?

Back 64

Proteases. Increases sulcular epithelial permeability, assist in the breakdownof gingival fiver collagen, promote apical migration of the JE, cause wideningof the intercellular spaces, limit the ability of immunoglobin and proteins to help in host defense.

Front 65

Bacteria that utilize protein vs carbohydrates as primary food source?

Back 65

Asaccharoltic

Front 66

True or False: The extercellular layer is protective of the host

Back 66

False (slime layer is produced to protect the bacteria from the host)

Front 67

The acquired pillicle is primarily composed of?

Back 67

Glycoproteins

Front 68

Undisturbed plaque that is aproximately 2 days old will be made up of primarily of what type of bacteria?

Back 68

Gram +, since it is still supra

Front 69

One of the factores that is responsible for the proliferation of bacteria in a biofilm is?

Back 69

Availability of nutirents

Front 70

Which bacteria will you see in the oral cavity in "health"?

Back 70

streptococci

Front 71

True or False: Spirochetes may be present as part of the biofilm in a pt with gingivits.

Back 71

True, but not in health

Front 72

True or False: One of the characteristics of AA that makes it suca a virulent bacteria is that is can invade normal host tissues

Back 72

True

Front 73

Which "zone" of subgingival plaque is considered to be the most injurious to root surfaces?

Back 73

Tooth-attached

Front 74

What substance is realased from the wall of gram - bacteria upon lysis?

Back 74

Endotoxins

Front 75

Leukotoxin does what?

Back 75

Destorys leukocytes

Front 76

What is the bacterial loads in health?

Back 76

Between 100 - 1,000 bacteria can be found in a healthy sulcus

Front 77

What is the bacterial load in gingivitis?

Back 77

Increased # of bacteria 1,000 - 100,000, chronic gingivitis: equal numbers of gram + and gram - bacteria

Front 78

What is the bacterial load in periodontitis?

Back 78

Usually 100,000 - 100,000,000, gram - bacteria (motile), Bacterial composition can change from patient to patinet and from site to site inthe same pts mounth