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63 Cards in this Set
- Front
- Back
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How many microbial species live I the human mouth |
650-1000 |
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Dysbiosis |
Shift from beneficial organisms and or a increase in pathogens |
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Innocuous |
Not harmful |
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Periodontal disease is |
Caused by many bacteria a mixed infection |
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Health>disease |
A shift of population of bacteria from gram positive aerobes to great - anarobes |
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Biofilm always begins |
Supragingival |
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Biofilm matures and goes sub gingival in |
3-12 weeks |
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Bacteria charicterisitics |
Can replicate quickly Ability to divide Ability to adapt to environmental change Tough protective layer - cell membranes Affected by gram staining |
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Gram positive bacteria |
Single thick call membrane Stain purple Exotoxins No outer membrane Produce exotoxins-released by living cells High resistance to physical disruption Less resistant to antibiotics |
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Gram negative bacteria |
Double cell membrane Stain red Endotoxins Outermembrane Produce endotoxins Low resistance to physical disruption More resistance to antibiotics |
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Exotoxins |
Are proteins that produced inside of pathogenic bacteria most commonly gram postive |
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Endotoxins |
Are the lipid portion of lippolysaccharides that are part of the outer membrane of the cell wall of gram negative bacteria. |
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Biofilms |
Complex community Begin to form supragingival Can exist on any surface exposed to bacteria containing fluid Free floating Attached to the surface or another bacteria Estimated that 65% of biofilm-induced |
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Biofilm induced diseases |
Tuberculosis Cystic Fibrosis Subacute bacterial endocarditis Periodontal disease |
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Biofilm in health |
Maintain a harmonious balance Mutual beneficial relationship between the host and the bacteria No one strain dominates |
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Biofilm in health |
Maintain a harmonious balance Mutual beneficial relationship between the host and the bacteria No one strain dominates |
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In disease |
Microbial imbalance Certain microbial species become dominant Live in disharmony or dysbiosis Can manifest in gingivitis and lead to excessive immune response |
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Quiescence |
Hibernation hibernating bacteria is unaffected by bacteria. |
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Progression of bacteria |
Free floating bacteria attach to surface in minutes 2-4 hours microbes form microcolonies 6-12 hr microbes produce protective matrix and become resistant to antiseptics and antibiotics 2-4 days fully mature biofilm colonies can be rapidly recover from mechanical disruption in 24 hr reform is seen |
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Attachment of biofilm tooth related |
From gingival margin to base of the sulcus Have ability to invade dental tubules cocci and rods Stretocussus miitis S. Sangria Actinomyces viscosis |
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Attachment of biofilm tissue associated |
Can invade connective tissue and alveolar bone. Most detrimental to periodontal tissue. Must be removed surgically. Contains a large number of spirochetes and flegellated bacteria, gram - cocchi and rods |
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Curtage |
Removal of tissue |
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Types of bacteria that affect tissue |
Streptococcus oralis. S. intermedius. Porphyomonad gingivalis. Preventella intermedia. Tannerella forsythia. Fusobacterium nucleatum |
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Free floating unattached bacteria |
Free swimming in pocket not a biofilm More virulent Gram- mobile anarobes Removed by flushing Not considered biofilm it just lives in the same environment |
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Acquired pellicle |
Film composed of salivary glycoprotein and antibodies Form within minutes of cleaning surface Protects enamel from acid Alters charge of tooth that allows for Or bacterial adhesion |
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Life cycle of biofilm |
Bacteria attach to acquired follicle early colonizers. 2. Additional bacteria colonize. 3. Attached bacteria release extracellular slime layer to attach to a surface and protect it. 4. Bacteria grow and multiply by cell division complex groups of micro colonies that communicate with others. 5. Clumps break off and are carried away can reattach to other surfaces. |
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Coaggregation |
Is a process by which genetically distinct bacteria become attached to one another via specific molecules |
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Bacteria microcolonies |
Environmental conditions vary Each species prefers a certain environment. Diversity aids in survival |
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Extracellular slime layer |
Proctects the microcolonies from antibiotics Antimicrobials and immune system |
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Leukocytes |
Defense cells from the immune system. May he blocked by slim layer |
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Fluid force |
Influence shape of biofilm and spacing inside bacteria. Causes extension that break off and spread more quickly |
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Fluid channels |
Penetrate the extracellular slime layer. Provide nutrients and oxygen carry waste products away |
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Quorum sensing |
Chemical cell communication via releasing of proteins
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3 types of cell communication |
Quorum sensing Adhesion of bacteria in slime layer Transfer of genes. |
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Periodontitis |
100,000-100,000,000 bacteria 74% gram negative rods Varies greatly patient to patient Site to site. |
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Papillary |
Involving interdental papullae only |
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Marginal |
Involving the gingival margin |
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Diffuse |
Involving the gingival margin,papillary, and attached gingiva |
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Periodontal disease |
Suspetible host Integrity of the mucosa and periodontist must be compromised. Immune system plays a larger role then bacteria |
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Defenses against perio |
Saliva-buffers Gingival crevicular fluid- constant flow/ cleanses sulcus. Oral epithelium- creates a barrier |
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Perio disease |
Environment just right Pockets conductive to colonization Deeper pockets Larger number of pathogenic bacteria. Oral temperature is perfect Tongue holds bacteria |
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Aggregatibacter actinomycetemcomitans |
Strongly associated with aggressive perio. Chronic perio Evades natural immune response Destroys connective tissue and bone Shown to be resistant to antibiotics Gram - facultative anaerobic rods |
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Temannerella forsythia |
Most common species detected in epithelium cells Non-motile, pleimirohic rod anaerobic Found in most forms of perio especially aggressive Found in deep pockets |
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Porphyromonas gingivalis |
Can invade the JE and multiply in that location Can be found in health in low numbers Common in aggressive non-resolving and periodontal disease with systemic influences Sensitive to most antibiotics Can penetrate host cells to avoid non specific immune response |
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Campylobacter rectus |
Single flagellum gives it mobility. Sensitive to antibiotics needs 2% micro flora to be pathogenic. Exists with prevotell intermedia, fusobacterium nucleatum, and tannerella forsythus |
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Fusobacterium nucleatum |
Sensitive to antibiotics Nonmotile Found in early stages of gingivitis and prominent component of subgingival plaque in perio with severe attachment loss Capable of initiating early inflammatory changes in tissue. |
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Preventella intermedia |
Pregnancy gingivitis and ANUG Found in health and disease Common in uncontrolled insulin dependent patients Can be resistant to antibiotics rather quickly. |
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Treponema denticola |
Predominantly in loose adherent subgingival plaque Intragingival in ANUG Correlation to bleeding and pocket depth Gram negative motile Very sensitive to o2 Chronic ANUG |
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ANUG |
Acute necrotizing ulcerative gingivitis |
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Perio risk factors |
Plaque and calc. Restorations orthodontics and extractions Anatomic figures Root canals Trautman Occlusion Habits Systemic factors |
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Transmission of plaque biofilm |
Person to person Aggregatibacter actinomycetemcomitans. Porphyromonas gingivalis |
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Controlling biofilm |
Resistance to systemic antibiotics Dormant bacteria are not affected by antibiotics and can reactivate. Antimicrobials are effective with good plaque/biofilm removal. Best way is mechanical in the form of brushing and flossing |
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Arestin |
Local antibiotics delivered into the pocket you may do.it in private practice. |
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Prevalence |
The number of all cases of a disease present in a given population at one time. |
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Incidence |
Number of new cases in a population that occur at a given time. |
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Severity |
The level of disease |
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Risk factors |
Exposure, behavior, ect. Associated with disease |
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Extent |
Level of extent of disease |
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Prevalence variables |
Most likely are Male Systemic illness, medications, smoking and stress Less education Black and Hispanic Access to dental care |
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Indices |
Clinical assessment of individual within the population. Simple and easy Quick to perform Must be sensitive. Sample mist be chosen |
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Measuring periodontal disease |
Difficult to do Dental caries are easier to measure Involves hard and soft tissue Multiple variables Attachment loss can be on multiple surfaces |
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Leading cause of tooth loss in adults over 45 |
Periodontal disease |
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Us adults ages 30+ who have severe periodontal disease |
7.8% |
