DH215 Exam #3 ch. 10, 11, 12

a characteristic, behavior, or exposure that increases a person's likelihood of developing a disease.

risk factor

Risk factors for periodontal disease are grouped into two broad categories:

modifiable and nonmodifiable

 Local risk factors that develop over time on or around the teeth, rather than being part of the tooth's natural form, are classified as __________

acquired risk factors

calculus is an _________ local risk factor whose rough, porous surface retains plaque biofilm against the tooth.

acquired

overhang and poorly contoured restorations are acquired ___________ that trap biofilm and make it difficult to remove.uire

local risk factors

Local risk factors related to the natural shape or position of the teeth are called _________

anatomical risk factors

malpositioned teeth are an anatomical risk factor because ___________ make biofilm removal difficult.

crowding and tipping

___________ are anatomical features of the root surface that harbor biofilm and are hard to instrument.

root grooves and concavities

The area where the roots of a multirooted tooth divide, called a furcation, is an anatomical risk factor once it becomes __________

exposed

controlled diabetes is a systemic condition that increases a patient's risk for periodontitis T or F

false

help explain why some individuals are more susceptible to periodontal disease than others, even with similar biofilm levels.

systemic factors

most significant known risk factor for periodontitis.

smoking

has a profound impact on disease development as well as the patient's immune/host response

smoking

a drug used to manage hypertension and angina, belongs to the calcium channel blockers class of medications associated with gingival overgrowth.

nifedipine

Certain medications can cause _________ of the gingiva.

enlargement

used to control seizures, is an example of an anticonvulsant associated with gingival overgrowth.

phenytoin

used to prevent organ transplant rejection, is an example of an immunosuppressant associated with gingival overgrowth

cyclosporine

Three additional risk factors listed in this chapter are hormonal changes (such as puberty or pregnancy), ____________, and neutrophilic disorders

bone metabolic disorders

Some persons with heavy, mature biofilms exhibit only mild periodontal disease, while others with light biofilms suffer severe periodontal disease. T or F

true

Untreated gingivitis does not always progress to periodontitis, which shows that factors other than bacteria help determine susceptibility. T or F

true

refers collectively to microscopic organisms such as bacteria, fungi, protozoa, and viruses.

microbe

all microbes are pathogenic and harmless to humans.

T or F

false

Bacteria have existed on Earth longer than any other organism and are the most ____________ type of cell.

abundant

is a complex multilayered structure that protects the microorganism from an inhospitable external environment.

bacteria cell envelope

Gram-positive bacteria stain __________ as seen under a light microscope.

purple

Gram-negative bacteria stain _________ as seen under a light microscope.

red

The thick, mesh-like cell wall of gram-positive bacteria is composed of sugars and amino acids called ________

peptidoglycan

In gram-__________ bacteria, the cell wall lies above the cytoplasmic/plasma membrane that faces the interior of the cell

positive

Gram-negative bacteria have how many membranes, with a thin peptidoglycan cell wall sandwiched between them

2

The outer membrane of gram-negative bacteria is composed of proteins and __________

lipopolysaccharides

a complex, dynamic microbial community of many species embedded within a self-protective matrix.

biofilm

Bacteria are social creatures, and their communities are often compared to human cities because they are multicultural and well-engineered. T or F

true

a slimy barrier of sugars and proteins that is secreted by the microbes themselves.

biofilm matrix

means that several species of organisms are present in a community

polymicrobial

 It is estimated that what percentage of all diseases are biofilm-induced.

65

Fully mature biofilm colonies can recover from mechanical disruption and reform within _____ hours

24

hibernation, is a protective factor in which dormant bacteria are unaffected by antibiotics.

quiescence

In the ______________, the matrix prevents large molecules and inflammatory cells from penetrating deeply into the biofilm

blocking protective factor

In mutual protection, antibiotic-resistant bacteria secrete protective ____________ that shield neighboring bacteria.

enzymes

 To kill bacteria living in a biofilm, it takes ________ the amount of antibiotic needed to kill free-floating bacteria.

1500x

___________ work best in tandem with mechanical disruption of the biofilm

antimicrobials

Once plaque biofilm is disrupted, bacteria have to start over with initial ____________

attachment

is vital to remove subgingival plaque biofilm.

periodontal instrumentation

indigenous, resident bacteria that are part of the normal flora of the mouth.

commensal bacteria

the mutually beneficial relationship between the host and commensal microorganisms

symbiosis

In a symbiotic relationship, the host provides the commensal bacteria with ________

nutrients

a microbial imbalance that results when certain microbial species become dominant.

dysbiosis

Initial dysbiosis can manifest clinically as __________

gingivitis

Established ___________ can trigger an inappropriate and excessive host response, resulting in periodontal tissue damage.

dysbiosis

the primary means by which saliva and bacterial contents are transmitted from one person to another.

kissing

Stage 1: Within minutes after cleaning, a film called the __________ forms over the tooth surface.

acquired pellicle

The______________ is composed of salivary glycoproteins and antibodies.

acquired pellicle

The _____________ protects enamel from acidic activity.

acquired pellice

Stage 2: ____________ occurs when genetically distinct bacteria become attached to one another.

coaggregation

Stage 2: Microbes able to withstand ___________ forces attain permanent attachment.

hydrodynamic

Stage 3 (6–12 hours): Firmly attached bacteria secrete the _______________, made of proteins, glycolipids, and bacterial DNA.

extracellular protective matrix

Stage 4: Microbes cluster together to form __________ microcolonies attached to the tooth by a narrow base.

mushroom-shaped

develop when specific species grow at an accelerated rate.

microbial blooms

penetrate the protective matrix, bringing nutrients and oxygen to microbes and carrying waste away.

fluid channels

when microbes in the biofilm release and sense small proteins to communicate and coordinate their behavior.

quorum sensing

Stage 5: During __________, microbes escape the colony to spread and colonize other tooth surfaces.

disperse

Neutrophils can pass through the capillary wall through _________ and their cytoplasm contains bactericidal lysosomal enzymes

diapedesis

The immune system is a network of different types of _________ and __________ that work together to defend the host from invasion

leukocytes, proteins

The two divisions of the immune system are __________ immunity and _________ immunity.

innate, adaptive (acquired)

immunity present at birth

innate

Because innate immunity is not antigen specific, exposure results in no _____________

immunological memory

this immunity has a lag time between infection and response

adaptive (acquired) immunity

Cells of innate immunity include neutrophils, monocytes, macrophages, eosinophils, basophils, mast cells, and ___________

NKT-lymphocytes

The two cell types of adaptive immunity are __________ and ___________

T-lymphocytes, B-lymphocytes

Physical barriers such as ____________ and __________are key components of the innate immune system.

skin, mucosal membranes

When the immune system encounters cells or molecules, it must determine whether they are ________ (part of the body) or ___________ (foreign).

self, nonself

The body’s response to infection is called

host response

The immune system defends against infectious organisms, parasitic infections, toxins, ______________, and _____________ that arise from the host itself.

transplanted tissues, cancerous cells

Rheumatic heart disease is an example of an overactive immune response, precipitated by invasion of ___________________

the pharynx (streptococcus pyogenes)

The functions of the PMN and the macrophage are phagocytosis, release of __________, and release of regulatory proteins called ________________

lysosomes, cytokines

The function of the B-lymphocyte/plasma cell is the production of ____________

immunoglobulins

The function of T-lymphocytes is to ___________ the immune response.

amplify

Functions of the ____________ include lysis of the cell membranes of certain bacteria, recruitment of additional phagocytic cells, and clearance of immune complexes from circulation.

complement system

immunity that develops throughout life following initial exposure to an antigen

adaptive (acquired) immunity

 Leukocytes are colorless, nucleated cells that originate from ______________ in bone marrow

hemopoietic stem cells

differentiate into common myeloid progenitor cells or lymphoid progenitor cells.

stem cells

Leukocytes are categorized according to the presence or absence of cytoplasmic __________

granules

include neutrophils, eosinophils, basophils, and mast cells

granulocytes

the first immune cells deployed and are the most abundant.

neutrophils

primarily combat parasitic infections and secondarily collaborate with mast cells and basophils to regulate the allergic response.

eosinophils

primarily modulate the allergic response and coordinate physiologic activity against immune diseases.

basophils

protect against pathogens and release key inflammatory mediators that modulate the allergic response.

mast cells

Leukocytes lacking granules are called and include lymphocytes and monocytes/macrophages.

agranulocytes

a _____________ leukocyte is a cell with a multilobulated nucleus.

PMN

_____________ are not included as polymorphonuclear leukocytes because they are mononuclear/single-lobed nucleus

mast cells

__________ are short-lived because they die during phagocytosis

neutrophils

The normal _______ count is 3000-6000 per milliliter of blood.

neutrophils

A neutrophil count below normal results in

neutropenia

a count above normal results in

neutrophilia

large phagocytes with a single irregular, kidney-shaped nucleus

are two to three times larger than a RED BLOOD cell.

monocytes

Because they lack cytoplasmic granules, monocytes are classified as

agranulocytes

________________ are the largest leukocytes, are highly phagocytic, and primarily function as ANTIGEN-presenting cells.

macrophages

___________are slower to arrive at the infection site than neutrophils.

macrophages

The phagocytic leukocyte found in the tissues is

macrophages

The three types of___________ are B-lymphocytes, T-lymphocytes, and NK-lymphocytes.

lymphocytes