Microbial Phase of Periodontal Diseases

Flashcards covering the aetiology, predisposing factors, color complex classification, and keystone concept in periodontal diseases.

What occurs in periodontal disease?

Supporting tissues of teeth are attacked, involving both microorganisms and the host immune response.

List some predisposing factors that may lead to periodontitis.

Trauma, tobacco smoking, viral infection, pregnancy, intestinal disturbances, vitamin deficiency, malnutrition, psychiatric disease, HIV infection, and diabetes.

What is acute/ulcerative gingivitis?

Inflammation of the gingiva caused by accumulation of dental plaque, clinically characterized by redness, swelling, and bleeding of tissue. Also known as ulcerative gingivitis.

Describe chronic gingivitis.

Swollen and red gingivae, not commonly causing pain and discomfort, but reversible with plaque control and good oral hygiene. Increase in anaerobic gram-negative bacteria, Actinomyces spp, and Capnocytophaga spp.

What is acute necrotizing ulcerative gingivitis?

A severe and painful form of gingivitis caused by Fusobacterium Nucleatum, Spirochaetes, Porphyromonas gingivalis, and Prevotella intermedia. Treatment includes removal of plaque, good oral hygiene, and metronidazole.

What is chronic/adult periodontitis?

The most common form of periodontitis, affecting adults, characterized by pocket depth > 3mm and is irreversible. Aetiology includes anaerobes and proteolytic enzymes such as Prophymonas gingivalis, Prevotella intermedia, Fusobaterium nucleatum, Eikenella corrodens, Wolinella recta, Agregabacter actinomycetemcomitans, Campylobacter, Selonomads, and Spirochaetes.

Describe aggressive/juvenile periodontitis.

Affects first molars and incisors, occurs in less than 0.01% of the population, with genetic predisposing factors. Aggregatibacter actinomycetemcomitans produces leukotoxin. Other bacteria include Capnocytophaga and Spirochaetes. Treatment includes tetracycline.

What are the bacteria in the red complex?

P. gingivalis, Tannerella forsythia, and Treponema denticola

What are the bacteria in the orange complex?

Prevotella intermedia, Prevotella nigrescenes, Fusobacterium nucleatum, P. micros, E. nodatum, and C. rectus

What are the bacteria in the green complex?

A.actinomycetemcomitans, Capnocytophyga species, and E corrodens

What are the bacteria in the purple complex?

Veillonella parvula and Actinomyces

Explain the keystone concept in the pathology of periodontal disease, focusing on P. gingivalis.

P. gingivalis impairs the innate immunity, altering the growth and development of the entire biofilm. This triggers a destructive change in the normal homeostatic host-microbial interplay in the periodontium (dysbiosis).