Oral Microbiology Lecture 5: Periodontitis

What is the main difference between gingivitis and periodontitis?

Irreversible bone/attachment loss

Is chronic periodontitis usually painful?

No

What portion of adults in the US suffered from periodontitis at some point in their lifetime?

1/3

What does the prevalence and severity of periodontitis increase with?

Age

What are the four predisposing factors of periodontitis?

1. Smoking

2. Emotional stress

3. Diabetes

4. High lipid diets

What is the connective tissue fibers attached at the cementoenamel junction called?

Gingival attachment apparatus

What is created when the gingival attachment apparatus is disrupted and reattached?

Periodontal pocket

How long could chronic periodontitis last if untreated?

20 years

What is the progression of untreated chronic periodontitis?

Episodic

What causes reduced stability of the tooth when the periodontal pocket reaches the alveolar bone?

Bone is reabsorbed

Is there a single pathogen responsible for chronic periodontitis?

No

Which color complex precedes the red complex related to periodontitis?

Orange

What are the three red complex bacteria?

1. Treponema denticola

2. Tannerella forsythia

3. Porphyromonas gingivalis

What are the two traits of Treponema denticola?

1. Spirochete

2. Motile

What are the two traits of Tannerella forsythia?

1. Bacillus

2. Nonmotile

What are the two traits of Porphyromonas gingivalis?

1. Bacillus

2. Nonmotile

What is referred to as early-onset periodontitis?

Aggressive periodontitis

When does aggressive periodontitis begin around?

Puberty

Which gender is aggressive periodontitis more common in?

Female

Which cells have functional abnormalities in aggressive periodontitis?

Neutrophils

Is aggressive periodontitis painful?

No

What does aggressive periodontitis result in?

Rapid bone loss

Is the severity of aggressive periodontitis consistent with plaque levels?

No

Is inflammation present in aggressive periodontitis?

No

Which bacteria is mainly present in aggressive periodontitis?

Aggregatibacter actinomycetemcomitans

What species is present in HIV gingivitis that is not in chronic gingivitis?

Candida albicans

Is HIV periodontitis or chronic periodontitis more severe and rapid?

HIV periodontitis

What symptom is in HIV periodontitis that is not in chronic periodontitis?

Tissue ulceration/necrosis

What is the expression of the virulence factors of periodontal pathogens regulated by?

Environmental conditions

What two bacterial factors allow for attachment to host cell surfaces?

1. Fimbriae

2. Surface adhesins

What bacterial factors allows for multiplication at a susceptible site by releasing nutrients?

Secreted proteases

What bacterial factor prevents phagocytosis?

Bacterial capsules

What bacterial factor lyse host white blood cells?

Secreted leukotoxins

What bacterial factor destroy host antibodies and complement proteins?

Secreted proteases

Which three bacterial factors break down host tissue?

1. Enzymes

2. Bone resorbing factors

3. Cytotoxins

Which bacterial factor of spirochetes enable the bacteria to rapidly colonize new sites?

Chemotaxis

What is the main treatment method of periodontal disease?

Mechanical therapy

Which treatment method is used to reduce the overall plaque mass?

Root debridement

What are the two benefits of mechanical debridement?

1. Disruption of plaque biofilm complex

2. Removal of calculus/endotoxin

What are the two benefits of removing biofilm from the root?

1. Gingival fibroblasts reestablish gingival attachment

2. Sub-gingival microbiota shift to healthy composition

What are the four conditions linked to periodontitis?

1. Cardiovascular/Respiratory diseases

2. Diabetes

3. Pre-term labor

4. Low birth weight

Why does the periodontium act as a source of microorganisms/inflammatory mediators?

It is very vascular

What other disease could periodontal pathogens give rise to?

Aspiration pneumonia

If swallowed, what could periodontal pathogens cause alterations in?

Gut microbiota

What disease risk is increased with periodontitis in diabetic patients?

End stage renal disease

What trait in periodontal pockets allow for systemic dissemination of bacteria and cytokines?

Gingival ulcerations

What condition does the disseminated cytokines by gingival ulcerations in periodontal pockets contribute to?

Intra-uterine inflammation