t/f no specific systemic diseas has been shwon to produce PD in the absence of local irritating factors?
True
Social factors contributing to PD (4)
Stress
Alcohol
Drugs
Tobacco
Evidence for genetic control of risk factors for some forms of PD include (3)
genetically transmitted traits
seperated twins w/ chronic onset
genetic studies of aggresive forms of periodontitis
The IL-1 gene patient is about __x more likely to develope perio
7
what percent of the poplulation has the gene for IL-1
30%
Several congenital diseases has manifestations of Perio (6)
Hereditary gingival fibromatosis
Cyclic neutropenia
Downs syndrome
Papillon-Lefevre syndrome
chediak-Higashi disease
Hypophosphatasia
About what percent of the enhanced risk for severe PD can be accoundted for by heredity alone
50%
Greater incidence of PD: males or females
males
Which race is at risk for PD
none
How does age effect PD
overtime, cumulation of biofilm
Stress works in two ways:
people change their behavior
bodies increase the production of glucocorticosteriods (protect against stress) and cortisone (type of glucocorticosteriod with results in immunosuppression and reduced risistance to infection
Diabetes results in Hyperglycemia and is classified into
type I
type II
Which type is caused by a severe insulin deficiency resulting from a destruction of beta-cells of the pancreas
Type I
Which type is more common
type 2
In which type is insulin being secreted, but receptors are broken
type 2
Which type has insulin resistance?
type 2
types 1 and 2 are at risk for (2)
gingivitis
PD
Hyperglycemia may suppress the immune response and lead to (2)
poor wound healing
recurrent infections (periodontal abscesses)
exaggerated inflammatory respone to local irritation may be evident in these women (3)
pregnant
pubertal
postmenopausal
in which trimesters do pregnant women have exaggerated gingival inflammatory changes (pregnancy gingivitis)
second and third
Gingival changes of inflammation and enlargement with increased tissue flow occur on this med
oral contraceptives
Can pubertal gingival inflammation and enlargement ocurr in males and females?
yes
Pubertal gingivitis more common in males or females
females
Result of estrogen depletion causing bone to be more porous
osteoperosis
risk factors associated with osteoporosis include (5)
age
calcium intake
physical activity
body build
smoking status
What type of meds may help improve total bone mineralization increase blood calcium, and stablalize supporting bone
bisphosphonates
People with what are taking bisphosphonates? (3)
osteoporosis
pagent's disease
bone metastasis
Normally there is n equilibrium between osteoblasts ans osteoclasts... what happens in patients taking bisphosphinates
there are no more osteoclasts to resorb (eat) the old necrotic bone
If necrotic bone stays what happens;
can result in?
inhibit healing and affect blood sypply to an are
Osteonecrosis of the jaw (ONJ)
ONJ shows up in patients taking
bisphosphonates
bisphosphonate half life
10 years
two types of bisphosphonates
non-nitrogenous (first generation)
nitrogenous (second and third generation)
which is more likely to cause ONJ
nitrogenous (second and third generation)
characterized by exposed, necrotic bone in teh maxillofacial region
ONJ (osteonecrosis of the jaw)
highest incedence of ONJ occurs after
extractions
ONJ can occur after
extractions
implant placement
periodontal procedures
endodontic therapy
orthodontic therapy
spontaneously without any tx
Risk factors for ONJ (6)
corticosteroid therapy
diabetes
smoking
alcohol use
poor oral hygiene
chemotherapeutic drugs
Prior to tx with bisphosphonates what should be done (5)
oral exam
extractions
restorative
endodontic
periodontal therapies
Risk for ONJ increased after the patient has been on bisphosphones for how many years
3 years
After three years of taking bisphosphonates, what test must be completed to determine if the patient can have invasive dental tx
c-terminal cross-linked telopeide blood test (CTx)
At what CTx level can you perform dental tx
at what level cant you
150pg/ml
100pg/ml
HIV patients are vulnerable to
aggressive necrotizing periodontal disease:
NUG (necrotizing ulcerative gingivitis)
NUP (necrotizing ulcerative periodontitis)
Have nutritional deficiencies been shown to cause PD
Yes
Which vit. plays a role in the fxns of fibroblasts, osteoblasts, ans odontoblasts
C
Do tough or coarse foods provide functional stimulation to the gingiva? do they help to remove plaque below teh contact points or cerviacl bulge on teh teeth
no, no
how many times more likely are smokers to have PD
2-6
why is tissue attachment prevented in smokers
products of cigarettes remain on teeth and in the GCF providing a reservoir of irritants for the soft tissue
Why does alcohol contribute to PD
poor oral hygiene
malnutrition
gingival overgrowth is caused by which meds
phenytoin (seizure med)
nifedipin/diltiazem (cardiovasuclar problems and hypertension)
cyclosporine (intransplant patients)
calcium channel blockers
steroids
gingival overgrowth has been reported in what percent of patients receiving phenytoin
nefedipine
cyclosporine
50%
15%
25%
systemic diseases associated with PD
Diabetes
Cardiovascular diseases
Respiratory diseases
Alziehmers
Relationships w/diabetes
may be more susceptible to developing PD but does not cause PD
relationship with cadio d
inceased risk for atherosclerosis and thromboembolisms if have PD
What is most common condition shared by PD patients? 50% risk
Heart Conditions
What percent increased riks for stroke if they also have perioD
30%
Inflammatory serum marker or a predictor of increased risk for cardioascular disease
CRP c-reactive protein
what percent of patients with coronary artery diseas suffered from moderated to sever peroi
91%
Women with PD may be __x more predisposed to deliver premature
7-8
Elevated levels of what stimulate labor contratctions
