Exam 2; Periodontitis and the Risk of Systemic Disease

Question 1

What is the focal infection concept

Answer 1

that the spread of bacteria from the oral cavity causes many chronic diseases

Question 2

What are three problems with the focal infection theory

Answer 2

extracting teeth didn’t necessarily cure the disease
people with good oral health and no infection still developed systemic diseases
people with no teeth still developed systemic diseases

Question 3

This is the mechanism by which periodontitis could potentially influence systemic diseases

Answer 3

acute-phase reaction cascade

Question 4

What are the four components of the acute phase reaction cascade

Answer 4

triggering factors → local reaction → mediators → secondary systemic reaction

Question 5

What are some examples of triggering factors in the APRC

Answer 5

infection
necrosis
surgery
neoplasia
radiation

Question 6

What are some examples of location reaction molecules in the APRC

Answer 6

marcophages
fibroblasts
endothelial and other cells

Question 7

What are some examples of mediators in the APRC

Answer 7

production and release of cytokines
TNF
IL
IFN

Question 8

What are some examples of secondary systemic reactions in the APRC

Answer 8

fever and leukocytosis
complement
serum glucocorticoids increased
altered synthesis of acute phase proteins

Question 9

This risk factor is when there are several studies with similar results

Answer 9

consistency of association

Question 10

This risk factor is when the potential factor precedes the occurrence of the disease

Answer 10

correct time sequence

Question 11

this risk factor is when if a given factor is related to other diseases, its association with the disease is less likely to be interpreted as casual

Answer 11

specificity of associations

Question 12

This risk factor is when the risk of developing the disease should be related to the degrees of exposure to the factor

Answer 12

degree of exposure

Question 13

This risk factor is when the association must make sense in light of known biological mechanisms and pathways

Answer 13

biological plausibility

Question 14

This risk factor is when induction of the disease in animals exposed to the risk factor

Answer 14

support from experimental evidence

Question 15

What are your major factors in studies of association of periodontitis and AVD

Answer 15

smoking
age
diabetes
educational and socioeconomic status

Question 16

What are three pathways that explain the link between periodontitis and cardiovascular disease

Answer 16

effect of periodontal bacteria on platelets
invasion of endothelial cells and macrophages on periodontal bacteria
endocrine-like effects of pro-inflammatory mediators

Question 17

Studied have shown that these two things are elevated in periodontally diseased subjects

Answer 17

c-reactive proteins and fibrinogen

Question 18

Studies have shown that this can reduce the correlation of heart issues (via decreasing CRP, decreased arterial thickness, etc.)

Answer 18

periodontal therapy; SRP

Question 19

What are the characteristics behind the strength of studies involving the link of periodontitis and AVD (strength of evidence)

Answer 19

the association between periodontitis and AVD is not a false finding
the strength reported is modest due to inconsistencies between studies

Question 20

What has several studies shown between the degrees of exposure and the correlation between AVD and periodontitis (strength of evidence)

Answer 20

several studies suggest that there is a higher cumulative frequency of occurrence of coronary artery disease and increasing periodontal severity

Question 21

What are three biological plausibility strength of evidence between AVD and periodontitis

Answer 21

periodontal pathogens have been isolated from human carotid thermos
P. gingivalis can induce platelet aggregation
Systemic pro-inflammatory mediators CRP and fibrinogen are elevated in subjects with periodontitis

Question 22

What is the experimental strengths of evidence between AVD and periodontitis

Answer 22

animal models have supported the plausibility and identified biological pathways that might mediate the linkage; however the models were overly simplistic

Question 23

What is the specificity as a strength of evidence toward AVD and periodontitis

Answer 23

periodontitis does not fully meet the criterion of specificity

Question 24

What is the main association between peridontitis and adverse pregnancy outcomes

Answer 24

preterm low birth weight (PLBW)

Question 25

What are two other associations between periodontitis and adverse pregnancy outcomes

Answer 25

preterm birth

intrauterine growth restriction

Question 26

How can periodontitis be associated with preterm birth and low birth weight

Answer 26

it can result in the translocation of bacteria and endotoxin into the systemic circulation
inflamed periodontal tissues produce significant quantities of inflammatory mediators; these can have systemic effects

Question 27

Did periodontal therapy in pregnant women with periodontitis lower the incidence of PLBW

Answer 27

Yes (kinda) studies have shown that treatment, such as scaling and root planing decreased the likelihood of delivering preterm or with a low birth weight
ALTHOUGH THESE FINDINGS ARE NOT SIGNIFICANT

Question 28

Poorly controlled this tend to have more periodontal attachment loss than healthy individuals

Answer 28

diabetics; both types

Question 29

Reduction of this has a clinical impact similar to adding a second drug to the diabetes treatment regime

Answer 29

reduction of HbA1c by SRP

Question 30

These can colonize dental plaque and serve as a source of subsequent infection, resulting in hospital-acquired pneumonia

Answer 30

respiratory pathogens

Question 31

It is possible that plaque can serve as a receiver for what

Answer 31

bacteria that cause hospital-acquired pneumonia

oral hygiene is likely to become an important consideration for hospitalized patients at risk for pneumonia

Question 32

Individuals with poor oral hygiene have an increased risk of developing what

Answer 32

chronic respiratory disorders (COPD)

Question 33

Patients with a history of COPD have significantly more what

Answer 33

attachment loss than subjects without COPD