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Periodontitis as a Manifestation of Systemic Disease (Exam 4)

Terms in this set (50)

Some systemic diseases share similar genetic and environmental factors as periodontal disease

We classify these differently!

True or false?
True
What are the 6 genetic disorders?
Down Syndrome (DS)

Leukocyte Adhesion Deficiency (LAD)

Papillon-Lefevre Syndrome (PLS)

Haim-Munk Syndrome

Chediak-Higashi Syndrome (CHS)

Congenital Neutropenia (Kostmann Syndrome)
What are genetic disorders caused by?
Gene mutations or chromosome disorder
How is down syndrome associated with periodontitis?
Increased migration of T-cells to the periodontium --> higher risk for periodontal tissue loss

Moderate to severe attachment loss --> starts in adolescence
T cells to the periodontium leads to higher risk for periodontal tissue loss:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Down syndrome
How is leukocyte adhesion deficiency (LAD) associated with periodontitis?
PMNs cannot move from blood vessel to infected tissue site

Lack of PMN surveillance and homeostatic mechanisms --> periodontal tissue loss
PMNs cannot move from blood vessel to infected tissue site

Lack of PMN surveillance and homeostatic mechanisms --> periodontal tissue loss:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Leukocyte Adhesion Deficiency (LAD)
If they can't stick to tissue of vessel, they can't leave vessel

Down Syndrome or Leukocyte Adhesion Deficiency
Leukocyte Adhesion Deficiency (LAD)
How is papillon-lefevre syndrome (PLS) associated with periodontitis?
Severe gingival inflammation and pocket formation after teeth eruption

Rapid loss of attachment and bone --> early loss of primary and permanent teeth at a young age

PMN function deficiency

Hyperkeratosis of palms and soles of the feet, knees and elbows
Severe gingival inflammation and pocket formation after teeth eruption

Rapid loss of attachment and bone --> early loss of primary and permanent teeth at a young age:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Papillon-Lefevre Syndrome (PLS)
PMN function deficiency:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Papillon-Lefevre Syndrome (PLS)
Hyperkeratosis of palms and soles of the feet, knees and elbows:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Papillon-Lefevre Syndrome (PLS)
How is haim-munk syndrome associated with periodontitis?
Compromised neutrophil functions

Hyperkeratotic lesions—changes in nails and radiographic deformity of the fingers

Severe gingival inflammation after eruption of teeth

High rate of attachment loss

Early loss of primary and permanent teeth
Compromised neutrophil functions:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Haim-Munk Syndrome
Hyperkeratotic lesions—changes in nails and radiographic deformity of the fingers:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Haim-Munk Syndrome
Severe gingival inflammation after eruption of teeth

High rate of attachment loss

Early loss of primary and permanent teeth:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Haim-Munk Syndrome
How is chediak-higashi syndrome (CHS) associated with periodontitis?
Early-onset severe gingival inflammation, deep PDs

Severe alveolar bone loss that progresses rapidly

Premature loss of teeth

Patients have albinism—lack of pigment

Neurlogic problems—intellectual deficit, dementia
Early-onset severe gingival inflammation, deep PDs

Severe alveolar bone loss that progresses rapidly

Premature loss of teeth:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Chediak-Higashi Syndrome (CHS)
Patients have albinism—lack of pigment

Neurlogic problems—intellectual deficit, dementia

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Chediak-Higashi Syndrome (CHS)
How is congenital neutropenia (kostmann syndrome) associated with periodontitis?
Oral ulcerations, periodontal inflammation and periodontitis

Low PMN count

Higher risk for tooth loss

Oral ulcers
Higher risk for tooth loss:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Congenital Neutropenia
Low PMN count:

Down Syndrome

Leukocyte Adhesion Deficiency

Papillon-Lefevre Syndrome

Haim-Munk Syndrome

Chediak-Higashi Syndrome

Congenital Neutropenia
Congenital Neutropenia
Deficiency in neutrophils (PMNs)

Chediak-Higashi Syndrome or Congenital Neutropenia
Congenital Neutropenia
What are the 6 metabolic and endocrine disorders?
Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
How is kindler syndrome associated with periodontitis?
Recurrent blister formation of skin and oral cavity

Photosensitivity

Severe periodontitis and rapid attachment loss
Recurrent blister formation of skin and oral cavity

Photosensitivity:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Kindler Syndrome
Severe periodontitis and rapid attachment loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Kindler Syndrome
How is diabetes type I and II associated with periodontitis?
Comorbidities—obesity and hypertension

Hyperinflammatory response to bacterial challenge:

Neutrophil defects, increased release of proinflammatory cytokines and oxidative stress reactions, and impaired healing

Advanced glycation end-produces (AGEs) --> contributes to pathogencity and accelerated bone loss
Comorbidities—obesity and hypertension:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Diabetes, Type I and II
Neutrophil defects, increased release of proinflammatory cytokines and oxidative stress reactions, and impaired healing

Advanced glycation end-produces (AGEs) --> contributes to pathogencity and accelerated bone loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Diabetes, Type I and II
How is obesity associated with periodontitis?
Dysfunction in adipose tissue changes macrophages --> can lead to chronic inflammation and insulin resistance

Releases more pro-inflammatory cytokines and chemokines --> systemic inflammation
Dysfunction in adipose tissue changes macrophages --> can lead to chronic inflammation and insulin resistance

Releases more pro-inflammatory cytokines and chemokines --> systemic inflammation:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Obesity
How is osteoporosis associated with periodontitis?
Postmenopausal women exhibit greater loss of periodontal attachment compared to women with normal bone density

Decrease in bone mineral density and weakening of bone micro-architechure --> high risk of bone fracture

Higher severity of alveolar bone loss

No clear association with periodontitis (probing depth or CAL)
Postmenopausal women exhibit greater loss of periodontal attachment compared to women with normal bone density:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Osteoporosis
Decrease in bone mineral density and weakening of bone micro-architechure --> high risk of bone fracture:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Osteoporosis
Higher severity of alveolar bone loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Osteoporosis
No clear association with periodontitis (probing depth or CAL):

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Osteoporosis
How is inflammatory bowel disease (IBD) associated with periodontitis?
Autoimmune disease

Hypersensitivity to commensal gut bacteria and dental plaque biofilm cause inflammation and alveolar bone loss

Abdominal pain, fever, diarrhea and weight loss

Increased prevalence and severity of periodontitis and attachment loss
Autoimmune disease:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Inflammatory Bowel Disease (IBD)
Hypersensitivity to commensal gut bacteria and dental plaque biofilm cause inflammation and alveolar bone loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Inflammatory Bowel Disease (IBD)
Abdominal pain, fever, diarrhea and weight loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Inflammatory Bowel Disease (IBD)
Increased prevalence and severity of periodontitis and attachment loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Inflammatory Bowel Disease (IBD)
How is arthtitis associated with periodontitis?
Rheumatoid arthritis (autoimmune disease)

Osteoarthritis (gradual deterioration of cartilage)

Increased risk for periodontal attachment and bone loss

Swelling of joint, redness --> inflammation
Rheumatoid arthritis (autoimmune disease):

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Arthritis
Osteoarthritis (gradual deterioration of cartilage):

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Arthritis
Increased risk for periodontal attachment and bone loss:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Arthritis
Swelling of joint, redness --> inflammation:

Kindler Syndrome

Diabetes, Type I and II

Obesity

Osteoporosis

Inflammatory Bowel Disease (IBD)

Arthritis
Arthritis
Some systemic conditions can affect the periodontium and cause attachment loss

True or false?
True
Some have a direct effect on the periodontium by altering host immune response

True or false?
True
Some have indirect effect on the periodontium --> changes in metabolic activity can affect tissues of the periodontium

True or false?
True
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