Perio- Chapter 15
Salivary antibodies
Immunoglobulin A -synthesized locally -bacteria in saliva frequently associated with IgA -inhibit attachment of oral streptococcus
Electrolytes within the sulcular fluid
INORGANIC contents: -potassium -sodium -calcium
Which of the following salivary components provides antibacterial action?
Lactoperoxidase
Clinical significance of GCF
Biologic fluid: potential in diagnostics and disease management -amount is greater when disease is present -small amounts of trauma can increase GCF
Organic components of sulcular fluid
-carbohydrates -proteins -glucose hexosamine -hexuronic acid -metabolic and bacterial products -varied methodology to analyze GCF compounds
Composition of sulcular fluid
-individual proteins -metabolites -specific antibodies -antigens -enzymes of several specificities -cellular elements: bacteria, desquamated epithelial cells, leukocytes
Decreased saliva increases:
-inflammatory gingival conditions -caries -rapid tooth destruction -cervical or cemental caries
Antibacterial factors of saliva
-lysozymes (break down gram-negative in the sulcus)
Which of the following is a probable mechanism of the cleansing function of saliva?
clearance of debris and bacteria
Clinical importance of saliva?
-mechanical -chemical -biologic -immunologic
Saliva
-protective functions -maintains oral tissues in physiologic state -influences plaque by cleansing exposed surfaces
Leukocytes in the dentogingival area
Increase in PMN's when inflammation happens -leukocytes are attracted by different plaque bacteria
Salivary enzymes
Increase in enzymes (lipase, collagenase) when perio disease is present -contribute to the initiation and progression of perio disease
Bicarbonate-carbonic acid system:
MOST important buffer -it is the neutralizer of acid within our mouthes
Clinical importance of saliva
Makes diagnosing local and systemic conditions possible through markers Low saliva: -risk factor for caries -risk for perio Xerostomia: -results from reduced or absent saliva -symptom of medical conditions -side effect of radiation and many medications
Saliva's role in periodontal pathology
Modulate plaque initiation, maturation, and metabolism -flow and composition influence calculus formation, perio, and caries -promotes wound healing
Leukocytes in saliva
PMNs are principal cells -number increased with gingivitis -positive correlation between PMN migration rate and gingival inflammation severity
Which of the following is the major enzyme found in saliva?
Parotid amylase
Can you place drugs in the GCF?
Yes, arestin is one to place deep in the pockets to use for perio therapy
What is another term for sulcular fluid?
gingival crevicular fluid
As gingivitis progresses, the amount of collagen destruction ______________.
increases