Perio- Chapter 15

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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


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