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Phases of Plaque Biofilm & Perio Destruction (phase 3 b: ESTABLISHED:…
Phases of Plaque Biofilm & Perio Destruction
Phase 1 - film coating
cocci adhere to tooth
1-2 days sphere shaped
NO lesion
S. Mutans & S. Sanguins
Phase 2: INITIAL: gingivitis subclinical 2-4 days
gram + and -
anaerobic start to form
2-4 days filamentous shape
INITIAL lesion
no clinical change
increase in crevicular fluid
vasoconstriction, vasodilation, margination, diapedesis, migration of PMNs
binding of single organisms
Phase 3 a: EARLY: 4-7 days acute
Fusobacterium nucleatum & prevotella intermedia
multiplication
plaque extends and thickens anaerobic bacteria
4-7 days: cocci, rods, filaments, and Fusbacteria
EARLY lesion
BOP, swelling, inflammation, decreased tissue tone, redness
acute
JE invagination w/ rete pegs
ulceration of SE
destruction of CT fibers
chronic inflammatory cells: macrophages and lymphocytes
multiplication
phase 3 b: ESTABLISHED: 14+ days Chronic
7-11 days or 14+ days: spirochetes and vibrios
ESTABLISHED lesion
plaque sub marginally
filaments and cocci = corn cob
gram - acts as antigen = irritants
chronic
elongated rete pegs in SE
breakdown of collagen
fibrotic response
blood vessels are congested
mod-severe inflammation, cyanosis, change in consistency, gingival pockets
repair process breaks down and new collagen forms
plasma cells predominate
increase in collagenase
multiplication
spirochetes and vibrios
Periodontitis ADVANCED, time depends on host response
ADVANCED lesion
depends on host
inflammation extends into CT attachment and bone
repair manifests as fibrotic tissue
bone resorption by osteoclasts
attachement loss, bone destruction, period pockets, periods of exacerbation and little activity
mature biofilm
THIS IS A COMBINED COGGLE OF WHAT'S GOING ON W/ BIOFILM GROWTH AND WHAT'S HAPPENING IN THE TISSUE
(because it IS happening at the same time)
continued growth