坏死性牙周病课件

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1、LiDeyiMicrobialInteractionwiththeHostinPeriodontalDiseases1MainPoints:ThevirulencefactorsofperiodontalpathogensTheinteractionofpathogenswiththehostinperiodontaldiseases2Contentsofthislesson:Textbook:P27-32P150-152Supplementaryreadingmaterial3一.Preface4HealthGingivitisPeriodontitisGingiva

2、lsulcusgingivaAlveolarboneperiodontalmembranecementumperiodontalpocketerythema,edema5ClassificationSystemforPeriodontalDiseases(1999)GingivalDiseases(牙龈病)ChronicPeriodontitis(慢性牙周炎)AggressivePeriodontitis(侵袭性牙周炎)PeriodontitisasaManifestationofSystemicDiseases(反映全身疾病的牙周炎)Necrotizingperiodo

3、ntalDiseases(坏死性牙周病)AbscessesofthePeriodontium(牙周组织脓肿)PeriodontitisAssosiatedwithEndodonticLesions(伴牙髓病变的牙周炎)DevelopmentalorAcquiredDeformitiesandConditions(发育性或获得性异常)678910BacteriaPeriodontiumHostVirulenceEcologicBalance(生态平衡)Response(Defense)PeriodontalHealthIncreaseEcologicDisturbance(

4、生态失调)DecreasePeriodontalDiseaseDecreaseEcologicModulation(生态调整)Increase(Therapy)HealingProcess11二.MicrobiologicAspectsoftheMicrobe-HostInteraction12PeriodontalPathogensConvincingDataExistSignificantEvidence(证据充分)(中等证据)ActinobacillusactinomycetemcomitansCampylobacterrectus(伴放线放线杆菌Aa)(直肠弯曲菌

5、)PorphyromonasgingivalisEubacteriumnodatum(牙龈卟啉单胞菌Pg)(缠结优杆菌)BacteroidesforsythusFusobacteruimnucleatum(福塞似杆菌Bf)(具核梭杆菌Fn)Prevotellaintermedia(中间普氏菌Pi)Peptostreptocoscusmicros(微小消化链球菌Pm)Streptococciintermedius(中间链球菌群)Treponemadenticola(牙密螺旋体Td)131.ColonizationandSurvivalinthePeriodontalRegi

6、onattachment(附着)oradhesion,multiplication(繁殖)andgrowth14SelectedBacterialAdhesinsBacterialAdhesinProbableAttachmentSurfaceFimbriae(Av)ToothMembraneprotein(Pg)TissueHeat-sensitiveprotein(Fn)Preexistingplaquemass15162.BacterialInvasion(入侵)ofHostTissue1718193.BacterialEvasion(逃避)ofHostDefen

7、seDegradationofspecificantibodyPg(IgA,IgG)InhibitionofIL-8(productionbyEC)PgKillLeukocytes(produceleukotoxin)Aa(neutrophils,monocytes,lymphocytes)20214.MicrobialMechanismsofHostTissueDamage22BacterialEnzymesCapableofDegradingHostTissuesBacterialEnzymeSpeciesCollagen