Resit-diagnostics

Collective teen that describes the tooth-supporting and investing tissues such as Gingiva, root cementum, periodontal ligament and alevolar bone

Saliva Gingival crevicular fluid

Protect teeth, oral and peri oral tissues Facilitate eating and speech

Different electrolytes including sodium, bicarbonates and phosphates Immune complexes such as immunoglobulins, proteins and mucins

Fluid that leaks out of blood vessels or tissue as a result on inflammation or injury

Gingival crevicular fluid Oral inflammatory exudate Found in the sulcus between the tooth and gingiva

Facilitate the antimicrobial defence of the periodontium Maintain structure of junctional epithelium

Blood, surrounding cells and various tissues of the periodontium

• plaque and bacteria build up -immune system responds sending wbc,cytokines ans other inflammatory mediators to the site -inflammation causes blood vessels in gums to become more permeable. More fluid in the sulcus between= GCF volume increases -GCF carries more immune cells enzymes and antibodies to try to fight the infection -enzymes damage surrounding tissue if inflammation persists -tissue breakdown deepens the sulcus forming a periodontal pocket which harbours more bacteria worsening the inflammation

Orally microbial driven inflammatory disease of the periodontium

Reoccurring inflammation of the gingiva Gingiva bleeding Formation of periodontal pockets

Eventual loss of periodontal ligament and subsequent destruction of alveolar bone

Collagen fibres detach from root cementum Apical migration of the junctional epithelium Deepened pocket formation Resorption of the alveolar bone Ultimately progress to bone destruction if untreated

Bacterial biofilms which are associated with changes in bacterial species and disregard normal oral micro biota.

Distribution of microbiome resulting in the imbalance in the microbiota Changes in functional composition and metabolic activities Shift in local distribution

Multiple bacterial species work together in a coordinated way Microbes support each others survival in biofilms ,modify the environment , interact with the host immune system to evade detection or supression Microorganisms acquire functional specialisation through synergistic activities,increasing community virulence resulting in dysbiosis and tissue homeostasis disruption of periodontal tissues

Periodontal microorganisms,bacterial metabolites and further biomarkers such as antigens into the body These bacteria and molecules may promote disease elsewhere in the body via dissemination of the circulars system eg Alzheimer’s

Illness that affect the entire body or multiple organ/systems

Due to transient bacteraemia and the distan deposition of oral microbial metabolites and the distal deposition of oral microbial metabolites which can result in metastatic spread of infection of oral metabolites

A biochemical ,cellular or molecular alternation that is measurable in any biological media such as the human tissues cells or fluids Used to indicate the medical state of an individual

Exposure biomarkers which enable the assessment of potential health risks Disease biomarkers which are currently in use for screening, diagnostics and monitoring exciting diseases

Bleeding on probing( however painful for the patient as the gingival pocket deepens ) Pocket depth analysis Clinical attachment levels Plaque indexes and analysis of radiographs of current Alveolar bone levels

A device that detects and measures biomarkers or other biological substances