Defence mechanism

Presented By Dr Bhagabat Bhattarai PG Resident Periodontology and Implantology Peoples Dental College

Guide Associate Professor Dr. Surendra Man S HOD- Periodontology and Implantology PDCH

Contents
Introduction

Epithelium Saliva
Antibacterial factor Salivary antibodies Buffers and coagulation factors Leukocytes Role in periodontal pathology

Introduction
Gingival tissue is constantly subjected to mechanical

and bacterial aggressions

Teeth penetrate the integument as a structure that

emerges from inside the body to outside the body

Role of sulcular fluid, leukocytes, saliva and epithelial

barrier of the gingival sulcus

gingival sulcular tissue is an area that provides a

biologic seal, but it is also the area where the plaque bacteria challenge the host
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Epithelium
main function of the gingival epithelium is to protect the deep structures-mechanical, chemical, water and microbial barrier, signalling functions -Achieved by proliferation and differentiation of the keratinocytes -mitosis in the basal layer and less frequently in the suprabasal layers larger number begin to migrate to the surface Differentiation involves the process of keratinization,
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Saliva
Maintain the oral tissues in a physiologic state

Lysozyme
- hydrolytic enzyme that cleaves the linkage

between structural components of the glycopeptide muramic acidcontaining region of the cell wall of certain bacteria in vitro veillonella species and Actinobacillus actinomycetemcomitans repels certain transient bacterial invaders of the mouth

Lactoperoxidase-thiocyanate system
bactericidal to some strains of Lactobacillus and

Streptococcus

preventing the accumulation of lysine and glutamic acid, both of which are essential for bacterial growth
Lactoferrin- antibacterial-Actinobacillus species

Myeloperoxidase
Released by leukocytes
Bactericidal for Actinobacillus Inhibit the attachment of Actinomyces strains to

hydroxyapatite

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Salivary Antibodies
preponderant immunoglobulin found in saliva is

immunoglobulins A (IgA)
immunoglobulins G (IgG) and M (IgM) are present lgG is more prevalent in GCF

Major and minor salivary - all the secretory IgA (sIgA) and

lesser amounts of IgG and IgM

Salivary antibodies appear to be synthesized locally,

because they react with strains of bacteria indigenous to the mouth but not with organisms characteristic of the intestinal tract
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impair the ability of bacteria to attach to mucosal or dental surfaces

Salivary enzymes
Derived from the salivary glands, bacteria,

leukocytes, oral tissues, and ingested substances

increased concentrations in periodontal disease:

-Hyaluronidase and lipase --glucuronidase and chondroitin sultatase -Amino acid decarboxvlases -catalase, peroxidase, and collagenase

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Salivary enzymes
saliva contains antiproteases that inhibit cysteine

proteases such as cathepsins'' and antileukoproteases that inhibit elastase

tissue inhibitor of matrix metalloproteinase TNIP,

has been shown to inhibit the activity of collagendegrading enzymes

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 glucoprotein-bacteria interactions facilitate bacterial

accumulation on the exposed tooth surface

interbacterial matrix of human plaque appears

tocontain polymers similar to salivary glycoproteins that may aid in maintaining the integrity of plaque
selectively adsorb to the hydroxyapatite to make up

part of the acquired pellicle Other salivary glycoproteins inhibit the sorption of some bacteria to the tooth surface and to epithelial cells of the oral mucosa
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 Glucoproteins and a glycolipid present on

mammalian cell surfaces appear to serve as receptors for the attachment of some viruses and bacteria
Thus the close similarity between glucoproteins of

salivary secretions and components of the epithelial cell surface suggests that the secretions can competitively inhibit antigen sorption and therefore may limit pathologic alterations.
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Salivary Buffers
maintenance of physiologic hydrogen ion

concentration (pH) at the mucosal epithelial cell surface and the tooth surface is an important important salivary butter is the bicarbonate carbonic acid system

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Coagulation Factors
Saliva also contains coagulation factors (factors

VIII, IX, and X; plasma thromboplastin antecedent (PTA); Hageman factor) that hasten blood coagulation and protect wounds from bacterial invasion.
An active fibrinolytic enzyme may also be present

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Leukocytes
saliva contains all forms of leukocytes, of which

the principal cells are PMNs. varies from person to person at different times of the day and is increased in gingivitis reach the oral cavity by migrating through the lining of the gingival sulcus
rate of migration correlates with the severity of

gingival inflammation and is therefore a reliable index tor assessing gingivitis.'''

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Role in Periodontal Pathology

major influence on plaque initiation, maturation,

and metabolism
Salivary flow and composition also influence

calculus formation, periodontal disease, and caries

gingival diseases, dental caries, and rapid tooth

destruction associated with cervical or cemental caries is partially a consequence of decreased salivas gland secretion
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 A. Refaie, O. Anuksaksathiem, G. Singh, J.

Moran, A.E. Dolby.Antibody to Collagen Type I in Gingival Crevicular Fluid. J Periodontol 1990;60:289-292.

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