1 - Anatomy of the Periodontium Flashcards
what is part of the normal periodontium
- gingiva
- tooth supporting structures
what are tooth supporting structures
- PDL
- cementum
3 alveolar process
what landmarks can you see at a cross section from B-L
sulcus, sulcular epithelium, junctional epithelium, cementum
what determines the color of gingiva
blood flow, physiologic pigmentation (melanin)
consistency of gingiva
firm with stippling sometimes
contour of gingiva
inderdental papillae fill interprox w/ no recession
three regions of gingiva
- oral or outer epithelium
- sulcular epithelium
- junctional epithelium
what has no nuclei in stratum corneum, distinct stratum granulosum
orthokeratinized outer epi
what has nuclei stratum corneum
parakeratinised outer epithelium
whawt region of gingiva is non-keratinized
sulcular and junctional
describe outer wall of sulcus
- has free gingival groove in 50% of patients
- keratinized
- unattached/free
width of keratinized gingiva
distance from gingival margin to MGJ (but varies w/ location in mouth
with of KG in maxilla
anterior > molar > premolar
width of keratinized gingiva in facial mandible
anterior > molar > premolar
width of keratinized gingiva in lingual mandible
molar > premolar > incisor
why important to know width of keratinized gingiva?
we want to know where is it vulnerable for patients to get gingival recession. often occurs where keratinized gingiva is thinnest. nothing protecting underlying bone resulting in bone loss
what is is. keratinized gingiva bound tightly to tooth and bone to be protective against recession
attached gingiva
what extends from base of sulcus to MGJ
attached gingiva
what thype of epithelium is attached gingiva
ortho or parakeratinized
what is the width of attached gingiva
width of KG - probing depth = width of attached gingiva
is stippling present in attached gingiva
depends on patient
how to determine the width of attached gingiva
- probe
- measure w/ KG
- attached gingiva = KG - PD
what is the differentce between KG and AG
attached = use perio probe, all is keratinized
not all keratnized is attached
the coronal extent of ____ is mucogingival junction
alveolar mucosa
what type of epithelium is alveolar mucosa
non-keratinized epi
is alveolr mucosa bound to bone
no,; mobile
what is more red in color due to lack of keratinization and visibility of underlying BC
alveolar mucosa
what is a Line that demarcates the keratinized gingiva from the
alveolar mucosa
mucogingival juncition
what is an absence of attached gingiva (0 mm)
mucogingival defect
what happens when a probe penetrates to or beyong MGJ
mucogingival defect
what happens when probing depth >/= width of keratinized gingiva
MGJ
what are surgical corrections for mucogingival defects
- CT graft
- free gingival graft
what is a combination of GINGIVAL phenotype and BONE morphotype
periodontal phenotypes
what are the periodontal phenotypes
- thin-scalloped
- thick-flat
- thick-scalloped
what periodontal phenotype is most likely to be risk of gingival reession
thin-scalloped
what periodontal phenotype is more likely to have more excessive gingival display, gummy smile
thick-flat
what shape dependent on the buccal lingual width of teeth
col: inderdental gingiva
shape of col on molars and premolar vs. anterior teeth
molars and premolar: saddle shaped
anterior: pyramidal shaped
depression between two interdental peaks
Col
where does periodontal disease start
where the toothbrush doesnt reach - interprodimal gingiva (col)
why does disease typically start at interproximal gingiva (col)
- col is non-keratinized
- more permeable
- less resistant to bacterial ingress
what is the predominate cell in epithelium
keratinocyte
what produces pigmentation (melanin)
melanocyte
what are dentritic cells (antigen presenting cells) important in immune response
Langerhans cells
what extends from oral epi to junctional epi
sulcular eip
what is 1-2 mm in depth (in health), non-keratinized, and semi-permeable
sulcular epi
what forms attachment between gingival and tooth
junctional epi
what is the confluence of oral epi and REE at tooth eruption
junctional epi
what are the 2 strata of junctional epi
- external basal lamina
- internal basal lamina
what basal lamina of JE faces CT
external basal lamina
what basal lamina of JE attaches to tooth thru hemidesmosomal attachment
internal basal lamina
JE is coronal to or at level of CEJ when
prior to disease
what are the functions of JE
- attachment to tooth
- permeable barrier against bacteria
- signal transduction
what allows diffusion of fluid and inflammatory cells to sulcus as host defense mech
permeable barrier against bacteria of JE
what allows hemidesmosomes to regulate gene expression, cell differentiation, an dproliferation of JE
signal transcution
what is the cell turnover rate of JE
rapid 1-6 days