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D2 Fall - Pt Care III > 8/20: Anatomy of the Periodontium > Flashcards

8/20: Anatomy of the Periodontium Flashcards

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1
Q

What is the periodontium?

A

Specialized connective tissue that provides support needed to maintain
teeth in function

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2
Q

What are the 4 main components of the periodontium?

A

i. gingiva
ii. Cementum
iii. Periodontal ligament
iv. Alveolar bone

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2
Q

What are the 3 zones of the oral mucosa?

A
  1. The gingiva & covering of the hard palate (masticatory mucosa)*
  2. Dorsum of the tongue (specialized mucosa)
  3. Oral mucous membrane lining remainder of oral cavity
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3
Q

What mucosa covers alveolar bone and tooth root coronal to the CEJ?

A

Masticatory mucosa

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4
Q

What are the 3 divisions of the masticatory mucosa?

A
  1. Marginal gingiva
  2. Attached gingiva
  3. Interdental areas
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5
Q

What gingiva is free, collar like tissue surrounding the teeth on facial, lingual, and interproximal surfaces?

A

Marginal gingiva/unattached gingiva

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6
Q

What kind of epithelium is marginal gingiva/unattached gingiva?

A

Nonkeratinized epithelium

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7
Q

What is the most coronal portion of the gingiva?

A

Gingival margin

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8
Q

What is the scalloped outline of the teeth?

A

Gingival margin

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9
Q

What is the size of the gingival margin?

A

1mm wide

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10
Q

What does the gingival margin form?

A

The soft tissue wall of the gingival sulcus

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11
Q

What is the shallow, natural space around a tooth?

A

Gingival sulcus

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12
Q

What is the gingival sulcus bounded by?

A

The surface of the tooth on one side and epithelium lining the free margin of the gingiva on the other side

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13
Q

What does the gingival sulcus barely permit entrance of?

A

A periodontal probe; sulcular measurements of 1-3mm in gingival health

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14
Q

What are the boundaries of the gingival sulcus?

A

Sulcular epithelium and the tooth

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15
Q

What epithelium is gingival sulcus?

A

Sulcular epithelium is the nonkeratinized continuation of keratinized epithelium covering the marginal gingiva

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16
Q

What does theinterdental gingiva occupy?

A

The gingival embrasure space between 2 adjacent teeth (interproximal space beneath area of tooth contact)

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17
Q

What is the interdental gingiva attached to the tooth by?

A

The JE and connective tissue fibers

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18
Q

Where does the interdental gingiva shape vary?

A

With space or distance between 2 adjacent teeth

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19
Q

What will the papilla be like if a wide space exists between 2 teeth?

A

Flat or saddled (WNL)

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20
Q

What will the papilla be like if the interdental space is narrow?

A

Pointed or pyramidal (WNL)

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21
Q

What is a valley-like depression of the interproximal contact areas?

A

Gingival col

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22
Q

What does the gingival col connect?

A

Lingual and buccal interdental papilla

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23
Q

When is the gingival col absent?

A

When teeth aren’t in contact

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24
Q

The nonkeratininzed epithelium of the gingival col is susceptible to?

A

Inflammation and disease

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25
Q

What divides free gingiva from attached gingiva?

A

Free gingival groove
-shallow depression
- found in 50% of patients

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26
Q

What epithelium is the free gingival groove covered in?

A

Keratinized epithelium

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27
Q

What is the attached gingiva continous with?

A

Marginal gingiva

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28
Q

Where does the facial aspect of the attached gingiva extend to?

A

Relatively loose and movable alveolar mucosa

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29
Q

What is the attached gingiva demarcated by?

A

The MGJ

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30
Q

What do changes in the width of attached gingiva result from?

A

Changes at the coronal end

31
Q

Where is the attached gingiva widest? narrowest?

A

In the facial aspect of maxillary central incisors
Narrowest in the mandibular premolar facial areas

32
Q

What results when attached gingiva is diminished?

A

Gingival recession

33
Q

What is a visible line where pink keratinized gingiva meet the more vascular alveolar mucosa?

A

Mucogingival junction (MGJ)

34
Q

Where is the mucogingival junction found?

A

On the maxillary facial and the mandibular facial and lingual areas

35
Q

What is movable tissue, loosely attached to underlying alveolar bone?

A

Alveolar mucosa
- thin, shoft, nonkeratinized epithelium
- separate from attached gingiva at the MGJ
- darker red than gingiva due to rich blood supply

36
Q

What epithelium composes the gingiva?

A

Stratified squamous epithelium and connective tissue

37
Q

What is gingiva mostly composed of?

A

Collagen fibers and ground substance

38
Q

What are the functions of the gingival epithelium?

A
  1. Physical barrier to infection
  2. Participate actively in responding to infection in signaling host response
  3. Protection of deep structures
  4. Allows a selective interchange with the oral environment
39
Q

Epithelium covering the free
gingiva may be differentiated into the following:

A
  1. The oral (outer) epithelium
  2. The sulcular epithelium
  3. The junctional epithelium
40
Q

What Covers the crest and outer surface of the marginal gingiva and the surface of attached gingiva?

A

Oral (outer epithelium)

41
Q

What is the thickness of oral epithelium?

A

Approx. 0.2-0.3mm

42
Q

What are the 4 layers of oral (outer) epithelium?

A
  • Basal layer
  • Prickle cell layer
  • Granular layer
  • Cornified layer
43
Q

What lines the gingival sulcus?

A

Sulcular epithelium

44
Q

Where does sulcular epithelium extend from?

A

The coronal limit of the
junctional epithelium to the crest of the gingiva margin

45
Q

What does a sulcular epithelium act as?

A

a semipermeable membrane through
which injurious bacterial products pass into the gingiva and seeps into the
sulcus

46
Q

What is surrounding and attaching to the tooth on one side and the gingival connective tissue on the other?

A

Junctional epithelium

47
Q

What is the length of the junctional epithelium?

A

0.25-1.35mm

48
Q

What is the base of the sulcus/pocket?

A

Junctional epithelium

49
Q

What is junctional epithelium formed by?

A

the confluence of the oral epithelium and
the reduced enamel epithelium during tooth eruption

50
Q

What does the junctional epithelium serve as a route of passage of?

A

fluid and cells from the
connective tissue into the sulcus for bacteria/bacterial
products from sulcus to connective tissue

51
Q

What are gingival fibers?

A

Type I Collagen fiber bundles

52
Q

What are the functions of gingival fibers?

A
  1. to brace the marginal gingiva firmly against the tooth
  2. to provide the rigidity necessary to withstand the forces of mastication
    without being deflected away from the tooth surface
  3. to unite the free marginal gingiva with the cementum of the root and the
    adjacent attached gingiva
53
Q

What fibers are embedded in the cementum between the CEJ and crest of alveolar bone; fan outward into
the attached and free gingiva; attach gingiva to the tooth apical to the epithelial attachment?

A

Dentinogingival fibers

54
Q

What fibers are inserted in crest of alveolar process and splay out through lamina propria into the free gingiva?

A

Alveologingival fibers

55
Q

What fibers encircle each tooth in a cufflike fashion within the free gingiva?

A

Circumferential fibers

56
Q

What fibers are embedded in the same portion of
the cementum as the
dentogingival fibers, but extend apically over the alveolar crest after passing through the lamina propria and the periosteum?

A

Dentoperiosteal fibers

57
Q

What fibers are Embedded in the same portion of the cementum as the dentogingival and
dentoperiosteal fibers; run a horizontal path from adjacent teeth?

A

Transseptal fibers

58
Q

Why does connective tissue of the gingiva have good healing and regenerative capacity?

A

Because of high cell turnover rate
- has little evidence of scarring

59
Q

What are clinical and microscopic features of tissue?

A

Color
Size
Contour
Shape
Consistency
Surface texture
Position

60
Q

What cells are present in marginal and attached gingiva?

A

Pigment containing cells

61
Q

What color are marginal and attached gingiva?

A

In health - coral pink
lighter color in blond individuals with fair complexions than dark haired

62
Q

What is the color of the alveolar mucosa?

A

Red
Smooth
Shiny
Epithelium thinner and nonkeratinized

63
Q

What is responsible for normal pigmentation of the skin, gingiva, and remainder of the oral mucous membrane?

A

Melanin

64
Q

What does the size of gingiva correspond with?

A

Number of cellular/intercellular elements and vascular supply

65
Q

What does contour of gingiva vary depending on?

A

Shape of teeth and alignment

66
Q

What is shape of gingiva depend on?

A

Interdental gingiva guided by contour of proximal tooth surfaces, location, and shape of embrasures

67
Q

What is the consistency of gingiva?

A

Firma and resilient

68
Q

What do collagen fibers determine?

A

Firmness of attached gingiva

69
Q

What do gingival fibers contribute?

A

Firmness of gingival margin

70
Q

What should the texture of gingiva be?

A

Stippled (orange peel)
Best viewed by drying tissue
Stippling is less prominent on lingual

71
Q

What does smoking cause?

A

Vasoconstriction; affecting body’s defense against infection

72
Q

What does smoking impair?

A

Chemotaxis and phagocytosis of neutrophils which aid in killing microorganisms

73
Q

What does smoking do to bone density?

A

Decreases; leading to resportion of alveolar bone

74
Q

What does smoking do to gingival tissues?

A

Firm and fibrotic due to decreased blood flow and limits delivery of oxygen and nutrients to epithelium

D2 Fall - Pt Care III (6 decks)

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