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PERIODONTICS > ANATOMY AND PHYSIOLOGY OF THE PERIODONTIUM > Flashcards

ANATOMY AND PHYSIOLOGY OF THE PERIODONTIUM Flashcards

1
Q

also called “the attachment apparatus” or “the supporting tissues of the teeth.”

A

periodontium

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2
Q
  • main function is to attach the tooth to the bone tissue of the jaws and to maintain the integrity of the surface of the masticatory mucosa of the oral cavity
A

periodontium

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3
Q

three zones of the oral mucosa

A
  • masticatory mucosa
  • specialized mucosa
  • oral mucous membrane
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4
Q

consists of the gingiva and covering of the hard palate

A

masticatory mucosa

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5
Q

covers the dorsum of the tongue

A

specialized mucosa

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6
Q

lines the remainder of the oral cavity. floor of the mouth, ventral side of the tongue, cheeks, lip, and soft palate

A

oral mucous membrane

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7
Q

the part of the oral mucosa that covers the alveolar process of the jaws and surrounds the cervical portion of the teeth.

A

gingiva

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8
Q

soft tissues that serves as a barrier which prevents microorganisms from entering the gingival connective tissue

A

gingiva

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9
Q

there is no mucogingival line present in the palate since the hard palate and the maxillary alveolar process are covered by the same type of masticatory mucosa

A

gingiva

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10
Q

also known as Unattached gingiva, Free gingiva

A

marginal gingiva

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11
Q

coral pink, has a dull surface and firm consistency. It extends from the gingival margin to the gingival groove

A

marginal gingiva

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12
Q

the terminal edge or border of the gingiva surrounding the teeth in collar like fashion

A

marginal gingiva

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13
Q

In 50% of the cases, it is demarcated from the adjacent, attached gingiva by a shallow linear depression,

A

free gingival groove

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14
Q

It may be separated from the tooth surface with a periodontal probe.

A

free gingival groove

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15
Q

positioned at a level corresponding to the level of the CEJ

A

free gingival groove

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16
Q

only present in 30-40% of adults

A

free gingival groove

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17
Q

The shallow crevice or space around the tooth bounded by the surface of the tooth on one side and the epithelium lining the free margin of the gingiva on the other.

A

gingival sulcus

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18
Q

it is v shaped

A

gingival sulcus

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19
Q

the so-called probing depth of a clinically normal gingival sulcus in humans

A

2-3mm

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20
Q

in pristine conditions, this does NOT exist.

A

gingival sulcus

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21
Q

After completed tooth eruption, the free gingival margin is located on the enamel surface is

A

approximately 1.5-2mm coronal to the CEJ.

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22
Q

attached firmly to alveolar bone and varies in width

A

attached gingiva

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23
Q

extends from the free gingival groove unto the mucogingival junction.

A

attached gingiva

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24
Q

it is firm, resilient, and tightly bound to the underlying periosteum of alveolar bone.

A

attached gingiva

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25
Q

attached gingiva is demarcated from the adjacent loose and moveable alveolar mucosa by the

A

mucogingival junction

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26
Q

the distance between the mucogingival junction and the projection on the external surface of the bottom of the gingival sulcus or the periodontal pocket.

A

width of the attached gingiva

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27
Q

the attached gingiva is greatest at

A

the incisor region

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28
Q

the attached gingiva is less in the

A

posterior segment

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29
Q

the width of the attached gingiva is least in the

A

premolar area

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30
Q

changed in the width of the attached gingiva is caused by

A

modifications in the position of its coronal end.

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31
Q

it increases with age and supraerupted teeth.

A

attached gingiva

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32
Q

palatal surface in the maxilla blends imperceptibly with the palatal mucosa.

A

attached gingiva

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33
Q

physiologically, if attached gingiva is absent

A

food can cause friction on mucosa which will lead to recession.

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34
Q

Occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact

A

interdental gingiva

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35
Q

can be pyramidal or have a “col” shape

A

interdental gingiva

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36
Q

the tip on one papilla is located immediately beneath the contact point

A

pyramidal

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37
Q

presents a valleylike depression that connects a facial and lingual papilla and conforms to the shape of the inter proximal contact.

A

col

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38
Q

compared to an orange peel

A

gingiva (Stippling)

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39
Q

varies with age and is absent in infancy, appears in some children at about 5 years of age, increases until adulthood, and frequently begins to disappear in old age

A

stippling

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40
Q

feature of a healthy gingiva

A

stippling

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41
Q

reduction or loss of this is a common sign of gingival disease.

A

stippling

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42
Q

Microorganisms are present and could be still inflamed.

A

clinically healthy gingiva

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43
Q

-Marginal gingiva is scalloped, following the CEJ
-posterior, less scalloping, fills up the embrasures
-closely adapted to tooth structure
-consistency (firm and immobility for attached gingiva); -presence of stippling (orange peel appearance which is present in 40-60% of population
-dependent on rete pegs)

A

clinically healthy gingiva

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44
Q

three different areas of the gingival epithelium

A

-oral epithelium
- sulcular epithelium
- junctional epthelium

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45
Q

area of the gingival epthelium that faces the oral cavity

A

oral epithelium

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46
Q

area of the gingival epithelium that faces the tooth without being in contact with the tooth surface

A

sulcular epithelium

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47
Q

area of the gingival epithelium that provides the contact between the gingiva and the tooth.

A

junctional epithelium

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48
Q

The boundary between the oral epithelium and underlying connective tissue has

A

a wavy course

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49
Q

the connective tissue portions which project into the epithelium

A

connective tissue papilla

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50
Q

gingival epithelium is separated to each other by

A

epithelial ridges known as rete pegs

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51
Q

this is lacking in the junctional epithelium

A

rete pegs

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52
Q

these has rete pegs

A

oral and sulcular epithelium

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53
Q

lined by keratinized, stratified squamous epithelium

A

oral epithelium

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54
Q

4 layers of the oral epithelium

A
  1. Basal cell layer (stratum basale/germinativum)
  2. Spinous cell layer (stratum spinosum)
  3. Granular cell layer (stratum granulosum) 4. Keratinized cell layer (Stratum corneum
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55
Q

principal cell type of the oral epithelium

A

keratinocyte

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56
Q

keratinocyte in the oral epithelium undergoes

A

proliferation and differentiation

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57
Q

main function of this is to protect the deep structures while allowing a selective interchange with the oral environment

A

oral epithelium

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58
Q

takes place by mitosis in the basal layer and less frequently in the supra basal layers

A

proliferation of keratinocytes

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59
Q

involves the process of keratinization

A

differentiation of keratinocytes

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60
Q

morphologic changes in the oral epithelium

A

-Progressive flattening of the cell
-increased number of tonofilaments and intercellular junctions
-production of hyaline granules
-disappearance of nucleus.

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61
Q

Keratinocytes are attached with each other thru

A

desmosomes

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62
Q

also known as macula adherens

A

desmosomes

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63
Q

a cell structure specialized for cell to cell ADHESION

A

desmosome

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64
Q

consists of two adjoining hemidesmosomes

A

desmosomes

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65
Q

involved in the attachment of the epithelium to the underlying basement membrane

A

hemidesmosomes

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66
Q

absence of nuclei in the stratum corneum, has a well defined stratum granulosum

A

orthokeratinized

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67
Q

the stratum corneum contains pyknotic nuclei. Keratohyalin granules are dispersed, absence of stratum granulosum

A

parakeratinized

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68
Q

superficial cells has visible nuclei, absence of stratum granulosum and stratum corneum.

A

non-keratinized

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69
Q

stratum basale or stratum germinativum

A

basal cell layer

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70
Q

cells are either cylindric or cuboidal and are in contact with the basement membrane.

A

basal cell layer/basale/germinativum

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71
Q

possess the ability to divide (undergo mitotic cell division)

A

basal cell layer

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72
Q

considered as the progenitor cell compartment of the epithelium.

A

basal cell layer

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73
Q

has a very prominent round nucleus; organelles present

A

basal cell layer

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74
Q

stratum SPINosum

A

prickle cell layer

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75
Q

consists of 10-20 layers of relatively polyhedral cells, equipped with short cytoplasmic processes resembling SPINES.

A

prickle cell layer

76
Q

presence of large number of desmosomes indicating that the cohesion between the epithelial cells is solid.

A

prickle cell layer

77
Q

the nucleus is smaller, organelles are still present

A

prickle cell layer

78
Q

stratum GRANULosum

A

granular cell layer

79
Q

in this layer, electron dense keratohyalin bodies and clusters of glycogen-containing granules start to occur.

A

granular cell layer

80
Q

the tonofilaments in the cytoplasm and the number of desmosomes continue to increase in this layer

A

granular cell layer

81
Q

in this layer, there is a decrease in the number of organelles (mitochondria, lamellae of rough endoplasmic reticulum, golgi apparatus) in the keratinocytes

A

granulosum

82
Q

has a flattened nucleus, seems like cell is dying

A

granulosum

83
Q

stratum corneum or cornified layer

A

keratinized cell layer

84
Q

there is a very sudden keratinization of the cytoplasm of the keratinocyte in this layer

A

keratinized cell layer

85
Q

in this layer, the cytoplasm of the cells is filled with KERATIN.

A

keratinized cell layer

86
Q

in this layer, the entire apparatus for protein synthesis is lost. (nucleus, mitochondria, endoplasmic reticulum, golgi apparatus)

A

keratinized cell layer

87
Q

basement membrane

A

basal lamina

88
Q

the interface between the oral epithelium and the lamina propria

A

basal lamina

89
Q

composed of type IV collagen

A

lamina densa

90
Q

composed of glycoprotein laminin

A

lamina lucida

91
Q

consists of loose connective tissue within the connective tissue papillae, along with blood vessels and nerve tissue

A

lamina propia

92
Q

consists of loose connective tissue within the connective tissue papillae, along with blood vessels and nerve tissue

A

lamina propia

93
Q

the lamina propia is composed of

A

60% collagen fibers
5% fibroblasts
35% vessels and nerves

94
Q

cells of the gingival epithelium

A

keratinocyte - principal cell type
nonkeratinocytes (clear cells)

95
Q

principal cell type of the gingival epithelium

A

keratinocyte

96
Q

clear cells of the gingival epithelium

A

non-keratinocytes

97
Q

non keratinocytes

A

langerhans cells
merkel cells
melanocytes

98
Q

believed to play a role in the defense mechanism of the oral mucosa.

A

Langerhans cells

99
Q

they react with antigens which are in the process of penetrating the epithelium.

A

Langerhans cells

100
Q

antigen presenting cells for lymphocytes

A

Langerhans cells

101
Q

Non Keratinocytes found mostly at the basal layer

A

Langerhans cells

102
Q

Non Keratinocytes identified as tactile perceptors

A

merkel cells

103
Q

located in the basal layers and are connected to adjacent cells by desmosomes

A

merkel cells

104
Q

Non Keratinocytes that harbor nerve endings

A

merkel cells

105
Q

located in the basal layers and is responsible for the synthesis of MELANIN pigment

A

melanocytes

106
Q

lines the gingival sulcus

A

Oral Sulcular Epithelium

107
Q

thin, nonkeratinized stratified squamous epithelium without rete pegs

A

Oral Sulcular Epithelium

108
Q

extends from the coronal limit of the junctional epithelium to the crest of the gingival margin.

A

Oral Sulcular Epithelium

109
Q

It lacks stratum granulosum and stratum corneum

A

Oral Sulcular Epithelium

110
Q

composed of basal and spinous cell layers and lacks stratum granulosum and stratum corneum.

A

Junctional Epithelium

111
Q

consists of a collar like band of stratified squamous nonkeratinizing epithelium without rete pegs

A

Junctional Epithelium

112
Q

formed by the union of the oral epithelium and the reduced enamel epithelium during tooth eruption

A

Junctional Epithelium

113
Q

Different types of cells present in the connective tissue

A

Fibroblast
Mast cells
Macrophage
Neutrophilic Granulocytes Lymphocytes
Plasma cells

114
Q

predominant CT cell (65%)

A

fibroblast

115
Q

engaged in the production of various types of fibers found in the CT, but is also instrumental in the synthesis of the CT matrix

A

fibroblast

116
Q

cell that is responsible for the host defense mechanism

A

mast cells

117
Q

produces vasoactive substances which can affect the function of the microvascular system and control the flow of blood through the tissue.

A

mast cells

118
Q

has phagocytic and synthetic functions

A

macrophage

119
Q

phagocytose foreign bodies/chemicals

A

macrophage

120
Q

numerous in inflamed tissues

A

macrophage

121
Q

derived from circulating blood monocytes

A

macrophage

122
Q

also called polymorphonuclear leukocytes

A

Neutrophilic Granulocytes

123
Q

scarce in normal tissue/gingiva

A

Neutrophilic Granulocytes

124
Q

influence the behavior of the overlying epithelium by releasing of cytokines

A

Lymphocytes and plasma cells

125
Q

dependent on the nature and duration of injury

A

Lymphocytes and plasma cells

126
Q

Types of Connective Tissue Fibers

A

Collagen Fibers
Reticulin Fibers
Oxytalan Fibers
Elastic Fibers

127
Q

most essential component of the periodontium

A

Collagen Fibers

128
Q

are cells which also possess the ability to produce collagen.

A

cementoblasts and osteoblasts

129
Q

CT fibers located near the blood vessels

A

Reticulin Fibers

130
Q

CT fibers located in the apical region

A

Oxytalan fibers

131
Q

CT fibers that are scarce in the gingiva but numerous in the periodontal ligament

A

Oxytalan fibers

132
Q

CT fibers that are only present in association with blood vessels.

A

Elastic fibers

133
Q

Major Collagen Fiber Groups

A

Circular Fibers
Dentogingival Fibers
Dentoperiosteal Fibers
Transseptal Fibers

134
Q

collagen fiber group that encircles neck of root

A

Circular Fibers

135
Q

collagen fiber group that maintains the position of the free gingiva

A

Circular Fibers

136
Q

collagen fiber group that is embedded in the cementum and projects out/towards the free gingiva.

A

Dentogingival Fibers

137
Q

collagen fiber group that is embedded in the cementum and projects towards the periosteum of alveolar bone

A

Dentoperiosteal Fibers

138
Q

collagen fiber group that is embedded in the cementum of approximating teeth and is found on the distal side of tooth and to the medial of the other

A

Transseptal Fibers

139
Q

prominent in the dentogingival and dento periosteal fibers.

A

Gingival Groove

140
Q

aka gingival crevicular fluid (GCF) or sulcular fluid

A

Gingival Fluid

141
Q

contains antibodies, immunoglobulins, plasma cells, and PMNs.

A

Gingival Fluid

142
Q

this isbincreased in the presence of gingival inflammation

A

Gingival Fluid

143
Q

Gingival Fluid is believed to

A

-cleanse material from the sulcus
-contain plasma proteins that may improve adhesion of the epithelium to the tooth
-possess antimicrobial properties
-exert antibody activity to defend the gingiva

144
Q

CT that surrounds the root and connects it to the bone

145
Q

has the shape of an hourglass and is narrowest at the mid root level.

146
Q

width of the PDL

A

approximately 0.25mm

147
Q

this distributes the force elicited during mastication. and is essential for mobility of the teeth.

148
Q

Principal Fibers of the Periodontal Ligament

A

Alveolar Crest Fibers
Horizontal Fibers
Oblique Fibers
Apical Fibers
Interradicular Fibers

149
Q

PDL fibers that extend obliquely from the cementum just beneath the junctional epithelium to the alveolar crest

A

Alveolar Crest Fibers

150
Q

PDL fibers that prevent extrusion of the tooth and resists lateral tooth movement

A

Alveolar Crest Fibers

151
Q

PDL fibers that extend at right angles to the long axis of the tooth from the cementum to the alveolar bone

A

Horizontal Fibers

152
Q

largest group of fibers in the periodontal ligament

A

oblique fibers

153
Q

PDL fibers that extends from the cementum in a coronal direction OBLIQUELY to the bone.

A

oblique fibers

154
Q

PDL fibers that bear the impact of masticatory stresses and transform them in a tension on the alveolar bone.

A

oblique fibers

155
Q

PDL fibers that radiate in an irregular fashion from the cementum to the bone at the APICAL region of the socket.

A

apical fibers

156
Q

these PDL fibers - do not occur on incompletely formed roots

A

apical fibers

157
Q

PDL fibers that cementum FAN OUT from the to the tooth in furcation areas of multi rooted teeth.

A

Interradicular Fibers

158
Q

these are TERMINAL portions of the principal fibers that insert into cementum and bone.

A

sharpey’s fibers

159
Q

specialized mineralized tissue covering the root surfaces and occasionally, small portions of the crown of the teeth.

160
Q

has no blood or lymph vessels, no innervation, does not undergo physiologic resorption or remodeling.

161
Q

characterized by continuous deposition throughout life and attaches the periodontal ligament fibers to the root.

162
Q

cementum can be

A

acellular and cellular

163
Q

does not contain any cell (collagen fibrils or cementocytes) in
its matrix

A

Acellular, afibrillar cementum

164
Q

coronal cementum

A

Acellular, afibrillar cementum

165
Q

with well-defined, type I collagen fibrils (part of Sharpey’s fibers)

A

Acellular, extrinsic fiber cementum

166
Q

found in coronal 2/3 of the root and connects the tooth with the alveolar bone proper

A

Acellular, extrinsic fiber cementum

167
Q

primary cementum

A

Acellular, extrinsic fiber cementum

168
Q

found in apical 1/3 of root and in the furcations

A

cellular cementum

169
Q

Secondary cementum

A

cellular cementum

170
Q

cementum forming cells

A

cementoblasts

171
Q

cementoblasts trapped in the cementum matrix

A

cementocytes

172
Q

parts of the maxilla and the mandible that form and support the sockets of the teeth.

A

alveolar bone

173
Q

alveolar bone is composed of

A
  1. cortical bone
  2. alveolar bone proper
174
Q

compact bone

A

cortical bone

175
Q

part of the alveolar bone that covers the alveolus.

A

cortical bone

176
Q

appears on the radiograph as the lamina dura

A

cortical bone

177
Q

spongy bone

A

alveolar bone proper

178
Q

has many lacunae active for blood forming

A

alveolar bone proper

179
Q

appears on the radiograph as meshwork

A

alveolar bone proper

180
Q

bone FORMING cells

A

osteoBLASTS

181
Q

giant cells specialized in the BREAKDOWN of mineralized matrix (bone, dentin, cementum)

A

osteoCLASTS

182
Q

stellate shaped cells that are trapped within the mineralized bone matrix and participates in the blood calcium homeostasis

A

osteocytes

183
Q

when the bone at the coronal portion of the root is MISSING.

A

dehiscence

184
Q

an area of DENUDED bone, surrounded by an intact bone

A

Fenestration

185
Q

in dehiscence and fenestration the root is covered only by

A

periodontal ligament and the overlying gingiva.

PERIODONTICS (4 decks)

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