ANATOMY AND PHYSIOLOGY OF THE PERIODONTIUM Flashcards
1
Q
also called “the attachment apparatus” or “the supporting tissues of the teeth.”
A
periodontium
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
3
Q
three zones of the oral mucosa
A
- masticatory mucosa
- specialized mucosa
- oral mucous membrane
4
Q
consists of the gingiva and covering of the hard palate
A
masticatory mucosa
5
Q
covers the dorsum of the tongue
A
specialized mucosa
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
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
8
Q
soft tissues that serves as a barrier which prevents microorganisms from entering the gingival connective tissue
A
gingiva
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
10
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also known as Unattached gingiva, Free gingiva
A
marginal gingiva
11
Q
coral pink, has a dull surface and firm consistency. It extends from the gingival margin to the gingival groove
A
marginal gingiva
12
Q
the terminal edge or border of the gingiva surrounding the teeth in collar like fashion
A
marginal gingiva
13
Q
In 50% of the cases, it is demarcated from the adjacent, attached gingiva by a shallow linear depression,
A
free gingival groove
14
Q
It may be separated from the tooth surface with a periodontal probe.
A
free gingival groove
15
Q
positioned at a level corresponding to the level of the CEJ
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free gingival groove
16
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only present in 30-40% of adults
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free gingival groove
17
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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
18
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it is v shaped
A
gingival sulcus
19
Q
the so-called probing depth of a clinically normal gingival sulcus in humans
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2-3mm
20
Q
in pristine conditions, this does NOT exist.
A
gingival sulcus
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.
22
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attached firmly to alveolar bone and varies in width
A
attached gingiva
23
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extends from the free gingival groove unto the mucogingival junction.
A
attached gingiva
24
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it is firm, resilient, and tightly bound to the underlying periosteum of alveolar bone.
A
attached gingiva
25
attached gingiva is demarcated from the adjacent loose and moveable alveolar mucosa by the
mucogingival junction
26
the distance between the mucogingival junction and the projection on the external surface of the bottom of the gingival sulcus or the periodontal pocket.
width of the attached gingiva
27
the attached gingiva is greatest at
the incisor region
28
the attached gingiva is less in the
posterior segment
29
the width of the attached gingiva is least in the
premolar area
30
changed in the width of the attached gingiva is caused by
modifications in the position of its coronal end.
31
it increases with age and supraerupted teeth.
attached gingiva
32
palatal surface in the maxilla blends imperceptibly with the palatal mucosa.
attached gingiva
33
physiologically, if attached gingiva is absent
food can cause friction on mucosa which will lead to recession.
34
Occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact
interdental gingiva
35
can be pyramidal or have a “col” shape
interdental gingiva
36
the tip on one papilla is located immediately beneath the contact point
pyramidal
37
presents a valleylike depression that connects a facial and lingual papilla and conforms to the shape of the inter proximal contact.
col
38
compared to an orange peel
gingiva (Stippling)
39
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
stippling
40
feature of a healthy gingiva
stippling
41
reduction or loss of this is a common sign of gingival disease.
stippling
42
Microorganisms are present and could be still inflamed.
clinically healthy gingiva
43
-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)
clinically healthy gingiva
44
three different areas of the gingival epithelium
-oral epithelium
- sulcular epithelium
- junctional epthelium
45
area of the gingival epthelium that faces the oral cavity
oral epithelium
46
area of the gingival epithelium that faces the tooth without being in contact with the tooth surface
sulcular epithelium
47
area of the gingival epithelium that provides the contact between the gingiva and the tooth.
junctional epithelium
48
The boundary between the oral epithelium and underlying connective tissue has
a wavy course
49
the connective tissue portions which project into the epithelium
connective tissue papilla
50
gingival epithelium is separated to each other by
epithelial ridges known as rete pegs
51
this is lacking in the junctional epithelium
rete pegs
52
these has rete pegs
oral and sulcular epithelium
53
lined by keratinized, stratified squamous epithelium
oral epithelium
54
4 layers of the oral epithelium
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
55
principal cell type of the oral epithelium
keratinocyte
56
keratinocyte in the oral epithelium undergoes
proliferation and differentiation
57
main function of this is to protect the deep structures while allowing a selective interchange with the oral environment
oral epithelium
58
takes place by mitosis in the basal layer and less frequently in the supra basal layers
proliferation of keratinocytes
59
involves the process of keratinization
differentiation of keratinocytes
60
morphologic changes in the oral epithelium
-Progressive flattening of the cell
-increased number of tonofilaments and intercellular junctions
-production of hyaline granules
-disappearance of nucleus.
61
Keratinocytes are attached with each other thru
desmosomes
62
also known as macula adherens
desmosomes
63
a cell structure specialized for cell to cell ADHESION
desmosome
64
consists of two adjoining hemidesmosomes
desmosomes
65
involved in the attachment of the epithelium to the underlying basement membrane
hemidesmosomes
66
absence of nuclei in the stratum corneum, has a well defined stratum granulosum
orthokeratinized
67
the stratum corneum contains pyknotic nuclei. Keratohyalin granules are dispersed, absence of stratum granulosum
parakeratinized
68
superficial cells has visible nuclei, absence of stratum granulosum and stratum corneum.
non-keratinized
69
stratum basale or stratum germinativum
basal cell layer
70
cells are either cylindric or cuboidal and are in contact with the basement membrane.
basal cell layer/basale/germinativum
71
possess the ability to divide (undergo mitotic cell division)
basal cell layer
72
considered as the progenitor cell compartment of the epithelium.
basal cell layer
73
has a very prominent round nucleus; organelles present
basal cell layer
74
stratum SPINosum
prickle cell layer
75
consists of 10-20 layers of relatively polyhedral cells, equipped with short cytoplasmic processes resembling SPINES.
prickle cell layer
76
presence of large number of desmosomes indicating that the cohesion between the epithelial cells is solid.
prickle cell layer
77
the nucleus is smaller, organelles are still present
prickle cell layer
78
stratum GRANULosum
granular cell layer
79
in this layer, electron dense keratohyalin bodies and clusters of glycogen-containing granules start to occur.
granular cell layer
80
the tonofilaments in the cytoplasm and the number of desmosomes continue to increase in this layer
granular cell layer
81
in this layer, there is a decrease in the number of organelles (mitochondria, lamellae of rough endoplasmic reticulum, golgi apparatus) in the keratinocytes
granulosum
82
has a flattened nucleus, seems like cell is dying
granulosum
83
stratum corneum or cornified layer
keratinized cell layer
84
there is a very sudden keratinization of the cytoplasm of the keratinocyte in this layer
keratinized cell layer
85
in this layer, the cytoplasm of the cells is filled with KERATIN.
keratinized cell layer
86
in this layer, the entire apparatus for protein synthesis is lost. (nucleus, mitochondria, endoplasmic reticulum, golgi apparatus)
keratinized cell layer
87
basement membrane
basal lamina
88
the interface between the oral epithelium and the lamina propria
basal lamina
89
composed of type IV collagen
lamina densa
90
composed of glycoprotein laminin
lamina lucida
91
consists of loose connective tissue within the connective tissue papillae, along with blood vessels and nerve tissue
lamina propia
92
consists of loose connective tissue within the connective tissue papillae, along with blood vessels and nerve tissue
lamina propia
93
the lamina propia is composed of
60% collagen fibers
5% fibroblasts
35% vessels and nerves
94
cells of the gingival epithelium
keratinocyte - principal cell type
nonkeratinocytes (clear cells)
95
principal cell type of the gingival epithelium
keratinocyte
96
clear cells of the gingival epithelium
non-keratinocytes
97
non keratinocytes
langerhans cells
merkel cells
melanocytes
98
believed to play a role in the defense mechanism of the oral mucosa.
Langerhans cells
99
they react with antigens which are in the process of penetrating the epithelium.
Langerhans cells
100
antigen presenting cells for lymphocytes
Langerhans cells
101
Non Keratinocytes found mostly at the basal layer
Langerhans cells
102
Non Keratinocytes identified as tactile perceptors
merkel cells
103
located in the basal layers and are connected to adjacent cells by desmosomes
merkel cells
104
Non Keratinocytes that harbor nerve endings
merkel cells
105
located in the basal layers and is responsible for the synthesis of MELANIN pigment
melanocytes
106
lines the gingival sulcus
Oral Sulcular Epithelium
107
thin, nonkeratinized stratified squamous epithelium without rete pegs
Oral Sulcular Epithelium
108
extends from the coronal limit of the junctional epithelium to the crest of the gingival margin.
Oral Sulcular Epithelium
109
It lacks stratum granulosum and stratum corneum
Oral Sulcular Epithelium
110
composed of basal and spinous cell layers and lacks stratum granulosum and stratum corneum.
Junctional Epithelium
111
consists of a collar like band of stratified squamous nonkeratinizing epithelium without rete pegs
Junctional Epithelium
112
formed by the union of the oral epithelium and the reduced enamel epithelium during tooth eruption
Junctional Epithelium
113
Different types of cells present in the connective tissue
Fibroblast
Mast cells
Macrophage
Neutrophilic Granulocytes Lymphocytes
Plasma cells
114
predominant CT cell (65%)
fibroblast
115
engaged in the production of various types of fibers found in the CT, but is also instrumental in the synthesis of the CT matrix
fibroblast
116
cell that is responsible for the host defense mechanism
mast cells
117
produces vasoactive substances which can affect the function of the microvascular system and control the flow of blood through the tissue.
mast cells
118
has phagocytic and synthetic functions
macrophage
119
phagocytose foreign bodies/chemicals
macrophage
120
numerous in inflamed tissues
macrophage
121
derived from circulating blood monocytes
macrophage
122
also called polymorphonuclear leukocytes
Neutrophilic Granulocytes
123
scarce in normal tissue/gingiva
Neutrophilic Granulocytes
124
influence the behavior of the overlying epithelium by releasing of cytokines
Lymphocytes and plasma cells
125
dependent on the nature and duration of injury
Lymphocytes and plasma cells
126
Types of Connective Tissue Fibers
Collagen Fibers
Reticulin Fibers
Oxytalan Fibers
Elastic Fibers
127
most essential component of the periodontium
Collagen Fibers
128
are cells which also possess the ability to produce collagen.
cementoblasts and osteoblasts
129
CT fibers located near the blood vessels
Reticulin Fibers
130
CT fibers located in the apical region
Oxytalan fibers
131
CT fibers that are scarce in the gingiva but numerous in the periodontal ligament
Oxytalan fibers
132
CT fibers that are only present in association with blood vessels.
Elastic fibers
133
Major Collagen Fiber Groups
Circular Fibers
Dentogingival Fibers
Dentoperiosteal Fibers
Transseptal Fibers
134
collagen fiber group that encircles neck of root
Circular Fibers
135
collagen fiber group that maintains the position of the free gingiva
Circular Fibers
136
collagen fiber group that is embedded in the cementum and projects out/towards the free gingiva.
Dentogingival Fibers
137
collagen fiber group that is embedded in the cementum and projects towards the periosteum of alveolar bone
Dentoperiosteal Fibers
138
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
Transseptal Fibers
139
prominent in the dentogingival and dento periosteal fibers.
Gingival Groove
140
aka gingival crevicular fluid (GCF) or sulcular fluid
Gingival Fluid
141
contains antibodies, immunoglobulins, plasma cells, and PMNs.
Gingival Fluid
142
this isbincreased in the presence of gingival inflammation
Gingival Fluid
143
Gingival Fluid is believed to
-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
CT that surrounds the root and connects it to the bone
PDL
145
has the shape of an hourglass and is narrowest at the mid root level.
PDL
146
width of the PDL
approximately 0.25mm
147
this distributes the force elicited during mastication. and is essential for mobility of the teeth.
PDL
148
Principal Fibers of the Periodontal Ligament
Alveolar Crest Fibers
Horizontal Fibers
Oblique Fibers
Apical Fibers
Interradicular Fibers
149
PDL fibers that extend obliquely from the cementum just beneath the junctional epithelium to the alveolar crest
Alveolar Crest Fibers
150
PDL fibers that prevent extrusion of the tooth and resists lateral tooth movement
Alveolar Crest Fibers
151
PDL fibers that extend at right angles to the long axis of the tooth from the cementum to the alveolar bone
Horizontal Fibers
152
largest group of fibers in the periodontal ligament
oblique fibers
153
PDL fibers that extends from the cementum in a coronal direction OBLIQUELY to the bone.
oblique fibers
154
PDL fibers that bear the impact of masticatory stresses and transform them in a tension on the alveolar bone.
oblique fibers
155
PDL fibers that radiate in an irregular fashion from the cementum to the bone at the APICAL region of the socket.
apical fibers
156
these PDL fibers - do not occur on incompletely formed roots
apical fibers
157
PDL fibers that cementum FAN OUT from the to the tooth in furcation areas of multi rooted teeth.
Interradicular Fibers
158
these are TERMINAL portions of the principal fibers that insert into cementum and bone.
sharpey’s fibers
159
specialized mineralized tissue covering the root surfaces and occasionally, small portions of the crown of the teeth.
cementum
160
has no blood or lymph vessels, no innervation, does not undergo physiologic resorption or remodeling.
cementum
161
characterized by continuous deposition throughout life and attaches the periodontal ligament fibers to the root.
cementum
162
cementum can be
acellular and cellular
163
does not contain any cell (collagen fibrils or cementocytes) in
its matrix
Acellular, afibrillar cementum
164
coronal cementum
Acellular, afibrillar cementum
165
with well-defined, type I collagen fibrils (part of Sharpey’s fibers)
Acellular, extrinsic fiber cementum
166
found in coronal 2/3 of the root and connects the tooth with the alveolar bone proper
Acellular, extrinsic fiber cementum
167
primary cementum
Acellular, extrinsic fiber cementum
168
found in apical 1/3 of root and in the furcations
cellular cementum
169
Secondary cementum
cellular cementum
170
cementum forming cells
cementoblasts
171
cementoblasts trapped in the cementum matrix
cementocytes
172
parts of the maxilla and the mandible that form and support the sockets of the teeth.
alveolar bone
173
alveolar bone is composed of
1. cortical bone
2. alveolar bone proper
174
compact bone
cortical bone
175
part of the alveolar bone that covers the alveolus.
cortical bone
176
appears on the radiograph as the lamina dura
cortical bone
177
spongy bone
alveolar bone proper
178
has many lacunae active for blood forming
alveolar bone proper
179
appears on the radiograph as meshwork
alveolar bone proper
180
bone FORMING cells
osteoBLASTS
181
giant cells specialized in the BREAKDOWN of mineralized matrix (bone, dentin, cementum)
osteoCLASTS
182
stellate shaped cells that are trapped within the mineralized bone matrix and participates in the blood calcium homeostasis
osteocytes
183
when the bone at the coronal portion of the root is MISSING.
dehiscence
184
an area of DENUDED bone, surrounded by an intact bone
Fenestration
185
in dehiscence and fenestration the root is covered only by
periodontal ligament and the overlying gingiva.
