Anatomy - Final Test Questions Flashcards
What describes the periodontal ligament
It is a soft tissue structure that atatched the tooth to the bone
What type of tissue primary makes up the periodontal ligament
connective tissue
What cells is most directly involved in forming cementum
cementoblasts
Primary function of cementum is to
Protect the the dentin and anchor the tooth
What is the primary mineral component of alveolar bone?
Hydroxyaptite
Cementum is the most simlar in composition to?
Dentin
The alveolar bone is
The portion of the jawbown that supports and anchors teeth
In response to forces like chewing which structure helps maintain stabitlity and position of tooth?
Periodontal Ligamanet
Which term describes the type of bone removing that occurs in the alvolar bone in response to tooth movement
Bone resoprtion and deposition
The area used most during the masticatory/chewing of food?
masticory mucosa
The mucous membrane found in the regions of the taste buds on the dorsum of the tongue?
specalized mucosa
Covers the inner surfaces of the lips, cheeks, the
floor of the mouth, the underside of the tongue, the soft palate, and the alveolar mucosa.
lining mucosa
A thin layer of calcified connective tissue that
covers the tooth from the CEJ to and around the
apical foramen?
Cementum
- Occupies the interproximal area between 2 adjacent teeth in health?
interdental pappillae
- The crevice or space between the free gingiva and the tooth?
gingival sulucs
A shallow linear groove that demarcates the free
gingiva from the attached gingiva?
Free gingival groove
The enamel originates from the…
Ectoderm - the most outer layer
The main mineral component of mature enamel is…
Calcium Hydroxyapatite
Odontoblasts are cells that produce…
Dentin
Secondary dentin is formed…
After eruption due to normal occlusal forces
Blood and lymphatic vessels can be found in the..
pulp
What is not a part of the periodontium?
Dentin
These periodontal fibers DO NOT insert into the alveolar bone
Gingival fibers
These periodontal fibers resist forces placed on the long axis of the tooth
Oblique Fibers
This major salivary gland produces the most of the saliva volume in our oral cavity
Submandibular
The alveolar bone is highly vascular - true or false?
True
An Articulation is…
An area of the skeleton where the bones are joined together
The external auditory meatus can be found on which bones?
Temporal bones
The incisive foramen can be found on the…
Hard palate
Which are the 2 types of momvents of the TMJ?
Hinge and Glide
The 3 bony parts of the TMJ are
The glenoid fossa, articular eminence, and the condyloid process
The muscles of mastication include the
Masseter, temporal, medial pterygoid, lateral pterygoid
This muscle elevates the tounge, arches the tongue against the soft palate and depresses the soft plalate torwarrds the tongue
Palataoglossus
The single bone that forms the back and base of the cranium is the _____ bone.
Occipital bone
The sagittal suture is located at the ______ of the cranium.
Midline
The bones that contain the external auditory meatus or external opening to the ear are the _____ bones
Temporal
The large foramen that allows the spinal cord to pass through the cranium and connect with the brain stem is the:
Foramen Magnum
The term that refers to a projection or extension of bone is:
Process
The bones that form the prominence of the cheeks are the _________ bones.
Zygomatic
The hard palate is composed of the palatine bones and the __________ of the maxilla.
Horizontal Palatine Process
The nasal septum is formed by tissue extending between the vomer bone and the _________ bone.
Ethmoid
The area of the mandible commonly known as the chin, is the:
Mental Protuberance
The ridge of bone that supports the teeth on both the maxilla and mandible is called the:
Alveolar Process
The _________ foramen are located midway up the internal surface of the ramus of the mandible.
Mandibular
The __________ bone does not contain a paranasal sinus.
Temporal
The ______________ are the largest of the paranasal sinuses.
Maxillary
The only bone that does not articulate with another bone is the:
Hyoid
The area of the maxilla, distal to the dentition, is the:
Maxillary Tuberosity
The sagittal suture joins the..
Parietal bone
The meniscus of the temporomandibular joint is also known as the:
Articular disc
The portion of the mandible involved in the TMJ is the ____________ process.
Condyloid
The __________ is the area of the temporal bone that accommodates the process of the mandible.
Glenoid fossa
Which of the following ligaments associated with the TMJ is used to reinforce the capsule?
Temporomandibular ligament
What is the first phase of movement for the TMJ?
Rotational movement (hinge)
Forms the midline on the internal surface of mandible and provides points of muscle attachment
genial tubercles
Concave areas between the condyle and the coronoid process
mandibular notch
Articulates with the temporal bone, forming the moveable part of the TMJ
Condyle
Largest, stongest, and only moveable facial bone
Mandible
Projects vertically and backward from the body of the mandible
ramus
Forms a crest (on the external surface of the mandible) where the ramus joins the body of the mandible
external oblique ridge
Horizontal portion running from the anterior to lateral aspects of the mandible
Body of the mandible
Chin?
Mental protuberance
Forms the anterior border of the ramus and provides points of muscle attachment
coronoid process
Foramen below and between the first and second premolars
mental foramen
The ____________ of a muscle is the more fixed end, attached to the least movable
Origin
The muscle of mastication responsible for forceful elevation and retraction of the mandible, with an insertion on the coronoid process is the:
Temporal Muscle
The _________ pterygoid muscle has two separate origins and functions to move the mandible side to side.
External
The ____________ muscle extends laterally between left and right sides of the body of the mandible and forms the floor of the mouth.
Mylohyoid
The __________ group of muscles are responsible for elevation of the hyoid bone and depression of the mandible.
Suprahyoid
The muscle of facial expression originating on the alveolar process of both the maxilla and located on the inner surface of the cheek is the ________ muscle.
Buccinator muscle
The mentalis muscle:
Pushes up the lower tip
The _________ muscle draws the angles of the mouth up and back when smiling.
Zygomatic Major
The large, triangular muscle located at the back of the neck and shoulders is the ____________ muscle.
Trapezius Muscle
Skeletal muscles, responsible for body movements, are also known as _________ muscles.
Striated muscles
Muscle that flattens the cheek when contracted and positions food for chewing
Buccinator
Fan-shaped muscle that extends from the temporal bone to the mandible, supports the overall action of closing the lower jaw and ultimately closing the mouth
Temporalis
Extends from the corners of the mouth to the cheekbone; called the smiling muscle
Zygomaticus Major
Sphyincter muscle encircling the mouth; called the kissing muscle
Orbicularis oris
Paired muscles, one found on each side of the neck
Sternocleiudomastoid
A chewing muscle that closes the jaw by elevating the mandible
Masseter
A large flat triangular shaped muscle covering the back of the neck, shoulder, and clavicle; moves head backward and sideways turns the skull
Trapzieus
Raises the upper lip
Zygomaticus minor
Sheet like muscle that covers the anterolateral neck
Platsyma
Provides stability to the lower lip and allows it to pout, cause protrusion of the lower lip
Mentalis
Active during mastication and brings jaw forward (protrusion)
Lateral pterygoid
Long, narrow, muscles located in the front of the neck, located below the hyoid bone; depress the hyoid bone
Infrahyoid muscle group
The facial nerves are cranial nerves VI - True or False?
False - They are Cranial Nerves VII
The fifth (V) cranial nerves are the trigeminal nerves. True or False?
True
The nasopalatine nerve enters the oral cavity through the incisive papilla. True or False?
False - passes through the base of the skull through the foramen in the sphenoid bone and lies in a depression in the bone behind and below the eye
Access to the inferior alveolar nerve can be obtained through the mandibular and mental foramina. True or False?
True
The gingival tissues, lingual to the mandibular teeth, is innervated by the __________ nerve.
Lingual Nerve
The maxillary second bicuspids are innervated by the __________ nerve.
Middle Superior Alveolar Nerve
The tissue palatal to the maxillary molars is innervated by the ________ nerve.
Greater Palatine Nerve
The mucosa palatal to the maxillary incisors is innervated by the _________ nerve.
Nasopalatine Nerve
The mandibular molars are innervated by the __________ nerve.
Inferior Alveolar Nerve
The muscles of facial expression are innervated by the __________ nerves.
Facial Nerves
The injections for anesthesia of the inferior alveolar nerve are known as __________ injections.
Block
_____________ anesthesia requires the operator to anesthetize the teeth and all surrounding tissue.
Profound
The common carotid artery arises from the
_________ and subdivides into the
________ and ___________ carotid arteries
The common carotid artery arises from the
aorta and subdivides into the internal and external carotid arteries
To what does the internal carotid artery supply blood?
brain and eyes
To what does the external carotid provide blood?
face and mouth
Which branch of the mandibular division supplies the tongue?
Lingual branch
Which branch of the mandibular division
supplies the teeth?
IAN small Dental nerves
Which branch of the mandibular division
does not supply the tongue or teeth?
The mylohyoid nerve (also buccal for buccal mucosal by molars)
Cranial Nerve
Oh
Oh
Oh
To
Touch
And
Feel
Very
Green
Vegtables
A
H
Which artery supplies blood to the face and mouth?
External Carotid
Which artery supplies blood to the maxillary anterior teeth?
Anterior Superior Alveolar
- The oral cavity is primarily innervated by which of the following nerves?
Trigeminal (V)
- Which nerve innervates the maxillary first and
second premolars?
MSA
Which of the following arteries supplies the
maxillary posterior teeth?
Posterior superior alveolar artery
If a patient has permanent paralysis of the tongue
and lip after the extraction of a mandibular third
molar, which cranial nerve was damaged?
c) V – trigeminal
The trigeminal nerve subdivides into 3 main
divisions which are the:
Ophthalmic division, maxillary division,
mandibular division
A nerve block occurs..
when local anesthethic is deposited close to a main nerve trunk
The absense of all teeth is called…
Anodontia
Hyperdontia may also be known as …
supernumary teeth
The absense of one or more teeth is known as ..
Hypodontia
What is the name of the condition that has these
characteristics:
* Hereditary etiology
* Can affect all teeth of both the primary and permanent dentitions
* Teeth have very thin enamel that chips off or have no enamel at all – crowns are thus yellow
Ameologensis imperfecta
What is the difference between abrasion and recession?
Abrasion is the mechanical wearing away of tooth,
where as recession is the when the gingival tissue
wears away, exposing more of the tooth structure.
Characteristics of __________ include: * Changes that can vary from barely noticeable white spots in mild forms to staining and pitting in the more severe
forms. * Only occurs when younger children consume too much
______ from any source over long periods when teeth are developing under the gums
Dental Fluorisis
-Fluoride
Commonly missing tooth
Lateral incisors
Anodontia
Complete congenital absence of teeth
Mesiodens
A small supernumerary tooth that forms between the central incisors
Hypercementosis
Excessive cementum around the root of an erupted tooth
Gemination
Large single rooted tooth with one pulp canal
Dentinogenesis Imperfecta
Hereditary disorder that affects the dentin formation of both dentitions
Enamel Pearls
Enamel sphere on root
Dental fluorosis
A form of enamel hypocalcifucation
tubercles
a small enamel projection forming extra cusps
Dens in Dente
Enamel organ invaginated into the dental papilla
Macrodontia
Abnormally large teeth
Abrasion
Mechanical wearing away of the tooth
Which structure of the periodontium is primarily responsible for anchoring the tooth to the alveolar bone?
Periodontal ligament
What is the main function of the gingival fibers in the periodontium?
to attach the gingiva to the tooth and bone
In periodontal disease, loss of attachment primarily refers to:
breakdown of the gingival fibers and periodontal ligament
Sharpey’s fibers are embedded into which two structures of the periodontium?
cementum and alveolar bone
The zygomatic bone is commonly known as the
cheek bone
The suture that connects the parietal bones to the frontal bone is the
coronal suture
Which bone contains the external acoustic meatus?
temporal bone
Which of these muscle is known as the “smile” muscle
zygomaticus major
The platysma muscle is located in the:
Neck
The sternocleidomastoid muscle is involved in:
Neck fexion and rotation
Which muscle compresses the cheeks, as in blowing air?
Buccinator
The facial nerve is also known as cranial nerve:
VII (7)
The hypoglossal nerve (XII) controls:
Tongue Movement
Which cranial nerve provides sensory innervation to the face?
Trigeminal nerve (V)
Which condition is characterized by the presence of an extra tooth in the dental arch?
Hyperdontia
Which anomaly involves the union of two tooth germs resulting in a single large tooth and fewer teeth in the dentition?
Fusion
(Gemination typically has a notch in between the two teeth - and the right number of teeth)
Which tooth anomaly involves abnormal angulation or sharp bend in the root or crown?
Dilaceration
Which condition results in abnormal development of enamel due to a genetic mutation?
Amelogenesis imperfecta
Hutchinson’s incisors and Mulberry molars are dental anomalies associated with:
Congenital syphilis
Enamel loss due to mechanical wear, such as brushing with excessive force, is called:
Abrasion
Which of the following structures allows communication between the pulp and dentin?
Dentinal tubules
The pulp’s primary function is to:
provide sensory, nutritive, and reparative functions
Which division of the trigeminal nerve is responsible for providing sensory innervation to the maxillary teeth?
V2
Which branch of the mandibular nerve is typically anesthetized during an inferior alveolar nerve block?
inferior alveolar nerve (IAN)
Which branch of the maxillary nerve provides sensory innervation to the palatal tissues of the anterior teeth?
Nasopalatine Nerve
Which structure is located on the temporal bone anterior to the glenoid fossa of the jaw joint?
Articular eminence
- ___________ Lubricates the TMJ to make the movement smooth:
Synovial Fluid
Saliva from the submandibular gland enters the mouth through
Wharton’s Duct
The facial nerve VII (7) innervates:
Muscle of Facial Expressions
The third division of the trigeminal nerve is the ________ division
Mandibular
The mucosa of the hard palate adjacent to the maxillary anterior
teeth is innervated by the________ nerve
Nasopalatine
The posterior superior alveolar nerve innervates the
Maxillary Molars
The infraorbital foramen is located:
Below the orbit of the eyes
Which muscle of mastication is responsible for closing the jaw and
pulling the mandible to one side?
Medial pterygoid
The orbicularis oris muscle:
Closes and puckers the lips
Reparative dentin forms:
In response to trauma
The purpose of the gingival fibers is to:
Holds gingiva close to tooth
The 1.6 is innervated by the
Both PSA and MSA
The greater palatine nerve provides innervation to
The mucosa of the hard palate except lingual to the maxillary molars
Which nerve innervates the mandibular incisors?
Incisive Nerve
The temporal muscle is responsible for _________ of the mandible?
Elevation and retrusion
Which muscle forms the floor of the mouth?
Mylohyoid
The infrahyoid muscles are responsible for:
depressing the hyoid bone
The rod sheath…
covers the enamel rod & is acid resistant
- Which of the following terms refers to enamel:
Lines of Retzius, Lamellae and Tufts
ENAMEL SPINDLE IS NOT REFERING TO ENAMEL - IT IS REFERING TO DENTIN
The loss of enamel structure that occurs through chemical means
(via acid), and does not involve bacteria, is known as:
Erosion
Fibers of the PDL that become trapped in the developing cementum
and are responsible for attaching the PDL firmly to the tooth and
alveolar bone is:
Sharpey’s Fibers
Dentin that creates the wall of the dentinal tubule is:
Peritubular Dentin
The pulp is responsible for
Production of Secondary Dentin & Nourishment of the odontoblastic cell
The zone of pulp closest to the dentin is the:
Odontoblastic Layer
Which bone of the jaw consists of cancellous (or spongy) bone?
Trabecular bone
The excessive production of cellular cementum, which mainly occurs
at the apex or apices of the tooth, is called what?
Hypercementosis
This type of cementum can widen over time, and layers can be
added.
Cellular
Anodontia is:
Partial or complete absence of teeth
“The union of two adjacent tooth germs resulting in a large tooth with two pulp cavities” defines which tooth anomaly?
Fusion
An odontoma is:
A benign bone tumor ( can be compound or complex)
The wearing down of the incisal or occlusal surfaces from frictional contact is:
Attrition
The mechanical wearing away of tooth surface from toothbrushes or
abrasive agents is:
Abrasion (Recession will affect gingiva)
A v-shaped notch on the cervical third of a tooth usually as a result
of parafunctional habits is:
Abfraction
The chemical wearing away or dissolution of enamel is:
Erosion
A sialolith:
Is a salivary stone of the major salivary gland
A white patch that varies in appearance and texture that is commonly linked to chronic irritation or trauma is:
Leukoplakia
Varicella zoster and Herpes Zoster are the result of, or caused by:
A virus
Candida albicans is a type of:
Fungi
Atrophic candidiasis can be characterized by:
Smooth red patches (erythamatous)
An expression of the herpes simplex virus appearing on the eye is
known as:
Herpes conjunctivitis
Whitlow - is hands
Gingivostomatitis - gingiva palate
- What consists of both the supporting soft and hard dental tissue between the tooth and the alveolar process, as well as parts of the tooth and alveolar process?
Periodontium
What does enamel orignate from?
The Ectoderm
What is enamel formed by?
Ameloblasts
Is Enamel a living tissue?
Not a living tissue
-mature enamel does not contain cells that are capable of repair & regeneration
-no blood supply or nerves
Is Enamel Permeable?
Yes
- allows for the exchange of ions
-demineralization and remineralization
What is the hardest tissue in the body?
Enamel
What is enamel composed of?
composed of inorganic (mineral) and organic substances
appox. 96% inorganic materials and 1% organic materials and 3% water
Main mineral component of enamel?
-calcium hydoxyapatite
other minerals also present in smaller amounts:
-carbonate, magnesium, potassium, sodium & fluoride
Thickness of enamel?
0.2 to 2.6mm
-as thick as 2.6mm at cusps of molar teeth
- thinner at incisal edges
Enamel colour of primary teeth?
Whiter than permanent
-more opaque crystalline form
Enamel colour of permanent teeth?
yellowish-white to gray
reflects underlying dentin
What are Lines of Retzius?
Incremental lines - represent the deposition of enamel during the formation of a tooth
What are Hunter-Schreger bands?
Alternating light and dark bands - caused by enamel prisms changing direction
Enamel Rods are..
Enamel Rods (also known as enamel prisms) - crystalline structural unit of enamel, perpendicular to the surface of the tooth
What is Rod Sheath?
-covering of the enamel rod
-acid resistant (hardest enamel structure)
What is Inter-rod substance?
-the material between the keyhole shaped enamel rods
-like a cement or glue
What is Enamel Lamellae?
-Enamel lamellae are partially mineralized vertical sheets of enamel matrix that extend from the DEJ near the tooth’s cervix to the outer occlusal surface
What are Enamel tufts?
enamel tufts are noted as small, dark brushes with their bases near the DEJ
What are Enamel Spindles?
- they represent short dentinal tubules near the DEJ junction
- odontoblasts that crossed the basement membrane before it mineralized into the DEJ
-dentinal tubules become trapped during the appositional growth of enamel matrix, which becomes mineralized around them
What is Bruxism?
Grinding/clenching of teeth
Origin of Dentin?
Dental papilla > Mesenchyme cells
Is Dentin Living Tissue?
Yes - odontoblasts (dentin producing cells) are present throughout life of a tooth to continuously produce dentin
Dentin vs. Enamel?
Dentin is softer than enamel (less calcified)
Dentin is more flexible
Dentin is less mineralized - more radiolucent on a radiograph
What is the composition of dentin?
Inorganic subtance - 70%
Organic Substance (proteins) - 20%
Water - 10%
Is Dentin harder than bone?
- dentin is harder than bone & cementum
- resembles bone in physcal and chemical properties
Colour of Dentin?
clinical colour of a tooth - can be see through translucency of enamel
What is a dentinal tubule?
- long tube running from DEJ/DCJ to pulp
-least mineralized
-contains odontoblastic process (provides nutrients to dentin) - may play a role in pain sensation of a tooth
Arrangment of a Dentinal Tubule
- apex and cusp areas: Straight & perpendicular to DEJ/DCJ
- sides of tooth and top 1/2 of root: s-shaped
What is dentinal fluid?
- the extravascular fluid which appears on the surface of freshly cut dentin
What is dentinal fluid composed of?
composed mainly of cytoplasm from ondotoblastic process
What is the Odontoblastic Process?
long cellular extension of the cell inside the dentinal tubule
- still attached to the cell body of the ondotoblast in the pulp
What are the 5 types of dentin?
Peritubular Dentin - walls of the dentinal tubules
Intertubular dentin - between the tubules, bulk of dentin
Primary Dentin - dentin formed before eruption, forms the bulk of the tooth
Secondary Dentin - formed after eruption due to normal occlusal forces, protects the pulp
Tertiary (reparative) dentin - formed in response to trauma
Explain the development of pulp
- comes from dental papilla
Is pulp mineralized?
- it is the only non-mineralized tissue of a tooth and consists of blood vessels, lymp tissue and nerves
What are fibroblast cells?
- predominant type of cell in pulp
- mesenchymal cells which become fibroblasts
- are responsible for the formation of intercellular substance in the pulp
What are odontoblast cells?
Produces DENTIN
-only the cell body is in the pulp
-odontoblastic proces is in dentin
-originated from mesenchyme
What do hystocyte cells do?
-part of pulp’s defense mechanism - respond to injury
What are Korff’s Fibers?
- in intercellular substance
-fibrous substance - appears as coiled rope
-mostly functional role: forms dentin matrix
What do blood vessels and lymphatic vessels do in pulp?
- supply oxygen and nutrients and take away CO2 waste
- superior and inferior alveolar artery enter via apical foramen
Are there nerves in pulp?
Yes - V2 & V3 of Trigeminal nerve
What are denticles?
Pulp stones - mineralized bodies of irregular rounded shape
- have various shapes, size increases with age, free in soft tissue of pulp
What are diffuse mineralizations?
- known as “false pulp stones”
- diffuse calcifications
-small thin scatterings of calcified material
What are the Pulp Zones?
- Odontoblastic Zone - line outer pulpal wall, forms dentin
- Cell Free Zone - fewer cells but not 0, buffer area, movement area for other zones
- Cell Rich Zone - reservoir of undifferntiated cellls, new ondoblasts, defense cells
Functions of the Pulp
- Formative - in development of tissues
- Sensory Function - nerve fibers in pulp, sensation of pain
- Nutritive Function - nutrients delivered from blood stream
- Defense Function - inflammatory reaction - if damage or irritants to the pulp
- Vitality - keeps the tooth alive, or from enamel becoming brittle
What is Pulpitis?
When the pulp is injured by cavity prep through mechanical or chemical injury, and even by extensive caries or traumatic injury, it may undergo inflammation (which is pulpitis)
What can pulpitis cause?
Pulpitis can later cause a pulpal infection in the form of a periapical abscess or cyst in the surrounding periodontium, spreading by way of the apical foramen.
Types of Diseased Gingiva Papilla?
-Blunted
-Bulbous
- Cratering
-Festooned (exaggerated rolling)
-Clefts
-Rounded-rolled
What structures does the periodontium consist of?
- Cementum
-Periodontal Ligaments
-Alveolar Bone
-Gingiva (more of a minor role)
Function of the Cementum?
attaches the teeth to the alveolar process by anchoring the periodontal ligaments
What is the composition of cementum?
65% inorganic substance
23% organic substance (proteins)
12% water
What are the physical characteristics of Cementum?
-yellowish in colour, clinically looks like dentin
- 1 hair thick (16-60microns) in coronal half, thicker in the apical half (150-200 microns)
- may be removed by brushing, decays easily
What forms cementum?
Cementoblasts
What are Sharpey’s Fibers?
Ends of the fibers of the PDL that become trapped in the developing cementum
- attach the PDL fimrly to the tooth and suspend the tooth in the socket
The Formation of Cementum
- Forms in layers - cementoblasts in the PDL start at CEJ and move downward secreting a ground substance for the full length of the tooth
- 3 relationships with enamel and dentin
-Overlaps at enamel at CEJ (15%)
-Meets Enamel at CEJ (52%)
-Does not meet Enamel at CEJ (33%) - Acelllular cementum
-first layer of cementum deposited at the DCJ
-also considered primary cementum - Cellular Cementum
-secondary dentin
-apicial portion of tooth
-contains cementocytes
Main function of cementum?
-Anchors tooth to bony socket
-compensates for loss of enamel
- repairs damaged tooth root
What is the function of the Periodontal Ligaments?
the PDL is part of the periodontium that provides for the attachment of the teeth to the surrounding alveolar bone by way of the cementum
What does PDL form from?
Froms from the Dental Sac - process begins after cementum formation begins
What are cementicles?
Small calcified bodies in the PDL
Purpose of Gingival Fibers?
Holds gingiva close to tooth
Purpose of Transseptal Fibers?
ensures teeth remain in proper relationship to one another and support the interproximal gingiva
Purpose of Alveolar Crest Fibers?
Resists horizontal movements and maintain tooth in socket
Purpose of Horizontal Fibers?
resists horizontal (lateral) pressures applied to crown of tooth
Purpose of Oblique Fibers?
Resist forces placed on the long axis of the tooth
Purpose of Apical Fibers?
- prevent the tooth from tipping
-protect the blood, lymph and nerves supply to the tooth
Purpose of Interradicular Fibers?
stabalize tooth (resist tipping and tilting)
5 Functions of the PDL?
- Supportive - shock absorption
- Formative - throughout life, tension (pull) on PDL > cementum+bone formation
- Resorptive - Pressure on PDL > becomes narrower (think braces)
- Sensory - determines pressure and touch
- Nutritive - presence of blood vessels provide essential nutrients to area
Composition of Alveolar Bone?
Inorganic Substance - 60%
Organic Substance - 25%
Water - 15%
What does Alveolar Bone Process make up?
Makes up the lining of the tooth socket
What is the Lamina Dura?
part of the alveolar bone that is uniformially radiopaque
What is the Alveolar Crest?
the most cervical part of the alveolar bone
What is Cortical bone?
A plate of compact bone on both the facial and lingual surfaces of the alveolar process
What is the Trabecular/Spongy/Cancellous bone?
Consits of cancellous or spongy bone that is located between the alveolar bone and the plates of cortical bone
Three types of bone cells?
Osteoctyes - bone cells
Lacunae - “little spaces” where osteocytes are located
Canaliculi - “little canals” connect lacunae-to-lacunae
Two Bone connective tissue coverings?
Periosteum - tough connective tissue outside of bone
Endosteum - delicate connective tissue, inner surface of compact bone
What does new bone form from?
New bone forms from periosteum or endosteum
Which of the following best describes the periodontal
ligament (PDL)?
It is a soft tissue structure that attaches the tooth to the alveolar bone.
What type of tissue primarily makes up the
periodontal ligament?
Connective tissue
Which of the following cells is most directly
involved in forming the cementum?
Cementoblasts
The primary function of cementum is to:
Protect the root dentin and anchor the periodontal ligament
What is the primary mineral component of
alveolar bone?
Hydroxyapatite
Cementum is most similar in composition to
which other dental tissue?
Dentin
The alveolar bone is:
The portion of the jawbone that supports and
anchors teeth.
Which of the following is the main function of
alveolar bone?
To support teeth and anchor them in the jaw
Which structure provides nutrients to the
periodontal ligament?
Blood vessels in the alveolar bone
In response to forces like chewing, which structure helps maintain the stability and position
of the tooth?
Periodontal ligament
Which term describes the type of bone
remodeling that occurs in the alveolar bone in
response to tooth movement?
Bone resorption and deposition
How does cementum differ from enamel?
Cementum is softer and less mineralized than enamel.
The primary function of cementum is to
anchor:
Periodontal ligament fibers to the tooth.
Alveolar bone can be lost due to which of the following conditions?
Periodontitis
What is the mucous membrane?
It is the epithelial tissue that lines a body cavity that opens to the outside of the body
- rests on connective tissue layer
- seperated by a basement membrane
The area used most during the mastication of food:
covers the gingiva and hard palate?
Masticatory mucosa
The mucous membrane found in the regions of the
taste buds on the dorsum of the tongue?
Specialized mucosa
Covers the inner surfaces of the lips, cheeks, the
floor of the mouth, the underside of the tongue, the soft palate, and the alveolar mucosa.
Lining Mucosa
A thin layer of calcified connective tissue that
covers the tooth from the CEJ to and around the
apical foramen?
Cementum
- Occupies the interproximal area between 2 adjacent teeth in health?
Interdental papillae
The crevice of space between the free gingiva and the tooth?
Gingival Sulcus
A shallow linear groove that demarcates (outlines) the free gingiva from the attached gingiva?
Free gingival groove
What is a gland?
A gland is a structure that produces secretion necessary for normal body function
What is an exocrine gland?
A gland having a duct associated with it
What is a duct?
A duct is a passageway that allows the glandular secretion to be emptied directly into the location where the secretion is to be used
What is a endocrine gland?
a ductless gland with its secretions conveyed directly into the blood and then carried to some distant location to be used
Two types of saliva?
Serous - watery, mainly protein
Mucous - very thick, mainy carbohydrate
Three major salivary glands?
Parotid salivary gland (parotid duct/stensen’s duct)
Submandibular sailvary gland (Wharton’s duct)
Sublingual salivary gland (sublingual duct/bartholin’s duct)
How much saliva does Parotid Salivary Gland provide?
25%
How much saliva does Submandibular Salivary gland provide?
60 to 65%
How much saliva does sublingual salivary gland provide?
10%
What type of gland is the Thyroid gland??
It is the LARGEST endocrine gland (secretes hormones directly into the blood)
There are five groups of superficial lymph nodes in
the head
Occipital
Retroauricular
Anterior auricular
Superficial parotid
Facial nodes
What is articulation?
Is an area of the skeleton where the bones are joined to each other. They can be either movable or immovable.
What are sutures?
appear on the skull as “cracks”. Firm joining of two or more bones
What are joints?
is the moveable junction of two or more bones
What is a “process”?
Is an extension of a bone
What is a Meatus?
canal-like opening into a bone from outside of the body (external) as in the opening to the ear
Number of bones?
Cranium has a total of 8 bones
There are 14 facial bones
A total of 22 bones in the skull excluding ossicles in the inner ear
Frontal bone - paired or single?
Single
Parietal bone - paired or single?
Paired
Occipital bone - paired or single?
Single
Temporal bone - paired or single?
Paired
Sphenoid bone - - paired or single?
Single
Ethmoid bone - paired or single?
Single
What suture joints the parietal and occipital bones?
the lamboidal suture
What suture joins the frontal bone and the parietal bone?
the coronal suture
Spinal cord passes through…
the spinal cord passes through the foramen magnum of the occiptal bone
What does the sphenoid bone articulate with?
sphenoid articulates with the temporal bones and the frontal bone to form the back of the eye orbit
Maxilla bone - - paired or single?
paired
zygomatic bone - paired or single?
paired
palatine bone - paired or single?
paired
nasal bone - paired or single?
paired
lacrimal bone - - paired or single?
paired
inferior nasal conchae - paired or single?
paired
vomer bone - - paired or single?
single
mandible bone - - paired or single?
single
What forms the Zygomatic arch?
There is a temporal process of the Zygomatic bone (that projects backwards) articulates with the Zygomatic process of the temporal bone
What are nasal conchae formed from?
The ethmoid bone
What bone does not articulate with any other bone?
The hyoid bone
What is the hyoid bone an attachment point for?
The neck and tongue muscles
The three types of auditory ossicles?
- Stapes - stirrup
- Incus - anvil
- Malleus - hammer
The Mandible Bone is composed of three parts:
- Body
- Alveolar Process
- Ramus
What is the moveable bone of the skull?
Mandible
What are the largest of the paranasal sinuses?
The maxillary sinuses
Where are the frontal sinuses located?
within the forehead just above the eyes
Where are the ethmoid sinuses located?
separated from the orbital cavity by a very thin layer of bone
they are irregulary shaped air cells
Where are the sphenoid sinuses located?
on side of skull - close to the optic nerves
What are the functions of the sinuses?
- Lighten the skull bones
- Act as sound resonators
- Provide mucus for the nasal cavity
What is the TMJ?
The Temporomandibular Joint is a joint on each side of the head that allows for movement of the mandible for speech and mastication
3 bony parts of the TMJ?
-Glenoid fossa of the temporal bone
-Articular eminence of the temporal bone
-Condyloid process of the mandible
What is the Capsular Ligament?
a fibrous joint capsule completely encloses the TMJ
-wraps around the margin of the temporal bones articular eminence and articular fossa
- wraps around the circumference of the mandibular condyle
What is the Articular Space?
The area between capsular ligament and the surfaces of the glenoid fossa and condyle
What is the articular disc (meniscus)?
is a cushion of dense specialized connective tissue that divides the articular space into upper and lower compartments (compartments filled with synovial fluid - lubricates)
What are the movement types of the TMJ?
Hinge action - first phase of mouth opening, only lower compartment of the joint is used
Gliding movement - allows the lower jaw to move forward or backwards, involves both lower and upper compartments of joint, condyle and articular disc “glide” forward and downward along the articular eminence
What is protrusion?
Forward movement of the mandible
What is retrusion?
the backward movement of the mandible
How does lateral movement of the mandible occur?
when the internal and external pterygoid muscles on the same side of the face contract together
What is Subluxation?
When the jaw locks open
What are the 4 muscles of mastication?
Masseter
Temporal
Lateral (external) pterygoid
Medial (internal) pterygoid
What is the function of the Masseter muscle?
Raises the mandible and closes the jaw
What is the function of the Temporal Muscle?
Raises the mandible and closes the jaw
What is the function of the medial (internal) pterygoid?
Closes the jaw, elevates the mandible
What is the function of the lateral (external) pterygoid?
mandible side to side, bring jaw forward
Origin & Insertion of the Temporal Muscle?
Origin - Temporal fossa of temporal bone
Insertion - coronoid process and anterior border of mandibular ramus
Origin & Insertion of Masseter muscle?
Origin - Superficial part: lower border of zygomatic arch. Deep part: posterior and medial side of zygomatic arch
Insertion - Superficial part: angle and lower lateral side of mandibular ramus. Deep part: upper lateral ramus and mandibular coronoid process
Origin & Insertion of Internal (medial) pterygoid?
Origin: medial surface of lateral pterygoid plate of sphenoid bone, palatine bone, and tuberosity of maxillary bone
Insertion: into inner (medial) surface of ramus and angle of mandible
Origin & Insertion of External (lateral) pterygoid?
Origin: from two heads; upper head originates from greater wing of sphenoid bone
Insertion: Into neck of condyle of mandible and into articular disc of capsular ligament of TMJ
What muscles accomplish the opening of the mouth?
Hyoid Muscles - floor of the mouth
Two groups of hyoid muscles?
Suprahyoid (above)
Infrahyoid (below)
4 Mucles of the Floor of the Mouth (Suprahyoid)
- Digastric
- Mylohyoid
- Stylohyoid
- Geniohyoid
Purpose of the Digastric Muscle?
Elevation of the hyoid bone, as well as depression of the mandible
Purpose of the Stylohyoid Muscle?
Assists in swallowing by raising the hyoid bone
Purpose of the Mylohyoid muscle?
Forms the floor of the mouth (raises the tongue and depresses the lower jaw)
Purpose of the Geniohyoid muscle?
pulls the tongue and hyoid bone forward
Digastric Origin & Insertion?
Origin - anterior belly: lower border of the mandible. posterior belly: mastoid process of temporal bone
Insertion - Body and great horn of hyoid bone
Stylohyoid Origin & Insertion?
Origin: Styloid process of temporal bone
Insertion: Body of hyoid bone
Mylohyoid bone Origin & Insertion?
Origin: Left and right portions are joined at the midline; each portion originates on mylohyoid line of mandible
Insertion: body of hypid bone
Geniohyoid Origin & Insertion?
Origin: Medial (inner) surface of mandible, near symphysis
Insertion: Body of hyoid
4 Muscles of the Infrahyoid?
Depresses the hyoid bone:
Omohyoid Muscle
Stenohyoid Muscle
Thyrohyoid Muscle
Depresses the thyroid cartilage:
Sternothyroid muscle
4 Muscles of Facial Expression?
Orbicularis Oris
Buccinator
Mentalis
Zygomatic major
Purpose of the Orbicularis oris?
closes and puckers the lips
Purpose of the Buccinator?
Compressses the cheeks against the teeth and retracts the angle of the mouth
Purpose of the Mentalis?
Raises and wrinkles the skin of the chin and pushes the lower lip up
Purpose of the Zygomatic major?
Draws the angles of hte mouth upward and backward, as in laughing
Origin & Insertion of Obicularis Oris?
Origin: From muscle fibers around the mouth, no skeletal attachment
Insertion: into itself and surrounding skin
Origin and Insertion of Buccinator?
Origin: Posterior portion of alveolar process of maxillary bone and mandible
Insertion: Fibers of orbicularis oris, at angle of mouth
Origin & Insertion of Mentalis?
origin: incisive fossa of mandible
Insertion: Skin of chin
Origin & Insertion of Zygomatic Major?
Origin: Zygomatic bone
Insertion: Into fibers of orbicularis
3 Muscles of the Neck?
Platysma
Trapzeius
Sternocleidomastoid
What is the function of the Platysma muscle?
Grimacing
Raising the skin of the neck and pulling the corners of the mouth down
What is the function of the Trapezius muscle?
Lifts the clavicle and shoulder blade - as when the shoulders are shrugged
What is the function of the Sternocleidomastoid muscle?
If one side of the muscle is contracted, the head turns to that side
if both are contracted, the head will flex at the neck and move forward and down
Origin & Insertion of the Sternocleidomastoid?
Origin: Clavicle (collarbone) and lateral surfaces of sternum
insertion: Posterior and inferior to external acoustic meatus
Origin & Insertion of Trepezius?
Origin: External surface of occipital bone
Insertion: Lateral third of clavicle and parts of scapula
3 Extrinsic msucles of the tongue
Genioglossus - depresses and protrudes the tounge
Hyoglossus - retracts and pulls down the side of the tonge
Styloglossus - retracts the tongue
Origin & Insertion of Genioglossus?
Origin: Medial (inner) surface of mandible, near symphysis
Insertion: Hyoid bone and inferior (lower) surface of the tongue
Origin & Insertion of the Hyoglossus?
Origin: Body of hyoid bone
Insertion: Side of tongue
Origin & Insertion of Styloglossus?
Origin: Styloid process of temporal bone
Insertion: Side and undersurface of the tongue
2 Major Muscles of the Soft Palate?
Palatoglossus - elevates base of tongue, arching tongue against soft palate; depresses soft palate toward tongue
Palatopharyngeus - forms posterior pillar of fauces; serves to narrow fauces and helps shut off nasopharynx
Origin & Insertion of the Palatoglossus?
Origin: Anterior arch on each side of throat; arises from soft palate
Insertion: along posterior side of the tongue
Origin & Insertion of the Palatopharyngeal?
Origin: Posterior border of thyroid cartilage and connective tissue of pharynx
Insertion: Thyroid cartilage and wall of pharynx
The Major Arteries of the Face & Oral Cavity
Common carotid artery - arises from the aorta and subdivides into the internal and external carotid arteries
Internal carotid artery - supplies blood to the brain and eyes
External carotid artery -provides the major blood supply to the face and mouth
The External Carotid Artery branches into..
Facial artery
Lingual artery
Maxillary artery - Divides into the inferior alveolar, ptergyoid and pterygopalatine
Mandibular artery
What supplies blood to muscles of facial expression?
Branches and small arteries from maxillary, facial, and opthalmic arteries
What supplies blood to the maxilllary bones?
Anterior, middle, and posterior alveolar arteries
What supplies blood to the maxillary teeth?
Anterior, middle, and posterior alveolar arteries
What supplies blood to the mandible?
Inferior alveolar artieries
What supplies blood to the mandibular teeth?
Inferior alveolar arteries
What supplies blood to the tongue?
Lingual artery
What supplies blood to the muscles of mastication?
facial artieres
What are the major veins of the face and the oral cavity?
-Maxillary vein
-Retromandibular Vein
-External jugular vein
-Subclavian vein
-facial vein
-Common facial vein
-deep facial vein
-lingual veins
-internal jugular vein
How many pairs of cranial nerves?
12 pairs of cranial nerves - all connected to the brain
-both sensory & motor functions
What is Cranial Nerve V?
The Trigeminal Nerve
The 3 divisions of the Trigeminal Nerve?
- Opthalmic Division (V1)
- Maxillary Division (V2)
- Mandibular Division (V3)
The Maxillary Division supplies nerves to…
the maxillary teeth, periosteum, mucous membrane, maxillary sinuses & soft palate
The Maxillary Division subdivides into…
-nasopalatine nerve
-greater palatine nerve
-anterior superior alveolar nerve
-middle superior alveolar nerve
-posterior superior alveolar nerve
What nerve supplies the mesiobuccal root of the maxillary first molar?
The MSA Nerve
The Mandibular Nerve subdivides into….
-the buccal nerve
-the lingual nerve
-the inferior alveolar nerve
What nerve supplies the tounge?
The lingual nerve
Divisions of the Inferior Alveolar Nerve (IAN)?
Mylohyoid nerve - supplies the mylohyoid muscles
Small dental nerves - supply the molar, premolar alveolar process, periosteum
Mental Nerve - supplies chin and lower lip
Incisive nerve - supplies incisor teeth
What is the Facial Nerve?
Cranial Nerve VII
Is a mixed nerve - sensory portion concerned with taste; motor portion controls facial expression and secretion of tears & saliva
Difference between Maxillary Anesthesia vs. Mandibular?
Local anesthetic injection techniques differ from mandibular approaches because of the porous nature of the alveolar cancellous bone in the maxilla
Mandibluar bone is dense, compact
If a patient has permanent paralysis of the tongue and lip after the extraction of a mandibular third molar, which cranial nerve was damaged?
VII - Facial
The trigeminal nerve subdivides into 3 main
divisions which are the:
Ophthalmic division, maxillary division,
mandibular division
A nerve block occurs:
When local anesthetic is deposited close to a
main nerve trunk
What is an exostoses?
A benign bony growth projecting outward from the surface of a bone
What is Macrognathia?
An abnormally large jaw
What is micrognathia?
An abnormally small jaw
What is ankyloglossia?
Often called tongue-tied; results in a short lingual frenum that extends to the apex of the tongue
What stage of tooth development does abnormal number of teeth occur?
Initiation stage
Lack of initiation within the dental lamina
What is Anodontia?
Partial or complete absence of teeth
commonly include:
-permanent third molars
-maxillary lateral incisors
-mandibular second premolars
What is Hyperdontia?
supernumerary tooth/teeth
commonly found:
between permanent max incisors
distal to third molars
- is hereditary
What is Mesiodens?
- small extra central incisor that erupts between the two centrals
What stage of tooth development does abnormal size of teeth occur?
Bud stage of development
- Generally genetic with partial
- Endocrine dysfunction associated with complete
What is Macrodontia?
Abnormal increase in tooth size
What is Microdontia?
abnormally small teeth
- complete microdontia is rare (associated with downs syndrome)
-partial microdontia - hereditary factors involved - commonly affects the permanent max lateral insiors and perm third molars
What stage of development does abnormal shape of teeth occur?
Later stages of tooth development
- Cap & Maturation stages
-Proliferation & morphodiffentiation processes
What is Dens in Dente?
-enamel organ invaginates into the dental papillae
-happens during cap stage
-hereiditary
What is Gemination?
-The tooth germ tries to divide and develops a
large single-rooted tooth with one pulp cavity and
“twinning “ in the crown of anterior teeth
-The correct number of teeth will be present
- notch in incisal edge
- happens during cap stage
- hereditary
What is Fusion?
- union of two adjacent tooth germs, results in a large tooth with two pulp cavitites
- one fewer tooth in the dention
- common in anteriors in primary dention
-resulting during cap stage due to pressure
What is a Tubercle?
-small rounded enamel extension
- happens during cap stage
What is an Enamel Pearl?
- sphere of enamel on root
- happens during apposition & maturation stage
- due to displacement of ameloblasts to root surface
What is hypercementosis?
- excess deposition of cementum on root surfaces
- may cause concrescence
What is Concrescence?
- union of the root structure of two or more teeth by cementum
- common in max perm molars
- happens during apposition/maturation stage
- due to trauma / crowding
What is dilaceration?
results in a distorted root or severe crown angulation (caused by injury or pressure during development)
What is Flexion?
a deviation or bend restricted just to the root
What is accessory roots?
due to trauma, pressure, or metabolic disease that effects HERS (hertwig) during root development
What is Enamel Dysplasia?
-results from a reduction in the quantity of the enamel matrix
- teeth appear with pitting and intrinsic colour changes in the enamel
What is Amelogeneis Imperfecta?
-teeth have very thin enamel that chips off or have no enamel at all - crowns are thus yellow
What is Enamel Hypoplasia?
-pits and grooves
-lack of enamel
What is Turner’s Teeth?
Hypoplasia of the enamel involving a single permanent tooth
What tooth abnormalities are caused by congenital syphilis?
Hutchinson’s incisors - abnormally shaped permanent front teeth
Mulberry molars - a first molar tooth whose occlusal surface is pitted with nodules replacing the cusps
What is Dentin Dysplasia?
Faulty development of dentin
What is Dentinogenesis Imperfecta?
- results in blue-gray or brown teeth with an opalescent sheen
- enamel appears as usual but chips off due to lack of support from the abnormal underlying dentin
What is complex odontomas?
-when the calcified dental tissues are simply arranged in an irregular mass bearing no morphologic similarity to rudimentary teeth
What is compound odontomas?
composed of all odontogenic tissues in an orderly pattern that results in many teeth-like structures without morphologic resemblance to normal teeth
What is Ameloblastoma?
◦ A tumor composed of remnants of the dental lamina
What is premature eruption?
teeth are present at birth (natal teeth)
Neonatal teeth are those that erupt within the first 30 days of life
What is ankylosis?
bone has fused to cementum and dentin, preventing exfolation of primary teeth
What is an ulcer?
a defect or break in continuity of the mucosa that results in a punched-out area similar to a crater
What are Nodules?
may appear below the surface or may be slightly elevated, are small, round, solid lesions
- feels like a pea beneath surface
What is Cellulitis?
inflammation spreads through the soft tissue or organ
dangerous when in oral cavity because it can travel quickly to eyes or brain
What is Leukoplakia?
-means white patch
-uknown etiology by commonly linked to chronic irritation or trauma
What is a Ranula?
*usually caused by a sialolith or local trauma to the duct *saliva escapes into the connective tissue of the floor of the mouth
What is Glossitis?
- General term used to describe inflammation and
changes in the topography of the tongue
What is Black Hairy Tongue?
The filiform papillae are so greatly elongated that
they resemble hairs
What is Fissured Tongue?
The dorsal surface (top) of the tongue is marked
by having deep fissures or grooves, which become
irritated if food debris collects in them
What is Bifid Tongue?
tongue only partial fusion during tongue development resulting in split tongue
What is HIV Gingivitis?
There is often a bright red line along the border of
the free gingival margin
* Also known as atypical gingivitis(ATYP)
What is Cervical Lymphadenopathy?
Enlargement of the cervical (neck) nodes
Associated with AIDS
What is Lymphoma?
Lymphoma is the general term used to describe
malignant disorders of the lymphoid tissue
What is Kaposi Sarcoma
- One of the opportunistic infections that occurs in
patients with HIV infection - Lesions may appear as multiple bluish, blackish, or
reddish blotches that are usually flat in the early
stages
What is Cancer?
Cells in the mouth sometimes change and no longer grow or behave normally
- can also lead to non-cancerous tumours/warts
The most common precancerous conditions of the mouth?
Leukoplakia & erythroplakia
What is Erythroplakia?
is a flat or slightly raised, red area
that often bleeds easily if it is scraped.
What is Erythroleukoplakia?
is a patch with both red and white areas
Where does oral cancer often start?
in the flat, thin squamous cells
This type of cancer is called squamous cell
carcinoma of the mouth
What is Carcinoma?
Malignant neoplasm (growth) of the
epithelium (tissue lining the mouth)
What is Adenocarcinoma?
Malignant tumor that arises from the submucous glands underlying the oral mucosa
What is Sarcoma?
Malignant neoplasm arising from
supportive and connective tissue
What is Osteosarcoma?
Malignant tumor involving the bone
In the mouth, the affected bones are the bones of the jaws
What is Metastasize?
Cancer spreads to other regions of the body
* Oral cancer – usually spreads to the neck and
cervical lymph nodes
Etiology of Cancer?
- Exact etiology unknown
- Changes (mutations) to the DNA within cells - can
cause the cell to stop its normal function and may
allow a cell to become cancerous.
What are the dental implications of radiation therapy?
Xerostomia
Radiation caries
Osteoradionecrosis - bone may be subject to death
Symptoms of HPV-Related Head and
Neck Cancers?
- A sore, or soreness or irritation that doesn’t go away
- Red or white patches, or pain, tenderness, or numbness in mouth or lips
- Lumps, thickening tissues, rough spots, crusty oreroded areas
- Difficulty chewing, swallowing, speaking or moving your jaw or tongue
- A change in the way your teeth fit together when you close your mouth
