Anatomy of the Periodontium Flashcards
1
Q
Tissues of the Periodontium include:
A
- Gingiva
- Cementum
- Periodontal ligament
- Alveolar bone
2
Q
Oral mucosa consists of three zones, these include:
A
- The gingiva & covering of the hard palate (masticatory mucosa)
- Dorsum of the tongue (specialized mucosa)
- Oral mucous membrane lining remainder of oral cavity
3
Q
Oral mucosa of the gingiva & covering of the hard palate:
A
Masticatory mucosa
4
Q
Oral mucosa of the dorsum of the tongue:
A
Specialized mucosa
5
Q
Masticatory mucosa that covers alveolar bone and tooth root coronal to the CEJ:
A
Gingiva
6
Q
Gingiva is divided into what three categories:
A
- Marginal gingiva
- Attached gingiva
- Interdental areas
7
Q
Label the following image:
A
A) gingiva
B) Cementum
C) Periodontal ligamanet
D) Alveolar bone
8
Q
What is being pointed at in the following image?
A
Gingiva
9
Q
Label the following image:
A
A) much-gingival junction
B) attached gingiva
C) gingival margin
D) alveolar mucosa
E) vestibule
F) free gingiva
10
Q
Label the following image:
A
A) marginal gingiva
B) attached gingiva
C) mucosa
11
Q
Free, or unattached, cufflike tissue surrounding the teeth on facial, lingual, and inter proximal surfaces:
A
Marginal gingiva
12
Q
Marginal gingiva may be _____ or ____
A
Free or unattached
13
Q
Where is marginal gingiva located?
A
Surrounds teeth on facial, lingual and interproximal surfaces
14
Q
What is seen in the following image?
A
The gingival margin
15
Q
The most coronal portion of the gingiva; scalloped outline of teeth:
A
Gingival margin
16
Q
Space formed by tooth and sulcular epithelium (laterally) and the coronal end of the JE (apically):
A
Gingival sulcus
17
Q
What forms the space of the gingival sulcus laterally?
A
Tooth & sulcular epithelium
18
Q
What forms the space of the gingival sulcus apically?
A
the coronal end of the JE
19
Q
Sulcular measurements of ____ are considered WNL of gingival health
A
2-3mm
20
Q
What does the red box represent in the following image:
A
Free gingival groove
21
Q
Interdental gingiva may also be referred to as:
A
Papilla
22
Q
Interdental gingiva (papilla) is part of:
A
Free gingiva
23
Q
Occupies the interdental space (fills embrasure space apical to tooth contact):
A
Interdental gingiva
24
Q
The interdental gingiva (papilla) is attached to the tooth by the _____ and _____
A
JE & connective tissue fibers
25
What are the red arrows representing in the following image?
Interdental gingiva (papilla)
26
Valley-like depression of the interproximal contact areas:
The gingival col
27
The gingival col connects:
Lingual and buccal interdental papilla
28
When is the gingival col absent?
When the teeth are not in contact
29
The gingival col is comprised of:
Nonkeratinized epithelium
30
The gingival col is susceptible to ____ and ____
Inflammation; disease progression
31
Label the following image:
Gingival col
32
Gingiva that is attached to the alveolar bone and cementum by connective tissue fibers and epithelial attachment:
Attached gingiva
33
Attached gingiva is attached to the ___ & ___ by connective tissue fibers and epithelial attachment
alveolar bone & cementum
34
Boundary of attached gingiva are apically demarcated by:
Mucogingival junction (MGJ)
35
Boundary of attached gingiva are coronally demarcated by:
The base of the gingival sulcus
36
The width of attached gingiva varies from _____ to ____ mm
1 to 9mm
37
Attached gingiva is widest in the facial aspect of the _______ and narrowest in the facial areas of the _______
Maxillary central incisors; mandibular premolars
38
Where should attached gingiva NOT be measured?
On the palate
39
Any changes in the width of the attached gingiva results from changes at the _____ end
Coronal
40
Example of when their is a change in width of the attached gingiva at the coronal end:
Recession
41
What is the formula for measuring the attached gingiva?
Width of attached gingiva = Total width of gingiva - probing depth
42
What would the measurement of the attached gingiva be?
Total width of gingiva from the GM to the MGJ: 6 mm
Probing depth: 2 mm
4 mm
(6 mm - 2 mm = 4 mm)
43
What would the measurement of the attached gingiva be?
Total width of gingiva from the GM to the MGJ: 5 mm
Probing depth: 5 mm
0 mm
(5 mm - 5 mm = 0 mm)
44
Movable tissue, loosely attached to the underlying bone; separate from attached gingiva at the MGJ:
Alveolar mucosa
45
Describe the type of tissue that comprises the alveolar mucosa:
Thin, nonkeratinized epithelium
46
What color is the alveolar mucosa, why?
Darker shade of red than the gingiva; due to rich blood supply
47
What are the following images pointing to?
alveolar mucosa
48
Visible line where the pink keratinized gingiva meets the more vascular alveolar mucosa:
Mucogingival junction (MGJ)
49
Describe what the MGJ represents:
The division between where the gingiva meets the alveolar mucosa
50
The MGJ is found on the _____ and the _____ and _____ areas
maxillary facial; mandibular facial; lingual
51
Looking at the gingiva under a microscope, it is composed of ______ and _____
Stratified squamous epithelium; connective tissue
52
Looking at the gingiva under a microscope, the epithelium is mostly ____ in nature
Cellular
53
Looking at the gingiva under a microscope the connective tissue is less ____ and mostly composed of ____ and ____
Cellular; collagen fibers; ground substance
54
What are the four functions of the gingival epithelium?
1. Physical barrier of infection
2. Participate actively in responding to infection (signals host response)
3. Allows selective interchange with the oral environment
4. Protection of deep structures
55
Epithelium covering the free gingiva may be differentiated into: (3)
1. oral/outer epithelium
2. sulcular epithelium
3. junctional epithelium
56
Label the following categories of epithelium:
A) sulcular epithelium
B) junctional epithelium
C) oral epithelium
57
Nonkeratinized epithelium surrounding and attaching to the tooth on one side, and the gingival connective tissue on the other side:
Junctional epithelium
58
Junctional epithelium can be described as being found at the:
Base of sulcus/pocket
59
Serves as a route of passage of fluid and cells from connective tissue into the sulcus for bacteria/bacterial products from sulcus to connective tissue:
Junctional epithelium
60
The JE is more permeable to:
Cells and fluid
61
The JE serves as a route of passage of fluid and cells from ____ into the ___ for bacteria/bacterial cell products
Connective tissue into the sulcus
62
The junctional epithelium is easily penetrated by the periodontal probe, especially:
When gingiva is inflamed
63
What is the length of the junctional epithelium?
0.25-1.35 mm
64
Correlation of clinical and microscopic features:
1. color
2. size
3. contour
4. shape
5. consistency
6. surface texture
7. position
65
The gingiva (both attached/marginal) is generally _____ in color
Coral pink
66
Why is the gingiva (both attached/marginal) generally coral pink?
due to vascular supply and thickness/degree of keratinization and the presence of pigment-containing cells
67
Compared to individuals with dark-compexion & dark hair, the gingiva of blonde-haired individuals with fair complexions is:
Lighter in color
68
Alveolar muscosa can be described appearance-wise as:
1. Red
2. Smooth
3. Shiny
69
Why does the alveolar mucosa has a more red color compared to ginigva?
Epithelium is thinner and nonkeratinized & blood vessels are more numerous
70
_____ is responsible for normal pigmentation of the skin, gingiva and remainder of the oral mucous membrane
Melanin
71
Melanin is present in ______, but can be absent or severely diminished in _____
all people; albinos
72
Melanin pigmentation in the oral cavity is prominent in:
Black individuals
73
Appears as a diffuse, deep-purplish discoloration or as irregularly shaped brown and light-brown patches:
Melanin pigmentation
74
What can be seen in the following image?
Melanin pigmentation
75
Size of the gingiva corresponds with the:
Number of cellular/intercellular elements & vascular supply
76
What does a change in size of the gingiva indicate?
Gingival disease
77
Contour of the gingiva varies depending on:
The shape & alignment of teeth
78
Marginal gingiva follows a ____ outline
Scalloped
79
What does it mean to say that the "biotype varies" when discussing the contour gingiva?
thickness of the tissue varies
80
The shape of the ____ is governed by contour of proximal tooth surfaces, location, and shape of embrasures
Interdental gingiva
81
The shape of the interdental gingiva is governed by: (3)
1. contour of proximal tooth surfaces
2. location
3. shape of embrasures
82
The interdental papilla can appear _____ in form or ____ depending on location
pyramidal; flattened
83
Describe the consistency of gingiva:
Firm and resilient (except for the free margin)
84
What determines the firmness of attached gingiva?
What else contributes?
Collagen fibers; gingival fibers
85
Describe the surface texture of gingiva:
Gingiva presents as stippled
86
When is the stippling of the gingiva best viewed?
After drying the tissue
87
______ gingiva is stippled, _____ gingiva is NOT stippled
attached; marginal
88
Stippling is less prominent on ____ than ____ surfaces
Lingual; facial
89
Calcified connective tissue covering the roots of teeth:
Cementum
90
The least mineralized of the calcified tissues of teeth:
Cementum
91
What are the two types of cementum?
1. acellular (primary)
2. cellular (secondary)
92
The two types of cementum (both cellular and acellular) consist of ____ and ____.
Calcified interfibrillar matrix & collagen fibrils
93
What is the function of cementum?
To attach fibers of the PDL to the tooth (like cement) and to sea; the tubules of the root dentin
94
Functions to attach the fibers of the PDL to the tooth (like cement):
cementum
95
Functions to seal the tubules of the root dentin:
cementum
96
What is not present within cementum?
1. blood vessels
2. lymph vessels
97
Describe the deposition of cementum:
Continuously deposited in the apical area of the root throughout life
98
The first cementum formed:
Acellular cementum
99
Cementum formed after the tooth reaches the occlusal plane:
Cellular cementum
100
Cellular cementum is formed after:
The tooth reaches the occlusal plane
101
Cementum that covers approximately the cervical 1/3 or 1/2 the root:
Acellular cementum
102
Cementum that is less calcified:
Cellular cementum
103
Cementum that does not contain cells:
Acellular cementum
104
Cementum that is deposited throughout the life of the tooth:
Cellular cementum
105
Cementum that is formed before the tooth reaches the occlusal plane:
Acellular cementum
106
Acellular cementum is formed:
(when)
Before the tooth reaches the occlusal plane
107
Cementum deposited at intervals, producing arrest lines:
Cellular cementum
108
Because cellular cementum is deposited at intervals, this produces:
Arrest lines
109
Label the following diagram of the different types of cementum:
A) coronal cementum
B) radicular cementum
C) Acellular cementum
D) Cellular cementum
110
local abnormal thickening of parts of the cementum:
Hypercementosis
111
Hypercementosis is typically found at the ____ region
Apical
112
Hypercementosis may be seen as a result of: (4)
1. chronic inflammation of the tooth
2. no opposing tooth
3. additional eruption
4. tooth becoming fused to surrounding alveolar bone proper
113
This image shows a tooth with:
Hypercementosis
114
Understanding the relationship between the ____ and ____ is of clinical importance in scaling and root planing procedures
cementum; enamel junction
115
What are the three relationships involving the cementum that may exist at the CEJ:
1. space
2. end-to-end
3. overlap
116
If we classify someone as having "space" when referring to the CEJ, we are describing:
Space between the enamel and cementum with the dentin exposed
117
If we classify someone as having "end-to-end" when referring to the CEJ, we are describing:
Then enamel and cementum being edge-to-edge
118
If we classify someone as having "overlap" when referring to the CEJ, we are describing:
Cementum overlapping the enamel
119
List the prevalence of each CEJ relationship:
1. space
2. end-to-end
3. overlap
1. space = 10%
2. end-to-end = 30%
3. overlap = 60%
120
Label the CEJ relationship shown below:
Space
121
Label the CEJ relationship shown below:
End-to-End
122
Label the CEJ relationship shown below:
Overlap
123
Fibrous connective tissue surrounding and attaching roots of teeth to bone:
PDL
124
The PDL is located in the:
Periodontal space between cementum and bone
125
Located in the periodontal space between the cementum and bone:
PDL
126
The PDL is composed of:
Connective tissue cells & intracellular substance
127
Composed of connective tissue cells and intracellular substance:
PDL
128
The fibers inserted into the cementum on one side and bone on the other are called:
Sharpey's fibers
129
The functions of the periodontal ligament (PDL) include: (4)
1. supportive
2. formative
3. nutritive
4. sensory
130
What function of the PDL is being described below:
Anchors tooth to bone
Supportive
131
What function of the PDL is being described below:
Helps maintain biologic activity of bone and cementum
Formative
132
What function of the PDL is being described below:
Supplies nutrients and removes waste products via blood and lymph vessels
Nutritive
133
What function of the PDL is being described below:
Capable of transmitting tactile pressure and pain sensations
Sensory
134
Sharpey's fibers are the portion of the PDL that insert into bone and cementum and therefore contribute to the PDL's ____ function
Supportive
135
Portion of the PDL that insert into bone and cementum:
Sharpey's fibers
136
The PDL width can be seen only in:
Radiographs
137
PDL width depends on: (4)
1. age
2. stage of eruption
3. function of tooth
4. angle of film
138
The arrows in this image are pointing out:
PDL width
139
PDL fiber groups around the cervical area within the gingival tissues:
Gingival fiber groups
140
PDL fiber groups surrounding the root:
Principal fiber groups
141
What are the two main categories of PDL fiber groups?
1. gingival fiber groups
2. principal fiber groups
142
List the PDL fiber groups that are considered gingival fiber groups: (5)
1. dentogingival fibers
2. alveologingival fibers
3. circumferential fibers
4. dentoperiosteal fibers
5. transseptal fibers
143
List the PDL fiber groups that are considered principal fiber groups: (5)
1. apical fibers
2. oblique fibers
3. horizontal fibers
4. alveolar crest fibers
5. interradicular fibers
144
PDL fibers: free gingival:
dentogingival dibers
145
PDL fibers: attached gingival:
alveologingival fibers
146
PDL fibers: circular:
circumferential fibers
147
PDL fibres: alveolar crest:
dentoperiosteal fibers
148
PDL fibers from the cementum in the cervical region into the free gingiva to give support to the gingiva:
dentogingival fibers (free gingival)
149
PDL fibers from the alveolar crest into the free and attached gingival to provide support:
Alveologingival fibers (attached gingival)
150
PDL fibers that are continuous around the neck of the tooth to help maintain the tooth in position:
Circumferential fibers (circular)
151
PDL fibers from the cervical cementum over the alveolar crest to blend with fibers of the periosteum of the bone:
Dentoperiosteal fibers (alveolar crest)
152
PDL fibers from the cervical area of one tooth across to an adjacent tooth (on the mesial or distal only) to provide resistance to separation of teeth:
Transseptal fibers
153
Label the following types of PDL fibers and components:
a) circular group
b) dentogingival group
c) dentoperiosteal group
d) alveologingival group
e) alveolar bone
154
Label the following types of PDL fibers & components:
a) alveologingival fibers
b) dentogingival fibers
c) circumferential fibers
d) dentoperiosteal fibers
e) cementum
155
PDL fiber group from the root apex to adjacent surrounding bone to resist vertical forces:
Apical fibers
156
PDL fiber group from the root above the apical fibers obliquely towards the occlusal to resist vertical and unexpected strong forces:
Oblique fibers
157
PDL fiber group from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth:
Horizontal fibers
158
PDL fiber group from the alveolar crest to the cementum just below the CEJ to resist intrusive forces:
Alveolar crest fibers
159
PDL fiber group from cementum between the roots of multirooted teeth to the adjacent bone to resist vertical and lateral forces:
Interradicular fibers
160
Label the following image:
Purple: alveolar crest fibers
Blue: horizontal fibers
Red: interradicular fibers
Green: oblique fibers
Orange: apical fibers
161
Label the following PDL fiber groups:
Turquoise: interradicular group
Lime green: apical group
Sunshine yellow: oblique group
Citrus: horizontal group
Bloody murder: alveolar crest group
162
Bone that forms and supports the alveoli (tooth socket):
Alveolar bone (alveolar process)
163
Alveolar bone consists of:
Alveolar bone proper & supporting bone
164
Contour of the alveolar bone follows contour of the _____ and arrangement of the ____
CEJ; dentition
165
Bone that forms and supports the alveoli (tooth sockets):
Alveolar bone
166
Consists of alveolar bone proper and supporting bone:
Alveolar bone
167
Contour of the alveolar bone follows contour of the _____ and arrangement of the _____
CEJ; Dentition
168
Shape of the alveolar crest is generally parallel to the ______ of adjacent teeth
CEJ
169
The alveolar crest is approximately _____, apical to the CEJ
1.5-2
170
Compare the cortical plates of the mandible vs. maxilla
Cortical plates are usually thicker in the mandible than the maxilla
171
(True/False): Cortical plates are usually thicker in the maxilla than in the mandible
FALSE- usually thicker in the mandible than the maxilla
172
Think layer of bone that surrounds the root and gives attachment to the PDL:
Alveolar bone proper
173
What does the alveolar bone proper provide attachment for?
PDL
174
What is the alveolar bone proper termed in radiographic images?
Lamina dura
175
The alveolar bone proper may also be referred to as:
Cribiform plate
176
Portion of alveolar process that surrounds the alveolar bone proper and give support to the sockets:
supportive alveolar bone
177
Describe the type of bone comprising the supportive alveolar bone:
-compact (cortical)
-cancellous or trabecular (spongy)
178
