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Patient Care III > Anatomy of the Periodontium > Flashcards

Anatomy of the Periodontium Flashcards

1
Q

Tissues of the Periodontium include:

A
  1. Gingiva
  2. Cementum
  3. Periodontal ligament
  4. Alveolar bone
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2
Q

Oral mucosa consists of three zones, these include:

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

Oral mucosa of the gingiva & covering of the hard palate:

A

Masticatory mucosa

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4
Q

Oral mucosa of the dorsum of the tongue:

A

Specialized mucosa

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5
Q

Masticatory mucosa that covers alveolar bone and tooth root coronal to the CEJ:

A

Gingiva

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6
Q

Gingiva is divided into what three categories:

A
  1. Marginal gingiva
  2. Attached gingiva
  3. Interdental areas
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7
Q

Label the following image:

A

A) gingiva
B) Cementum
C) Periodontal ligamanet
D) Alveolar bone

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8
Q

What is being pointed at in the following image?

A

Gingiva

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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

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10
Q

Label the following image:

A

A) marginal gingiva
B) attached gingiva
C) mucosa

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11
Q

Free, or unattached, cufflike tissue surrounding the teeth on facial, lingual, and inter proximal surfaces:

A

Marginal gingiva

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12
Q

Marginal gingiva may be _____ or ____

A

Free or unattached

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13
Q

Where is marginal gingiva located?

A

Surrounds teeth on facial, lingual and interproximal surfaces

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14
Q

What is seen in the following image?

A

The gingival margin

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15
Q

The most coronal portion of the gingiva; scalloped outline of teeth:

A

Gingival margin

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16
Q

Space formed by tooth and sulcular epithelium (laterally) and the coronal end of the JE (apically):

A

Gingival sulcus

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17
Q

What forms the space of the gingival sulcus laterally?

A

Tooth & sulcular epithelium

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18
Q

What forms the space of the gingival sulcus apically?

A

the coronal end of the JE

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19
Q

Sulcular measurements of ____ are considered WNL of gingival health

A

2-3mm

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20
Q

What does the red box represent in the following image:

A

Free gingival groove

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21
Q

Interdental gingiva may also be referred to as:

A

Papilla

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22
Q

Interdental gingiva (papilla) is part of:

A

Free gingiva

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23
Q

Occupies the interdental space (fills embrasure space apical to tooth contact):

A

Interdental gingiva

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24
Q

The interdental gingiva (papilla) is attached to the tooth by the _____ and _____

A

JE & connective tissue fibers

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25
Q

What are the red arrows representing in the following image?

A

Interdental gingiva (papilla)

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26
Q

Valley-like depression of the interproximal contact areas:

A

The gingival col

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27
Q

The gingival col connects:

A

Lingual and buccal interdental papilla

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28
Q

When is the gingival col absent?

A

When the teeth are not in contact

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29
Q

The gingival col is comprised of:

A

Nonkeratinized epithelium

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30
Q

The gingival col is susceptible to ____ and ____

A

Inflammation; disease progression

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31
Q

Label the following image:

A

Gingival col

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32
Q

Gingiva that is attached to the alveolar bone and cementum by connective tissue fibers and epithelial attachment:

A

Attached gingiva

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33
Q

Attached gingiva is attached to the ___ & ___ by connective tissue fibers and epithelial attachment

A

alveolar bone & cementum

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34
Q

Boundary of attached gingiva are apically demarcated by:

A

Mucogingival junction (MGJ)

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35
Q

Boundary of attached gingiva are coronally demarcated by:

A

The base of the gingival sulcus

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36
Q

The width of attached gingiva varies from _____ to ____ mm

A

1 to 9mm

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37
Q

Attached gingiva is widest in the facial aspect of the _______ and narrowest in the facial areas of the _______

A

Maxillary central incisors; mandibular premolars

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38
Q

Where should attached gingiva NOT be measured?

A

On the palate

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39
Q

Any changes in the width of the attached gingiva results from changes at the _____ end

A

Coronal

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40
Q

Example of when their is a change in width of the attached gingiva at the coronal end:

A

Recession

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41
Q

What is the formula for measuring the attached gingiva?

A

Width of attached gingiva = Total width of gingiva - probing depth

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42
Q

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

A

4 mm

(6 mm - 2 mm = 4 mm)

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43
Q

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

A

0 mm

(5 mm - 5 mm = 0 mm)

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44
Q

Movable tissue, loosely attached to the underlying bone; separate from attached gingiva at the MGJ:

A

Alveolar mucosa

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45
Q

Describe the type of tissue that comprises the alveolar mucosa:

A

Thin, nonkeratinized epithelium

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46
Q

What color is the alveolar mucosa, why?

A

Darker shade of red than the gingiva; due to rich blood supply

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47
Q

What are the following images pointing to?

A

alveolar mucosa

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48
Q

Visible line where the pink keratinized gingiva meets the more vascular alveolar mucosa:

A

Mucogingival junction (MGJ)

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49
Q

Describe what the MGJ represents:

A

The division between where the gingiva meets the alveolar mucosa

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50
Q

The MGJ is found on the _____ and the _____ and _____ areas

A

maxillary facial; mandibular facial; lingual

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51
Q

Looking at the gingiva under a microscope, it is composed of ______ and _____

A

Stratified squamous epithelium; connective tissue

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52
Q

Looking at the gingiva under a microscope, the epithelium is mostly ____ in nature

A

Cellular

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53
Q

Looking at the gingiva under a microscope the connective tissue is less ____ and mostly composed of ____ and ____

A

Cellular; collagen fibers; ground substance

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54
Q

What are the four functions of the gingival epithelium?

A
  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
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55
Q

Epithelium covering the free gingiva may be differentiated into: (3)

A
  1. oral/outer epithelium
  2. sulcular epithelium
  3. junctional epithelium
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56
Q

Label the following categories of epithelium:

A

A) sulcular epithelium
B) junctional epithelium
C) oral epithelium

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57
Q

Nonkeratinized epithelium surrounding and attaching to the tooth on one side, and the gingival connective tissue on the other side:

A

Junctional epithelium

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58
Q

Junctional epithelium can be described as being found at the:

A

Base of sulcus/pocket

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59
Q

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:

A

Junctional epithelium

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60
Q

The JE is more permeable to:

A

Cells and fluid

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61
Q

The JE serves as a route of passage of fluid and cells from ____ into the ___ for bacteria/bacterial cell products

A

Connective tissue into the sulcus

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62
Q

The junctional epithelium is easily penetrated by the periodontal probe, especially:

A

When gingiva is inflamed

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63
Q

What is the length of the junctional epithelium?

A

0.25-1.35 mm

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64
Q

Correlation of clinical and microscopic features:

A
  1. color
  2. size
  3. contour
  4. shape
  5. consistency
  6. surface texture
  7. position
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65
Q

The gingiva (both attached/marginal) is generally _____ in color

A

Coral pink

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66
Q

Why is the gingiva (both attached/marginal) generally coral pink?

A

due to vascular supply and thickness/degree of keratinization and the presence of pigment-containing cells

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67
Q

Compared to individuals with dark-compexion & dark hair, the gingiva of blonde-haired individuals with fair complexions is:

A

Lighter in color

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68
Q

Alveolar muscosa can be described appearance-wise as:

A
  1. Red
  2. Smooth
  3. Shiny
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69
Q

Why does the alveolar mucosa has a more red color compared to ginigva?

A

Epithelium is thinner and nonkeratinized & blood vessels are more numerous

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70
Q

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

A

Melanin

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71
Q

Melanin is present in ______, but can be absent or severely diminished in _____

A

all people; albinos

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72
Q

Melanin pigmentation in the oral cavity is prominent in:

A

Black individuals

73
Q

Appears as a diffuse, deep-purplish discoloration or as irregularly shaped brown and light-brown patches:

A

Melanin pigmentation

74
Q

What can be seen in the following image?

A

Melanin pigmentation

75
Q

Size of the gingiva corresponds with the:

A

Number of cellular/intercellular elements & vascular supply

76
Q

What does a change in size of the gingiva indicate?

A

Gingival disease

77
Q

Contour of the gingiva varies depending on:

A

The shape & alignment of teeth

78
Q

Marginal gingiva follows a ____ outline

A

Scalloped

79
Q

What does it mean to say that the “biotype varies” when discussing the contour gingiva?

A

thickness of the tissue varies

80
Q

The shape of the ____ is governed by contour of proximal tooth surfaces, location, and shape of embrasures

A

Interdental gingiva

81
Q

The shape of the interdental gingiva is governed by: (3)

A
  1. contour of proximal tooth surfaces
  2. location
  3. shape of embrasures
82
Q

The interdental papilla can appear _____ in form or ____ depending on location

A

pyramidal; flattened

83
Q

Describe the consistency of gingiva:

A

Firm and resilient (except for the free margin)

84
Q

What determines the firmness of attached gingiva?
What else contributes?

A

Collagen fibers; gingival fibers

85
Q

Describe the surface texture of gingiva:

A

Gingiva presents as stippled

86
Q

When is the stippling of the gingiva best viewed?

A

After drying the tissue

87
Q

______ gingiva is stippled, _____ gingiva is NOT stippled

A

attached; marginal

88
Q

Stippling is less prominent on ____ than ____ surfaces

A

Lingual; facial

89
Q

Calcified connective tissue covering the roots of teeth:

A

Cementum

90
Q

The least mineralized of the calcified tissues of teeth:

A

Cementum

91
Q

What are the two types of cementum?

A
  1. acellular (primary)
  2. cellular (secondary)
92
Q

The two types of cementum (both cellular and acellular) consist of ____ and ____.

A

Calcified interfibrillar matrix & collagen fibrils

93
Q

What is the function of cementum?

A

To attach fibers of the PDL to the tooth (like cement) and to sea; the tubules of the root dentin

94
Q

Functions to attach the fibers of the PDL to the tooth (like cement):

A

cementum

95
Q

Functions to seal the tubules of the root dentin:

A

cementum

96
Q

What is not present within cementum?

A
  1. blood vessels
  2. lymph vessels
97
Q

Describe the deposition of cementum:

A

Continuously deposited in the apical area of the root throughout life

98
Q

The first cementum formed:

A

Acellular cementum

99
Q

Cementum formed after the tooth reaches the occlusal plane:

A

Cellular cementum

100
Q

Cellular cementum is formed after:

A

The tooth reaches the occlusal plane

101
Q

Cementum that covers approximately the cervical 1/3 or 1/2 the root:

A

Acellular cementum

102
Q

Cementum that is less calcified:

A

Cellular cementum

103
Q

Cementum that does not contain cells:

A

Acellular cementum

104
Q

Cementum that is deposited throughout the life of the tooth:

A

Cellular cementum

105
Q

Cementum that is formed before the tooth reaches the occlusal plane:

A

Acellular cementum

106
Q

Acellular cementum is formed:

(when)

A

Before the tooth reaches the occlusal plane

107
Q

Cementum deposited at intervals, producing arrest lines:

A

Cellular cementum

108
Q

Because cellular cementum is deposited at intervals, this produces:

A

Arrest lines

109
Q

Label the following diagram of the different types of cementum:

A

A) coronal cementum
B) radicular cementum
C) Acellular cementum
D) Cellular cementum

110
Q

local abnormal thickening of parts of the cementum:

A

Hypercementosis

111
Q

Hypercementosis is typically found at the ____ region

A

Apical

112
Q

Hypercementosis may be seen as a result of: (4)

A
  1. chronic inflammation of the tooth
  2. no opposing tooth
  3. additional eruption
  4. tooth becoming fused to surrounding alveolar bone proper
113
Q

This image shows a tooth with:

A

Hypercementosis

114
Q

Understanding the relationship between the ____ and ____ is of clinical importance in scaling and root planing procedures

A

cementum; enamel junction

115
Q

What are the three relationships involving the cementum that may exist at the CEJ:

A
  1. space
  2. end-to-end
  3. overlap
116
Q

If we classify someone as having “space” when referring to the CEJ, we are describing:

A

Space between the enamel and cementum with the dentin exposed

117
Q

If we classify someone as having “end-to-end” when referring to the CEJ, we are describing:

A

Then enamel and cementum being edge-to-edge

118
Q

If we classify someone as having “overlap” when referring to the CEJ, we are describing:

A

Cementum overlapping the enamel

119
Q

List the prevalence of each CEJ relationship:

  1. space
  2. end-to-end
  3. overlap
A
  1. space = 10%
  2. end-to-end = 30%
  3. overlap = 60%
120
Q

Label the CEJ relationship shown below:

A

Space

121
Q

Label the CEJ relationship shown below:

A

End-to-End

122
Q

Label the CEJ relationship shown below:

A

Overlap

123
Q

Fibrous connective tissue surrounding and attaching roots of teeth to bone:

A

PDL

124
Q

The PDL is located in the:

A

Periodontal space between cementum and bone

125
Q

Located in the periodontal space between the cementum and bone:

A

PDL

126
Q

The PDL is composed of:

A

Connective tissue cells & intracellular substance

127
Q

Composed of connective tissue cells and intracellular substance:

A

PDL

128
Q

The fibers inserted into the cementum on one side and bone on the other are called:

A

Sharpey’s fibers

129
Q

The functions of the periodontal ligament (PDL) include: (4)

A
  1. supportive
  2. formative
  3. nutritive
  4. sensory
130
Q

What function of the PDL is being described below:

Anchors tooth to bone

A

Supportive

131
Q

What function of the PDL is being described below:

Helps maintain biologic activity of bone and cementum

A

Formative

132
Q

What function of the PDL is being described below:

Supplies nutrients and removes waste products via blood and lymph vessels

A

Nutritive

133
Q

What function of the PDL is being described below:

Capable of transmitting tactile pressure and pain sensations

A

Sensory

134
Q

Sharpey’s fibers are the portion of the PDL that insert into bone and cementum and therefore contribute to the PDL’s ____ function

A

Supportive

135
Q

Portion of the PDL that insert into bone and cementum:

A

Sharpey’s fibers

136
Q

The PDL width can be seen only in:

A

Radiographs

137
Q

PDL width depends on: (4)

A
  1. age
  2. stage of eruption
  3. function of tooth
  4. angle of film
138
Q

The arrows in this image are pointing out:

A

PDL width

139
Q

PDL fiber groups around the cervical area within the gingival tissues:

A

Gingival fiber groups

140
Q

PDL fiber groups surrounding the root:

A

Principal fiber groups

141
Q

What are the two main categories of PDL fiber groups?

A
  1. gingival fiber groups
  2. principal fiber groups
142
Q

List the PDL fiber groups that are considered gingival fiber groups: (5)

A
  1. dentogingival fibers
  2. alveologingival fibers
  3. circumferential fibers
  4. dentoperiosteal fibers
  5. transseptal fibers
143
Q

List the PDL fiber groups that are considered principal fiber groups: (5)

A
  1. apical fibers
  2. oblique fibers
  3. horizontal fibers
  4. alveolar crest fibers
  5. interradicular fibers
144
Q

PDL fibers: free gingival:

A

dentogingival dibers

145
Q

PDL fibers: attached gingival:

A

alveologingival fibers

146
Q

PDL fibers: circular:

A

circumferential fibers

147
Q

PDL fibres: alveolar crest:

A

dentoperiosteal fibers

148
Q

PDL fibers from the cementum in the cervical region into the free gingiva to give support to the gingiva:

A

dentogingival fibers (free gingival)

149
Q

PDL fibers from the alveolar crest into the free and attached gingival to provide support:

A

Alveologingival fibers (attached gingival)

150
Q

PDL fibers that are continuous around the neck of the tooth to help maintain the tooth in position:

A

Circumferential fibers (circular)

151
Q

PDL fibers from the cervical cementum over the alveolar crest to blend with fibers of the periosteum of the bone:

A

Dentoperiosteal fibers (alveolar crest)

152
Q

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:

A

Transseptal fibers

153
Q

Label the following types of PDL fibers and components:

A

a) circular group
b) dentogingival group
c) dentoperiosteal group
d) alveologingival group
e) alveolar bone

154
Q

Label the following types of PDL fibers & components:

A

a) alveologingival fibers
b) dentogingival fibers
c) circumferential fibers
d) dentoperiosteal fibers
e) cementum

155
Q

PDL fiber group from the root apex to adjacent surrounding bone to resist vertical forces:

A

Apical fibers

156
Q

PDL fiber group from the root above the apical fibers obliquely towards the occlusal to resist vertical and unexpected strong forces:

A

Oblique fibers

157
Q

PDL fiber group from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth:

A

Horizontal fibers

158
Q

PDL fiber group from the alveolar crest to the cementum just below the CEJ to resist intrusive forces:

A

Alveolar crest fibers

159
Q

PDL fiber group from cementum between the roots of multirooted teeth to the adjacent bone to resist vertical and lateral forces:

A

Interradicular fibers

160
Q

Label the following image:

A

Purple: alveolar crest fibers
Blue: horizontal fibers
Red: interradicular fibers
Green: oblique fibers
Orange: apical fibers

161
Q

Label the following PDL fiber groups:

A

Turquoise: interradicular group
Lime green: apical group
Sunshine yellow: oblique group
Citrus: horizontal group
Bloody murder: alveolar crest group

162
Q

Bone that forms and supports the alveoli (tooth socket):

A

Alveolar bone (alveolar process)

163
Q

Alveolar bone consists of:

A

Alveolar bone proper & supporting bone

164
Q

Contour of the alveolar bone follows contour of the _____ and arrangement of the ____

A

CEJ; dentition

165
Q

Bone that forms and supports the alveoli (tooth sockets):

A

Alveolar bone

166
Q

Consists of alveolar bone proper and supporting bone:

A

Alveolar bone

167
Q

Contour of the alveolar bone follows contour of the _____ and arrangement of the _____

A

CEJ; Dentition

168
Q

Shape of the alveolar crest is generally parallel to the ______ of adjacent teeth

A

CEJ

169
Q

The alveolar crest is approximately _____, apical to the CEJ

A

1.5-2

170
Q

Compare the cortical plates of the mandible vs. maxilla

A

Cortical plates are usually thicker in the mandible than the maxilla

171
Q

(True/False): Cortical plates are usually thicker in the maxilla than in the mandible

A

FALSE- usually thicker in the mandible than the maxilla

172
Q

Think layer of bone that surrounds the root and gives attachment to the PDL:

A

Alveolar bone proper

173
Q

What does the alveolar bone proper provide attachment for?

A

PDL

174
Q

What is the alveolar bone proper termed in radiographic images?

A

Lamina dura

175
Q

The alveolar bone proper may also be referred to as:

A

Cribiform plate

176
Q

Portion of alveolar process that surrounds the alveolar bone proper and give support to the sockets:

A

supportive alveolar bone

177
Q

Describe the type of bone comprising the supportive alveolar bone:

A

-compact (cortical)
-cancellous or trabecular (spongy)

178
Q
A

Patient Care III (19 decks)

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