Anatomy Of The Periodontium Flashcards by Alex Ko Kam

Are specialized tissues that surround and support the teeth snd implants

Periodontium

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Four principal components of periodontium

Gingiva
Periodontal ligament
Cementum
Alveolar bone

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Part of the oral masticatory mucosa that covers the alveolar bone to a level just coronal to the CEJ

Gingiva

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It serves as a protection and barrier to the entry of microbial, chemical and mechanical noxious agents into the underlying tissues

Gingiva

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Undergoes constant renewal of damaged cells

Gingiva

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3 parts of the gingiva

Attached gingiva
Marginal gingiva
Interdental gingiva

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Occupies the gingival embrasure or interproximal spaces between tooth contact

Interdental gingiva

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A gingiva that extends in the apical direction tothe mucogingival junction where it becomes continuouswith the alveolar mucosa

Attached gingiva

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A gingiva that extends at the vestibular andlingual/palatal aspects of the teeth and in the interdental space which constitutes the peak of interdental papillae.

Marginal gingiva (free gingiva)

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Epithelial lining of gingiva

Stratified squamous epithelium

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Principal cell type and predominant cell in the epithelium of the gingiva and its function

Keratinocytes

For protection, barrier and repair

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Nonkeratinocyte cells in the gingival

Melanocytes
Langerhans cells
Merkel cells

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Pigment synthesizing cell that are specialized in producing melanin

Melanocytes

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A nonkeratinized cell of the gingiva that are derived from neural crest cell

Melanocytes

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Melanocytes produced as granules called?

Melanosomes

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A nonkeratinized dendritic cell of the gingiva

Langerhans cells

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Function of langerhans cells

Responsible for the defense mechanism during infection

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Responsible for the defense mechanism during infection

Langerhans cells

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Langerhans cells contain large granules called?

Birbeck granules

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A nonkeratinized cell of the gingiva that provides sensory function

Merkel cells

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Composed primarily of collagen fibers and ground substance

Connective tissue of the gingiva

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Predominant cells of the gingiva for development, maintenance and regeneration

Fibroblast

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Gingival connective tissue aka as

Lamina propria

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Two layers of laminate propria

Papillary layer and a reticular layer

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Lamina propria consists of??

60% collagen fiber bundle 55 cellular element that is the fibroblast 35% blood vessels, lymph nerves and matrix

Gingiva that has both cellular and extracellular components

Gingival connective tissue

Epitheelium covering the gingiva is diffeentiated into:

Oral epithelim - faces the oral cavity Sulcular epithelium - lines the marginal groove Junctional epithelium - provides contact between the gingiva and tooth

Epithelial lining of the oral epithelium

Stratified squamous keratinized epithelium

It covers the crest and other surface of the marginal gingiva and the surface of the attached gingiva

Oral epithelium

Average thickness of the oral epithelium

0.2-0.3mm

Layers of the oral eithelium

Stratum basale Stratum spinosum Stratum granulosum Stratum corneum

A type of oral epithelial lining that its nuclei are lost in the epithelium

Orthokeratinized epithelium

A type of oral epithelial lining that its nuclei are lost in the epithelium

Orthokeratinized epithelium

A type of oral epithelial lining that its superficial cells i.e. the cell of the stratum corneum are dead but retains the nucleus

Parakeratinized epithelium

A type of oral epithelial lining that has neither granulosum nor corneum strata. Superficial cell have viable nuclei

Nonkeratinized epithelium

A stratified squamous nonkeratinizing epithelium lining the gingival sulcus

Sulcular epithelium

An epithelium of the gingiva that acts as a semipermeable membrane

Sulcular epithelium

A stratified squamous nonkeratinizing epithelium that surround the tooth like a collar and it faces both the gingival connective tissue and tooth surface

Junctional epithelium

Function: - Support the free gingival firmly against the tooth - Reinforce the junctional epithelium - Provide rigidity to withstand forces of mastication - Connect the free gingiva with cementum and alveolar bone

Gingival fiber

Biologic width for natural tooth is __mm

2.04mm

Junctional epithelium __mm

0.97mm

Connective tissue attachment __mm

1.07mm

These are connective tissues that surround the root and connect it to the bone

Periodontal ligament

A component of the gingiva that is cellular in nature

Stratified squamous epithelium

A componentof a gingiva that is less cellular

Connective tissue

Divided into two layers and has both cellular and extracellular compnents

Lamina propria or gingival connective tissue

It is continuous with the connective tissue of the gingiva and communicate in the marrow spaces through the vascular channels of the bone

Periodontal ligament

3 functions of PDL

Physical Formative and remodeling Nutritional and sensory

What type of funciton in PDL 1. Soft tissue casing 2. Transmission of occlusal forces to the bone 3. Attachment of the teeth to the bone 4. Maintenance of gingival tissues 5. Resistance to the impact of occlusal forces

Physical

Most common cell in PDL that are ovoid and elongated

Fibroblasts

What are the types of connective tissue cells

1. Fibroblasts 2. Cementoblasts 3. Osteoblasts

Cellular elements of PDL

Connective tissue cells Epithelial rest cells Immune system cells

Ground substance of PDL

Glycosaminoglycans Glycoproteins

Hyalunoric acid Proteoglycans

Glycosaminoglycans

Fibronectin Laminin

Glycoproteins

What are the principal fiber group of PDL

Apical Oblique Horizontal Alveolar crest Transseptal Interradicular A O H A T I

Resist vertical forces

Apical

Most numerous, main resistance

Oblique

Resists lateral forces and tipping forces

Horizontal

Resists vertical and intrusive forces

Alveolar crest group

Resists tooth separation mesial and dista

Transseptal

Resists vertical and lateral movement

Interradiular

There are terminal portions of the principal fibers that are inserted into cementum and bone

Sharpey’s fibers

These are small in diameter and appear to interface with the collagen bundles, supporting the collagen bundles and the blood vessel walls

Oxytalan fibers

Small, spherical or ovoid calcified mass embedded within or attached to the cementum layer on the root surface of a tooth, or lying free within the PDL

Cementicles

Calcified, avascular mesenchymal tissue that forms the outer covering of the anatomic root

Cementum

Two main types of cementum

Accelular (primary cementum) Cellular (secondary cementum)

A cementum that is first to be formed, it covers the cervical 3rd and half of the toor; formed before the tooth reaches the occlusal plane; anchors the PDL to the tooth

Accellular (primary cementum)

A cementum that covers the apical 3rd of the root; formed after the tooth reaches the occlusal plane; functions for adaptation and repair; consists of intrinsic fibers and cementocytes

Cellular (secondary cementum))

Cellular (secondary cementum) consists of?

Intrinsic fibers and cementocytes

Two main sources of collagen fiber in cementum are:

Sharpey’s fiber (extrinsic) Fibers that belong to the cementum matrix (intrinsic)

A collagen fiber in cementum that are formed by fibroblasts

Sharpey’s fiber (extrinsic)

A collagen fiber in cementum that are produced by cementoblasts

Fibers that belong to the cementum matrix (intrinsic)

Organic matrix of cementum

Mainly collagen and glycoproteins

Inorganic matrix of cemetum

Hydroxyapatite

Synthesize collagen and protein polysaccharides which make up the organic matrix of cementum

Cementoblasts

Resorption of cementocytes and repair

Cementoclasts

During the formationof cellular cementum, cementoblasts became entrapped within their ownmatrix due to rapid deposition are called __

Cementocytes

Seen in both acellular and cellular cementum but more prominent in acellular cementum Highly mineralized with less collagen and more ground substance

Incremental lines of salter

Generalized thickening of the cementum due to excessive force and systemic condition (paget’s disease)

Hypercementosis

Fusion of the cementum and alveolar bone with obliteration of the PDL due o chronic periapical infection, tooth replantation or occlusal trauma

Ankylosis