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PATIENT CARE III > anatomy of the periodontium > Flashcards

anatomy of the periodontium Flashcards

1
Q

specialized connective tissue that provides support needed to maintain teeth in function

A

periodontium

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2
Q

periodontium 4 structures

A

gingiva
cementum
periodontal ligaments
alveolar bone

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3
Q

oral mucosa consists of 3 zones

A
  1. gingiva and 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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4
Q

masticatory mucosa that covers alveolar bone and tooth root coronal to the cementoenamel junction (CEJ)

A

gingiva

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5
Q

the gingiva is divided into 3 parts

A
  1. marginal gingiva
  2. attached gingiva
  3. interdental areas
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6
Q

free, collar-like tissue surrounding the teeth on facial, lingual, and interproximal surfaces

A

marginal gingiva/unattached gingiva

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7
Q

marginal gingiva/unattached gingiva epithelium type:

A

nonkeratinized epithelium [on the inner side]

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8
Q

most coronal portion of the gingiva.
scalloped outline of teeth.
about 1mm wide and forms the soft-tissue wall of the gingival sulcus

A

gingival margin

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9
Q

the shallow, natural space around a tooth bounded by the surface of the tooth on one side and epithelial lining the free margin on the gingiva on the other side

A

gingival sulcus
1-3mm for healthly

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10
Q

what time of epithelium is the sulcular epithelium

A

nonkeratinized

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11
Q

what are the boundaries of the gingival sulcus

A

sulcular epithelium and the tooth

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12
Q

occupies the gingival embrasure space between two adjacent teeth (inter-proximal space beneath area of tooth contact).

attached to the tooth by the JE and connective tissue fibers

A

interdental gingiva (papilla)
*part of free gingiva

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13
Q

valley-like depression of the interproximal contact areas.
connects lingual and buccal interdental papilla

A

the gingiva col

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14
Q

what is absent when teeth are not in contact

A

the col

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15
Q

what type of epithelium is the col which is susceptible to inflammation and disease progression

A

non-keratinized

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16
Q

divides free gingiva from attach gingiva.
shallow depression.
found only in 50% of patients.

A

free gingival groove

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17
Q

what type of epithelium is the gingival groove

A

keratinized

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18
Q

continuous with marginal gingiva; firm, resilient, tightly bound to underlying periosteum of alveolar bone

A

attached gingiva

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19
Q

what kind of epithelium is the attached gingiva

A

keratinized

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20
Q

what width varies with attached gingiva and where is the widest area located
and narrowest

A

1-9mm
widest area in facial aspect of max central incisors
narrowest in mand premolar facial areas

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21
Q

visible line where the pink keratinized gingiva meets the more vascular alveolar mucosa

A

mucogingival junction (MGJ)

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22
Q

movable tissue, loosely attached to underlying alveolar bone. thin, soft and darker shade of red than gingiva due to RICH blood supply (vascularization)

A

alveolar mucosa

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23
Q

what type of epithelium is alveolar mucosa

A

nonkeratinized

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24
Q

the gingiva is composed of _________epithelium and _____ tissue

A

stratified squamous epithelium and connective tissue

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25
Q

which is more cellular in nature and which is less cellular/mostly composed of collagen fibers and ground substances

[connective tissue vs epithelium]

A

epithelium is mostly cellular
connective tissue is less cellular

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26
Q

name 4 functions of the gingival epithelium

A
  1. physical barrier to infection
  2. helps respond to infection in signaling host response
  3. protection of deep structures
  4. allows selective interchange with oral environment
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27
Q

covers the crest and outer surface of marginal gingiva and the surface of attached gingiva

A

oral (outer) epithelium

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28
Q

how thick is the oral (outer) epithelium

A

0.2-0.3 mm

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29
Q

what type of epithelium is the oral (outer) epithelium

A

parakeratinized
then turns into keratinized

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30
Q

what 4 layers is the oral (outer) epithelium composed of

A

basal layer
prickle cell layer
granular layer
cornified layer

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31
Q

lines the gingival sulcus.
extends from the coronal limit of the junctional epithelium to the crest of the gingiva margin

A

sulcular epithelium

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32
Q

what type of epithelium is sulcular epithelium

A

nonkeratinized
thin
without rete pegs

33
Q

this is extremely important in that it may act as a semipermeable membrane through which injurious bacterial products pass into the gingiva and seeps into the sulcus

A

sulcular epithelium

34
Q

epithelium surrounding and attaching to the tooth on one side, and the gingival connective tissue on the other side.
base of the sulcus/pocket

A

junctional epithelium

35
Q

what type of epithelium is the junctional epithelium

A

nonkeratinized

36
Q

length of the junctional epithelium

A

0.25-1.35 mm

37
Q

which is more permeable to cells and fluid

junctional epithelium or sulcular epithelium

A

junctional epithelium

38
Q

serves as route of passage of fluids and cells from the connective tissue into the sulcus for bacteria/bacterial products from sulcus to connective tissue

A

junctional epithelium

39
Q

connective tissue of the marginal gingiva is densely collagenous and contains a prominent system of collagen fiber bundles called:

A

gingival fibers

40
Q

what type of collagen are the gingival fibers

A

type I collagen

41
Q

what functions do the gingival fibers have

A
  1. brace marginal gingiva against tooth
  2. provide rigidity to withstand mastication
  3. unite free marginal gingiva with cementum of root and adjacent attached gingiva
42
Q

5 gingival fiber groups

A
  1. dentogingival fibers
  2. alveolagingival fibers
  3. circumferential fibers
  4. dentoperiosteal fibers
  5. transseptal fibers
43
Q

gingival fibers that are embedded in the cementum between the CEJ and crest of alveolar bone; fan outward into the attached and free gingiva; attach gingiva to the tooth apical to the epithelial attachment

A

dentogingival fibers

44
Q

gingival fibers that are inserted in crest of alveolar process and splay out through lamina propria into the free gingiva

A

alveologingival fibers

45
Q

encircle each tooth in a cufflike fashion within the free gingiva

A

circumferential fibers

46
Q

embedded in the same portion of the cementum as the dentogingival fibers, but extend apically over the alveolar crest after passing through the lamina propria and the periosteum

A

dentoperiosteal fibers

47
Q

embedded in the same portion of the cementum as the dentogingival and dentoperiosteal fibers; run a horizontal path from adjacent teeth

A

transseptal fibers

48
Q

color of marginal and attached gingiva in health

A

coral pink

49
Q

how does smoking affect the peridontium

A

-causes vasoconstriction affecting body’s natural defense system against infection
-leaves gingival tissue FIRM and FIBROTIC due to decreased blood flow and limits delivery of oxygen and nutrients to epithelium

50
Q

composed of a complex vascular and highly cellular connective tissue that surrounds the tooth root and connects it to the inner wall of the alveolar bone.

it diminishes around teeth that are not in function/ unerupted teeth, but increases in teeth that are hyperfunction

A

PDL

51
Q

most important elements of the PDL and arranged in bundles of 6 groups.
located in peridontal space between cementum and bone.
composed of connective tissue cells and intracellular substance

A

periodontal/principle fibers

52
Q

the periodontal/principle fibers are inserted in the cementum on one side and bone on the other which are called

A

sharpey’s fibers

53
Q

physical functions of PDL

A
  1. casing that protects vessels and nerves
  2. transmission of occlusal forces to bone
  3. attachment
  4. resistance to impact of occlusal forces (like shock absorption)
54
Q

this supplies nutrients to cementum, bone, and gingiva by way of blood vessels; also provides lymphatic drainage

A

PDL

55
Q

PDL is abudantly supplied with sensory nerve fibers that are capable of transmitting tactile, pressure, and pain sensations via the what pathways

A

trigeminal pathways

56
Q

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

A

apical fibers

57
Q

principle fiber group from the root above the apical fibers obliquely toward the occlusal to resist vertical and unexpected strong forces

A

oblique fibers

58
Q

principle fiber group that extends interproximally over the alveolar bone crest and are embedded in the cementum of adjacent teeth

A

transseptal fibers

59
Q

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

A

horizontal fibers

60
Q

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

A

alveolar crest fibers

61
Q

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

A

interradicular fibers

62
Q

calcified, avascular mesenchymal tissue covering the roots of the teeth

A

cementum

63
Q

least mineralized of the calcified tissues of the tooth

A

cementum

64
Q

what are the 2 types of cementum

A

acellular(primary) and cellular(secondary)

consisting of a calcified interfibrillar matrix and collagen fibrils

65
Q

what is the function of the cementum

A

to attach fibers of the pdl to the tooth (like cement) to seal the tubules of the root dentin

66
Q

what is the first cementum formed

A

acellular cementum

67
Q

which cementum contains cells and which does not?
name of cells?

A

cellular contains cells called CEMENTOCYTES in individual lacunas which communicate via canaliculi

acellular cementum does not contain cells

68
Q

when are acellular and cellular cementum formed

A

acellular formed before tooth reaches occlusal plane

cellular forms after tooth reaches occlusal plane [deposited throughout life of tooth]

69
Q

local abnormal thickening of parts of the cementum

A

hypercementosis

70
Q

where is hypercementosis usually found?
what is it seen as a result of?

A

found apically
result of chronic inflammation of tooth, no opposing tooth, additional eruption, tooth becoming fused to surrounding alveolar bone

71
Q

most common CEJ cases
[rank them]

A

60% of cases are cementum overlapping enamel

then end to end 30%

10% space exposing dentin

72
Q

bone that forms and supports the alveoli (tooth sockets); tooth dependent-structures

A

alveolar process

73
Q

when does the alveolar process form?
describe its progression

A

when the tooth erupts to provide osseous attachment to forming PDL; disappears gradually after tooth is lost

74
Q

the alveolar process consists of an external plate of cortical bone formed by

A

haversian bone and compacted bone lamellae

75
Q

the inner socket wall of thin compact bone of the alveolar process is called the:
contains holes for neurovascular bundles to link PDL with cancellous bone

A

alveolar bone proper

76
Q

alveolar bone consists of _____ inorganic matter and ____ organic matrix

A

2/3 inorganic
1/3 organic

77
Q

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

A

melanin

78
Q

melanin is presented in all people but can be absent/severely diminished in:
and prominent in:

A

absent: albinos
prominent: dark skin tones

79
Q

how does melanin pigmentation variation from normal (WNL)

A

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

PATIENT CARE III (7 decks)

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