applied anatomy Flashcards
what is the keratinized gingiva
The attached gingiva+ the marginal gingiva
what kinda of gingiva is found beyond the mucogingival jucntion
Unkeratinized gingiva
how to find the width of attached gingiva
measure from gingival margin to mucogingival junction
subtract probe deapth from this
what is used to diagnosis of periodontisis
based on attachment loss, NOT probe depths
how to calculate attachment loss
Pocket depth+ gingival recession
how does Soft tissue attach to the tooth
via fibrous tissue and via junctional epithelium
what is the connective tissue attachment
1.06-1.08mm
what is the epithelial attachment
1.4mm
what should the distance from CEJ to alveolar crest be
2mm
what should you do if the distance from crown margin to alveolar crest is less than 2mm
Crown lengthening
what was the initial thinking to create recession
width of keratiniezed tissue less than 2mm
problem with narrow gingiva
Cannot protect from friction
cannot buffer against muscle pull
facilitates subgingival plaque formation
what does narrow gingiva facilitate subgingival plaque formation
Mobile tissue causes pocket to open
Facilitates food impaction
Impedes oral hygiene
why does the gingiva move down
Via bone resorption witch in turn pulls down the connective tissue that supports the gingiva
what is recession described as when the gingival margin is coronal to CEJ
NEgative recession
what happens if you violate the biologic width
leads to lots of inflammation
what is modern ideal concerning gingival health in association with its dimensio
Gingival health can be maintained indepedent of its dimensions
what has more resistance to attachment loss, narrow or wide gingiva
Both equal
what receeds more thick or thin gingiva
Thin more
what is more vulnerable to trauma, thick or thin gingiva
Thin more
what is more vulnerable to inflammation, thick or thin gingiva
Thin
what has less favorable tratment outcomes, thick or thin gingiva
Thin
why would you receommend gingival grafts
When recession causes symptoms
Subgingival restoration margins on thin biotype
Pre-ortho therapy
gingival grafts for when recession causes symptoms
Caries
Esthetic Concerns
Progressive recession
Sensitivity
what determines the characterisitics of the gingiva
Geneticall determined rather than being the result of functional adaptation to environmental stimul
what interaction is important for gingiva growth
Epithelial mesenchymal interactions
how did we think gigniva became keratinized early on
In response to friction
How do we now think gingiva becomes keratinized
Connective tissue determines epithelial characteristics
why did we originally do coronally advanced flaps
Keratinized epithelium converted to firm attached gingiva and eptihlium directs new eptihlium
now what do we do to graft gingiva
Connective tissue grafts
early gingival grafts
free gingival grafts
Coronaly advanced flaps
what happens if you develop antibodies to the basement membrane
basememnt membrane goes away
you blister since epithlium goes away
what do the cells of the alveolar bone come from
Cells from the dental follicle
Cells independent of tooth development
what makes up the alveolar bone
CAncellous bone
Cortical bone
Marrow
what is found in the bone marrow of alveolar bone
Adipocytes
Vascular structures
Undifferentiated mesenchymal cels
why does the alveolar bone remodel
In response to forces and tooth movement
what forms the cortical plate of the alveolar bone
The cortical bone
how does healing occur after extraction
Cloting Wound cleaning New vasculature Provision connective tissue Immature bone Bundle bone (Socket proper is resorbed Woven bone maturation of bone
what does wound cleaning after an extraction
PMNs, monocytes, macrophages
what forms the granulation tissue after an extraction
Mesenchymal cells from the PDL
why preseve a socket
for bone morphology in the case of an implant
what normally happens in the healing of bone
Pulls socket togeher
how to preseve asocket
Fill with bone granules
where are fibroblasts of the PDL
along principle fibers
where are osteoblasts of the pdl
Line bone surface
where are cementoblasts of the PDL
Line cemntal surface
what is the principle of guided tissue regnetation
epithlium grows faster than bone or connective tissue
what does epithelial exclusion allow
Selective growth of connective tissue cells
how to do guided tissue regeneration
Fill with bone chips
keep chips in with barrier membrane
epithlium flows over membrane and bone replaces the bone chips
