Applied anatomy of the Periodontium #3

Question 1

______ is how gingiva reaches final position.

Answer 1

Passive eruption

Question 2

What happens if passive eruption does not complete?

Answer 2

Probe depths will be deep

Question 3

How will inflamed tissue affect probe depths?

Answer 3

They make them inaccurate, b/c tissue is softer and will compress, increasing the probe depth.

Question 4

In health, the probe should penetrate to the _______.

Answer 4

Free gingival goove

Question 5

T or F, Periodontitis diagnoses is based on probe depths.

Answer 5

False! It is based on attachment loss!

Question 6

Is recession periodontitis?

Answer 6

No! b/c periodontitis must be induced by bacteria and involve bone loss.

Question 7

How can you diagnose periodontitis?

Answer 7

Must have multiple factors:
Bone loss (not enough by itself)
Inflammation
Plaque
Attachment loss (migration of JE down root)

Question 8

What is the Col?

Answer 8

The concavity formed by the contact of adjacent teeth on the interdental papilla. *Non keratinized b/c it is sheltered.

Question 9

How do you probe interproximally?

Answer 9

1. Find contact (contact area should determine probe angulation)
2. Use contact as guide and insert probe
3. Open angulation by 10 degrees measure

Question 10

T or F, Gingival attachment loss is much more common in narrow gingiva vs wide gingiva.

Answer 10

False, narrow and wide gingiva have equal resistance.

Question 11

What are some of the problems with the thin gingiva phenotype?

Answer 11

• increased recession
• more vulnerable to trauma
• more inflammation
• less favorable outcome with treatments (root coverage, GTR…)

Question 12

When would you recommend gingival grafts?

Answer 12

1. When recession causes symptoms (caries, esthetics, sensitivity)
2. Subgingival restoration margins on thin phenotype.
3. Pre-orthodontic therapy (final tooth position will be buccal)

Question 13

Is tissue differentiation in the adult organism influenced by environmental or genetic factors?

Answer 13

The characteristics of gingiva are genetically determined rather than being environmentally determined.

Question 14

______ determines epithelial characteristics.

Answer 14

Connective tissue *this is why we use CT grafts!

Question 15

Is there pocketing with necrosis of Junctional epithelium?

Answer 15

No, because cells die!

Question 16

What should the connective tissue attachment width be?

Answer 16

1.06-1.08mm

Question 17

What should the Epithelial tissue attachment width be?

Answer 17

1.4mm

Question 18

Distance from CEJ to alveolar crest should be ________.

Answer 18

2mm (biological width, if anything foreign encroaches on this space bone will begin to resorb)

Question 19

What needs to happen if you have less than 2mm between crown margin and alveolar ridge?

Answer 19

Crown lengthening (cut gums open and reduce bone down)

Question 20

What are the steps in healing after tooth extraction?

Answer 20

1. clot formation
2. Wound formation
3. New vasculature, mesenchymal cells form granulation tissue.
4. Provisional connective tissue
5. Immature bone forms
6. Bundle bone is resorbed
7. Wound filled with woven bone
8. Bone Maturation

Question 21

Why is socket preservation important?

Answer 21

for preserving bone morphology (implants)

Question 22

______ grows faster than bone or connective tissue.

Answer 22

Epithelial tissues