Classic Lit CONCEPTS Flashcards
What are the tissues that comprise the periodontium?
Gingiva
PDL
Root cementum
Alveolar bone proper
What are the different parts of the gingiva?
Free (marginal) gingiva
Attached Gingiva
Interdental gingiva
Describe the location of the Free (marginal) gingiva
The marginal gingiva extends from the gingival margin to the gingival groove
Is the free gingival groove always present? Provide evidence.
No. According to Ainamo and Loe 1966 it is present in 1/3 of normal gingiva
Histologically, why is the free gingival groove present? According to who?
When present, epithelium overlying the free gingival groove lacks support from underlying collagen fiber bundles as they transition from Free to Attached gingiva. It is most frequently present in the vestibular aspects of mandibular incisors and premolars (Lindhe 1983)
How can you identify the MucoGingival Junction?
Visualization
Roll technique
Schiller iodine solution
What are the demarcations of the attached gingiva?
Apically - the mucogingival junction
Coronally - the apical portion of the sulcus/pocket
Describe the attached gingiva
It is the portion of the gingiva that is tightly bound to the underlying periosteum, bone, and tooth. It may be stippled in about 40% of patients
Name 1 early sign of gingival inflammation
According to Green 1962, loss of stippling is the earliest sign of inflammation
What is stippling? Why is it there?
The orange peel appearance to the gingiva. It is “most likely connective tissue papillae projecting into the epithelium” (Karring and Loe 1970)
How do you measure Attached Gingiva? (calculation and clinical identification)
KG - PD
Visual assessment (AG is coral pink and less red than mucosa)
Schiller iodine - mucosa is glycogen + and gets stained
Roll technique - no elastic fibers in attached gingiva
How can we measure thickness of free/attached gingiva clinically? (according to?)
Malpartida-Arillo et al. 2020
1) Autopsy evaluation
2) Transgingival probing
3) Ultrasound
4) Calipers (surgical required)
5) Probe visibility (TRAN)
Kan 2010 - =1mm - visible probe | >1mm - non-visible probe
Rasperini 2015
Thin-blue/green/white
medium-blue/green
thick-blue
very thick-none
6) xray with gutta percha point
Is there a minimum amount of KG necessary?
Debatable -
Those who say “no, if good hygiene”: Cortellini and Bissada 2018, Wennstrom and Lindhe 1983
Those who say “yes…. just yes”: Lang and Loe 1972 (original - 2mm), Stetler and Bissada 1987 (in presence of sub-g resto <2mm vs >2mm)
Cook et al. 2011
Thin periodontal biotype was significantly related to thinner labial plate thickness (50%) increased distance from CEJ to alveolar crest, and narrow KG width
What 2 ways can a probe identify gingival thickness? (citation)
Ken et al. 2010 - =1mm (thin - visible probe), >1mm (thick - probe not visible) Rasperini et al. 2015 Thin-blue/green/white medium-blue/green thick-blue very thick-none
