Dr. Muroff - Trip Down the Root

Question 1

4 histologic zones in periodontal disease

Answer 1

• Zone of infection
• Zone of contamination
• Zone of irritation
• Zone of stimulation

Question 2

Define zone of infection

Answer 2

Microorganisms and PMNs replace normal cells

Question 3

Define zone of contamination

Answer 3

Toxins of dead cells and bacteria - plasma cells and lymphocytes replace most normal cells

Question 4

Define zone of irritation

Answer 4

Histiocytes & osteocytes predominate to distance source from rest of tissue - some normal cells remain > open gap to prevent wide-spread necrosis

Question 5

Define zone of stimulation

Answer 5

Toxins attenuated to stimulate fibroblasts & osteoblasts to wall off source of irritation and form new bone

Question 6

Color of healthy gingiva

Answer 6

Pale pink but racial pigmentation variation possible - clearly define from redder A.M.

Question 7

Density of healthy gingiva

Answer 7

Firm, tough, matte, non-shiny, stippled

Question 8

Crevice depth of healthy gingiva

Answer 8

1 - 3 mm

Question 9

Form of healthy gingiva

Answer 9

• Surface contour reflects bone contour
• Root prominence
• Interproximal depression apical to papilla = gingival festooning

Question 10

3 gingival components

Answer 10

• Marginal (free) gingiva
• Attached gingiva
• Gingival papilla

Question 11

Define the marginal (free) gingiva

Answer 11

Parabolic curve under greatest cervical contour of tooth - to protect and maintain thin knife-like gingival margin - not bound to underlying bone

Question 12

Criteria for attached gingiva

Answer 12

Must be wide enough to adequately separate free gingiva from alveolar mucosa

Question 13

Describe the gingival papilla

Answer 13

Fills interproximal area - margin follows CEJ meeting margin of adjacent tooth apical to contact. Tip more coronal than facial and lingual gingival margins

Question 14

Number of central peaks of anterior gingival papilla

Answer 14

1

Question 15

Number of peaks in posterior gingival papilla

Answer 15

2 peaks joined by concave knife edge = col. Due to more convez proximal contour and larger contact

Question 16

Location of earliest gingival inflammation

Answer 16

The Col

Question 17

Describe the histology of the col

Answer 17

Connective tissue of col covered only by thin layer of junctional epithelium (odontogenic epithelium) for some time after eruption, before being replaced by more protective oral E. from buccal and lingual peaks