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Oral Soft tissues > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Can bacteria alone cause PD

A

No, bacteria are ESSENTIAL but insufficient to cause disease

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2
Q

What host factors play a role in periodontitis?

A
  1. Heredity
  2. Environmental factors (smoking)
    - Equally important as bacteria in determining disease occurrence and severity of disease outcome
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3
Q

Bacteria and host factors (heredity, env. factors) are equally important in determining what two things?

A
  1. Disease occurrence

2. Severity of disease outcome

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4
Q

3 microbial risk factors to periodontitis

A
  1. Specific microorganism
  2. Total microbial burden
  3. Biofilm pathogenicity
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5
Q

System risk factors to periodontitis

A
  1. Diabetes
  2. Genetic factors
  3. Sex/race
  4. HIV
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6
Q

What is the most common form of PD?

A

Slight (mild) PD

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7
Q

What is important in diagnosing PD?

A

Clinical Attachment Loss

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8
Q

What are the tissues of the periodontium

A
  • Gingiva and alveolar mucosa

- Periodontal attachment apparatus (PDL, Cementum, Alveolar Bone)

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9
Q

T or F, The MGJ can recede along with periodontitis but cannot be restored

A

False, the MGJ does not change, that line is permanent

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10
Q

Where is the MGJ located?

A

At base of gingival mucosa and the top of the alveolar mucosa

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11
Q

Describe the MGJ as far as keratinized or non-keratinized epithelium

A

The point at which keratinized and non-keratinized epithelium meet

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12
Q

T or F, keratinized tissue extends from the gingival margin to the MGJ

A

True

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13
Q

How is attached gingiva measured?

A

From the gingival sulcus (GM) to the MGJ minus PD

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14
Q

Keratinized gingiva and mucosal epithelium is separated by what?

A

The MGJ

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15
Q

Where in the mouth is the tissue most keratinized and least keratinized?

A

Most: Hard palate
Least: Cheek

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16
Q

Describe the progression of teeth with most keratinized tissue to those that have the least amount.

A

Incisors > Molars > Premolars

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17
Q

Where would you find the most attached tissue and least attached tissue in the mouth?

A

Most attached gingiva –> Junctional epithelium

Least attached tissue –> Crevicular epithelium

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18
Q

What are the 2 mathematical equations to determine the attached gingiva

A
  1. AG=KG - Probing depth

2. AG=(GM to MGJ) - Probing depth

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19
Q

What are the 3 different types of epithelium

A

Crevicular (Sulcular) epithelium
Oral or outer epithelium
Junctional Epithelium

20
Q

Junctional epithelium

  • Keratinized?
  • Thickness
  • Length
  • Turnover
A
  • Non-keratinized
  • 2-30 cells thick
  • 0.25-1.35 mm length
  • Turnover 1-6 days
21
Q

How do hemidesmosomes play a role in junctional epithelium?

A

The attach:

  • Cell to tooth/implant
  • Cell to connective tissue
22
Q

Describe the attachment for junctional epithelium

A
  • Internal basal lamina
    • To tooth or implant
    • Lamina densa
    • Lamina lucida
  • External basal lamina
    • To connective tissue
23
Q

Oral or outer epithelium

  • Keratinized?
  • Turnover
A

Keratinized or parakeratinized

Turnover 10-12 days

24
Q

Crevicular Epithelium

- Keratinized?

A

non-keratinized (has potential to keratinize), thin and without rete pegs

25
Q

What is Stippling?

A

Depressions/raised areas in surface of attached gingiva

- Occurs at sites of rete pegs

26
Q

Junctional epithelium

  • keratinized?
  • Turnover?
A

Non-keratinized

Turnover 1-6 days

27
Q

What is the PDL?

A

a group of principal fibers that insert into cementum and the alveolar bone

28
Q

What are the terminal fibers of the PDL called?

A

Sharpey’s fibers

29
Q

PDL is composed of what type of cells?

A

Connective tissue cells
- (Fibroblasts, cementoblasts, & osteoblasts)
Host defense cells
Rests of malassez (isolated clusters of epithelium)

30
Q

PDL function

A

To transmit forces & maintain attachment

31
Q

PDL width

A

0.1-0.2 mm

32
Q

Is PDL found in implants?

A

No, implants form hemidesmosomes with the alveolar bone

33
Q

What is the gingival fiber group made up of and their functions?

A

Circular: support & contour to free gingiva
Gingivodental group
- Dentogingival: support of gingiva
- Dentoperiosteal: anchors tooth to bone
- Alveologingival: attaches gingiva to alveolar bone
Transseptal fibers: keep teeth in alignment and protects bone; continuously reform as bone and fibers are destroyed

34
Q

Which of the gingival fiber groups are not on implants?

A

Dentogingival
Dentoperiosteal
Transseptal

35
Q

What is the periodontal fibers group made up of and their functions?

A

Alveolar crest: resists lateral movement
Horizontal: opposes lateral forces
Oblique: absorbs occlusal forces (largest group)
Apical: resists tipping of tooth
Interradicular: resists forces of luxation (pulling out) and tipping

36
Q

What is biological width?

A

Physiologic zone of gingival tissue coronal to the alveolar bone crest
- Also called gingival attachment, physiologic dentogingival junction

37
Q

What is biological width composed of?

A

epithelial attachment and the gingival connective tissue attachment

38
Q

Biological width

  • Junctional epithelium distance
  • Connective tissue distance
  • Total biological width
A
  • JE - 0.97 mm
  • CT - 1.07 mm
  • BW - 2.04 mm
39
Q

3 violations of the biologic width

A
  1. Inflammation
  2. Increasing probing depth
  3. Inconsistent resorption of alveolar bone
40
Q

Be able to calculate clinical attachment loss via numbers or words

A

Probing depth measurement + Gingival margin level (+ if apical to CEJ or - if Coronal to CEJ) = CAL

41
Q

Two different types of gingivits

A

Plaque induced

Non-plaque induced

42
Q

What are the systemic factors for plaque induced gingivitis

A 
Endocrine (puberty, pregnancy, diabetes)
Blood dyscrasias (leukemia)
43
Q

What drugs contribute to plaque induced gingivitis

A

Treatment via cauterizing the tissue/vessels (dec. bleeding) will come back as long as pt is on the medication

  • Anti-seizure meds (Dilantin)
  • Ca channel blockers (Nifedipine)
  • Immunosuppressants (cyclosporin)
  • Oral contraceptives
44
Q

How does malnutrition contribute to plaque induced gingivitis

A

Rare in US

  • Vit deficiency
  • Scorbutic gingivitis (scurvy)
45
Q

What microorganisms contribute to non-plaque induced gingivitis

A

Bacteria: E. coli, Strep, Neisseria, Treponema
Viruses: Herpes
Fungal infections: Candidiasis, Histoplasmosis

46
Q

What systemic diseases contribute to Non-plaque induced gingivitis

A

Systemic diseases: Benign mucous membrane Pemphigoid, anywhere there is a mucous membrane

47
Q

Other than microorganisms and systemic diseases, what three other things can contribute to Non-plaque induced gingivitis

A

Trauma: toothbrush abrasion
Foreign body reactions: popcorn kernel, dental materials, ortho brackets
Genetic: Hereditary gingival fibromatosis

Oral Soft tissues (5 decks)

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