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Histopathology > Exam 2 - Periodontal and Gingival Fiber Ligaments > Flashcards

Exam 2 - Periodontal and Gingival Fiber Ligaments Flashcards

1
Q

What do gingival fiber ligaments do?

A

attach soft tissues to the tooth

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2
Q

What are the main functions of gingival fibers ligaments?

A

1) provide rigidity and density to the marginal gingiva
2) act as a periosteum for the IP crestal alveolar bone
3) provide 1/2 of biological width
4) act as a protective barrier to limit spread of inflammation
5) inhibit apical migration of the junctional epithelium

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3
Q

How much is the biological width?

A

2 mm

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4
Q

What is the biological width?

A

area of junctional epithelium + gingival fiber ligament attached to root of tooth

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5
Q

Where does the biological width extend from?

A

extends 2 mm from the gingival crest to the alveolar crest

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6
Q

What does violation of the biological width result in due to a restoration?

A

results in chronic inflammation and loss of the supporting alveolar bone with formation of a diseased periodontal pocket

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7
Q

Do gingival fiber ligaments insert into bone?

A

NO

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8
Q

____ fiber groups attach the tooth to the gingiva.

A

Dentogingival

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9
Q

____ fiber groups attach the tooth to the periosteum.

A

Dentoperiosteal

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10
Q

____ fiber groups attach the very top of the alveolar crest to the gingiva.

A

Alveologingival

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11
Q

____ fiber groups surround the tooth to keep it from moving back and forth.

A

Circular

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12
Q

____ fiber groups go straight across for mesial-distal stability.

A

Transseptal

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13
Q

____ fiber groups attach one tooth to another by going around facial and lingual surfaces (for buccal-lingual stability).

A

Semicircular

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14
Q

____ fiber groups go between the teeth buccolingually to keep the papilla tight.

A

Transgingival

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15
Q

Which GFL fiber group supports mesial-distal stability?

A

transseptal

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16
Q

Which GFL fiber group supports buccal-lingual stability?

A

semicircular

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17
Q

What are the 5 functions of the periodontal ligament?

A 
Supportive
Regenerative
Nutritional
Sensory
Protective
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18
Q

What is the PDL derived from?

A

ectomesenchymal (neural crest) cells in the intermediate zone of the follicle

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19
Q

What structure is derived from the proximal (inner) zone of the dental follicle?

A

cementoblasts

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20
Q

What structure is derived from the intermediate zone of the dental follicle?

A

PDL

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21
Q

What structure is derived from the peripheral (outer) zone of the dental follicle?

A

alveolar bone

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22
Q

During eruption, the fibers of the PDL are angled ____, contracting to help pull the tooth out.

A

upward

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23
Q

Contraction of PDL + appositional growth = ____?

A

tooth eruption

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24
Q

How do fibers of the PDL form?

A

growth together from opposite ends (from the tooth and the bone)

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25
Q

Do multiple strands of the PDL link together?

A

YES - the interdigitate

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26
Q

Collagen fibers from the PDL are embedded into the ____ of the tooth.

A

cementum

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27
Q

T/F: Plexuses from intermediate collagen fibers in random orientation support the principle fiber groups.

A

TRUE

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28
Q

Where do PDL fiber groups insert?

A

into bone

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29
Q

T/F: The arrangement of the PDL fiber groups resists rotational forces.

A

TRUE

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30
Q

The arrangement of the PDL fiber groups resists ____ forces.

A

rotational

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31
Q

The _____ PDL fiber groups go straight from the alveolar crest up into the tooth.

A

alveolar crest

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32
Q

The ____ PDL fiber groups go straight across to maintain the tooth in an upright position.

A

horizontal

33
Q

The ____ PDL fiber groups come up at an angle to maintain support against masticatory forces.

A

oblique

34
Q

The ____ PDL fiber groups wrap around the apex of the tooth.

A

apical

35
Q

The ____ PDL fiber groups are only located in the furcation of multi-rooted teeth.

A

interradicular

36
Q

What cell populations are located in the PDL?

A 
fibroblasts
osteoblasts
cementoblasts
macrophages
undifferentiated mesenchymal cells
endothelial cells (in blood vessels)
epithelial cells (from gingiva)
37
Q

Various phenotypes of ____ are involved in collagen production and physiologic collagen degradation.

A

fibroblasts

38
Q

____ continuously remodel supporting alveolar bone and regenerate and repair bone following orthodontic therapy or disease.

A

Osteoblasts

39
Q

____ regenerate and repair cementum following injury and continuously deposit cementum.

A

Cementoblasts

40
Q

Where are undifferentiated mesenchymal cells found in the PDL?

A

interstitial spaces

41
Q

____ differentiate into cementoblasts, osteoblasts, and fibroblasts.

A

Undifferentiated mesenchymal cells

42
Q

How does orthodontic tooth movement affect the PDL?

A

compression of PDL on the “leading side” of the root responding to movement

43
Q

____ due to orthodontic tooth movement results in loss of principle fiber orientation and resorption of adjacent bone.

A

Compression

44
Q

Tooth movement results in ____ of the PDL on the side opposite compression (following side).

A

tension/stretching

45
Q

Controlled tension results in bone ____.

A

apposition

46
Q

What is orthodontic relapse caused by?

A

transseptal fibers
semicircular fibers
PDL principle fiber groups (rotational, alveolar crest, etc.)

47
Q

What is ankylosis?

A

fusion of cementum directly to the surrounding alveolar bone (without PDL presence)

48
Q

Ankylosis is a decrease in the ____ space.

A

interstitial

49
Q

____ is usually a reparative response to PDL injury.

A

Ankylosis

50
Q

What happens if there is a SEVERE injury to the tooth, alveolar bone, and cementum?

A

ankylosis

51
Q

What happens if there is a SLIGHT injury to the tooth, alveolar bone, and cementum?

A

undifferentiated mesenchymal cells of the interstitial space have the potential to regenerate all tissues involved to restore PDL

52
Q

What is the first response in wound healing in the PDL?

A

undifferentiated mesenchymal cells migrate to the area as macrophages and PMNs remove damaged tissue

53
Q

What happens in PDL wound healing after macrophages and PMNs remove the damaged tissue?

A

fibroblasts and/or osteoblasts replace the damaged tissue

54
Q

What type of response is usually present in PDL wound healing that releases heparin and histamine?

A

mast cell response

55
Q

What do mast cells release?

A

histamine and heparin

56
Q

What does heparin do in the PDL wound healing response?

A

vasodilates

57
Q

What does histamine do in the PDL wound healing response?

A

thins the blood

58
Q

What is the purpose of the inflammatory response in wound healing?

A

it makes things more fluid and helps necessary cells reach their targets faster (vasodilation and blood thinning)

59
Q

What is the surgical technique called that regenerates the periodontal attachment apparatus on periodontically involved teeth?

A

guided tissue regeneration

60
Q

____ uses undifferentiated cells from the interstitial spaces of the PDL and marrow spaces of adjacent alveolar teeth to help heal pockets.

A

Guided tissue regeneration

61
Q

What does the membrane in guided tissue regeneration exclude?

A

gingival epithelial tissues from deeper part of wound

62
Q

What is the purpose of the membrane in guided tissue regeneration?

A

excluded gingival epithelial tissues

allows ONLY cells from existing PDL/bone to fill the wound

63
Q

Epithelial rests of Malassez are remnants of _____.

A

Hertwig’s epithelial sheath

64
Q

Epithelial rests of Malassez are more prevalent in the apical areas of ____.

A

adolescents

65
Q

_____ may have some effect on cementogenesis but their purpose in unknown.

A

Epithelial rests of Malassez

66
Q

____ give rise to lateral periodontal cysts.

A

Epithelial rests of Malassez

67
Q

Lateral periodontal cysts occur where along the root surface?

A

lateral root surface

68
Q

____ are circular and unilocular on radiographs.

A

Lateral periodontal cysts

69
Q

How do you know a lateral periodontal cyst is a cyst?

A

because you can see the PDL straight through it and the PDL is still intact

70
Q

____ give rise to gingival cysts.

A

Epithelial rests of Serres

71
Q

Epithelial rests of Serres are remnants of the ____.

A

dental lamina

72
Q

____ are odontogenic epithelium located in the connective tissue of gingiva.

A

Epithelial rests of Serres

73
Q

What are the excessive functional stresses placed on a tooth by an antagonist that exceeds the limits of physiologic adaptation called?

A

trauma from occlusion

74
Q

What does trauma from occlusion result in?

A

resorption of alveolar bone parallel to long axis
PDL wider than average width
tooth mobility

75
Q

Trauma from occlusion causes resorption of bone ____ to the long axis of the root.

A

parallel

76
Q

____ results from a tooth with no occlusal antagonist.

A

Disuse atrophy

77
Q

What does disuse atrophy result in?

A

significant decrease in density of bony trabeculae
decreased width of PDL
loss of orientation of PDL principle fibers
increased volume of bone marrow spaces

78
Q

Trauma from occlusion results in a PDL that is ___ than average; disuse atrophy results in a PDL that is ___ than average.

A

wider; narrower

Histopathology (7 decks)

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