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OCB02 > Gingiva & Peri-Implant Tissues > Flashcards

Gingiva & Peri-Implant Tissues Flashcards

1
Q

What are the three parts of an implant?

A

Fixture

Abutment

Crown/denture

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2
Q

What is osteointegration?

A

Formation of bone around fixture to create a strong bond

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3
Q

What are the three types of denture attachments?

A

Ball

Magnet

Bar

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4
Q

Why is a magnet denture attachment not good?

A

Corrodes in saliva

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5
Q

Why is a bar denture attachment not good?

A

Hard to clean

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6
Q

What is an external connection?

A

Screwed on and crown cannot rotate

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7
Q

What is an internal connection?

A

Crown sits within implant

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8
Q

What does the periodontium consist of?

A

Gingiva

PDL

Cementum

Alveolar bone

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9
Q

What is the periodontium?

A

Supporting structures of the tooth

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10
Q

What does the peri-implant structure consist of?

A

Peri-implant mucosa

Alveolar bone

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11
Q

What are the four epithelial layers of the gingiva?

A

Stratum basale

Stratum spinosum

Stratum granulosum

Stratum corneum

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12
Q

How thick is the epithelial layer of the gingiva?

A

0.2-0.3mm

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13
Q

What types of gingival keratinisation are there?

A

Orthokeratinised

Parakeratinised

Incomplete keratinisation

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14
Q

What defines the gingiva?

A

Cervical margin and mucogingival junction

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15
Q

Describe the gingiva.

A

Part of oral mucosa

Hard and bound to teeth

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16
Q

What are the two ways to divide the gingiva and what are the subgroups?

A

Position - attached, free, crevicular and junctional

Structures - epithelial elements and connective tissue elements

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17
Q

What is the width of the supracrestal tissue attachment?

A

2mm

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18
Q

What two regions make up the supracrestal tissue attachment?

A

Connective tissue attachment

Junctional epithelium

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19
Q

What happens to the supracrestal tissue attachment when you drill away some of the junctional epithelium?

A

Stays the same as bone is resorbed coronally

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20
Q

Describe the attached gingiva.

A

Pale pink, keratinised mucosa

May be stippled in health

Firm and tightly-bound onto bone

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21
Q

Where is the attached gingiva located?

A

From mucogingival junction to free gingival groove

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22
Q

Describe the free gingiva.

A

Pale pink, keratinised mucosa

Slightly loose and smooth

23
Q

Where is the free gingiva located?

A

Free gingival groove to cervical margin

24
Q

What is the papilla?

A

Interdental gingival tissue

25
Q

What is the shape of the anterior papillae?

A

Pyramidal

26
Q

What is the shape of the posterior papillae?

A

COL - tent-shaped

27
Q

What cells are found in the gingival epithelium? (5)

A

Keratinocytes

Melanocytes

Langerhan’s cells

Merkel cells

Some T-cells

28
Q

Where are the Langerhan’s cells found and what do they do?

A

Most coronal part of junctional epithelium

Antigen-presenting cells

29
Q

Where are the Merkel cells located and what do they do?

A

Stratum basale

Sensory touch receptors

30
Q

Is the crevicular epithelium keratinised?

A

No

31
Q

What cell types are found in the junctional epithelium and why?

A

Basal and suprabasal cells

Rapid turnover so insufficient time to differentiate

32
Q

What is the rate of turnover of the junctional epithelium?

A

10-14 days

33
Q

Why is the junctional epithelium permeable?

A

Large intercellular spaces

34
Q

What are four characteristics of the junctional epithelium?

A

Non-keratinised

Large intercellular spaces (permeable)

Rapid turnover

Hemidesmosomes

35
Q

What attaches the junctional epithelium to the enamel?

A

Hemidesmosomes to protein layer/extended basal lamina on enamel surface

36
Q

What is the range of thickness of the junctional epithelium?

A

3-30 cells thick

37
Q

What are the differences between probing healthy and inflamed junctional epithelium?

A

Healthy - stops in JE (0.7mm), not deep, no bleeding

Inflamed - ulcerated so stops in inflamed connective tissue, bleeding, more tender

38
Q

Which implant materials form a junctional epithelium?

A

Titanium

Zirconium

Aluminium

39
Q

What are the dimensions of a stable biological seal?

A

3mm supracrestal soft tissue attachment:

1mm connective tissue

2mm junctional epithelium

40
Q

Why is a probe likely to enter the connective tissue around an implant?

A

Weaker seal than natural tooth

41
Q

What is the inflammatory barrier?

A

Stable gingivitis-like lesion in health

42
Q

What could be controlling epithelial downgrowth?

A

Granulation tissue/underlying connective tissue

Signals from deeper tissues

43
Q

What does the gingival connective tissue contain? (7)

A

GAGs and fluid

Collagen I and III fibres in a strong, organised network

Elastic fibres

Fibroblasts

Blood vessels

Lymph vessels

Nerves

44
Q

What percentage of the normal gingival connective tissue volume is collagen?

A

50-60%

45
Q

How is the collagen network of gingival connective tissue different with an implant?

A

Fibres are differently orientated

No dentogingival fibres present

Scar tissue-like

46
Q

What are the 4 types of collagen fibres present in gingival connective tissue?

A

Dentogingival

Alveolar crest

Dentoalveolar

Circular

47
Q

Compare the two zones of the gingival connective tissue around an implant.

A

Inner - fibre-rich (87% collagen), few cells and vessels, lots of circular fibres

Outer - multidirectional fibres, less collagen (63%), more cells and vessels

48
Q

How thick is the inner zone of the gingival connective tissue around an implant?

A

50-100um

49
Q

When are the blood vessels in the gingival connective tissue constricted?

A

No infection

Smoking

50
Q

Where does the main blood supply for peri-implant tissue come from?

A

Supra-alveolar connective tissue

51
Q

Why does the peri-implant tissue have less of an inflammatory response than gingival connective tissue?

A

Less blood flow

52
Q

Where is the crest of the bone in healthy teeth?

A

1-2mm apical to cementoenamel junction

53
Q

Why is it dangerous that there are no ligament receptors with implants?

A

No jaw-opening reflex so could break other teeth

OCB02 (19 decks)

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