Healthy Periodontium Flashcards
1
Q
The oral cavity is lined by _____ ______
A
Oral Mucosa
2
Q
- Oral mucosa is made up of what type of tissue
- What lies underneath the oral mucosa?
A
- Stratified Squamous Epithelium
- Connective Tissues
3
Q
Oral Mucosa is divided into 3 categories..
A
- Masticatory Mucosa
- Specialized Mucosa
- Lining Mucosa
4
Q
What two things comprise masticatory mucosa?
A
- Gingiva
- Palate
5
Q
What is specialized oral mucosa?
A
The tongue
6
Q
What are two examples of lining mucosa?
A
- Vestibule
- Floor of the mouth
7
Q
This is the functional system of tissues surrounding teeth that attaches them to bone
A
Periodontium
8
Q
Name the types of periodontium
A
9
Q
Name the parts of the oral cavity
A
10
Q
This is an area of union between the gingiva and alveolar mucosa
A
Mucogingival Junction
11
Q
- Mucosa covering the alveolar process and continuing without demarcation into the vestibular area and the floor of the mouth.
- It is loosely attached to the _____
A
- Alveolar Mucosa
- Periostium
12
Q
Defined as the fibrous tissue, covered by stratified squamous epithelium, that immediately surrounds a tooth and is contiguous with its periodontal ligament and with the mucosa of the mouth
A
Gingiva
13
Q
What are functions of the gingiva? (2)
A
- Provides a tissue seal around the cervical portion of the tooth
- Holds tissue against tooth during mastication
14
Q
The gingiva is composed of a thin outer layer of _____ and an underlying core of _____ _____
A
- Epithelium
- Connective tissue
15
Q
Clinically, gingiva extends from the ______ to the _______
A
Gingival Margin to Mucogingival Junction
16
Q
This is the part of the gingiva that surrounds the tooth but is not directly attached to the tooth surface. It becomes less firm with disease
A
Gingival Margin (free gingiva)
17
Q
- Is the gingival margin stippled?
- Keratinized or non-keratinized?
A
- No
- Keratinized or parakeratinized
18
Q
The gingival margin forms the soft tissue wall of the ______ ______
A
Gingival Sulcus
19
Q
The name for where enamel ends and cementum starts
A
Cementoenamel Junction (CEJ)
20
Q
The CEJ is a landmark for the determination of __________
A
Periodontal Disease
21
Q
In healthy periodontal disease, should you be able to see the CEJ?
A
Nope! Visible CEJ means current or previous destructive periodontitis.
22
Q
If the FGM (free gingival margin) is slightly coronal to the CEJ,this is normal.
- What does it indicate if the FGM is significantly coronal to the CEJ?
- If the FGM is apical to the CEJ?
A
- Edematious tissue
- Recession
23
Q
This portion of the gingiva is firm, dense stippled and tightly bound to the underlying periosteum, tooth, and bone
A
Attached Gingiva
24
Q
The attached gingiva extends from the _______ to the ________
A
- Gingival Groove
- Mucogingival Junction
25
1. Attached gingiva is firmly bound to the underlying ________ \_\_\_\_\_\_ and _______ of the tooth
2. Attached gingiva is STIPPLED/NON-STIPPLED
3. It is KERATINIZED/NON-KERATINIZED
1. Alveolar Bone and cementum
2. Stippled
3. Keratinized (or parakeratinized)
26
This appearance on attached gingiva is connective tissue fibers that attach the attached gingiva to cementum and the alveolar bone
Stipples
27
What are the functions of attached gingiva? (2)
1. Allows gingival tissue to withstand mechanical forces created during chewing, speaking, and toothbrushing
2. Prevents gingiva from being pulled away from tooth when tension is applied to alveolar mucosa
28
This is interdental extension of the gingiva and occupies the interproximal space
Interdental Gingiva (Interdental Papilla)
29
What is the function of interdental papilla?
To prevent food from being packed between teeth during mastication
30
1. The interdental papilla includes part of the ______ and \_\_\_\_\_\_
2. It occupies the _____ space
3. Is it stippled?
4. What is the shape?
1. gingival margin and attached papilla
2. Embrasure Space
3. The central portion
4. Pyrimidal, forms a col
31
There is both a ____ interdental papilla and a _____ interdental papilla
Facial and Lingual
32
This is a valley like depression that is directly apical to the contact of teeth in the interdental papilla, and it is absent if teeth are missing or if there is recession (no contact means t won't exist)
COL
33
What is the main difference betwee buccal/palatal interdental papilla and the col?
Buccal and palatal interdental papilla are keratinized, col is nonkeratinized
34
Which part of the interdental papilla breaks down fastest and why?
The col because it is nonkeratinized
35
WHat instrument is used to investigate the gingival sulcus?
Periodontal Probe (Williams and NC 15)
36
The width of gingiva is the _____ to the \_\_\_\_\_
Gingival margin to the mucogingival junction
37
To measure width of gingiva, look for the alveolar mucosa as a boundary, which is red because it is \_\_\_\_\_\_\_\_
Unkeratinized
38
What is the pattern of the width of gingiva in the maxilla and mandible?
39
What is the pattern of width of gingiva for the lingual side of teeth (only mandibular)
40
This is the border between keratinized and nonkeratinized gingiva, and is usually detectable from color difference. The unkeratinized is darker.
Mucogingival Junction
41
Does the lingual maxillar gingiva have a mucogingival junction?
No! Useful because it's keratinized so food doesn't cause damage
42
What are the 3 things beneath the gingiva?
1. Tooth Root
2. Alveolar Bone
3. Periodontal Ligament
43
1. What is this a picture of?
2. What are the parts?
1. Alveolar Bone
2. The outer (buccal) compact cortical plate (cp), the trabecular bone (tb) and the inner (lingual) cortical plate (cp), tooth socket (wa)
44
What are other names for the tooth socket in this picture?
alveolar bone proper, cribriform plate, lamina dura (used for radiographs)
45
This is th ebone of the upper or lower jaw that surrounds and supports the roots teeth
Alveolar Bone
46
What are the functions of the alveolar bone? (3)
1. Forms the bony sockets of teeth
2. Supports and protects the roots of teeth
3. Provides anchorage for the fibers of the PDL
47
This is the mineralized tissue that covers the dentin of the roots of teeth
Cementum
48
Where is the cementum thicker?
At the apices of teeth
49
What are the functions of the cementum? (3)
1. Seals open dentinal tubules
2. Protects underlying dentin
3. Attaches PDLs to tooth
50
This is a thin sheet of fibrous tissue located between the tooth and its bony socket, connecting the tooth and the bony socket
Periodontal Ligament
51
What are the functions of the PDL? (4)
1. Attaches tooth to bon socket
2. Suspends tooth so it doesn't grind on bone during chewing
3. Transmits tactile pressure and pain sensations
4. Supplied with blood vessels that provide nutrients to cementum and bone
52
The PDL inserts into the ____ of the root and bone
Cementum
53
These are the ends of PDL fibers that are embedded in the cementum and alveolar bone
Sharpey's Fibers
54
Name the fibers in the picture
55
This is the shallow fissure between the marginal gingiva and the enamel or cementum of a tooth
Gingival Sulcus
56
Name the structures in this picture
Epithelium (E?), Oral Epithelium, Oral Sulcular Epithelium (OSE), Junctional Epithelium (JE), Cementoenamel Junction (CEJ), Connective Tissue (CT?)
57
This type of epithelium in the mouth faces the oral cavity, and covers marginal, interdental, and attached gingiva. It is the lining of the intraoral surfaces
Oral Epithelium
58
1. Is oral epithelium keratinized?
2. These are the epithelial connections that project into underlying connective tissue in mucous membranes
1. Yes.
2. Rete Pegs
59
This type of epithelium forms the lateral wall of the gingival sulcus. It extends from the base of the sulcus to the crest of the gingival margin. It is part of the epithelium of the gingival sulcus, and is thin.
Sucular Epithelium
60
Is sucular epithelium keratinized?
No
61
This epithelium is attached to the tooth surface at the base of the crevice, actually forming the base of the crevice in the gingival sulcus. It is also known as the epithelial attachment. (It's what the probe hits in the gingival sulcus)
Junctional Epithelium
62
1. Is the junctional epithelium keratinized?
2. Does it have rete pegs?
1. No.
2. No.
63
Since the junctional epithelium is thin and non-keratinized, how is it more significant clinically?
It is the easiest point of entry for bacteria to invade tissue
64
What is the function of the junctional epithelium? (2)
1. Provides a seal at the base of the gingival sulcus or periodontal pocket
2. Provides a protective barrier between plaque and protective tissue
65
So, the gingival sulcus is formed by 3 things:
1. Tooth enamel
2. Oral sucular epithelium
3. Junctional epithelium
66
What are the functions of gingival connective tissues? (3)
1. Provide solidity to gingiva
2. Attaches gingiva to cementum of the root and bone
3. Vascularization
67
1. What are the components of gingival connective tissue?
2. What also may be present in gingival connective tissues?
1. Fibroblasts, ECM, Blood Vessels, lymphatics and nerves
2. Lymphatics, macrophages, plasma cells
68
Why might lymphocytes, plasma cells, and macrophages be present in gingival connective tissue?
Bacteria are always present in the gingival crevice, and the body's defenses always alert the inflammatory cells to increase in inflamed gingiva
69
The gingival connective tissue is rope like collagen fiber bundles located APICAL/CORONAL to the alveolar crest
Coronal
70
This gingival connective tissue fiber group extends from the periosteum of the alveolar crest into the gingival connective tissue, attaching the gingiva to bone
Alveologingival
71
This gingival connective tissue group of fibers encircles the tooth in a ring-like manner, coronal to the alveolar crest, connecting adjacent teeth to one another
Circular
72
This gingival connective tissue fiber group is embedded in the cementum near the CEJ, and fans out into lingual connective tissue. They attach gingiva to the teeth
Dentogingival (DG)
73
This gingival connective tissue fiber group extends laterally from the periosteum of alveolar bone, attaching the gingiva to bone
Periostogingival
74
What is the average distance in health from the apical end of the junctional epithelium (at the CEJ) to the alveolar bone
1.5-2mm. CEJ remains relatively constant during disease
75
What color should healthy gingiva be? (2)
1. Coral Pink
2. Pigmented (does not mean unhealthy!)
76
What is the contour of healthy gingiva?
Scalloped (generally follows the CEJ)
77
The ______ follows the contours of teeth and bone underneat to appear scalloped around teeth
Gingival Margin
78
The shape of healthy gingiva should do 2 things
1. FIll interdental space
2. Form flat or knife edge (could also be rolled)
79
What should the consistency of healthy gingiva be?
Firm and Resilient (tissue should bounce back quickly, not leave imprints for long)
80
What should the surface texture of healthy gingiva be?
Scalloped
81
Which part of the gingiva is stippled? Note that absence in some areas doesn't indicate disease
Attached gingiva (not the gingival margin!)
82
The gingival margin should be slightly ______ to the CEJ in a healthy adult
Coronal
83
In a young child, the gingival margin will be coronal to the CEJ but will appear more ______ if the tooth is not completely erupted
Rounded
84
1. Does healthy gingiva bleed upon probing?
2. What is bleeding gingiva a sign of?
1. No!
2. Peirodontal DIsease
