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Periodontology I > Lec 1: Anatomy of the Periodontium > Flashcards

Lec 1: Anatomy of the Periodontium Flashcards

1
Q

What is the main function of the periodontium?

A

To maintain teeth in function

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2
Q

What are the 4 principal components of the periodontium?

A
  1. Gingiva
  2. Periodontal ligaments
  3. Cementum
  4. Alveolar bone
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3
Q

Those part of the masticatory mucosa surrounding the cervical part of teeth and covering the alveolar process.

A

Gingiva

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4
Q

Morphologic/anatomic divisions of the gingiva?

A

Marginal
Attached
Interdental papilla

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5
Q

4 factors that influence color of the gingiva?

A

Melanin pigmentation
Degree of keratinization
Degree of vascularity
Fibrous nature of the connective tissue

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6
Q

Terminal edge or border of the gingiva that surrounds the teeth in collar like fashion.

A

Marginal gingiva

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7
Q

Shallow linear depression that demarcates free gingiva to attached gingiva..

A

Free gingival groove

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8
Q

This forms the soft tissue wall of the gingival sulcus.

A

Marginal gingiva

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9
Q

The most apical point of the marginal gingival scallop.

A

Gingival zenith

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10
Q

The most coronal portion of the gingiva.

A

Free gingival margin

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11
Q

What is the location of a healthy free gingival margin?

A

1-2mm coronal to CEJ

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12
Q

What is the location of a healthy free gingival groove?

A

1-1.5mm apical to gingival margin at the base of the sulcus

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13
Q

A V-shaped shallow crevice or space around the tooth bounded by the surface of the tooth on one side and the epithelium lining of the in margin of the gingiva on the other side.

A

Gingival sulcus

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14
Q

What is the probing depth of normal gingival sulcus?

A

0.5-3mm

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15
Q

Transudate that emerges from gingival sulcus, containing a variety of enzymes and cells, particularly desquamating epithelium and neutrophils.

A

Gingival crevicular fluid

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16
Q

An increase in the crevicular flow is a sign of?

A

Inflammation

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17
Q

Once inflammation has occured, the GCF is now referred as?

A

Inflammatory exudate

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18
Q

Continuous with the marginal gingiva, firm, resilient, stippled.

A

Attached gingiva

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19
Q

Tightly bound to the underlying periosteum of alveolar bone and to the cementum by connective tissue fibers and epithelial attachment.

A

Attached gingiva

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20
Q

The attached gingiva is demarcated by?

A

Mucogingival junction

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21
Q

Epithelial projections that extend into gingival connective tissue.

A

Rete pegs

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22
Q

What do you call the depression, orange peel surface, or irregular surface texture of the attached gingiva?

A

Stippling

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23
Q

A recognizable borderline separating the alveolar mucosa from the gingival mucosa.

A

Mucogingival junction

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24
Q

The mucogingival junction is absent in what area?

A

Maxillary lingual area

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25
Q

Occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact.

A

Interdental papilla

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26
Q

A valleylike depression that connects a facial and lingual papilla and that conforms to the shape of the interproximal contact.

A

Col

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27
Q

The lateral borders and tips of the interdental papillae are formed by the _________ of the adjoining teeth, while he intervening portion consists of _____________.

A

marginal gingiva; attached gingiva

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28
Q
  • Extending from gingival margin to the mucogingival junction.
  • Keratinized stratified squamous epithelium.
  • Has rete pegs.
A

Oral epithelium

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29
Q
  • Lines the gingival sulcus.
  • Non-keratinized stratified squamous epithelium
  • No rete pegs.
A

Sulcular epithelium

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30
Q
  • Joints the inner surface of the gingiva to the tooth.
  • Non keratinized stratified squamous epithelium
  • No rete pegs
A

Junctional epithelium

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31
Q

What are the 3 areas of gingival epithelium?

A

Oral, sulcular, and junctional epithelium

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32
Q

The junctional epithelium is connected to the tooth by __________ and _________.

A

Internal basal lamina; hemidesmosomes

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33
Q

Serves as route for passage of fluid and cells from the connective tissue into the sulcus and for the passage of bacteria and bacteria products from the sulcus into the connective tissue.

A

Junctional epithelium

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34
Q

Length of a healthy junctional epithelium

A

0.25 to 1.35 mm

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35
Q

Inner layer of cells of the junctional epithelium that actually provides the attachment of gingiva to the tooth.

A

Epithelial attachment

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36
Q

The epithelial attachment consists of? (3)

A

Lamina lucida
Lamina densa
Hemidesmosomes

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37
Q

Helps in holding the marginal gingival tightly against the tooth.

A

Connective tissue

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38
Q

MAJOR COMPONENTS OF CONNECTIVE TISSUE:
Gingival fibers (connective tissue fibers)
-
-
-
-

-
-

-
-
-

Vessels and nerves

A

Gingival fibers (connective tissue fibers)
- Type I collagen fibers (60%)
- Oxytalan
- Elaunin
- Elastin fibers

Intercellular ground substance (or matrix)
- Proteoglycans
- Glycoproteins
- Water

Cells:
- Fibroblasts
- Mast cells
- Macrophages (histiocytes)
- Inflammatory cells

Vessels and nerves

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39
Q

Enumerate the gingival fibers.

A

Circular
Dentogingival
Dentoperiosteal
Alveogingival
Transseptal

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40
Q
  • Run their course in the free gingival and encircle the tooth in a cuff or ring like fashion; from cementum, across bony septum and to the other side.
  • Resist rotational force.
A

Circular fibers

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41
Q

Embedded in cementum of the supraalveolar portion of the root and project from here in a fan like configuration out into the free gingival tissue of facial, lingual, and interproximal spaces.

A

Dentogingival fibers

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42
Q

Embedded in the same portion of cementum, run their course apically over the vestibular and lingual bone crest and terminate in the tissue of the attached gingiva

A

Dentoperiosteal fibers

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43
Q

Insert in the crest of alveolar process and spread out through the lamina propria into the free gingiva.

A

Alveogingival fibers

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44
Q
  • Extend from tooth to tooth, coronal to the alveolar crest and are embedded in the cementum of adjacent teeth.
  • Not found on the facial aspect and have no attachment to alveolar crestal bone.
  • Connect all teeth and maintain the integrity of the dental arches.
  • Sometimes classified as Principal Fibers of PDL.
A

Transseptal fibers

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45
Q

Soft, richly vascular and cellular specialized form of connective tissue derived from dental sac that surrounds the roots of the teeth and joints the root cementum with the alveolar bone proper.

A

Periodontal ligament

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46
Q

Normal width of the periodontal ligament.

A

0.1-0.2mm

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47
Q

The dominant component of PDL, which is made up primarily of bundles of continuous intermingling connective tissue fibers arranged in a network running from cementum to the alveolar bone; and ground substance (proteoglycans, glycoproteins, and water).

A

Fibrous matrix

47
Q

Makes it possible to distribute and absorb trajectory of forces during mastication into the alveolar process via alveolar bone proper.

A

Periodontal ligament

48
Q

Enumerate the principal fibers of PDL.

A

Alveolar crest
Horizontal
Oblique
Apical
Interradicular

49
Q
  • From cementum of the tooth, running apically to the crest of the alveolar bone
  • Counterbalance occlusal forces on the more apical fibers
  • Prevents extrusion of tooth
  • Resists lateral movements
  • First to be destroyed in pathologic conditions
A

Alveolar crest fibers

50
Q
  • More apical than the former and run perpendicular from tooth to alveolar bone
  • Responsible on why tooth movement is possible
  • Resist lateral forces
A

Horizontal fibers

51
Q
  • Largest group; most abundant
  • Runs in a coronal direction from tooth obliquely to bone
  • More resistant to forces along the long axis of the tooth (vertical masticatory forces)
  • Most likely to be found in the middle third of the root.
A

Oblique fibers

52
Q
  • Radiate around the apex of the tooth to adjacent of bone
  • Offer initial resistance to tooth movement in an occlusal direction; prevent tipping and dislocation of tooth
  • Fibers affected during acute apical pulpitis (AAP)
A

Apical fibers

53
Q
  • Fibers that can be only seen in multirooted teeth (molars, premolars)
  • From cementum in the furcation area to the bone within the furcation
  • Is to be destroyed in col de sac incidence.
A

Interradicular fibers

54
Q

Terminal portion of collagen fibers which are embedded into the cementum and bone.

A

Sharpey’s fibers

55
Q
  • It is the calcified body (rests that degenerates) found in the periodontal ligament.
  • From apposition of cementum.
A

Cementicle

56
Q

Most common cell of the PDL

A

Fibroblasts

57
Q

Types of cells in the PDL (6)

A
  1. Fibroblasts
  2. Osteoclasts and osteoblasts
  3. Cementoclasts and cementoblasts
  4. Reserve cells or undifferentiated mesenchymal cells
  5. Mast cells (histamine and heparin), macrophages, eosinophils, cementicles
  6. Epithelial rest of Malassez
58
Q

Type of collagen fiber in the PDL

A

Collagen type 1

59
Q

Nerve fibers in the PDL arises from the branches of?

A

Trigeminal nerve (CN V)

60
Q

Pain; most abundant; Merkel cells; root length

A

Free nerve endings

61
Q

Pressure; proprioception; root apex

A

Ruffini corpuscle

62
Q

Pressure; mechanoreceptors

A

Pacinian corpuscle

63
Q

Midroot (nerve fibers)

A

Coiled Meissner’s endings

64
Q

Apex (nerve fibers)

A

Encapsulated spindle endings

65
Q

Vasculature for the PDL arises from?

A

Maxillary artery

66
Q

Lymph from the PDL drains to?

A

Submandibular lymph nodes

67
Q

What are the 5 roles of the PDL?

A

Mechanical
Formative
Nutritive
Homeostatic
Sensory

68
Q

Role of PDL: Attach tooth to bone; provide a cushion for absorption and transmission.

A

Mechanical

69
Q

Role of PDL: Contains cells that form periodontium.

A

Formative

70
Q

Role of PDL: Contains vascular network providing nutrients.

A

Nutritive

71
Q

Role of PDL: Maintain balance of function

A

Homeostatic

72
Q

Role of PDL: Has afferent nerve fibers for pain (free), pressure (Spindle-like) and proprioception (Ruffini-like receptor & Meissner’s corpuscle).

A

Sensory

73
Q

Specialized calcified tissue covering the root surface.

A

Cementum

74
Q

Cementum is thicker in the _____ of the root.

A

Apical third

75
Q

4 differences of cementum with the bone?

A
  1. Avascular
  2. No innervations
  3. Fewer cells
  4. No resorption/remodelling
76
Q

Origin of the cementum

A

Ectomesenchymal cells of the dental sac

77
Q

Composition of the cementum?

A

65% hydroxyapatite
32% collagen
3% water

78
Q

Classifications of cementum:
> By formation:
-
-
> By cellularity:
-
-

A

> By formation:
- Primary
- Secondary
By cellularity:
- Acellular
- Cellular

79
Q
  • First formed cementum
  • Covers coronal cementum
  • Is acellular
  • Consists of extrinsic collagen fibers
A

Primary cementum

80
Q
  • Covers apical cementum
  • May be either acellular or cellular
  • Consists of mixed collagen fibers
A

Secondary cementum

81
Q
  • Slowly formed before the tooth erupts to reach the occlusal plane.
  • Devoid of cells.
  • Found principally in coronal areas (cervical half) of the roots and is characterized by dense layers of calcified collagen seen in coronal cementum separated by growth lines.
A

Acellular cementum

82
Q

These are periodontal ligament extrinsic fibers embedded in the cementum.

A

Sharpey’s fibers

83
Q

Main function of acellular cementum.

A

Anchorage

84
Q
  • Rapidly formed after tooth reaches occlusal plane.
  • Most commonly found in apical areas of the tooth, and in furcation areas of multirooted teeth.
  • Within are masses of cementocytes, cementoblasts, and cementoclasts.
  • Forms after passive tooth eruption in response to function.
A

Cellular cementum

85
Q

Main function of cellular cementum?

A

Adaptation and repair

86
Q
  • Parts of maxilla and mandible that form and support the sockets of the teeth.
  • Main function: to distribute and absorbed forces generated by mastication.
A

Alveolar bone

87
Q

Two main components of the alveolar bone?

A

Alveolar bone proper (cribriform plate)
Supporting alveolar bone

88
Q

What is the shape of the alveolar crest?

A

Parallel to the CEJ

89
Q

What is the location of a healthy alveolar crest?

A

1.5-2mm apical to CEJ

90
Q

Dimension from the crest of the alveolar bone to the base of the sulcus.

A

Biological width

91
Q

Normal biological width?

A

2.04mm

92
Q

Normal width of the connective tissue?

A

1.07mm

93
Q

Normal width of the epithelial attachment?

A

0.97mm

94
Q

2 types of bone

A

Compact
Trabecular

95
Q

Cortical, dense, hard bone (solid bone mass)

A

Compact bone

96
Q

Spongy, cancellous, soft bone (honeycomb appearance)

A

Trabecular bone

97
Q

Unit structure of bone

A

Osteon / Haversian system

98
Q

One osteon is connected to another through?

A

Canaliculi

99
Q

3 types of lamellae of bone

A

Circumferential
Concentric
Interstitial

100
Q

2 types of coverings of bone

A

Periosteum
Endosteum

101
Q

External surface of bone

A

Periosteum

102
Q

Inner, surrounds bone marrow

A

Endosteum

103
Q

2 types of bone formation

A

Endochondral
Intramembranous

104
Q

Indirect method; cartilage becomes bone
Ex: Condyle, ethmoid bone, inferior conchae, sphenoid

A

Endochondral

105
Q

Direct method; bone cells secrete bone
Ex: maxillary and mandibular bone

A

Intramembranous

106
Q

Thin layer of cortical bone that immediately surrounds roots of the tooth and into which periodontal ligament fibers (Sharpey’s fibers) are embedded.

A

Alveolar bone proper (cribriform plate)

107
Q

Blood supply of:
Socket and lamina dura

A

Intraseptal artery

108
Q

Blood supply of:
Gingiva

A

Supraperiosteal blood vessels

109
Q

Blood supply of:
Junctional epithelium

A

Dentogingival plexus

110
Q

Blood supply of:
Oral epithelium of the free and attached gingiva

A

Subepithelial plexus

111
Q

Lymphatic drainage:
Buccal gingiva of the maxilla, and buccal and lingual of the mandibular premolar and molar region.

A

Submandibular lymph nodes (angle of the jaw)

112
Q

Lymphatic drainage:
Mandibular incisors

A

Submental

113
Q

Lymphatic drainage:
Third molars

A

Jugulodigastric

114
Q

Lymphatic drainage:
Labial and lingual gingival of the mandibular incisors

A

Submental (digastric)

115
Q

Lymphatic drainage:
Palatal gingival

A

Deep cervical lymph nodes (neck area)

Periodontology I (1 decks)

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