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Patient Care 3 > Lecture 1- Anatomy of Periodontium > Flashcards

Lecture 1- Anatomy of Periodontium Flashcards

1
Q

what are the 3 zones of the oral mucosa

A
  • the gingiva and covering of the hard palate - masticatory mucosa
  • dorsum of the tongue- specialized mucosa
  • oral mucous membrane lining remainder of oral cavity
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1
Q

what makes up the tissues of the periodontium

A
  • gingiva
  • cementum
  • PDL
  • alveolar bone
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2
Q

what does the masticatory mucosa cover

A

alveolar bone and tooth root coronal to the CEJ

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3
Q

what is masticatory mucosa divided into

A

marginal gingiva
- attached gingiva
- interdental areas

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4
Q

what is the marginal gingiva

A

free or unattached, cufflike tissue surrounding the teeth on facial , lingual, and interproximal surfaces

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5
Q

what is the gingival margin

A
  • most coronal portion of the gingiva
  • scalloped outline of teeth
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6
Q

what is the gingival sulcus

A

-space formed by tooth and sulcular epithelium and the coronal end of the JE

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7
Q

what sulcular measurements are WNL of gingival health

A

2-3mm

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8
Q

where is the free gingival groove

A

divides free gingiva from attached gingiva

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9
Q

what percentage of patients have free gingival groove

A

50%

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10
Q

what part of the gingiva does the interdental gingiva belong to

A

free gingiva

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11
Q

where is the interdental papilla

A

the interdental space

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12
Q

how is the interdental papilla attached to the tooth

A

by the JE and CT fibers

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13
Q

what is the gingival col

A

valley like depression of the interproximal contact areas
- connects lingual and buccal interdental papilla

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14
Q

when is the gingival col absent

A

when the teeth are not in contact

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15
Q

what is nonkeratinized epithelium susceptible to

A

inflammation and disease progression

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16
Q

what is attached gingiva attached to and by what

A

attached to alveolar bone and cementum by CT fibers and epithelial attachment

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17
Q

what are attached gingiva fibers demarcated by

A

-apically by the MGJ
- coronally by the base of the gingival sulcus

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18
Q

what is the width of the attached gingiva

A

varies from 1-9 mm

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19
Q

where is the widest aspect of attached gingiva and narrowest

A

maxillary central incisors and narrowest in premolar facial areas

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20
Q

how do you measure attached gingiva

A

subtract width of gingival from periodontal pocket

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21
Q

describe alveolar mucosa

A
  • movable tissue, loosely attached to underlying alveolar bone
  • thin, nonkeratinized epithelium
  • separate from attached gingiva at the MGJ
  • darker shade of red than gingiva due to blood supply
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22
Q

what is the MGJ and where is it found

A

visible line where the pink keratinized gingiva meets the more vascular alveolar mucosa
- found on maxillary facial and mandibular facial and lingual areas

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23
Q

describe gingiva microscopically

A
  • stratified squamous epithelium and CT
  • epithelium is mostly cellular in nature
  • CT is less cellular and mostly composed of collagen fibers and ground substance
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24
Q

what is the function of the gingival epithelium

A
  • physical barrier to infection
  • protection of deep strucures
  • participate actively in responding to infection in signlaing host response
  • allows a selective interchange with oral environment
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25
Q

epithelium covering the free gingiva may be differentiated into the following:

A
  • the oral/outer epithelium
  • the sulcular epithelium
  • the junctional epithelium
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26
Q

describe the sulcular epithelium

A

lines gingival sulcus, thin, non keratinized

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27
Q

what epithelium changes the most in the presence of bacteria

A

junctional epithelium

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28
Q

describe junctional epithelium

A

nonkeratinized epithelium surrounding and attaching to the tooth on one side and the gingival CT on the other side

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29
Q

where is junctional epithelium located

A

base of the sulcus/pocket

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30
Q

JE is more permeable to_____

A

cells and fluid

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31
Q

what does JE serve as a route of passage of

A

fluid and cells from the CT into the sulcus for bacteria/bacterial products from sulcus to CT

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32
Q

JE easily penetrated by ____ especially when _____

A

periodontal probe; gingiva is inflammed

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33
Q

what is the length of the JE

A

0.25-1.35mm

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34
Q

describe the color of the gingiva- attached/marginal

A
  • generally coral pink
  • produced by vascular supply and thickness/degree of keratinization
  • presence of pigment containing cells
  • lighter color in blond individuals with fair complexion than in dark complexioned dark haired individuals
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35
Q

describe the color of the alveolar mucosa

A

red
- smooth
- shiny
- epithelium is thinner and nonkeratinized
- blood vessels are more numerous

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36
Q

what is melanin responsible for

A

normal pigmentation of the skin, gingiva and remainer of the oral mucous membrane

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37
Q

melanin pigmentation in the oral cavity is prominent in______

A

black individuals

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38
Q

what does pigmentation in black individuals appear as

A

diffuse, deep-purplish discoloration or as irregularly shaped brown and light brown patches

39
Q

size of the gingiva corresponds with:

A

the number of cellular/intercellular elements and vascular supply

40
Q

what does the change in size of gingiva indicate

A

gingival disease

41
Q

what does the contour of gingiva vary depending on

A

the shape of the teeth and alignment

42
Q

what is gingival biotype

A

thickness of tissue

43
Q

what is the shape of interdental gingiva governed by

A

contour of proximal tooth surfaces, location and shape of embrasures

44
Q

interdental papilla can appear ____ or ____ depending on location

A

pyramidal; flattened

45
Q

describe the consistency of gingiva and why

A
  • firm and resilient except the free margin
  • collagen fibers determine firmness of attached gingiva
  • gingival fibers contribute to firmness of gingival margin
46
Q

describe the surface texture of gingiva

A
  • attached gingiva is stippled
  • marginal gingiva is not stippled
47
Q

where is stippling less prominent

A

on lingual than facial surfaces

48
Q

how is stippling best viewed

A

drying the tissue

49
Q

what are the ways to describe the quality of color of gingica

A

red, bright red, pink, cyanotic

50
Q

what are the ways to describe the quality of contour

A

bulbous
- flattened
- punched out
- cratered

51
Q

what are the ways to describe the quality of consistency

A

firm
- spongy

52
Q

what are the ways to describe the quality of surface textrue

A

smooth
- shiny
- eroded
- stippling

53
Q

describe cementum

A

-calcified connective tissue covering the roots of the teeth

54
Q

what is the least mineralized of the calcified tissues of the tooth

55
Q

what are the 2 types of cementum

A

acellular (primary) and cellular ( secondary) consisting of a caclified interfibrillar matrix and collagen fibrils

56
Q

what is the function of the cementum

A

to attach fibers of the PDL to the tooth to seal the tubules of the root dentin

57
Q

what is in cementum

A

no blood, lymph vessels of innervation noted

58
Q

where is cementum deposited and during what stages of life

A

continuously deposited in the apical area of the root throughout life

59
Q

describe acellular cementum

A
  • first cementum formed
  • covers approximately cervical third or half of the root
  • does not contain cells
  • formed before the tooth reaches the occlusal plane
60
Q

describe cellular cementum

A
  • formed after tooth reaches occlusal plane
  • less calcified
  • deposited throughout life of tooth
  • deposited at intervals producing arrest lines
61
Q

what is hypercementosis and where is it found

A

local abnormal thickening of parts of the cementum typically found in the apical region

62
Q

what is hypercementosis a result of

A
  • chronic inflammation of the tooth
  • no opposing tooth
  • additional eruption
  • tooth becoming fused to surrounding alveolar bone proper
63
Q

what are the 3 relationships involving and cementum that may exist at the CEJ

A
  • space between the enamel and cementum with the dentin exposed occurs in 10% of cases
  • end to end relationship of enamel and cementum occurs in 30% of cases
  • cementum overlapping the enamel occurs in 60% of cases
64
Q

what is the PDL

A
  • fibrous connective tissue surrounding and attaching roots of teeth to bone
65
Q

where is the PDL located

A

in periodontal space between the cementum and bone

66
Q

what is PDL composed of

A

connective tissue cells and intracellular substance

67
Q

what are sharpeys fibers

A

the fibers inserted into the cementum on one side and bone on the other

68
Q

what are the 4 functions of the PDL and describe each

A
  • supportive: anchors tooth to bone. sharpeys fibers
  • formative: helps maintain biologic activity of bone and cementum
  • nutritive: supplies nutrients and removes waste products via blood and lymph vessels
  • sensory: capable of transmitting tactile pressure and pain sensations
69
Q

how is PDL width seen

A

only in radiographs

70
Q

what does PDL width depend on

A

age, stage of eruption, function of tooth and angle of film

71
Q

what are the PDL fiber groups

A

gingival fiber groups and principal fibers

72
Q

where are gingival fiber groups located

A

around the cervical are within the gingival tissue

73
Q

what are the gingival fiber groups

A
  • dentogingival fibers (free gingival)
  • alveologingival fibers (attached gingival)
  • circumferential fibers (circular)
  • dentoperiosteal fibers (alveolar crest)
  • transseptal fibers
74
Q

where are principal fiber groups

A

surround the root

75
Q

what are the principal fiber groups

A
  • apical fibers
  • oblique fibers
  • horizontal fibers
  • alveolar crest fibers
  • interradicular fibers
76
Q

where are the dentogingival fibers

A

from the cementum in the cervical region into the free gingiva to give support to the gingiva

77
Q

where are the alveologingival fibers

A

from the alveolar crest into the free and attached gingival to provide support

78
Q

where are the circumferential fibers

A

continuous around the neck of the tooth to help maintain the tooth in positionw

79
Q

where are the dentoperiosteal fibers

A

from the cervical cementum over the alveolar crest to blend with fibers of the periosteum of the bone

80
Q

where are the transseptal fibers

A

from the cervical area of one tooth across to an adjacent tooth on the mesial or distal only to provide resistance to separation of teeth

81
Q

where ar apical fibers

A

from the root apex to adjacent surrounding bone to resist vertical forces

82
Q

where are oblique fibers

A

from the root above the apical fibers obloquely towards the occlusal to resist vertical and enexpected strong forces

83
Q

where are horizontal fibers

A

from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth

84
Q

where are the alveolar crest fibers

A

from the alveolar crest to the cementum just below the CEJ to resist intrusive forces

85
Q

where are interradicular fibers

A

from cementum between the roots of multirooted teeth to the adjacent bone to resist vertical and lateral forces

86
Q

what is alveolar bone and what is it made of

A
  • bone that forms and supports the alveoli (tooth sockets)
  • consists of alveolar bone proper and supporting bone
87
Q

contour of the alveolar bone follows contour of the _____

A

CEJ and arrangement of the dentition

88
Q

shape of the alveolar crest is generally ______

A

parallel to the CEJ of adjacent teeth’ approximately 1.5mm-2mm apical to the CEJ

89
Q

cortical plates are thicker in the _____

90
Q

what does the alveolar bone surround

A

thin layer of bone that surrounds the root and gives attachment to the PDL

91
Q

what is alveolar bone proper called in radiographic images

A

lamina dura or cribiform plate

92
Q

what is the supportive alveolar bone

A

portion of alveolar process that surrounds the alveolar bone proper and gives support to the sockets

93
Q

what are the types of supportive alveolar bone

A
  • compact (cortical)
  • cancellous or trabecular (spongy) bone

Patient Care 3 (22 decks)

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