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Perio - Exam 1 > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

T/F - The gingival connective tissue determines the differentiation of the epithelium.

A

TRUE

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2
Q

The gingival connective tissue is also known as?

A

Lamina propria

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3
Q

Lamina propria consists of 2 distinct layers. Name and describe.

A

Papillary Layer
-Forms finger-like extensions in the depressions delineated by the rete ridges

Reticular layer
-Beneath the rete ridges

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4
Q

T/F - The oral mucoperiosteum has no submucosa.

A

TRUE

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5
Q

Major gingival fiber groups are what? There are 3 groups. Name and describe them.

A

Bands of collagen fibers

Gingivodental group - Dentin into gingiva

Circular group - around the tooth

Transseptal group - Connects facial and lingual

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6
Q

What build up and tear down tissue?

A

Fibroblasts

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7
Q

Gingival CT - cells make up what %? Collagen fibers make up what %?

A

5%

65%

-Remainder is proteoglycans, glycoproteins, and CT ground substance

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8
Q

The vast majority of collagen int he gingival connective tissue is made up of what type?

A

Type I

*The reticular collagen is type III

Elastic fibers

Oxytalan fibers

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9
Q

Periodontal ligament does what and is made up of what?

A

Suspends and maintains tooth in socket.

Type I collagen

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10
Q

What has the thicker bundles of collagen, alveolar bone or cementum?

A

Alveolar bone

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11
Q

PDL + cementum + alveolar bone = ?

A

Attachment apparatus

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12
Q

Name 5 functions of the PDL.

A

1 - Suspends and maintains tooth in socket

2 - Provides pressure and pain sensory feeling to tooth

3 - Provides nutrients to cementum and bone

4 - Builds and maintains cementum and alveolar bone of tooth socket

5 - Remodels alveolar bone in response to pressure

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13
Q

What are the 4 collagen fibers of the PDL?

A

Principle

Intermediate plexus fibers

Sharpey’s fibers (Alveolar bone)

Indifferent fiber plexus

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14
Q

What are the elastic fibers of the PDL?

A

Oxytalan fibers

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15
Q

How thick is the PDL?

A

Varies from 0.1-0.25 mm

Widest during heavy occlusion, thinner in nonfunctional teeth

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16
Q

SA of socket wall?

A

150 - 275 sq mm of single root, 450 sq mm multirooted

2000/sq mm in non-functional
28,000 sq mm in functional

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17
Q

The rest cells of Malassez are remnants of what?

A

Hurtwigs root sheath

*Contiguous w/ REE

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18
Q

What are the cellular elements of the PDL?

A

Fibroblasts

Cementoblasts and cementoclasts

Osteoblasts and osteoclasts

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19
Q

What are the defense cells of the PDL?

A

Mast cells

Macrophages

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20
Q

What is cementum?

A

Thin layer of hard, mineralized tissue that covers root surface

Light yellow

Overlies dentin

Bone-like, but more resistant to resorption than bone

Does not have its own blood or nutrient supply

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21
Q

Primary cementum is called what?

A

Acellular cementum

22
Q

Secondary cementum is called what?

A

Cellular cementum

23
Q

CEJ relationships:

% cementum overlaps enamel

% cementum does not meet enamel (No CEJ)

% cementum meets enamel at a butt joint

A

60-65

5-10

30

24
Q

Cementum can be sensitive to cold/sweet due to what?

A

Underlying dentin is very sensitive

25
Q

What does alveolar bone do?

A

Surrounds and supports roots of teeth in upper and lower jaws

26
Q

T/F - Existence of alveolar bone is dependent on presence of teeth.

A

TRUE

EXTRACTIONS LEAD TO BONE RESORPTION (Especially on the facial)

27
Q

Why would we leave the root tip?

A

Prevent bone resorption

*If root tip remains, bone loss does NOT occur

28
Q

What are the 4 components of alveolar bone?

A

Alveolar bone proper (cribiform plate)

Cortical bone

Cancellous bone

Periosteum

29
Q

Alveolar bone proper is made up of what 2 types of bone?

A

Bundle bone

Lamellar bone

This is dependent on PDL space

30
Q

Supporting alveolar bone has two parts. Name them.

A

Cortical plate

  • Outer (labial, buccal)
  • Inner (lingual)

Supporting spongiosa

31
Q

Tell me about the alveolar bone proper. What is the alveolus?

A

Bony socket that houses the root of the tooth

Large pores where blood vessels connect

Ends of PDL fibers are embedded in alveolar bone proper

32
Q

Tell me about cortical bone.

A

Layer of compact bone that forms the hard outside wall of jaws on facial and lingual

Surrounds alveolar bone proper and gives support to socket

33
Q

Where is cortical bone the thinnest?

Where is cortical bone the thickest?

A

Incisors, canine, premolar

Molars

34
Q

Does cortical bone show up on radiographs?

A

NO

Alveolar crest most coronal portion

35
Q

Tell me about cancellous/spongy bone?

A

Spongy, lattice-like bone filler b/t cortical bone and alveolar bone proper

Oriented around tooth to form support for alveolar bone proper

Osteoporosis affects bone loss of this type of bone

36
Q

Tell me about periosteum.

A

Layer of connective tissue covering outer surface of bone

Provides nutrient supply

Consists of collagenous (type I) tissue and an inner layer of elastic fibers

*Get in and get out with periosteal surgeries

37
Q

What is the vascular supply of periodontal bone?

A

Apical vessels

Penetration thru alveolar bone

Anastomoses from the gingiva

Type I fibers - Fast fibers - mechanical and pain

*Also have lymphatic vessels and nerves present

38
Q

When inflammation occurs, what happens with the blood vessels?

A

They get leaky to allow immune products in

This leads to erythema as blood leaks into CT

39
Q

T/F - Oral pigmentation is a relatively common condition that may involve any portion of the oral cavity.

40
Q

Multiple causes of pigmentation. Name some.

A

Physiologic (Genetic)

Iatrogenic mechanisms - Bad dentistry

Local irritants - smoking

UV exposure - Frekeling

Complex medical disorders - Peutz-Jeghers syndrome

Cellular hyperplasia that can range from benign nevi to fatal oral melanoma

41
Q

If pigmented lesions are diffuse and bilateral, then what do you think?

A

Early onset
-If so, think genetic or Peutz-Jeghers

Adult onset
-Systemic?
—If so, Addison’s disease, heavy metal, kaposis sarcoma, Peptobismal has heavy metal and can cause pigmented lesions

-Not systemic?
—Drug induced, post inflammatory, Smokers melanosis

42
Q

If pigmented lesion is focal, look at the color.

A 
Red-blue-purple
-Blanching
—Varix
—Hemagioma
-Non-blanching
—Thrombus
—Hematoma

Blue-grey

  • Amalgam tattoo
  • Foreign body tattoo
  • Blue nevus

Brown

  • Melanotic macule
  • Pigmented nevus
  • Melanoma
  • Melanoacanthoma
43
Q

T/F - In Caucasian’s, 60-70% of subjects have melanocytes.

Where are they?

A

TRUE

Stratum basale and the suprabasal stratum spinosum

44
Q

Typically, physiologic pigmentation is found where?

A

Bilaterally, along attached gingiva

45
Q

Freckling on gingiva can happen from what?

A

UV radiation

46
Q

What is the diagnosis when there is pigmentation and bits of metal in the tissue surrounding the pigment?

A

Amalgam tattoo

*If in doubt, take a biopsy

47
Q

Tell me about smoker’s melanosis.

A

Melanin pigmentation occurring in the periodontium of heavy smokers

Occurs in 1 of 5 smokers, especially females taking birth control pills or hormone replacement

48
Q

T/F - Melanocytes are stimulated by nicotine.

49
Q

Why would smoker’s melanosis by found in children?

A

Usually environmental exposure

50
Q

T/F - Gingival pigmentation can be nothing to worry about or life-threatening.

Perio - Exam 1 (3 decks)

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