lecture 3- applied perio anatomy Flashcards
the healthy gingival sulcus is a ________
potential space
in a healthy patient, where does the probe penetrate to?
the free gingival groove
when disease (gingivitis) occurs, where would the probe penetrate to?
penetrates PAST junctional epithelium into connective tissue
diagnosis of periodontitis is based on ________, NOT _______
based on attachment loss, NOT probe depths
what is a “pseudo-pocket”
occurs when the Junctional Epithelium is still at the level of the CEJ, but the soft tissue becomes soft and allows the probe to go deeper
“true pockets” occur when?
- when there is a loss of attachment
- JE has attached lower on the root
T/F: periodontitis is based SOLELY on attachment loss
true
periodontitis occurs when junctional epithelium migrates __________
apically down the root surface
_________ junctional epithelium is necessary for pocket formation
viable
when taking probe depths, the distance from the CEJ to the bottom of the pocket will give you what reading?
attachment loss
the shape of interdental papilla depends on:
- contact relationship between adjacent teeth
- width of approximate tooth surfaces
- course of the CEJ
the position and dimension of the _________ determine probe angulations in posterior teeth
contact angle
a ______ degree angle is used to probe interproximally
10 degrees
T/F: narrow gingiva has a lower resistance to attachment compared to wide gingiva
FALSE
it has the same resistance
what type of gingival phenotype gives the highest resistance to recession?
stippled and thick biotype
a thin gingival phenotype will lead to a heightened risk for:
- increased recession
- more vulnerable to trauma
- more inflammation
- less favorable treatment outcome
when would you recommend gingival grafts?
1) when recession causes symptoms (pain, caries, esthetics)
2) subgingival restoration margins on thin biotype
3) pre-orthodontic therapy
the characteristics of the gingiva are ________ determined, as opposed to the result of functional adaptation
genetically
________ determines epithelial characteristics
connective tissue
what grafting procedure is now commonly used?
connective tissue graphs
a loss of junctional epithelium due to cell death is often seen in what condition? (leads to exposed bone)
Necrotizing ulcerative periodontitis (NUP)
soft tissue attachment to the tooth has 2 parts. What are they?
- Fibrous tissue
- junctional epithelium
what is the width of connective tissue attachment to a tooth? what is the epithelial attachment? total attachment?
CT- about 1mm
Epithelial attachment- 1.4mm
Total attachment- around 3mm
based on the biological total attachment width, what is the distance from the CEJ to the alveolar crest?
3mm
the distance from crown margins to the alveolar crest HAS to be _____mm
3mm
what must be done if the distance from crown margins to the alveolar crest is less than 3mm?
crown lengthening
what is the goal of crown lengthening?
to re-set the biologic width by removing bone (from the alveolar crest)
- must gain back the 2mm distance from the CEJ to the alveolar crest
alveolar bone is formed by cells of which 2 origins?
- cells of the dental follicle
- cells independent of tooth development
what types of bone are found in alveolar bone?
- cancellous bone
- cortical bone
- bone marrow
alveolar bone remodels in response to ______ and _______
force and tooth movement
what happens to the bundle bone (socket proper) after extraction?
it is resorbed
how is the bundle bone (socket proper) preserved after extraction?
-by packing it with bone (ground bone tissue)
________ line the bone surface of the periodontal ligament
osteoblasts
what is the basic principle for GTR (guided tissue regeneration)?
- epithelium grows faster than bone or connective tissue
- epithelial exclusion will allow selective growth of these cells
what is a barrier membrane? what is its purpose?
- collagen membrane that is packed over bone
- separates epithelial tissue from the regenerating bone structure
