lecture 3- applied perio anatomy

Question 1

the healthy gingival sulcus is a ________

Answer 1

potential space

Question 2

in a healthy patient, where does the probe penetrate to?

Answer 2

the free gingival groove

Question 3

when disease (gingivitis) occurs, where would the probe penetrate to?

Answer 3

penetrates PAST junctional epithelium into connective tissue

Question 4

diagnosis of periodontitis is based on ________, NOT _______

Answer 4

based on attachment loss, NOT probe depths

Question 5

what is a “pseudo-pocket”

Answer 5

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

Question 6

“true pockets” occur when?

Answer 6

• when there is a loss of attachment

- JE has attached lower on the root

Question 7

T/F: periodontitis is based SOLELY on attachment loss

Answer 7

true

Question 8

periodontitis occurs when junctional epithelium migrates __________

Answer 8

apically down the root surface

Question 9

_________ junctional epithelium is necessary for pocket formation

Answer 9

viable

Question 10

when taking probe depths, the distance from the CEJ to the bottom of the pocket will give you what reading?

Answer 10

attachment loss

Question 11

the shape of interdental papilla depends on:

Answer 11

• contact relationship between adjacent teeth
• width of approximate tooth surfaces
• course of the CEJ

Question 12

the position and dimension of the _________ determine probe angulations in posterior teeth

Answer 12

contact angle

Question 13

a ______ degree angle is used to probe interproximally

Answer 13

10 degrees

Question 14

T/F: narrow gingiva has a lower resistance to attachment compared to wide gingiva

Answer 14

FALSE

it has the same resistance

Question 15

what type of gingival phenotype gives the highest resistance to recession?

Answer 15

stippled and thick biotype

Question 16

a thin gingival phenotype will lead to a heightened risk for:

Answer 16

• increased recession
• more vulnerable to trauma
• more inflammation
• less favorable treatment outcome

Question 17

when would you recommend gingival grafts?

Answer 17

1) when recession causes symptoms (pain, caries, esthetics)
2) subgingival restoration margins on thin biotype
3) pre-orthodontic therapy

Question 18

the characteristics of the gingiva are ________ determined, as opposed to the result of functional adaptation

Answer 18

genetically

Question 19

________ determines epithelial characteristics

Answer 19

connective tissue

Question 20

what grafting procedure is now commonly used?

Answer 20

connective tissue graphs

Question 21

a loss of junctional epithelium due to cell death is often seen in what condition? (leads to exposed bone)

Answer 21

Necrotizing ulcerative periodontitis (NUP)

Question 22

soft tissue attachment to the tooth has 2 parts. What are they?

Answer 22

• Fibrous tissue

- junctional epithelium

Question 23

what is the width of connective tissue attachment to a tooth? what is the epithelial attachment? total attachment?

Answer 23

CT- about 1mm

Epithelial attachment- 1.4mm

Total attachment- around 3mm

Question 24

based on the biological total attachment width, what is the distance from the CEJ to the alveolar crest?

Answer 24

3mm

Question 25

the distance from crown margins to the alveolar crest HAS to be _____mm

Answer 25

3mm

Question 26

what must be done if the distance from crown margins to the alveolar crest is less than 3mm?

Answer 26

crown lengthening

Question 27

what is the goal of crown lengthening?

Answer 27

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

Question 28

alveolar bone is formed by cells of which 2 origins?

Answer 28

• cells of the dental follicle

- cells independent of tooth development

Question 29

what types of bone are found in alveolar bone?

Answer 29

• cancellous bone
• cortical bone
• bone marrow

Question 30

alveolar bone remodels in response to ______ and _______

Answer 30

force and tooth movement

Question 31

what happens to the bundle bone (socket proper) after extraction?

Answer 31

it is resorbed

Question 32

how is the bundle bone (socket proper) preserved after extraction?

Answer 32

-by packing it with bone (ground bone tissue)

Question 33

________ line the bone surface of the periodontal ligament

Answer 33

osteoblasts

Question 34

what is the basic principle for GTR (guided tissue regeneration)?

Answer 34

• epithelium grows faster than bone or connective tissue

- epithelial exclusion will allow selective growth of these cells

Question 35

what is a barrier membrane? what is its purpose?

Answer 35

• collagen membrane that is packed over bone

- separates epithelial tissue from the regenerating bone structure