Macro and Micro Anatomy

Question 1

The oral periodontium consists of?

Answer 1

Gingiva, Pdl, Alveolar bone and Cementum

Question 2

what are the types of the oral mucosa?

Answer 2

1. masticatory mucosa: (para keratinized epi + CT) ex: gingiva, hard palate.
2. specialized mucosa: (nerve endings for general sensory reception and taste perception) ex: dorsal tongue
3. lining mucosa: (non keratinized epi.) ex: soft palate, vestibules, ventral tongue, FOM, labial mucosa

Question 3

what is the free gingival margin?

Answer 3

a shallow V shape groove (junction between sulcular epi. and oral epi.) runs parallel to the margin of gingiva at a distance 0.5-1.5mm - Orban 1948

Question 4

Bosshardt et al. 2022?

Answer 4

1. Free gingival margin lack stippling
2. most common on Mand. I. and PM. - Buccal side
3. varies in width 0.5- 2mm

Question 5

Ainamo, Leo 1966?

Answer 5

Free gingival groove presents in 30% of adults

Question 6

Ways to detect attached Gingiva?

Answer 6

1. Visual (color)
2. Roll
3. Schiller’s Iodine test (due to glycogen : iodine interact with glycogen in squamous epithelium.
   columnar epithelium lacks glycogen)

Question 7

Ainamo & Talari 1962?

Answer 7

as the pt ages the Attached gingiva increases in width (bc the continuous eruption of the permemnant teeth and MGJ is a permanent landmark)

Question 8

Karring & Leo 1977?

Answer 8

1. Stippling - Rete ridges invading the underlying CT
2. presents in 40% of adults

Question 9

Greene 1962; JOP?

Answer 9

1. 300 pt (250 healthy gingiva, 50 diseases gingiva)
2. mucosa dried and observed
3. findings: a. stippling can be found in free gingival margin
   b. stippled tissue is highly keratinized
   c. pt with gingivitis - no stippling
   d. stippling is Negative predictive value - is related to health but not existence does not mean not health
   e. location: (most to least) Upper: ant, buccally. Lower: ant, buccal & lingual - post, Bucally

Question 10

Bowers 1963?

Answer 10

studied attached Gingival width - facial side

findings:
1. with each tooth? avg (1-9mm) greatest in CI & LI
least in C & PM
Max > Man
2. between each individual? AG width varies
3. with age? AG width increase with age (Ainamo & talaria 1962)
3. with sex? no diff between female and male
4factors affect width? muscles attachment, frenum, malposed teeth, recession

Question 11

Voigt 1978?

Answer 11

Studied attached gingival width lingually

findings:
1. (avg 1-8mm)
2. Most: 1st and 2nd M, least: I & C

Question 12

Ways to measure AG thickness?

Answer 12

1. Cadavers: autopsy/ext teeth
2. Caliper: during surgery
3. radiographs: cbct w/ lip retraced
4. ultrasounds
5. transgingival probing (endofiles) or
   5.(TRAN color coded probe Respirini 2015)

thick >1mm, thin <1mm (kan 2010)

Question 13

Andrew 1995; JOP?

Answer 13

• Thin gingiva is more prone to recession due to lacking underlying CT and less blood supply
• study findings:
  1. pt with tissue thickness =<1mm demonstrated 2.1 mm increase in recession

2. pt with tissue thickness => 1mm exhibited 0.6mm increase in recession

Question 14

clinical importance of AG width?

Question 15

clinical importance of AG thickness?

Question 16

Comparison between the 3-types of gingival epithelium? Table

Question 17

McHugh 1971?

Answer 17

• studied Interdental gingiva/lined by squamous epi.
• Findings:

1. 20 monkeys / B-L M-D tissue blocks harvested, stained with H&E , GI index and PI index used to measure susceptible to disease
2. True Col area has thinner cells 5 or mor squamous cells, no ameloblasts, almost nerve free PI index. 0.5% free Plaque)
3. Interproximal area more susceptible to gingivitis and exudate than B-L areas
4. Toward the middle of the tooth reduced enamel epithelium with ameloblasts

Question 18

Gingival “col”?

Answer 18

non keratinized epithelium, considered as the inter proximal JE of adjacent teeth., not present if adjacent teeth are missing

Question 19

SupraCrestal Tissue Attachment - BW?