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Midterm Flashcards

1
Q

Mandibular Anterior and Middle Buccal arterial supply

A

External: Inferior Labial Artery/Mental Artery

Internal: Incisive Artery

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2
Q

Mandibular Posterior Buccal arterial supply

A

External: Inferior Labial Artery

Internal: Inferior Alveolar Artery

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3
Q

Mandibular Lingual arterial supply

A

External: Sublingual Artery

Internal: Inferior Alveolar Artery

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4
Q

Maxillary Anterior and Middle Buccal arterial supply

A

External: Superior Labial Artery

Internal: ASA (anterior teeth), MSA (middle teeth)

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5
Q

Maxillary Posterior Buccal arterial supply

A

External: External branch of the PSA

Internal: PSA

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6
Q

Maxillary Lingual arterial supply

A

External: Greater Palatine Artery

Internal: ASA, MSA, PSA

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7
Q

Buccal gingiva of Maxillary Incisors, Canines, and Premolars nerve supply

A

Superior Labial branches from the Infraorbital Nerve

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8
Q

Buccal Gingiva of Maxillary Molars Nerve Supply

A

PSA Nerve

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9
Q

Posterior (Molars) Palatal Gingiva Nerve Supply

A

Greater Palatine Nerve

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10
Q

Anterior (Incisors and Premolars) Palatal Gingiva Nerve Supply

A

Nasopalatine Nerve

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11
Q

Buccal Gingiva of Mandibular Incisors and Premolars Nerve Supply

A

Mental Nerve

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12
Q

Buccal Gingiva of Mandibular Molars Nerve Supply

A

Long Buccal Nerve

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13
Q

Lingual Gingiva of Mandible Nerve Supply

A

Lingual Nerve

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14
Q

What does the submental lymph node drain?

A
  1. Mandibular Incisors

2. Labial and lingual gingiva over mandibular incisor region

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15
Q

What does the submandibular lymph node drain?

A
  1. Palatal and Buccal gingiva of maxilla
  2. Mandibular Posterior region
  3. All teeth and adjacent periodontal tissue
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16
Q

What does the jugulodigastic lymph node drain?

A

Tonsils and posterior tongue

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17
Q

Progression of lymph nodes from mandibular incisors

A
  1. Submental lymph nodes
  2. Submandibular lymph nodes
  3. Superior Deep Cervical lymph nodes
  4. Inferior Deep Cervical lymph nodes
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18
Q

What is the mucogingival junction?

A

Point at which the alveolar mucosa (non-keratinized) meets the attached gingiva (keratininzed)

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19
Q

Dimensions of Maxillary AG, Facial Aspect

A

Widest: Incisor region (3.5-4.5 mm)

Narrowest: Premolars region (1.9 mm)

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20
Q

Dimensions of Mandibular AG, Lingual Aspect

A

Widest: Molar region

Narrowest: Incisor Region

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21
Q

Dimensions of Mandibular AG, Facial Aspect

A

Widest: Incisor region (3.3-3.9 mm)

Narrowest: Canines and premolar region (1.8 mm)

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22
Q

General dimensions of the Attached Gingiva

A

1-9 mm

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23
Q

Order of Junction between tooth, epithelium, and Connective tissue (inside to outside)

A
  1. Tooth
  2. Internal Basal Lamina (Lamina Densa and Lamina Lucida)
  3. Junctional Epithelium
  4. External Basal Lamina
  5. Connective tissue
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24
Q

What is the Biologic Width?

A

Connective tissue attachment and junctional epithelium attachment (usually 2 mm)

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25
What PDL fibers are the most numerous and provide the main support to the tooth?
Oblique Fibers
26
What is the first type of cementum to be formed?
Acellular cementum
27
When is cellular cementum formed?
After the tooth has reached the occlusal plane
28
How are the Sharpey's fibers arranged in cellular cementum?
Parallel to the PDL or randomly
29
How are the Sharpey's fibers arranged in acellular cementum?
Perpendicular to the tooth (Right angles)
30
What is the composition of cementum?
Inorganic (40-50%): Hydroxyapatite Organic: Type I (90%) and Type III (5%) Collagen
31
What is the relative mineralization of the Periodontal structures?
- Enamel (97%) - Dentin (70%) - Bone (65%) - Cementum (40-50%)
32
What is the most common CEJ configuration?
Cementum overlapping enamel (60-65% of cases)
33
How is alveolar bone formed?
Intramembranous ossification
34
What is the hydroxyapatite composition of alveolar bone?
60-65% Hydroxyapatite
35
What is the function of Osteoblasts, Osteoclasts, and Osteocytes in alveolar bone?
- Osteoblasts: Form Osteoid/bone - Osteoblasts: Resorb and remodel bone - Osteocytes: Form networks of bone (in lacunae)
36
What makes up the attachment apparatus?
1. PDL 2. Cementum 3. Alveolar Bone
37
What is the physiologic Architecture of the Alveolar Bone?
Bone more coronal interproximally than on the lingual or facial side
38
What is the Reverse Architecture of the Alveolar Bone?
Bone more apical interproximally than on lingual or facial side (opposite of physiologic architecture)
39
What is dehiscence?
V-shaped defect with the marginal bone gone
40
What is Fenestration?
"window" defect in bone with marginal bone still intact
41
What is mesial drift?
Distal = Bone formation Mesial = Bone resorption
42
What is the cranial nerve supplying the periodontium?
The trigeminal nerve (CN 5)
43
What happens to keratinization of the periodontium when aging?
It decreases
44
What happens to the CT cellularity of the periodontium when aging?
It decreases
45
What happens to the Epithelium of the periodotium when aging?
It thins
46
What happens to the Intercellular substance of the periodontium when aging?
It increases
47
What happens to the Rate of Collagen Synthesis of the Periodontium while aging?
It decreases
48
What happens to the cementum thickness of the periodontium while aging?
It thickens (usually apically 5-10X)
49
What happens to the width of the PDL during aging?
It narrows due to cementum thickening
50
What is Abrasion?
Wearing away of tooth structure by forces other than mastication (e.g. tooth brushing)
51
What is Erosion?
Loss of tooth structure via a chemical process (e.g. anorexia/bulimia, acid reflux, soda)
52
What is Attrition?
Loss of vertical dimension due to tooth-to-tooth contact or wearing away of structure
53
What happens to periodontitis prevalence as people age?
It increases in both prevalence and severity
54
What is the main differentiation between gingivitis and periodontitis?
Gingivitis is reversible and does not exhibit attachment loss and Periodontitis is irreversible and does exhibit attachment loss
55
Characteristics of Stage IV Periodontitis Lesion
1. Plasma cells predominate (not PMNs) | 2. Extension of lesion into alveolar bone and PDL
56
Where do the earliest signs of gingivitis occur?
In the interdental papillae (Papillary gingivitis)
57
What is the most common cause of gingival bleeding?
Plaque/caries
58
What are examples of mechanical trauma that cause gingival bleeding?
Tooth brushing, toothpicks, and food impaction (may cause recession too)
59
What Systemic Factors are related to Gingival Bleeding?
1. Hemorrhagic diseases 2. Vascular Abnormalities 3. Platelet disorders 4. Hypothrmobinpenia (Vit. K def) 5. Coagulation defects 6. Multiple Myeloma 7. Postrubella Purpura 8. Use of ASA and Anticoagulants
60
Color changes in the gingiva in gingivitis
Becomes redder due to increased vascularity or decreased keratinization
61
Systemic Diseases associated with Periodontitis
1. AIDS 2. Diabetes 3. Down's Syndrome 4. Cyclic Neutropenia 5. Papillon Lefevre 6. LAD
62
What are the clinical manifestations of NUG?
"PIG" - Pain - Interdental Cratering - Gingival Bleeding
63
What is Leukemia associated with?
Bleeding gums (Coagulation defect)
64
What drugs may cause gingival overgrowth?
1. Dilantin (anti-seizure) 2. Nifedipine (CCB) 3. Cyclosporin
65
Classification of Calculus
Supragingival (C1) Calculus: Salivary source of mineral ions Subgingival (C2) Calculus: Serum source of mineral ions
66
Components of Calculus
- 80% inorganic salts (calcium and phosphorus) - Hydroxyapatite - Brushite
67
What is the Primary etiology of periodontitis?
Plaque
68
Characteristic of Periodontitis
- Destruction of gingival and periodontal fibers - Cyclic in nature - Rate of progression related to mass and composition of flora - Not all teeth/tooth surfaces equally susceptible
69
Calculations of Clinical Probing Attachment Level
w/o recession: probing depth (mm) - distance from free gingival margin to CEJ (mm) w/recession: probing depth (mm) + gingival recession (mm)
70
Golden rule of periodontitis
Attachment loss
71
Clinical signs of periodontal pocket
- Enlarged bluish/red marginal gingiva - Edema - Bleeding
72
What is the difference between suprabony and infra/intrabony pockets?
Suprabony: Base of pocket is coronal to alveolar crest; Horizontal pattern of bone destruction Infrabony: Base of pocket is apical to alveolar crest; Vertical/Angular pattern of bone destruction
73
Differential Diagnosis between endo and perio
Pulp Test: Endo: Nonvital Perio: Vital Periodontal Pocket: Endo: Narrow Perio: Wide coronally, narrow apically
74
Causative relationship between gingivitis and periodontitis
Periodontitis is always preceded by gingivitis, but not all gingivitis progresses to periodontitis
75
What resorption/formation conditions may result in bone loss?
1. Normal resorption and decreased formation 2. Normal formation and increased resorption 3. Increased resorption and decreased formation
76
What are the characteristics of bone destruction?
- Cyclic nature | - Demineralization followed by degradation of organic matrix
77
What will most likely occur with thinning of the periodontium?
Dehiscence or fenestration
78
Classifications of Vertical bone loss
Based on number of osseous walls remaining - 1 wall - 2 wall - 3 wall - Combination defects
79
What is an Osseous crater?
Special 2-wall vertical bone loss where the Lingual and facial plates still remain, but two walls against adjacent teeth are missing
80
What is the most common vertical defect and where is it commonly located?
Osseous Crater In the mandible
81
What is incidence?
Number of defects that occur over a period of time
82
What is prevalence?
Number of defects that occur in a population at one point in time
83
What is attachment loss?
Apical migration of the JE and CT attachments
84
What is the mean attachment loss for males and females?
Males: 2.04 mm Females: 1.80 mm
85
What Percentage of US adults have gingival bleeding?
50%
86
What Percentage of US adults (30+) have periodontitis?
47%
87
What Percentage of the population is at risk for severe periodontitis?
10-20%
88
O'Leary Plaque Record
Score = Number of sites with plaque/(number of teeth x 4) Goal = 10% in hygiene clinic
89
Gingival Index
0: Normal Gingiva 1: Mild inflammation, slight change in color, slight edema (NO BLEEDING) 2: Moderate inflammation, redness, edema, glazing (BOP) 3: Severe inflammation, marked redness and edema, ulcerations (spontaneous bleeding)
90
Miller Mobility Index
0: No movement 1: Barely any movement 2: crown moves up to 1mm in any direction 3: Crown moves >1mm in any direction or is depressible
91
What is the predominant Ig in GCF?
IgG
92
What is GCF?
An inflammatory exudate derived from the serum
93
What are the functions of Macrophages?
1. Process and Present Ag to Lymphocytes 2. Produce Collagenase, IL-1, PGE2, IL-6, IL-8, IL-10, IL-13, etc. 3. Phagocytosis
94
What are the functions of IL-1?
1. Promote T-cell helper function 2. Inhibit T-cell suppressor function 3. Promote B-cell maturation 4. Activate Macrophages to produce PGE2 5. *Activate Osteoclasts
95
What are the functions of PGE2?
1. Vasoactive 2. Edema, pain, fever 3. Neutrophil and monocyte chemotaxis 4. *Activates osteoclasts
96
Functions of C3b
1. Induce macrophage secretion and cytokine production 2. *Opsonization 3. Stimulate leukocyte oxidative metabolism
97
Functions of C5a
1. Leukocyte Chemotaxis 2. Stimulate leukocyte oxidative metabolism 3. Activate neutrophil and mast cell degranulation 4. *Increase Vascular permeability
98
Functions of C3a
Increase vascular permeability via Histamine
99
Function of C5b-9
Membrane attack complex
100
What are in vitro bone resorption factors?
1. LPS 2. Lipoteichoic Acid and muramyl dipeptides of gram +ve organisms 3. PGE2 4. IL-1 5. IL-6 6. TNF
101
Role of GCF
1. Cleansing 2. Antimicrobial properties 3. Adhesive properties
102
Functions of saliva
1. Lubrication 2. Physical protection 3. Cleansing 4. Buffering 5. Maintain tooth integrity
103
Antibody functions
1. Ag/Ab complexes inactivate toxins 2. Ag/Ab complexes activate classical complement pathway 3. Ab (w/C3b) opsonizes bacteria
104
T-cell functions
1. Cytotoxic 2. Helper 3. Suppressor 4. Lymphokines
105
Antibacterial Neutrophil Factors
1. Reactive Oxygen Species 2. Myeloperoxidase 3. Lactoferrin 4. Lysozyme 5. Neutral Proteases (Cathepsin G, Elastase, Collagenase)
106
What do Macrophages secrete?
1. IL-1, IL-6, TNF 2. Collagenase and elastase 3. PGE2 4. Complement components 5. Fibroblast and endothelial mitogens
107
What are the components of the periodontium?
1. Alveolar bone 2. Gingiva 3. PDL 4. Cementum
108
Bacteria with strong evidence for periodontitis etiology
1. Aggrebacter actinomycetemcomitans 2. Porphyromonas gingivalis 3. Tannerella forsythia
109
What bacteria make up the "red complex?"
1. Porphyromonas gingivalis 2. Tannerella forsythia 3. Treponema denticola
110
What bacteria is LAP associated with?
Aggrebacter actinomycetemcomitans
111
What bacteria is GAP associated with?
Porphyromonas gingivalis

Theoretical Perio (1 decks)

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