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ICS1 > Midterm I: Intro perio + Odontogenesis > Flashcards

Midterm I: Intro perio + Odontogenesis Flashcards

1
Q

what is root dilaceration

A

projection from root

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2
Q

concrescence

A

cementum of two teeth join together.

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3
Q

talons cusp

A

extra cusp on labial aspect of maxillary lateral incisor

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4
Q

crown dilaceration

A

projection from crown

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5
Q

taurodontism

A

vertical enlargement of body/pulp of tooth taking up part of the root, as a result the forcation of the root is moved down

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6
Q

enamel pearl

A

enamel spot on root surface (often at furcation)

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7
Q

what genes are involved in dental anomalies

A
  1. bone morphogenic protein (MPG)
  2. fibroblast growth factor (FgF)
  3. Sonic hedgehog (SHH)
  4. Wingless-related integration site (Wnt)
  5. ectodysplasin A (Eda)
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8
Q

what are some types of drugs that may cause dental anomalies

A

chemotherapy and anti-epilepsy drugs

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9
Q

what are the 3 risk factors for teeth deformities

A

genetic
medications
malnutrition (vitamins and minerals)

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10
Q

what occurs in the initiation stage of odontogenesis

A

the dental lamina forms - it is a ‘swelling’ on the oral epithelium (stratified squamous)

  • within the dental lamina a DENTAL PLACODE (or initiation knot/transient signaling center) sends signals to dental mesenchyme below. informing cells around that odontogenesis will begin. SHH, WNT, BMP and FGF are all involved.
  • odontogenic potential of oral epithelium - if you transferred dental placode to another part of the body, will form a tooth
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11
Q

what occurs in the bud stage of odontogenesis

A

start of morphogenic stage
-dental lamina continues to extend into mesenchyme forming ‘tooth bud’ protrusion at the end
-a condensation of ectomesenchyme cells forms around the tooth bud
(still label with oral epithelium at the top, then dental lamina then tooth bud)
-ectomesenchyme assumes the odontogenic potential

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12
Q

what occurs at the cap stage of odontogenesis

A

‘enamel organ’ forms- consists of outer enamel epithelium- cuboidal ep, inner enamel epithlelium- columnar ep, and stellate reticulum in the middle.

  • condensation fo ectomesenchyme becomes the dental sac or dental follicle. a little groove in the enamel organ /protrusiion of dental sac is called the dental papilla
  • outer and inner enamel epithelium start to store glycogen
  • stellate reticulum cells produce glycosaminoglycans
  • enamel knot is cluster of nondividing epithelial cells involved in signaling and pattern formation of cusps- differential gene expression starts :
  • – for incisors: Msx-1 , Msx-2, and Alx-3 in presumptive incisor mesenchyme
  • – for presumptive molar region : Barx-1, Dlx-1/-2

(btw, dental lamina is still above the enamel organ)

(dental papilla will become dental pulp and odontoblasts, and dental follicle will become cementoblasts, PDL, and alveolar bone proper-part coming in direct contact w root viapdl)

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13
Q

what occurs in the bell stage of odontogenesis

A

in bell->cap stage - secondary enamel knots form for premolars and molars - two protrusions with enamel knots (signalers)
Bell stage:
-crown shape is established
-enamel knot dissapears
-formation of stratum intermedium (inside of IEE)
-dental lamina breaks into islands of epithelial cells (epithelial rest of serres)
-cervical loop at edges ; starts root formation
-mineralization starts - amelogenesis dentinogenesis

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14
Q

when does permanent tooth formation occur?

A

starts during cap and bell stage of the deciduous predecessor . arises from the dental lamina of deciduous tooth for incisors, premolars and canines.. Molars have no deciduous predecessors

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15
Q

what is the late bell stage

A

ending of bell stage- increase amounts of minerals, increased size of crystals. maturation of crystals, completion of crown formation.

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16
Q

what are the topics to address for gingival health?

A

color
contour
consistency
bleeding upon probing?

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17
Q

what will determine the color of gingiva

A

vascular supply and thickness/degree of keratinization.

should be a coral pink/salmon

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18
Q

what is the contour/shape of gingiva

A

contour is the papilla filling the embrasure space (b/w teeth) comes to a point when gingiva is healthy.
also free gingival margin - should come to a knife edge.
((((-will be impacted by location/size of proximal contact and dimensions of gingival embrasures)))

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19
Q

what should gingiva consistency be?

A

firm and resilient, orange peel texture is healthy (not always there).

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20
Q

where on tooth should bone be

A

normal/healthy bone should be 1-2 mm apical to the CEJ

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21
Q

what are the symptoms of inflammation

A

heat, edema , erythmea (red), pain

22
Q

what are characteristics for gingivitis

A
  • clinical signs of inflammation (free gingival margins rolled rather than knife edge, red, inflamed)
  • no evidence of attachment loss (bone stops at cej)- bone is still 1-2 mm apical to cej
  • soft tissue margins coronal to cemento enamel junction
23
Q

what are characteristics of periodontitis

A
  • clincial evidence of attachment loss : does probe stop at cej? does radiograph show bone loss?
  • clinical signs of inflammation
24
Q

how prevalent is periodontal disease

A

74% of adults had some form of periodontal disease 1969
adults over 30 had 47.2% prevalence of periodontitis (highest for males, smokers, low education, below poverty line)
-mexican americans -66.7%, non hispanic blacks - 58.6%, non hispanic whites - 42.6%

25
Q

what is experimental periodontitis model

A

-do you get gingivitis from not brushing (students–yes)
yon lindhe: dog experiment- it concludes that conversion from gingivitis to periodontitis cant be explained by palque accumulation alone.
-conversion factors possible : microbiological and host factors (susceptible host)

26
Q

what bacteria leads to periodontitis?

A

Gram+ facultative rods and cocci - acinomyces streptococci and

27
Q

from healthy to gingivitis to periodontitis- what is the shift in bacteria?

A

G+ facultative rods and cocci- actinomyces streptococci are predominant in healthy mouths, to G- anacrobic rods, (mostly bacteroides fusobacteria) which are predominant in periodontitis. In gingivitis there is a larger portion that is G- and by periodontitis, it is more prevalent than G+

28
Q

what does the host inflammatory response use for CT and bone metabolism

A

cytokines and prostanoids, matrix metalloproteinases

29
Q

what are the two types of plaque control

A

chemical (dentrifices, mouthwashes) and mechanical (toothbrush, etc)

30
Q

how often should a toothbrush be replaced

A

every 3 months

31
Q

what is interdental cleaning

A

like flossing- brushing doesnt get all the stuff in between teeth
-purpose of floss is to remove plaque not to dislodge food. useful for narrow embrasures with intact papillae and tight contacts

32
Q

what are the types of floss

A

multifilament, wax vs unwaxed, thick vs thin. up to patient

33
Q

what kinds of instruments are used for treating periodontal disease (non surgical)

A

curettes, scalers, ultra-sonics (etc)

34
Q

what are the delivery modes for periodontal treatments (non surgical)

A

topical, local (irrigation/sustained release), systemic

35
Q

what are occlusal splints

A

like night guards- used to ease muscle tension/stabilize the jaw.
temporary acrylic splints used to stabilize teeth teeth– connecting them together so they function better. but needs to be a big enough space for flossing

36
Q

what are typical amounts of time between periodontal maintenance procedures

A

3, 4 or 6 (rarely)

37
Q

what is a gingivectomy

A

(removing gum tissue) for patients with deep pockets at re-evaluation that cant be naintained with good home care..

38
Q

what is an apically positioned flap

A

a way to address deep pockets- more commonly used.
-gives access to bone (unlike gingivectomy) so you can work on the bone
teeth are longer but pockets are reduced
-

39
Q

what is bone resection used for with flap procedure

A

cutting part of bone to create a contour that the gingiva can follow when it heals. (going from negative architecture back to healthy positive architecture)

40
Q

what is a root resection

A

if having issues in a furcation, can remove one of the root extensions -first sever from rest of tooth then remove, then they can clean there.

41
Q

what is a hemisection procedure and which teeth is it done on

A

for mandibular molars !

-cut tooth in half, take out bad root and keep good root. usually remove a tooth and put an implant instead these days

42
Q

what is bicuspidization of a mandibular molar

A

after hemisection (cutting in half) prosthodontist restores it as two bicuspids.

43
Q

what are options for creating positive architecture

A

bone resection (cut away) or bone graft

44
Q

what is a membrane placement for

A

it blocks out the epithelial cells overlying it , allowing time for the osteoblasts, cementoblasts etc to regenerate and pdl to regenerate.
good way to buy time for healing etc

45
Q

what is functional crown lengthening

A

increasing tooth structure exposed so the tooth can be restored , cant retain a crown when theres hardly any tooth exposed.
there are also aesthetic ones

46
Q

what are the 3 types of periodontal plastic surgery

A

soft tissue grafting, ridge augmemtation, esthetic crown lengthening

47
Q

what is soft tissue grafting

A

aka subepithelial connective tissue graft

  • do a splint thickness flap - reflect a flap and place some CT from the palate and suture there, then close flap over that.
  • small part of graft is exposed when tissue is brought down , the CT is covering that would be exposed part of the root (slide 76)
48
Q

what is a ridge augmentation

A

adding bone graft/soft tissue graft

  • instances like an extracted tooth leads to loss of bone
  • adding soft tissue for an esthetic bridge
49
Q

what is esthetic crown lengthening

A

removing bone to expose that 1-2 mm before the CEJ if teeth are very small.

50
Q

what aspect of implants are periodontists involved in

A

preparation of site (not restoring it- general dentist or prosthodontist does this)
-prepare site for implant, placement of implant, and maintaining the implant!!

ICS1 (23 decks)

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