oral mucosa and periodontium Flashcards
oral mucosa functions
1) protection
- deeper tissues protected from environment
- barrier to microbes
2) secretion
- saliva
- sebaceous (insignificant)
3) thermoregulation
- heat is dissipated in dogs
4) sensation
- taste buds
- temperature touch and pain
masticatory mucosa
1) gingiva and hard palate
2) mastication role
lining mucosa
1) buccal, labial, alveolar, floor of mouth, soft palate
2) lining tissue
specialized mucosa
1) tongue with taste buds
clinical features
1) teeth
2) gingiva
3) vestibule
4) buccal mucosa
5) labial mucosa
6) alveolar mucosa
- covers alveolar bone
gingiva types
1) marginal / free gingiva
- around the tooth
2) attached
- below
3) interdental
4) mucogingival junction / groove
- separates attached from the alveolar mucosa
healthy oral mucosa
1) stippling pattern
2) fordyce granules
- yellow spots
-sebaceous glands in LP
3) salivary glands in submucosa
oral mucosa
1) epithelium
- SS
—
connective tissue papilla with rete pegs interdigitate
—
2) lamina propria
- mainly collagen type I and elastic
3) submucosa
- rich in fat, vessels, nerves
4) bone and periosteum or muscle
keratinization of oral mucosa
1) orthokeratization
2) parakertinization
3) nonkeratinization
orthokeratinization
1) basal cell layer
- cuboidal cells
2) prickel cell layer
- spherical cells
3) granular layer
- flat cells with keratohyaline granules
4) keratinized layer
- no nuclei
—
1) masticatory mucosa
2) specialized mucosa
parakeratinization
1) picnotic nuclei are retained in many oral squamous cells
2) keratinized
nonkeratinized
1) lining tissue
2) intermediate layer and superficial layer above the prickel cell layer
linea alba
1) growth of keratin on the mucous membrane
2) linea alba (chronic cheek bite)
- variation in keratinization of nonkeratinized buccal mucosa
- most common form of frictional keratosis
hyperkeratotic epithelium
1) chronic irritation such as tobacco smoke causes keratinization of epithelium
intercellular junctions
1) barrier to microbes (cohesiveness)
2) cohesion is provided by protein carbohydrate complexes
- from epithelial cells themselves
3) desmosomes /macula adherens
- stratum spinosum
- tonofilaments are bundles of intermediate filaments
4) hemidesmosomes
- epithelium to CT below
5) gap junctions are occasionally seen
6) tight junctions are rare
nonkeratinocyte
1) 10%
2) melanocytes
3) langerhans cells
4) merkel cell
5)lymphocytes
permability and absorption
1) floor of mouth
2) one of the thinnest areas
3) drugs absorbed here
hard palate
1) keratinized ss
2) rugae
- permanent
3) interdental papilla
4) mucoperiosteium
- firmly attached to bone
5) fat cushions and protects nerves and vessels
soft palate
1) deep pink and yellowish hue
2) moist
3) compressible and elastic
4) speech and swallowing
5) NKSS
sulcus terminalis
1) foramen cecum marks the beginning
base of tongue
1) lymphoid tissue
- lingual tonsils
anterior portion of tongue papilla
1) fungiform papilla
- NK round structures
2) filiform
- cone shaped
- thick keratinized cone shaped
3) foliate
- leaf like
- parallel ridges that alternate with deep grooves in papilla
- lateral aspect
4) circumvallate
- 8-12 large and close to sulcus terminalis
- glands of ebner (minor salivary)
lingual papillae shape
1) filiform
- hair like
2) fungiform
- fungus like
3) foliate
4) circumvallate
- dorsum of the tongue
hairy tongue
1) dorsal surface of the tongue
2) normal level of shedding of epithelium of the filiform lingual papillae is lacking
periodontium function
1) protection
- gingiva
2) support to
- PDL, alveolar bone, cementum
mucogingival junction
3) mucogingival junction
- separate the gingiva to alveolar mucosa
- epithelium and LP changes
2) gingiva
- parakeratinized with LP
- collagen bundles attached to periosteoum
- formed by mucoperiostium
- less blood vessels
- protect the bone
3) alveolar mucosa
- NK overlying loose LP
- elastic fibers to thick submucosa layer
- vessels in MP
overkeratinized gingiva
1) hard palate and attached gingiva blend into each other
2) masticatory mucosa with keratinized epithelium
healthy color
1) pink or pale pink
2) red indicates inflammation
3) melanin pigmentation is normal
gingival size
1) abundant KG
2) limited gingiva
- decrease protection of the tooth
contour and consistency
1) knife edge anatomy
2) gingiva recession
- rolled
how to assess gingiva
1) dry it
2) the tissue is firm, dull, immobile
3) stippling
- 40% of population
- rete pegs in CT papilla
gingival position
1) cementum covered by gingiva
2) recession
- GM becomes more epical
- loss of tooth protection
bleeding on probing
1) should not bleed
2) the junctional epithelium is not healthy
3) clinical sign of inflammation
dentoginigval junction
1) tooth surface and gingival tissue
2) sulcular epithelium
- gingival crest on top
3) marginal epithelium
4) junctional epithelium
- attaches to tooth
5) attached gingiva
- gingival epithelium
oral epithelium
1) SSK facing oral cavity
sulcular epithelium
1) no adhesion to tooth
2) gingival sulcus or gingival crevice
junctional epithelium
1) non keratinized
- thinner than sulcular epithelium
2) adhesion between gingiva and tooth
3) epithelial attachment at the bottom
- probe will stop right here
4) hemidesmosomes
- connect tooth and gingiva
connective tissue
1) lamina propria
interdental gingiva
1) concave shape
- gingival col
2) can have pyramidal shape in incisors and flat shape in molars
3) non keratinized and more susceptible to infection
gingival crevicular fluid
1) blood supply from LP creates GCF
2) sits in epithelial cells in gingival sulcus
- WBC, immunoglobulin and complement factors
- derived from serum, epithelial cells, and oral bacteria
3) minimal in healthy state
4) maintains dentinojunctional structure and protects from bacteria
5) proteinases and cytokines detected in GCF of diseased sites
periodontal inflammation
1) increased GCF volume
- to fight microbial attack
2) higher BOP and GCF volume in diseased group
components of LP
1) collagen 60%
- type I mostly
2) fibroblast 5%
3) vessels, nerves, matrix 35%
—
1) fibroblasts 65% of cells
2) mast cells
3) macrophages
4) neutrophils
5) lymphocytes
6) plasma cells
gingival fibers
1) dentogingival group
- most common
- LP of free and attached gingiva to cervical cementum
2) alveologingival group
- bone of alveolar crest to LP of free gingiva and attached ginigva
3) circular group
- support going around the tooth
4) dentoperiostal group
- cementum to alveolar process
5) transseptal
- interdentally
transseptal group
1) fibers run interdentally from base of junctional epithelium of one tooth and insert to cementum of adjacent tooth
2) interdental ligament that connect all teeth of arch
primary acellular cementum
1) formed during root development and slowly
- before eruption
2) at CEJ
- acellular afibrillar cementum
- limited to cervical enamel surface
- spurs from aceulluar extrinsic fiber cementum or isolated at CEJ
3) extrinsic fibers (sharpey’s) inserting from PDL
- anchor tooth to socket
secondary cellular cementum
1) at least half of tooth is formed and tooth in functional position
2) less mineralized and reparative adaptive functions
3) fibers made by cementoblasts
- intrinsic fibers
4) apical and interradicular regions of the tooth
cemento enamel junction
1) three configurations
a) cementum over enamel 60-65%
b) root dentin exposed 5-10%
c) butt joint 30%
hypercementosis
1) excessive production of cementum over normal root cementum
2) harder to extract
PDL fibers
1) prinicpal fiber bundles between tooth and bone
- the embedded portion is sharpey’s fibers
2) alveolar crest group
- cementum below CEJ and runs to ring of alveolus
3) horizontal group
- apical to alveolar crest group
- right angle from cementum to bone
4) oblique group
- most numerous
- cementum and runs oblique to bone coronally
5) apical group
- radiated from cementum to apex of the bone
6 )interradicular
- between multirooted teeth
- cementum to bone
hertwigs epithelial root sheath
1) clusters remain in PDL
2) epithelial cell rests of malassez
alveolar process
1) bone of jaw that make sockets of teeth
2) outer cortical plate
- buccal and lingual
3) central spongiosa
- trabecular
4) bone lining alveolus
- alveolar bone
- lamina dura
