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Perio > Oral Mucosa part II > Flashcards

Oral Mucosa part II Flashcards

1
Q

Name some host derived enzymes found in the GCF.

A

Acid phosphates Alkaline phosphatase Alpha 1 antitrypsin Arulsulphatse Aspartate aminotransfarase B-glucuronidase Cathespin D, G Matrix metalloprotiens MMPS Elastase Plaminogen activators

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2
Q

Where does elastase come from? What does high levels of elastase indicate?

A

PMNs. Disease

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3
Q

If there are high levels of anitbodies in the GCF what does that indicate?

A

That the sulcus has turned into a pocket.

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4
Q

Name some bacterial derived enzymes in the GCF.

A

Acid phosphates Alkaline phosphatase Collagenase Hyaluronidase phosphlipase A phospholipase c Bacterial proteinases ENDO and EXOpeptidases

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5
Q

Name the cellular elements of the GCF (3)

A

Bacteria desquamated epithelial cells leukocytes PMNs, lymphocytes, monocytes

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6
Q

Where do leukocytes migrate through into the sulcus in healthy tissue?

A

Sulcular epithelium

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7
Q

List the electrolytes found in the GCF (5)

A

Potassium K Sodium Na Calcium Ca Magnesium Mg Fluoride F

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8
Q

During inflammation, _____ and ____ concentrations have a positive correlation with _____ ratio in the GCF.

A

Ca and Na Na/K

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9
Q

List (2) organic compounds found in the GCF.

A

GLUCOSE hexosamine Hexuronic acid

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10
Q

Glucose concentration in the gingival fluid is _____ times greater than that in _____.

A

3-4 serum

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11
Q

The excess glucose in diabetic patients can be used by what and cause what?

A

Bacteria lactic acid that leads to caries

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12
Q

List the metabolic end products of bacteria (6)

A

Lactic Acid Endotoxins Urea Hydroxyproline Cytotoxic substances Hydrogen sulfide - smelly!!

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13
Q

What are cytokines?

A

Potent local mediators of inflammation. Produced by a variety of cells Communication between white blood cells

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14
Q

What can cytokine be diagnostic markers for in the oral mucosa?

A

Periodontal disease

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15
Q

List (5) types of cytokines.

A

Interleukin 1alpha Interleukin 1beta interleukin 6 interleukin 8 tumor necrosis factor

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16
Q

What interleukins have pro-inflamatory affects?

A

IL 1 alpha IL 1 beta * can stimulate bone reposition or formation

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17
Q

What is prostaglandin E2?

A

inflammatory mediator A product of the cyclooxyrgenase path

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18
Q

Where the levels of PGE2 elevated or depressed in patients with periodontitis?

A

ELEVATED!

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19
Q

What color is the attached gingiva?

A

Light pink, coral pink * may be pigmented depending on skin color. Darker skin - darker attached gingiva

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20
Q

What are the functions of the attached gingiva?

A

Withstand mechanical forces Prevents free gingival from being pulled away from the tooth when tension is applied to mucosa (lip being pulled out)

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21
Q

What are stipplings?

A

The attachement points of fibers to the gingival tissue, cement, and bone. Rete pegs and epithelial projections.

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22
Q

Healthy texture is ______

A

stippled

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23
Q

Does the absence of stippling mean anything?

A

NO! Presence of stippling does not mean disease.

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24
Q

Maxillary ATTACHED GINGIVA width: * incisors:_______ * premolar:__________

A

3.5 - 4.4 mm 1.9 mm * more recession can occur in the incisors before it is huge concern.

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25
Q

Mandibular ATTACHED GINGIVA width: * Incisors: _______ * Premolars: ________

A

3.3 - 3.9 mm 1.8 mm

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26
Q

The entire palate is attached tissue? T or F

A

True

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27
Q

Should lacerations of the palatal rugae be noted in the patients chart? Why?

A

Yes! It is a clinical finding. Can occur due to sharp foods.

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28
Q

Interdental paplla

A

should extend up between the teeth until tooth contact. Fill the entire inter proximal space.

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29
Q

What largely determines the shape of the gingiva? (3)

A
  1. Relationship to teeth (crowns) 2. Genetics 3. State of health Varies according to the dimension
30
Q

If you change the relationship of the contact points and bone what can you change?

A

The height of the contact point - and eventually the height of papilla

31
Q

What is the length of the papilla?

A

5mm or less (100% of time) 6 mm or more (present 56% of the time)

32
Q

If there is no contact what affect does this have on the papilla?

A

No contact – NO PAPILLA

33
Q

What is the Col?

A

Depression between facial and lingual interdental gingiva. Interproximal area

34
Q

Is the Col nonkeratinized or keratinized tissue?

A

Nonkeratinized * more susceptible to disease!

35
Q

List the fiber bundles near the Col. (4)

A

Dentogingival group Circular group Periosteal group Alveologingival group

36
Q

With recession what happens to the interdental gingiva?

A

It becomes nonkeratinized tissue (keratinized –> Nonkeratinized) *good result health wise, bad cosmetically

37
Q

What shape does the cole have before recession and after?

A

Concave Convex

38
Q

When perio-probing where is the probe ending at?

A

Junctional epithelium (not CEJ)

39
Q

During a healthy situation there is a space at the sulcus. T or F

A

False - healthy tissue should be approximated to the enamel via the GCF.

40
Q

What attaches the sulcus to the enamel of the tooth?

A

Hemidesmosomes

41
Q

Name 3 aspects of the junctional epithelium.

A
  1. Continuous with sulcular epithelium 2. Encircles the tooth 3. On enamel and extends apically onto CEJ
42
Q

As you get recession what happens to the junctional epithelium>

A

Depresses down the root surface. That is why it seems there is a pocket because you are still robin till the junctional epithelium - it is just further down that usual.

43
Q

What is junctional epithelium derived from?

A

Reduced enamel epithelium

44
Q

How long after eruption does it take for the REE to turn into the junctional epithelium?

A

3-4 years post eruption

45
Q

What is the histology of junctional epithelium?

A

Stratified squamos, non keratinized Surrounded by TWO basal laminas Reinforced by collagenous fibers in the marginal gingiva.

46
Q

What is the typical cell length of the JE

A

.25 to 1.35mm

47
Q

How many basal laminas surround the JE

A

TWO! only area in the body that has two * internal – attaches to enamel * external – attaches to CT

48
Q

What connects the JE to the basal laminas?

A

Hemidesmosomes

49
Q

What is the Dentino-gingival unit

A

Junctional epithelium reinforced by collagenous fibers in the marginal gingiva.

50
Q

Where is the JE widest? Narrowest?

A

Widest - suclular epithelium (15 - 30 cells) Narrow - apical end (1-3 cells)

51
Q

With more inflammation where will the probe reach?

A

Apical end of the JE

52
Q

JE length varies according to stage of eruption. T or F

A

True!

53
Q

When a tooth first erupts the JE covers what?

A

Most of the enamel

54
Q

Where does the fluid for the GCF in a healthy sulcus pass through?

A

Junctional Epithelium

55
Q

If diseased (pocket) where does the GCF enter the pocket?

A

Junctional epithelium and Sulcular wall

56
Q

Rate of JE turnover is VERY RAPID! Epithelial cells move coronally and she into the oral cavity via gingival crevice.

A

TRUE!

57
Q

What does the turnover rate of the JE depend on?

A

Demands placed on tissue. Directly related to degree of inflammation.

58
Q

Label this image:

A

Circular Group
Dentinogingival Group
Dentoperiosteal Group
Alvelogingival Group
Alveolar Bone

59
Q

What are the two layers of ther Lamina Propria?

A
60
Q

What extends into the papillary layer?

A

Rete Pegs

61
Q

List the gingival Fiber Groups:
1
2
3
4
5

A

Gingivodental

Circular
Dentoperiosteal
Alveologingival
Transeptal

62
Q

List some cells of the gingival connective tissue:

A

Osteoblasts, osteoclasts, fibroblasts…..

63
Q

What is the composition of connective tissue?

A

65% Fibers
5% cells

Remaining % proteoglycans

64
Q

What is the periodontal ligament?

A

Suspends and maintins the tooth in the socket
Direct conection between cementum and bone

Anastomosis of Fibers

65
Q

What is the attachment apparatus?

A

PDL, cementum, alveolar bone

66
Q

What is characteristic of the fibers in the PDL?

A

Fiber bundles are thicker and less abundant on the bone surface

67
Q

What are the collagen fibers found in the PDL? (4)

A

Principle fiber
Intermediate plexus
Sharpey’s fibers
indifferent fiber plexus

68
Q

What are the elastic fibers found in the PDL?

A

oxytalan fibers

69
Q

What is the thickness of the PDL?

A

.1 - .25 mm
Widest during heavy occlusion
Thinner in nonfunctioning teeth
Diameter doubles from eruption to fully functional

70
Q

What are the groups of ther periodontal ligament fibers?

A

Alveolar Crest
Horizontal
Oblique
Apical
Interradicular
Transseptal?

71
Q

Label the fiber groups of the periodontal ligaments.

A

Alveloar Crest
Horizontal
Oblique
Apical
Interradicular

Perio (8 decks)

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