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perio, exam 1 > PDL, alveolar bone, cementum, vascular/lymphatic supply > Flashcards

PDL, alveolar bone, cementum, vascular/lymphatic supply Flashcards

1
Q

PDL

A

PDL =

  • -connective tissue structure that surrounds the root and connects it to bone
  • -continuous with CT of gingiva
  • -communicates with marrow spaces through vascular channels in the bone
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2
Q

principle PDL fiber bundles (6)

A
  1. alveolar crest
  2. horizontal
  3. oblique**MAJORITY
  4. apical
  5. interradicular
    * *6. transseptal: do not go from bone to tooth, so he says to keep in gingiva
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3
Q

alveolar crest PDL fibers

A
  • from cervical cementum to crestal bone just below junctional epithelium
  • counterbalance force of more apical fibers, keeping tooth in socket
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4
Q

horizontal PDL fibers

A
  • extend horizontally from cementum to alveolar bone, perpindicular to tooth root (long axis of tooth)
  • counterbalance force of more apical and coronal fibers, stabilizing tooth in socket
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5
Q

oblique PDL fibers

A
  • largest group
  • extend from cementum coronally to bone
  • take vertical/occlusal forces and transform them to tension forces on bone
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6
Q

apical PDL fibers

A
  • radiate from cementum to bone at fundus of socket (at the root apex)
  • not found in teeth with incompletely formed roots
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7
Q

interradicular PDL fibers

A
  • go through furcation

- extend across crest of interradicular bony septum of multirooted teeth

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8
Q

transseptal PDL fibers

A
  • extend interproximally are are embedded in cementum of adjacent teeth
  • *??? bc he said keep them classified in gingival fibers
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9
Q

sharpey’s fibers

A

terminal parts of PDL fibers where they insert into bone or cementum

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10
Q

cell types in PDL

A
  • fibroblasts
  • cementoblasts
  • osteoblasts (form bone)
  • osteoclasts (destroy bone)
  • macrophages
  • epithelial rest cells: in devo, they got left behind in PDL adn do nothing
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11
Q

alveolar bone

A
  • alveolar processes = part of maxilla/mandible that provides housing for roots of teeth
  • comprised of alveolar bone proper (adjacent to tooth), cancellous bone, compact bone
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12
Q

normal level of alveolar bone

A
  • usually 2mm cementum exposed between CEJ adn crest of alveolus
  • in that cementum space, crestal fibers and gingival CT attach
  • coronal to that is CEJ adn junctional epithelium
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13
Q

compact bone

A
  • superficial/outer surface of buccal adn lingual plates
  • densest
  • you want implants to contact this becasue denser
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14
Q

cancellous bone

A
  • supporting bone

- comprised of bony trabeculae with irregularly shaped marrow spaces

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15
Q

alveolar bone proper

A

AKA cribiform plate

  • *solid narrow zone of compact bone around tooth
  • radiographically seen as lamina dura
  • comprised of dense compact bone adn bundle bone (bone with sharpey’s fiber insertions)
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16
Q

bundle bone

A

part of alveolvar bone proper (in addition to compact bone) that is where sharpey’s fibers insert

17
Q

radiograph of alveolar bone

A
  • dark line next to tooth is PDL

- white bone just beyond that is alveolar proper, which is called LAMINA DURA

18
Q

interdental bone contour depends on…

A
  • contour of enamel and interdental width aka shape of contact (bone follows shape of gingiva)
  • degree of eruption
  • position and angulation of tooth (crest of bone parallels CEJ of adjacent teeth - optical illusion in supraerupted/ tipped teeth)
  • BL width/position of tooth
19
Q

facial adn lingual bone depends on…

A
  • alignment and position of teeth (normal, crowded, spaced)
  • angulation of root (tipped facially = thinner facial plate)
  • occlusal forces may result in thicker bone (bruxer/grinder)
  • posterior bone thicker than anterior
20
Q

fenestration

A

isolated area where the root is denuded of bone, leaving only the periosteum adn gingiva over the root with marginal bone intact
**just a little hole (window) where root peeks out through bone, can only find in surgery, not by probing bc of jxnal epithelium

21
Q

dehiscence

A
  • denuded area of bone that goes all the wya through marginal bone
  • if loss of CT attachment, you could potentially probe down this
  • usually on facial, so you cannot see on film bc of dense tooth
22
Q

occurence of fensetration adn dehiscences

A

20% of teeth
faical more common that lingual
anterior more common than posterior

23
Q

alveolar bone composition

A

70% inorganic, 30% organic (mainly type I collagen)

**least stable periodontal tissue under constant turnover

24
Q

cells of alveolar bone

A
  • osteoblasts: produce organic matrix of bone
  • osteoclasts: bone resorption
  • osteocytes: resident cells of bone
25
Q

cementum

A
  • primary = acellular, does not continue to grow, more cervical (near CEJ), sharpeys fibers
  • secondary = cellular, contains cementocytes in lacunae, formed after tooth reaches occlusal plane, apical portion (other fibers in addition to sharpeys fibers embedded in it), thicker
  • cementum covers roots
26
Q

cementum - near CEJ, near apex

A

primary is near CEJ

secondary is more apical

27
Q

cementum thicknes

A
  • primary (cervical 2/3): 16-60 micrometers

- secondary (apical 1/3 adn furcations): 150-200

28
Q

CEJ overlap %s

A

overlap = 60%
edge to edge = 30%
fail to meet = 10% (**hypersensitivity bc of exposed dentin)

29
Q

sharpeys fibers angle

A

insert at 90 degrees into cementum, parallel to cemental fibril

30
Q

vascular supply of periodontium

A

numerous anastomoses

31
Q

vascular supply maxilla

A

**superior alveolar artery –> dental a, intraseptal a which then penetrate bone to supply alveolar process, PDL, gingiva

**anterior adn posterior superior alveolar aa + infraorbital a + greater palatine a –> supraperiosteal branches, which become teh PDL vessels

**PDL vessels supply alveolar process, PDL, gingiva

32
Q

vascular supply to mandible

A

**inferior alveolar a –> dental a + intraseptal a, which penetrate the bone and supply the alveolar process, PDL, gingiva

**buccal, facial, mental, sublingual aa –> supraperiosteal branches which become the PDL vessels

**PDL vessels supply the alveolar process, pDL and gingiva

33
Q

PDL vessels

A
  • from supraperiosteal branches
  • supply PDL, alveolar bone, gingiva
  • maxilla: anterior + posterior superior alveolar aa –> supraperiosteal branches
  • mandible: buccal, facial, sublingual, mental aa –> supraperiosteal branches
34
Q

dental and intraseptal arteries

A

-penetrate bone adn supply PDL, alveolar process, gingiva

  • *maxilla: from superior alveolar a
  • *mandible: from interferior alveolar a
35
Q

venous vessels

A
  • return of venous blood and lymph parallels arterial supply
  • deep cervical nodes: palatal gingiva and tissue around 3rd molars
  • submental nodes: mandibular incisor tissues
  • submandibular: everything else
36
Q

innervation

A

TRIGEMINAL NERVE

  • gingiva: posterior/middle/anterior superior alveolar, infraorbital, greater palatine, nasopalatine, mental, buccal, and lingual
  • PDL: posterior/middle/ anterior superior alveolar, palatal, infraorbital, inferior alveolar

perio, exam 1 (6 decks)

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