Perio Flashcards
4 components of periodontium
Gingiva, PDL, Cementum, Alveolar bone
Oral mucosa is what kind of epithelium
Stratified squamous (most keratinized/parakerantinzied)
What oral tissue is not keratinized
Sulcular and junctional
What is the primary cell of the stratified squamous epithelium
keratinocyte
What are rete pegs
extension of the gingival epithelium that integrate into the CT “dermal papilla”
4 functions of cervical fluid
cleanse, adhesion via plasma proteins, antimicrobial properties, antibody activity
What is the lamina propria
- Connective tissue
- Papillary layer – dermal papilla
- reticular layer – continuous with periosteum
- Cellular - fibroblasts, collagen, glycoproteins, macrophages, neutrophils, etc
- extracellular - ground substance (proteoglycan, glycoproteins, water), type 1 collagen
Rests of Serres
Remnant of dental lamina in gingiva
Predominant cells in PDL
Fibroblasts
What anchors cementum to the alveolar bone
Sharpeys fibers (type 1 collagen)
What are the 6 types of periodontal fibers and what is the most abundant
Transeptal, alveolar, horizontal, oblique, apical, interradicular
Mosts abundant = oblique
What are the three types of cells of PDL
PDL comes from the dnetal sac or follicle
Cells - fibroblast, cementoblasts, osteoblasts
What are the epithelial rests of malassez
Remnants of hertwig root sheath (forms the outer and inner enamel epithelium)
What is the main type of CT in cementum
Collagen 1
Where is the thickest and thinnest parts of cementum
thickest - apically
Thinnest - coronally
What are the 2 main types of cementum
Acellular - primary – cervical root
Cellular - secondary - apical root
What is the most common type of CEJ morphology in the dog and cat
Dog - type 3
Cat - type 4
Where is rankl present on
Where is OPG present on
Osteoblast
What is Rank present on
Osteoclast
What is biological width
2mm
Is the soft tissue attachment – junctional epithelium and connective tissue
How long does it take for plaque biofilm and calculus to form
Plaque - 24 hr
Calc - 48-72 hr
What type of bacteria is found in early and late biofilm
early - g+ aerobic
late - g- anaerobic
What cytokines are stimulate osteoclast activity in PDz
IL1B, IL6, PGE2, TNFa
What is prostaglandin E2 produced by
Macrophage and fibroblasts
What type of matrix metalloproteinases are found in healthy and PDz tissue
MMP1- secreted by fibroblasts to maintain CT
MMP8/9- secreted by neutrophils in PDz
What are 2 types of anti-inflammatory cytokines
IL10 and TGF b
Breeds of cats and dogs predisposed to PDz
Cat- abyssinian, somali
Dog - Min Schnauzer, maltese, sighthound
Attachment loss
pd probing depth + GR - GE
What organs does PDz have systemic effect on
Kidney - microalbuminuria and increased creatinine
Liver – c-reactive proteins
Myocardium (left AV) – endocarditis
Soft accumulation of bacteria, food, cellular debris that is white
Materia Alba
Primary supraginigval bacteria dog
Gram - in healthy
*neisseria
*bergeyella
Gram + in PDz
Subgingival bacteria dog
Healthy = gram -
* bacteriodetes, fusobacterium and proteobacteria
PDz = gram +
* firmicutes, bacteriodetes and proteobacteria
Supragingival bacteria cat
g- in healthy and + in Pdz
gram –ve’s:
Pasteurella spp.
Moraxella spp.
Thermomonas spp
Subgingival bacteria cat
Mainly g-
healthy/pdz = bacteriodetes and proteobacteria) and spirochetes
**not the same subspecies though
red complex
p. gingivalis
treponema denticola
tanneralla forsythia
How to tell if an instrument is dull/sharp
Dull - reflect light
Sharp - edges dont reflect light
What stones need oil/water and what stones dont
Dont - ceramic (or water)
Need oil - arkansas and india
What are the sharpening angle for scalers, curettes, elevator/luxator, osteotome, ochsenbein, scissors
Scalers/curettes – 110° (toe at 45°)
Elevators, luxators – 45°
Osteotome – 45°
Ochsenbein – 20°
Scissors – flush (10 °)
What is the power of low speed handpiece? What do green, blue, red bands mean?
Power - 20,000-40,000 rpm
Green = REDUCTION ratio
*Green 4:1 = 4x slower = 5000rpm
Blue ring (or no colour) = no gear ratio = 1:1 ratio = same speed, 20,000rpm
Red = INCREASE ratio
*Red 1:5 = 5x faster = 100,000rpm
what is the speed of high speed handpiece
350,000-400,000 rpm
What is the frequency of of electrosurgery vs radiosurgery
Electro- 0.5-2.9 MHz
Radio- 3-4 MHz
What are the 4 types of waveforms (radiowave)
**Fully filtered waveform: pure, continuous flow of current; smoothest incision; least amount of thermal necrosis and tissue shrinkage; YES to close proximity to bone.
**Fully rectified waveform: simultaneous cutting and hemostasis; slightly wider zone of thermal damage and more tissue shrinkage; NOT be used in close proximity to bone or dental hard tissues.
**Partially rectified waveform: intermittent flow of energy; effective hemostasis while causing more thermal necrosis and tissue shrinkage; NOT suitable for gingivectomy/gingivoplasty
**Fulguration: most destructive; considerable thermal necrosis, tissue shrinkage and scarring. ABSOLUTELY NOT for gingivectomy/gingivoplasty
What are the 3 types of crown lengthening
1- GV
2- apically repositioned flap
3- forced eruption with Ortho
Osteoconduction
material that occupy space– scaffold
osteoinduction
Growth factors and hormones to produce new bone
osteogenic
live cells to lay down bone
allograft
same species, different individual
conductivee/inductive
alloplast
synthetic
conductive
autogenous
same individual
conductive/inductive/osteogenic
xenograft
diff species
conductive
What are the 4 possibilites of GTR invasion and what are the results
**gingival epithelial cells grow in 1st, long junctional epithelium results, which may be unstable and has high chance of PP recurrence.
**connective tissue grows in 1st, fibers will be parallel to root surface and alveolar bone will regenerate w/o connection to cementum.
**bone grows in 1st, RR and ankylosis usually occur
**PDL cells proliferate coronally can new cementum occur, restoring healthy attachment.
What are the indications for GTR
FE2
2/3 walled vertical sites
3 walled palatal defect
What are the three main types of flaps
envelope - linear margin with no vertical incision
pedicle - two vertical releasing incision
Triangle - 1 vertical releasing incision
Layers of epithelium
Corneum
granulosum
Spinousum
basale
Zones of pulp (out to inner)
- odontoblastic process
- predentin
- odontoblast
- cell free zone (zone of weil)
- cell rich zone
- Pulp
What dose the periodontium look like under the scope
