perio anatomy Flashcards
parts of the periodontium
gingiva, cementum, pdl, alveolar bone
3 parts of gingiva
free gingiva, attached gingiva, interdental papilla
where is the FGM located?
2 mm coronal to CEJ
what is also associated with the FGG
CEJ
histology of the gingival sulcus
nnon keratinized mucosa, no CT, not attached to periosteum
boundaries of attatched gingiva
FGG to MGJ
more than Xmm is considered a pocket
2
t/f. there is a MGJ on both the F and L side of the maxillary dentition
f. there is only attached gingiva on the hard palate (L)
describe the size of attached gingiva max buccal
widest in incisors, narrowest in premolars
describe the size of attached gingiva max ling
all attached, cant measure
describe the size of the attached gingiva mand ling
narrowest in incisors, widest in molars
how do you measure the width of attached gingiva
apical to coronal
t/f. premorals and canines have the least amount of buccal attached gingiva
true.
free and attached gingiva are keratinized or non keratinized?
keratinized
3 zones of oral mucosa
masticatory, specialized, oral mucous membrane
masticatory mucosa
tissue of hard palate and gingiva (covers alveolar process)
specialized mucosa
covers dorsum of the tongue
oral mucous membrane
covers the remainder of the oral cavity (not masticatory or specialized)
recession
when the FGM is apical to the CEJ
t/f. narrow gingiva has less resistance to attachment loss than wider gingiva without inflammation
false. narrow and wide gingiva have the same resistance to attachment loss without inflammation; therefor the amount of inflammation is more important than the amount of recession
people with a thin phenotype have to be careful because (4 things)
increased recession, more vulnerable to trauma, more inflammation, less favorable Tx outcome
connective tissue graft
make a flap on the hard palate and take a wedge of gingiva with ct and place it in the site of recession
free gingival graft
take entire epithelium (maybe periosteum), then place it where you need it
which is more aesthetic, free gingival graft or ct graft
ct graft
what is the col
concavity in the interdental papilla of the contact areas of the premolar/molar region of interdental papilla
differences of interdental gingiva in the anterior vs posterior teeth
ant - pyramidal
post - col
when the distance between the crest of bone to the contact point is Xmm, a papilla will form
- anything larger, the papilla will not fill in completely
orthokeratinized
no nucleus
parakeratinized
nuclear remnants
layers of oral epithelium
basal, prickle cell (spinosum), granular (granulosum), keratinized (corneum)
relationship of cytoplasmic tonofilaments and desmosomes to organelles from basal to granular layer
cytoplasmic tonofilaments and desmosomes increase while the number of organelles decrease
cells other than keratinocytes in the oral epithelium
melaocytes, langerhans (immune), merkel (sensory) cells
2 layers of basement membrane
lamina lucida (adj to basal cells) lamina densa (adj to ct)
what causes the stippling appearance
when rete pegs fuse
t/f rete pegs are at the JE site
false. there are no rete pegs at the JE
type of epithelium at JE
stratified squamous non keratinized epithelium about 0.24 - 1.35mm long
location of JE in diseased adult
below CEJ
location of JE in child
above CEJ
periodontitis is a result of
attachment loss and pocket
how do you measure attachment loss
subtract 2 from probing depth (assuming 2mm is healthy length of free gingiva)
diagnosis when someone has necrotic JE
NUP, seen in AIDS patients
gingival fibers
circular, dentiogingival (cementum to FG), dentinoperiosteal (cementum to AG), transseptal
width of PDL
0.25mm
t/f. PDL is vascular
true.
PDL fibers
alveolar crest, horizontal, oblique, apical
cells of the PDL
fibroblasts, osteoblasts, cementoblasts, osteoclasts, epithelial cells, nerve fibers, epithelial rests of mallassez
principle of guided tissue regeneration
epithelium grows faster than bone
epithelial exclusion will allow selective growth of bone and ct
what do you use in guided tissue regeneration surgery
barrier membranes to prevent epithelium from growing in the space the ct is supposed to grow in
what makes cementum different than bone tissue
no blood vessels, no lymph, no innervation, no remodeling
intrinsic cemental fibers
produced by cementoblasts, fibers parallel to root
extrinsic cemental fibers
produced by PDL fibroblasts, sharpeys fibers
cementum at coronal/middle portion of root
acellular, extrinsic fiber cementum
cementum at apical 1/3 of root and furcations
cellular, mixed stratified cementum
cementum in resorption lacunae
cellular, intrinsic cementum
cementum thickness in cervical portion of root
20 - 50um
cementum thickness in apical portion of root
150 - 250um
dental tissue that most closely resembles bone
cementum
biological width
ct and JE
length of biological width
2.04mm, round to 3
what do you have to do if your distance from the crown margin to alveolar crest (BW) is shorter than 3mm
crown lengthening
blood supply to periodontal tissues
dental artery, sup/inf alveolar, intraseptal, rami perforantes (terminal branches of intraseptal)
which CN branches innervate the periodontium
trigeminal
what part of embryogenesis precedes the periodontium
dental follicle
what produces PDL
fibroblasts that are differentiated from the dental follicle, lateral to the cementum
