Perio Anatomy Flashcards
Cells that form the periodontium originate from the ________ ______.
Neural crest
T/F: Periodontal structures rely on epithelial interactions for formation.
TRUE
Why don’t you bleed during tooth eruption?
No blood supply to epithelium
What part of the tooth germ forms the periodontium?
Dental follicle
Describe the formation of cementum.
Hertwig’s root sheath is between follicle and dentin -> root sheath gets holes in it (fenestrates) -> amelogenin induces differentiation of follicle to cementoblasts -> cementoid forms and intermingles with dentinal fibers
What types of cells form the PDL?
Fibroblasts from dental follicle
What cells form the alveolar bone?
Osteoblasts from dental follicle ectomesenchymal cells
What cells remain in the periodontium as stem cells?
Ectomesenchymal cells
What are the three parts of the gingiva?
- Free gingiva
- Attached gingiva
- Interdental papilla
T/F: Free gingiva is made of keratinized epithelium.
TRUE
What is the free gingival groove?
Junction between free and attached gingiva (typically at CEJ)
T/F: A visible free gingival groove is a sign of disease.
FALSE
T/F: Sulcular epithelium can be regenerated from oral epithelium.
TRUE
The _______ ________ provides the first contact between gingiva and the tooth.
Junctional epithelium (epithelial cuff)
T/F: The width of attached gingiva increases with age.
TRUE
The width of attached gingiva is widest in ________ and narrowest in _________. (Except in mandibular lingual)
Incisors; premolars
When can stippling indicate disease?
If stippling was observed and is later not seen
Where is there not a mucogingival junction?
Palate!!
It is all keratinized tissue
What is the biggest negative of an implant over natural tooth?
No PDL
Neural crest cells form _____________ beneath stomadeal epithelium to eventually form the periodontium.
Ectomesenchyme
Interactions between which two tissue types are key in perio development?
Epithelial-ectomesechyme interactions
The dental papilla gives rise to the __________, while the dental follicle gives rise to the __________.
Dentin and pulp; periodontium
____________ induces differentiation of ectomesenchymal cells at the root surface to cementoblasts.
Amelogenin
The free gingiva extends from the ___________ to the __________.
Free gingival margin; free gingival groove
In a normal patient, the free gingival margin is locate _____ mm coronal to the CEJ.
1.5-2 mm
T/F: The free gingival groove is visible in most patients.
FALSE
What provides the attachment between the gingiva and the tooth?
Junctional epithelium
How does the width of the attached gingiva vary?
- Increases with age
2. Varies between teeth
On the mandibular lingual gingiva where is the attached gingiva widest? Narrowest?
Widest: molars
Narrowest: incisors
What percentage of adults present with stippling?
40%
T/F: The mucogingival junction is seen on the maxillary facial and lingual sides.
FALSE
No MGJ in the palate
What provides the base for movable elements?
Attached gingiva
The attached gingiva has a thick _________ layer and is firmly bound to the ___________ and ______.
Connective tissue; periosteum and bone
T/F: Width and thickness of attached gingiva is pivotal for all patients.
False.
With great oral hygiene these will not matter
The oral epithelium is made of what kind of tissue?
Keratinized, stratified squamous epithelium
What are the four layers in oral epithelium?
- Basal layer
- Stratum spinosum
- Stratum granulosum
- Stratum corneum
An ____keratinized cell has no nucleus, but a ____keratinized cell has nuclear remnants.
Ortho; para
T/F: The number of tonofilaments and desmosomes increases as you go from basal layer to granular layer of oral epithelium.
TRUE
How much of the oral epithelium is made of keratinocytes?
90%
What are the clear cells of the oral epithelium?
- Melanocytes
- Langerhans cells
- Merkel’s cells
T/F: THe basement membrane sits between oral epithelium and connective tissue and is full of glycoproteins.
True
There are two layers of the basement membrane: the ________ is adjacent to the basal cells and the _______ is adjacent to the connective tissue.
Lamina Lucida; lamina densa
What are rete pegs?
Epithelial ridges that represent the interconnection of connective tissue and epithelium.
NOT seen in JE
The junctional epithelium constitutes which part of the biological width?
The coronal part
T/F: During tooth eruption there is reduced dental epithelium.
True
How is the JE created after tooth eruption?
Cells of oral epithelium differentiate into JE cells
T/F: The JE is widest towards the CEJ.
FALSE
Wider coronally than apically
T/F: The JE has a faster turnover rate than the Oral Epithelium.
True
How is the JE different than the OE?
- JE has larger cells
- JE has more intracellular space
- JE has less desmosomes
- JE is not keratinized.. but it has the potential to be
T/F: The JE is physically attached to the tooth.
True
Do most healthy people have a JE at the CEJ?
NO
Mostly about 1mm below due to passive eruption
As a child will the JE be at the CEJ?
NO it will be coronal to the CEJ
Will there be pocketing seen in Necrotizing Ulcerative Periodontitis?
NO
The JE cells die. If no JE can be no pocket. The bone will be exposed
What are the various cells found in the lamina propria?
- FIbroblasts
- Mast cells
- Macrophages
- Neutrophils
- Lymphocytes
- Plasma cells
What are the four types of fibers found in the lamina propria?
- Collagen
- Reticular
- Oxytalan
- Elastic
The _________ fibers reinforce the gingiva, provide resilience and tone, and maintain architectural form and integrity.
Gingival
What are the four types of gingival fibers?
- Circular fibers
- Dentogingival fibers
- Dentoperiosteal fibers
- Transseptal fibers
T/F: The PDL is richly vascular and cellular.
True
The ______ joins the cementum to the alveolar bone.
PDL
What are the four fibers of the PDL?
- Alveolar crest fibers
- Horizontal fibers
- Oblique fibers
- Apical fibers
The epithelial rests of Mallasez in the PDL are remnants of what structure?
Hertwig’s epithelial root sheath
What differentiates cementum from bone tissue?
- No blood vessels
- No lymph
- No nerves
- No resorption/remodeling
T/F: The cementum has a continuing deposition throughout life.
True
In the cementum, the ______ fibers are parallel to the root and produced by cementoblasts. The ________ fibers are perpendicular to the root and produced by fibroblasts in the PDL.
Intrinsic; extrinsic (Sharpey’s)
T/F: Cementum is thicker apically than cervically.
True
T/F: The cementum continues to get thicker throughout life.
True
T/F: The alveolar bone is formed completely independent from tooth development.
False
Cells from dental follicle also help form alveolar bone
Which dental tissue most closely resembles bone?
Cementum
What four lymph nodes drain the periodontium?
- Submental nodes
- Deep cervical nodes
- Submandibular nodes
- Jugulodigastric node