Perio doc micks Flashcards
Parts of Periodontium
- Gingiva
- PDL
- Cementum
- Alveolar bone
REMEMBER‼️📌📌
PDL, Cementum, & Alveolar Bone
Attachment Apparatus
Gingival fibers & Epithelial attachment
Gingival Apparatus
composed of epithelium & conn. tissue
Gingiva
Characteristics of Normal gingiva Color Shape Tone Texture
Coral pink Knife edge free gingival margin Scalloped gingival margin-follow CEJ contour Tone: resilient & fibrous Texture: Stippling
found in attached gingiva
irregularities of epithelial ridges & rete pegs
least determinant for gingivitis
Stippling
‼️📌REMEMBER
Absence of Stippling
Normal variation
Inflammation
Edema
Most important criteria for Gingivitis
Bleeding on Probing
Why bleed?
Microulceration in the gingiva
Stippling
Orange peel/ Peau’d orange
Gingival Epithelium Histologic divisions
- Oral Epithelium
- Sulcular Epithelium
- Junctional Epithelium
parakeratinized but both present
keratinized stratified, squamous epithelium
Oral Epithelium
non-keratinized but can keratinized
but some has parakeratinized
Sulcular Epithelium
part of biologic width Non-kerarinized Collar-like band of stratified squamous epithelium thicker near the sulcus thinner at the apex
Junctional Epithelium
Ideal at the CEJ
Junctional Epithelium
type of transudate that is produced in the gingival sulcus contains cells (neutrophils) enzymes & IgA
Gingival Crevicular Fluid (GCF) / Sulcular Fluid
gingival sulcus
transudate
exudate
pus
specific gravity
Exudate
protein content
Transudate
Keratinization
- Orthokeratinize
2. Parakeratinize
complete keratinization
w/out nucleus
Orthokeratinize
incomplete
w/ nucleus
Parakeratinize
Prevent relapse after tx
- Supracrestal fiberotomy
- Retainer
- Overcorrection
Aka. Supracrestal connective tissue fibers
Gingival Fiber Group
Attaches the gingiva to the tooth & alveolar bone
Made up of Type I collagen
Gingival Fiber Group
Gingival Fiber Group
- Dentogingival Fibers
- Dentoperiosteal Fibers
- Circular Fibers
- Alveologingival fibers
- Transseptal Fibers
attached to the cementum to the gingiva
Dentogingival fibers
from cementum to the periosteum
Dentoperiosteal fibers
from cementum to the periosteum
Dentoperiosteal fibers
encircles the tooth , resist rotational forces
Circular Fiber
attaches gingiva to the alveolar crest
Alveologingival fibers
attaches cementum to cementum of adjacent teet ; doesn’t attach to bone
Most cause of relapse
Transseptal fibers
Principal Periodontal Ligament Fiber Group
Made up Type I collagen
from cervical cementum of tooth to alveolar crest
Mainly resists lateral movements
Alveolar Crest Fiber Group
run perpendicularly from the root of the tooth to alveolar bone
resists lateral movements & vertical movements
Horizontal Fiber Group
runs obliquely from cementum & extends occlusally towards bone found in the middle 3rd of root
📌Most numerous
📌Mosr resistant to forces along lomg axis of thd tooth / masticatory forces
Oblique Fiber Group
radiate apically from cementum to bone
primary fibers that resist tooth towards occlusal direction
Compressed during intrusion & masticatiom
Apical Fiber Group
from cementum in the fircarion towards bone in the furcation area
Found only in multirooted teeth
Interradicular Fiber Group
‼️📌REMEMBER📌‼️
Periodontal fibers embedded in cementum & bone are called
Sharpey’s Fibers (mineralized)
Other name of Alveolar Bone Proper
Bundle bone / Cribriform plate
Most numerous cells found in PDL
Fibroblast
Anatomic Parts of the Gingiva
- Free Gingiva / Marginal Gingiva
- Gingival Margin
- Free gingival groove
- Attached ginigva
- Gingival sulcus
tissue not attached to the tooth or bone
measured from free gingival crest (gingival margin) to the free gingival groove
Free Gingiv or Marginal Gingiva
most coronal portion of gingiva
Gingival Margin
line between marginal gingiva & attached gingiva
coincides with apical border of junctional epithelium
Free Gingival groove
Measured from the free gingival groove to the mucogingival junction
Stipplings are found here
Tightly bound to underlying periosteum & cementum
Attached Gingiva
between marginal gingiva & attached gingiva
coincides with apical border of junctional epithelium
Free Gingival Groove
measured from free gingival groove to the mucogingival junction
stippling are found here
tightly bound to underlying periosteum & cementum
Attached Gingiva
between marginal gingiva & tooth surface; GCF is found here
bounded by
Sulcular epithelium- laterally
JE- apically
Gingival sulcus
‼️📌BE
Thinnest Attached gingiva
Thickest
Posterior portion of the mandible
Anterior (maxilla) - labial surface of lateral incisors
valley like structure between the lingual papilla & facial papilla
Interdental Col / Inter papillary Saddle
Occupies the gingival embrasure of the interdental space above the alveolar crest
Pyramidal shape
Interdental or Interproximal gingiva (papilla)
A line betweem attached gingiva & alveolar mucosa
Mucogingival Junction
loosely attached mucosa covering the base of the alveolar process continuing towards the vestibule & floor of the mouth
Alveolar mucosa
Probing force
10gm- 25gm
- 010 kg - 0.025 kg
- 022 lbs - 0.055 lbs
normally in CEJ or above CEJ (in enamel)
Level of Free Gingival Margin in Relation to CEJ
Probing must be gentle- Walking Technique
BOP
measured from Gingival margin to base of sulcus
Pocket Depth or Probing Depth
Position , angulation & orientation of probe
Ideally: Parallel to the tooth surface
Maximum: Angle 0-10*
xray angle
bitewing radiograph
readily combines with mercury to form gamma 2 phase weakest ohase & contributes to failure of amalgam restoration
Tin
scazenger
zinc
‼️📌 Calcular deposits are composed of
Calcium & Phosphate
Sticky deposits in oral cavity where microorganisms accumulate are called?
Plaque
Immediately after cleansing a tooth a thin film of saliva covers the tooth .,It is called
Pellicle
measured from CEJ towards Base of Sulcus
CAL
measured from CEJ to Gingival margin
Gingival recessiom = CAL- Pocket depth
Gingival recession
📌‼️‼️REMEMBER
can be tx by Free Gingival graft
Recessions
obtained from Edentulous region or palatal area
Graft
Most common failure of autographs
Loss of Blood supply
infection
source of Blood supply of Autografts
Bed of recipient tissue
important to evaluate prognosis of tooth
Mobility
due to coronal migration of gingival margin
gingival hyperplasia
gingival hypertrophy
Pseudopocket
apical migration of the junctional epithelium
(loss of attachment)
related to bone loss
Tru Pocket
Miller Classification of Tooth Mobility
Grade I
Grade II
Grade III
horizontal mobililtyn<1mm, normal
Grade I
Horizontal mobility > 1mm - 2mm
Grade II
Horizontal Mobility >2mm or vertical mobility; Poorest prognosis
Grade III
Joint between a tooth & alveolaf bone
Gomphosis
use Naber’s Probe
Furcation Evaluation
Furcation Classification by Glickman
Grade I
Grade II
Grade III
Grade IV