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Classic Lit Fall 2021 > Perio Macro and Micro Structures > Flashcards

Perio Macro and Micro Structures Flashcards

1
Q

What articles are important when discussing the importance of KG width?

A

Lang and Loe 1972 (Need >2mm)

Stetler and Bissada 1987 (when sub G resto, >2mm better)

Wennstrom and Lindhe 1983 (when plaque control, doesnt matter)

Cortellini and Bissada 2018 (when plaque control, doesnt matter)

Kennedy and Dorfman 1980 (longitudinal split mouth - >2mm was protective against inflammation)

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2
Q

How much of the population has stippling? What does it mean?

A

~40% Karring&Loe
if lost, early sign of inflammation
Green 1962
“ONLY LOST if inflammation goes beyond the FGM and in to the attached gingiva” - Orban (said in Green 1962)

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3
Q

How much of the population has a free gingival groove?

A

~30% - Ainamo and Loe

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4
Q

What is the width of the free gingival groove?

A

0.5 - 2mm
Bosshardt

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5
Q

Width of attached facial gingiva

A

Bowers 1963
1-9mm
Most in incisors (Max>Mand)
Least in Canine and 1st premolars

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6
Q

What is the width of lingual gingiva - what happens from primary to permanent teeth?

A

1-8mm
Decreases (lingual eruption of permanent teeth)
Voight 1978
Most in 1st and 2nd molars

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7
Q

What study said we need 2mm kg?

A

Lang and Loe 1972
Stetler and Bissada 1987 (SubG Restoration)

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8
Q

What study said we do NOT need 2mm KG?

A

Wennstrom & Lindhe 1983
Beagle dog study - removed attached gingiva and did FGG in 1/2
Oral hygiene
No difference in inflammation

Cortellini & Bissada 2018

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9
Q

How is phenotype related to KT width and bone morphotype?

A

Cook et al. 2011 reported Thin biotype associated with 50% thinner buccal plate
as CEJ-Crest increased, KG decreased

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10
Q

What are some protective/risk factors against recession?

A

Chambrone & Tatakis
Protective: KTW/GT
Risk: Lack of AG

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11
Q

Describe the epithelium of Junctional, Sulcular, and Oral epithelium

A

Junctional/Sulcular are non-keratinized stratified squamous
Oral is Para-keratinized stratified squamous

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12
Q

How many cell layers in Junctional, Sulcular, and Oral epithelium

A

Junction and sulcular: 2 - Basale and Suprabasale
Oral: 4 - Basale, Spinosum, Granulosum, Corneum

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13
Q

Where are rete pegs present?

A

Junctional - only in inflammation
Sulcus - present
Oral - present

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14
Q

How many cells thick are the Junctional, Sulcular, and Oral epithelium?

A

Junctional: 3-4 at apical, 15-20 coronal
Sulcus: Variable
Oral: 20-40

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15
Q

Cell size of Junctional, Sulcular, and Oral epithelium

A

Junctional: Largest
Sulcular: Med
Oral: Smallest

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16
Q

Intercellular space of Junctional, Sulcular, and Oral epithelium

A

Junctional: Widest
Sulcular: narrow
Oral: narrowest

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17
Q

Cell Junctions and permeability of the Junctional, Sulcular, and Oral epithelium

A

Most abundant in all of them is Desmosomes
Oral epi has the most of them (> Junctional)

Junctional: Gap junctions (allows cell leakage (GCT and innate immunity)) Hemidesmosomes (attachment to enamel and basement membrane - RAPID TURNOVER

Sulcular: Desmosomes

Oral: Tight Junctions, Hemidesmosomes to basement membranes

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18
Q

What is the clinical significance of Junctional, Sulcular, and Oral epithelium

A

Junctional: Barrier (attached to tooth) - Access of GCF and innate immune cells

Sulcular: more susceptible to breakdown - non-keratinized

Oral: mechanical/bacterial barrier

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19
Q

Gargiulo 1961

A

Sulcus: 0.69mm
JE: 0.97mm (most variable)
CT: 1.07mm (most constant)

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20
Q

What kinds of keratinization is there and what is the difference? Where are they present?

A

Ortho-Keratinized (no nuclei)
Pera-Keratinized (nuclei remnants)
Corneal layer has a range of these

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21
Q

What is the cellular makeup of the oral epithelium?

A

90% Keratinocytes
10% non-keratinocytes (clear cells)

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22
Q

What cells make up the % of the oral epi that is not keratinocytes? Where are they located?

A

4 types of clear cells

Merkel’s cells (basal)
Melanocytes (basal)
Langerhans cells (mostly suprabasal)
Inflammatory cells (variable)

23
Q

What is a key histoloical feature of langerhans cells?

A

Bierbeck granuals (tennis racket)

24
Q

What is the basal cell attached to? How

A

Basement membrane - Hemidesmosomes

25
Q

How many layers are in the basement membrane and what are they?

A

2
Lamina Lucida
Lamina Densa

26
Q

What is the most superfical layer of the BM made of and why is it named the way it is?

A

Lamina Lucida
Electron lucent
Lamanin, nidrogens, dystroglycans

27
Q

What is the most inferior layer of the BM made of and why is it named the way it is/How is it connected to the CT layer?

A

Lamina Densa
Electron dense
Anchoring Fibrils (COL VII)

28
Q

What is the BM composed of?

A

50% Type IV Collagen
Lamanin (most abundant non-collagen protein)
Proteoglycans

29
Q

What is the CT composted of?

A

aka Lamina Propria
60-65% fibers (Collagen type I>Collagen type III)
35% ECM/vessels
5% cells (65% fibroblasts)

30
Q

How many layers is the CT and what are they?

A

2
Papillary (loose - CT papilla between rete pegs)
Reticular (dense - continuous with periosteum)

31
Q

What are the most abundant GAGs in the periodontium?

A

Epithelium: Heparan sulfate (60%)
CT: Dermatan Sulfate (60%)
Cementum/Bone: Chondroitin Sulfate (94%)

32
Q

What other GAGs are there? Are they in the periodontium at all?

A

Hyaluronic Acid (in CT/synovial fluid)
Keratan sulfate (Cornea/bone/cartilage)

33
Q

Where is Chondroitin Sulfate found in the body?

A

Cartilage/Bone/Heart valve/Cementum

34
Q

Where is Dermatan Sulfate found in the body?

A

Gingival CT/skin/vessels/heart valves/lung/tendons

35
Q

Where is Heparan Sulfate found in the boyd?

A

Basement Membrane!
cell surface component

36
Q

Where is Hyaluronic Acid found in the body?

A

Synovial fluid
ECM
Skin
Articular cartilage

37
Q

What are the gingival fiber groups?

A

5 groups
Trans-septal
Circular
Dento-Gingival
Dento-Alveolar
Alveolo-gingival

38
Q

What are the principle fiber groups of the PDL?

A

Alveolar crest fibers
Horizontal fibers
Oblique fibers
Apical fibers
Interradicular fibers

39
Q

What cells does the PDL contain?

A

Mesenchymal cells that can differentiate into fibroblasts, osteoblasts, or cementoblasts

40
Q

What are the functions of the PDL?

A

PDL Never Stops Forming Self

Protective
Nutritive
Supportive
Formative
Sensory

41
Q

How thick is the PDL?

A

0.2-0.4mm Carranzza

42
Q

What is the primary collagens of CT, PDL, and Cementum?

A

Col I and III
Cementum: 90% I
PDL : 80% I
CT: 70% I

43
Q

What are the different types of cementum? CITATION?

A

Schroeder 1986
Acellular Afibrillar
Acellular Extrinsic-fiber
Cellular Intrinsic-fiber
Cellular Mixed

44
Q

Where are the different cementums present? How thick are they?

A

AAF: Coronal to PDL fibers: 1-15microns
AEFC: Coronal-Mid third: 30-230microns
CIFC: Apical third: variable
CMC: Apical 1/2-1/3/Furcation: 100-1000microns

45
Q

What is the first cementum produced?

A

AAC

46
Q

What cementum is produced to repair itself?

A

CIFC - resorption lacunae and GTR

47
Q

What fibers act in adapting to occlusal forces?

A

CIFC and CMC

48
Q

How is cementum oriented with enamel?

A

OMG rule
Overlapping: 60%
Meeting: 30%
Gap: 10%

49
Q

How is cementum deposition characterized and what does it respond to? CITATION

A

Kerr 1961
Continuous throughout life
3fold increase from 20-70
Thickest at apex
Responds to inflammation, occlusion, ortho movement, pathology

50
Q

What are the different names for the bone surrounding a tooth?

A

Bundle bone
Cribriform bone
Lamina dura

51
Q

What are the layers of the periosteum?

A

Fibrous (outer/dense)
Osteogenic (loose CT/Inner)

52
Q

Where are the most common places for fenestration/dehisence? CITATION

A

Ruperecht et al. 2001
Maxillary 1st Molar: 58% of Fenestrations
Mandibular Canine: 67% of Dehisences

53
Q

How does blood flow in the periodontium

A

Kleinheinz 2005
Primarily posterior
Secondarily inferior

54
Q

What are the main lymph nodes that the oral cavity drains to?
What drains to each?

A

Submental (mand anteriors)
Submandibular (Max Facial/Mand Posteriors)
Jugulodigastric (3rd molars)
Deep cervical (Max Palatal)

Classic Lit Fall 2021 (29 decks)

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