Periodontal Health Gingival Disease/Conditions Flashcards

1
Q

In looking at the gingiva, it is either:

A

in health or disease

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2
Q

Periodontal health- What is the importance?

A

To find the common reference point for assessing disease and determining the meaningful treatment outcomes

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3
Q

The portion of the gingiva surrounding the neck of the tooth:

A

marginal/free gingiva

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4
Q

Describe the attachment of the marginal/free gingiva:

A

Not directly attached to the tooth

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5
Q

The marginal/free gingiva forms:

A

The soft tissue wall of the gingival sulcus

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6
Q

Marginal/free gingiva extends from:

A

gingival margin to the gingival (marginal) groove

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7
Q

Space bounded by the tooth and the free gingiva:

A

gingival sulcus

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8
Q

The gingival sulcus has ______ as its base

A

junctional epithelium

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9
Q

The gingival sulcus is comprised of _______ epithelium

A

non-keratinized

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10
Q

No ____ are present in the gingival sulcus

A

Rete pegs

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11
Q

The gingival sulcus is considered a _____ membrane

A

semi-permeable

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12
Q

Portion of the gingival that extends apically from the area of the free gingival groove to the mucogingival junction:

A

attached gingiva

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13
Q

The attached gingiva is normally covered by:

A

keratinized epithelium with rete ridges

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14
Q

No _____ is present in the attached gingiva

A

submucosa

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15
Q

The attached gingiva is bound to the:

A

bound to the underlying tooth and bone

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16
Q

Portion of the gingiva extends between the teeth:

A

interdental gingiva

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17
Q

Includes the Col area which is composed of a non-keratinized stratified squamous epithelium in the interproximal space:

A

interdental gingiva

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18
Q

Describe the gingival col:

A

Area comprised of a non-keratinized squamous epithelium in the interproximal space

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19
Q

What is the cellular makeup of the gingival col?

A

non-stratified squamous epithelium

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20
Q

The gingival col is found in what area of gingiva?

A

interdental gingiva

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21
Q

Microscopic features of the anatomy of the periodontium includes: (3)

A
  1. oral epithelium
  2. sulcular epithelium
  3. junctional epithelium
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22
Q

The oral epithelium is comprised of:

A

Keratinized stratified squamous epithelium

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23
Q

Describe the turnover rate of the oral epithelium:

A

turnover rate of 30 days

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24
Q

The sulcular epithelium is comprised of:

A

Non-keratinized stratified squamous epithelium

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25
Q

Rete pegs are present in the sulcular epithelium. The sulcular epithelium is considered a semi-permeable membrane.

A

First statement false; second statement true

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26
Q

The juncntioal epithelium is comprised of:

A

non-keratinized stratified squamous epithelium

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27
Q

The junctional epithelium is attached to the tooth with:

A

hemidesmosomes

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28
Q

The junctional epithelium can be infiltrated by:

A

PMNs

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29
Q

Describe the rate of turnover for the junctional epithelium:

A

high rate of turnover (7-10 days)

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30
Q
  • keratinized epithelium
  • rete pegs present
  • resistant to forces of mastication
A

oral epithelium

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31
Q
  • non-keratinized epithelium
  • no rete pegs present
  • semi-permeable membrane
A

sulcular epithelium

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32
Q
  • non-keratinized epithelium
  • hemi-desmosomal and non-collagenous proteins attachment
  • attachment on the tooth is normally at or near the CEJ
  • can be infiltrated by PMNs
A

junctional epithelium

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33
Q
  • diffused amorphous ground substance
  • collagen fibers
  • blood vessels in the papillary projections of the connective tissue
A

gingival connective tissue

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34
Q

Forms the connective tissue attachment of the junctional epithelium:

A

densely packed collagen fibers

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35
Q

The stability of this attachment is a key factor in the limitation of the migration of junctional epithelium:

A

connective tissue attachment

36
Q

The stability of the connective tissue attachment is a key factor in the limitation of:

A

migration of the junctional epithelium

37
Q

The term “biologic width” has been replaced with:

A

supracrestal tissue attachment

38
Q

Supracrestal tissue attachment (biologic width) is made up of:

A

junctional epithelium (0.97mm) + connective tissue attachment (1.07 mm) = 2.04mm

39
Q

When plaque is present, the epithelium lining the sulcus is prone to:

A

invasion by bacteria & their byproducts due to the nature of the type of epithelium

40
Q

If plaque is present, the epithelium lining the sulcus is prone to invasion by bacteria and their byproducts due to the nature of the type of epithelium. Therefore:

A

Inflammation can initiated and cause the clinical signs of gingivitis, which can progress to periodontitis, if left untreated

41
Q

Features of the gingiva (to be noted): (7)

A
  1. color
  2. contour
  3. consistency
  4. shape
  5. size
  6. surface texture
  7. position
42
Q

The color of attached and marginal gingiva displays a range from:

A

brown, orange to pink

43
Q

The color of the attached and marginal gingiva is dependent on: (4)

A
  1. vascular supply
  2. the thickness
  3. degree of keratinization of epithelium
  4. pigment-containing cells
44
Q

The color of the attached and marginal gingival varies among different ______ and correlates with _____

A

persons; cutaneous (skin) pigmentation

45
Q

In the following images, the marginal and attached gingiva are ____. The alveolar mucosa I _____

A

coral pink; red/smooth/shiny

46
Q

The contour of the gingiva should be:

A

scalloped and collar-like

47
Q

In regards to the contour of the gingiva, the gingival level is higher:

A

interproximally

48
Q

What is indicated by the arrows in the following image? What type of gingiva comprises this area?

A

interdental papillae (formed by the attached gingiva)

49
Q

The shape of the interdental gingiva is governed by the:

A

contour of the proximal surface and location and shape of the gingival embrasures

50
Q

The consistency of health gingiva would be described as:

A

firm & resilient

50
Q

The size of the gingiva should correspond with the sum total of the:

A

bulk of cellular and intercellular elements and vascular supply

51
Q

What contributes to the firmness go the gingival margin?

A

gingival fibers

52
Q

The surface texture of the attached gingiva is ______ the surface texture of the marginal gingiva is ____

A

stippled; not stippled

53
Q

Stippling varies with ____

A

age

  • absent during infancy, appears in some children about 5 years of age, it increases until adulthood, and it frequently begins to disappear during old age
54
Q

Stippling is less prominent on ______ than ____ surfaces and may be absent in some persons

A

lingal; facial

55
Q

Microscopically, stippling is produced by:

A

alternated rounded protuberances and depressions in the gingival surface

56
Q

Describes the level to which the gingival margin is attached to the tooth:

A

position

57
Q

The absence of clinically detectable inflammation within the gingiva:

A

gingival health

58
Q

Microbiological determinants of gingival health: (2)

A
  1. supragingival plaque
  2. subgingival plaque
59
Q

Host determinants of gingival health: (2)

A
  1. local predisposing factors
  2. systemic modifying factors
60
Q

List some LOCAL predisposing factors that contribute to gingival health: (4)

A
  1. periodontal pockets
  2. restorations
  3. root anatomy
  4. tooth position & crowding
61
Q

List some SYSTEMIC modifying factors that contribute to gingival health: (3)

A
  1. host immune function
  2. systemic health
  3. genetics
62
Q

Environmental determinants of gingival health: (4)

A
  1. smoking
  2. medication
  3. stress
  4. nutrition
63
Q

What might be some ways to determine gingival health?

A
  1. bleeding upon probing
  2. periodontal probing
  3. radiographic features
  4. tooth mobility
64
Q

T/F: Periodontal probing is inadequate for diagnosis when used alone

A

True

65
Q

T/F: Ideally the lamina dura is 4,, from the most coronal part of the alveolar crest to the CEJ

A

False- 2mm

66
Q

T/F: Tooth mobility is recommended as a singular means of diagnosis

A

False

67
Q

T/F: Gingival health can be attained following treatment of gingivitis

A

True

68
Q

The treated and stable periodontitis patient with current gingival health still remains at an increased risk for:

A

recurrent periodontitis

69
Q

Classify the category of periodontal health:

  • total absence of clinical inflammation and physiologic immune surveillance with no attachment or bone loss
A

Pristine Periodontal Health

70
Q

Classify the category of periodontal health:

  • absence or minimal levels of clinical inflammation with no attachment or bone loss
A

Clinical Periodontal Health

71
Q

Classify the category of periodontal health:

  • absence or minimal levels of clinical inflammation in a reduced periodontium
A

Periodontal Disease Stability

72
Q

Classify the category of periodontal health:

  • absence of minimal levels of clinical inflammation in a reduced periodontium with previous inflammation and disease
A

Periodontal Disease Remission/Control

73
Q

What are the 2 main categories of gingivitis:

A
  1. dental plaque-induced gingival diseases
  2. non-dental plaque-induced gingival diseases
74
Q

_____ is the MOST common form of periodontal disease

A

gingivitis

75
Q

Signs and symptoms a patient with gingivitis may experience includes: (4)

A
  1. bleeding when brushing
  2. blood in saliva
  3. gingival swelling & redness
  4. halitosis
76
Q

For a patient with gingivitis, what are some of the clinical findings at the dental exam? (2)

A
  1. bleeding upon gentle probing
  2. change in gingival clinical features such as color, contour, shape, size, consistency, surface texture, &/or position
77
Q

One of the early signs prior to color change or other visual signs of inflammation:

A

gingival bleeding on probing

78
Q

______ is an excellent negative predictor of future attachment loss

A

absence of BOP

79
Q

_____ masks BOP by suppressing the inflammatory response

A

smoking

80
Q

Smoking masks BOP by suppressing the:

A

inflammatory response

81
Q

Color is an important clinical sign of gingival disease and can present in the following locations/ ways: (4)

A
  1. marginal
  2. patch-like
  3. generalized
  4. localized
82
Q

What colors are associated with gingivitis? (4)

A
  1. pale
  2. red
  3. bluish-red
  4. whitish-gray
83
Q

The changes in consistency of the gingiva with gingivitis are resulting from:

A

Predominance of destructive and reparative processes

84
Q

List some of the CHRONIC forms of consistency associated with gingivitis: (3)

A
  1. soggy puffiness
  2. softness & friability
  3. firm, leathery consistency
85
Q

start on slide 37

A