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periodontics II > periodontal macro/micro structures > Flashcards

periodontal macro/micro structures Flashcards

1
Q

What are the periodontium components?

A

Gingiva
Periodontal Ligament
Cementum
Alveolar bone

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2
Q

What are the microstructures of the gingiva?

A

Gingival epithelium
Basement membrane
Gingival connective tissue
Supracrestal tissue attachment (formerly known as biologic width)

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2
Q

What are the macrostructures of the gingiva?

A

Free gingiva
Attached gingiva
Interdental gingiva

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2
Q

What is Free Gingiva?

A

The coronal demarcation of attached gingiva (AG), corresponding to the CEJ if healthy.

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3
Q

How commonly is Free Gingiva present in normal gingiva?

A

It is present in only 1/3 of normal gingiva (Ainamo and Loe, 1966).

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4
Q

What does the mucogingival junction (MGJ) represent?

A

The junction between keratinized gingiva and non-keratinized mucosa.

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5
Q

How can the mucogingival junction be determined?

A

1) visualization;
2) roll technique;
3) Schiller iodine solution.

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6
Q

What are the types of gingival epithelium?

A

Junctional, sulcular, and oral epithelium.

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6
Q

What are the layers (strata) of the oral epithelium?

A

Stratum corneum
stratum granulosum
stratum spinosum
stratum basale

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7
Q

What percentage of oral epithelium cells are keratinocytes?

A

90%

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7
Q

What is gingival epithelium?

A

Stratified squamous epithelium attached to the underlying connective tissue

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8
Q

Which layer of the oral epithelium is keratinized?

A

The stratum corneum.

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9
Q

What percentage of oral epithelium cells are non-keratinocytes?

A

10%

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10
Q

Oral epithelium is in which epithelium layers?

A

Stratum basale, spinosum, granulosum and corneum

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10
Q

What are inflammatory cells in oral epithelium?

A

They are the inflammatory response of oral mucosa, their location varies

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11
Q

Are rate pegs present or absent in Sulcular and Junctional epithelium?

A

Absent

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11
Q

Oral epithelium is what epithelium type?

A

Keratinized Stratified Squamous

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11
Q

Sulcular and Junctional epithelium are what epithelium type?

A

Non-keratinized Stratified Squamous

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12
Q

What offers defense against bacterial invasion and periodontal disease destruction?

A

Oral Epithelium

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12
Q

Sulcular and Junctional epithelium are in what epithelium layers?

A

Stratum basale and suprabasale

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12
Q

How is keratinized gingiva measured?

A

attached gingiva + probing depth

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12
Q

Are rate pegs present or absent in Oral epithelium?

A

Present

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13
Q

What is the ranking of the Intracellular Space for Sulcular, Junctional, and Oral epithelium from widest to narrowest?

A
  1. Junctional (widest)
  2. Suclular
  3. Oral (narrowest)
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13
Q

What is the ranking of the Permeability for Sulcular, Junctional, and Oral epithelium from greatest to least?

A
  1. Junctional (greatest)
  2. Suclular
  3. Oral (least)
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13
Q

What cells produce keratin in the oral epithelium?

A

Squamous cells, also called keratinocytes.

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14
Q

What is the function of keratinized oral epithelium?

A

It provides protection against mechanical trauma and bacterial invasion.

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15
Q

What is the process by which keratinocytes produce keratin and migrate to the upper layers?

A

Keratinization

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15
Q

Is the Col present in areas with missing or non-contacting teeth?

A

No

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16
Q

Where is the Col located?

A

Apical to the contact point, dependent on the shape and position of the contact point.

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16
Q

Which parts of the gingiva are keratinized?

A

Both the free and attached gingiva.

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17
Q

What is the Col in terms of gingiva?

A

A valley-like depression connecting the facial and lingual/palatal gingival papillae.

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18
Q

What type of epithelium covers the Col?

A

Non-keratinized epithelium.

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18
Q

What are the Cell Junctions for Sulcular and Oral epithelium?

A

Desmosomes
Hemidesmosomes (for anchorage to basement membrane)

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19
Q

Why is the Col important?

A

It is considered an important site for the initiation of periodontal inflammation.

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19
Q

What is the basement membrane in gingival epithelium?

A

The interface between the basal epithelial cells and the underlying connective tissue (lamina propria).

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20
Q

What are the Cell Junctions for Junctional epithelium?

A

Desmosomes
Hemidesmosomes (anchorage to the tooth and basement membrane)

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20
Q

T or F: Intercellular space differs among the types of gingival epithelium

A

True

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21
Q

What is the role of desmosomes in gingival epithelium?

A

Desmosomes connect epithelial cells and are characterized by anchoring fibrils.

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22
Q

What is associated with autoantibodies directed against antigens of desmoglein, which helps to form desmosomal junctions between cells?

A

PEMPHIGUS Vulgaris

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23
Q

What are the two layers of the basement membrane?

A

Lamina lucida (electron lucent) and lamina densa (electron dense).

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24
Q

How is lamina lucida connected to the stratum basale?

A

It contacts the stratum basale via hemidesmosomes.

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25
Q

What is the composition of collagen fibers in lamina propria?

A

Type I collagen (major)
Type III collagen and elastin fiber (minor)

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25
Q

How is lamina densa attached to the connective tissue?

A

It is attached to the connective tissue via anchoring fibrils.

26
Q

What is the disease associated with autoantibodies directed against antigens in the basal membrane zone?

A

Mucous Membrane PEMPHIGOID

27
Q

What is the lamina propria?

A

The connective tissue located below the basement membrane.

27
Q

What are the main components of the Lamina Propria

A

Collagen fibers
Cells
Ground Substance

27
Q

What are the two layers of the lamina propria?

A

Papillary layer and reticular layer

28
Q

What does the reticular layer consist of?

A

dense irregular connective tissue with thick fibers

29
Q

What does the papillary layer consist of and located?

A

loose connective tissue
directly below the basement membrane.

30
Q

What is the function of cells in lamina propria?

A

Fibroblast produce connective tissue fibers:
1.Collagen fibers

30
Q

What is the composition of cells in lamina propria?

A

Fibroblast (65%)
Mast cells, macrophages and inflammatory cells

31
Q

What is the function of collagen fibers in lamina propria?

A

Tensile strength

32
Q

What is the composition of ground substance in lamina propria?

A

Clear, viscous fluid that fills the space between the cells and fibers.
Composed of glycosaminoglycans and proteoglycans

33
Q

What is the function of ground substance in lamina propria?

A

Glue for the cells to attach to the matrix
Molecular sieve for substances to travel between blood capillaries and cells.

34
Q

What is the composition of the Extracellular Matrix (ECM)

A

Glycosaminoglycans (GAGs)
proteoglycans
collagenous
non-collagenous proteins

34
Q

How do GAGs participate in biological processes?

A

They regulate their protein partners called proteoglycans.

35
Q

What is the function of the composition of the ECM

A

Scaffold to support and anchor cells, mediates adhesion, cell signaling and transport of nutrients

36
Q

What are the structural proteins in the ECM?

A

Collagen and elastin.

36
Q

What are the adhesive glycoproteins in the ECM?

A

Fibronectin and laminin.

37
Q

What are the types of glycosaminoglycans (GAGs)?

A

Hyaluronan, chondroitin sulfate, dermatan sulfate, heparan sulfate, heparin, and keratan sulfate.

37
Q

What are proteoglycans?

A

Proteins that are heavily glycosylated.

38
Q

Where is Dermatan sulfate located and involved in?

A

blood vessels
involved in wound repair

38
Q

What are proteoglycans in the ECM?

A

Aggrecan and decorin.

38
Q

What are Glycosaminoglycans (GAGs)?

A

Linear polymers containing repeating disaccharides of N-acetyl hexosamine and a hexuronic acid or hexose.

38
Q

What are the types of GAGs?

A

Hyaluronic acid
Dermatan sulfate
Chondroitin-4 sulfate
Heparan sulfate
Keratan sulfate

39
Q

Where is Heparan sulfate located?

A

Basement membranes and cell surfaces

40
Q

Where is Hyaluronic acid located?

A

ECM of loose connective tissue

41
Q

Collagen Type III Tissue Distribution

A

Gingiva

41
Q

Where is Chondroitin-4 sulfate and Keratan sulfate located?

A

Bone

41
Q

Collagen Type I Tissue Distribution

A

bone, gingiva, ligament

42
Q

Collagen Type V Site of Synthesis

A

Smooth muscle

42
Q

What is the basic unit of a proteoglycan?

A

A core protein covalently attached to glycosaminoglycans (GAGs).

43
Q

Collagen Type I Site of Synthesis

A

Fibroblasts
Osteoblasts
Odontoblasts

44
Q

What is Connective Tissue Growth Factor (CTGF)?

A

An ECM protein involved in the control of biological processes.

44
Q

Collagen Type V Tissue Distribution

A

bone, gingiva

44
Q

Collagen Type III Site of Synthesis

A

Fibroblasts

45
Q

What happens when CTGF is upregulated?

A

It is linked to multiple chronic diseases, such as liver fibrosis and congestive heart failure.

46
Q

What is the role of CTGF in periodontitis?

A

The exact mechanism of CTGF in alveolar bone loss in periodontitis is under investigation.

47
Q

What is Transforming Growth Factor beta (TGF-β)?

A

A cytokine belonging to the transforming growth factor superfamily.

48
Q

What are cytokines known for?

A

proteins that act as immunomodulating agents.

49
Q

Which cells produce cytokines?

A

white blood cell lineages, including neutrophils, lymphocytes, natural killer cells, and monocytes.

50
Q

What is the triple-helical structure of collagen made of?

A

It arises from an abundance of glycine, proline, and hydroxyproline.

51
Q

What is the characteristic repeating motif in collagen?

A

The repeating motif is Gly-Pro-X, where X can be any amino acid.

52
Q

What does collagen provide to body tissues?

A

Collagen provides strength and structure to body tissues.

53
Q

What contributes to the strength of collagen?

A

The fiber organization within the ECM contributes to its strength.

54
Q

How does the tensile strength of collagen compare to steel?

A

Collagen approaches the tensile strength of steel on a per weight basis.

55
Q

What condition is caused by a deficiency in Vitamin C?

A

Scurvy

56
Q

What is required for the hydroxylation of proline?

A

Vitamin C.

57
Q

What happens if proline hydroxylation fails?

A

It leads to the formation of defective pro-α collagen chains that fail to form a stable triple helix and are degraded within the cell.

58
Q

Is collagen resistant to degradation?

A

Yes

58
Q

What are the consequences of defective collagen formation?

A

Blood vessel fragility and loss of tooth attachment within sockets.

59
Q

What happens during stimulation of collagen?

A

Collagen Fragments Stimulate the Production of New Collagen

60
Q

What enzymes digest collagen?

A

Matrix Metalloproteinases (MMP)

61
Q

What are MMPs regulated by?

A

Tissue Inhibitors of MMPs (TIMPS)

62
Q

What is the purpose of bone remodeling?

A

To adjust bone architecture to meet changing mechanical needs and prevent the accumulation of old bone.

62
Q

What is the MMP of Collagenase 2?

A

MMP-8

63
Q

What are the Substrates of Collagenase 2?

A

Collagens I, II, III

64
Q

What term did Gargiulo describe in 1961?

A

The “Physiologic dentogingival unit.”

65
Q

Who introduced the term “biologic width” and when?

A

Cohen in 1962.

66
Q

What does biologic width refer to?

A

The space over the tooth surface occupied by connective tissue (CT) and epithelial attachments.

67
Q

What term replaced “biologic width” in 2017?

A

“Supracrestal tissue attachment” (STA), as defined by Jepsen et al. in 2018.

68
Q

What are the phases of bone remodeling?

A

Resting
Resorption (osteoclasts digest old bone)
Reversal (mononuclear cells on the bone surface)
Formation (osteoblasts lay down new bone)
Mineralization (osteocytes).

69
Q

How does chronic inflammation contribute to alveolar bone loss in periodontitis?

A

By uncoupling bone formation from resorption.

69
Q

What local factors regulate bone remodeling?

A

Insulin-like growth factors (IGFs)
Prostaglandins
Tumor growth factor-beta (TGF-beta)
Bone morphogenetic proteins (BMP)
Cytokines
RANK/receptor/OPG system

70
Q

What is the spatial consideration in inflammation-induced bone loss?

A

Bacteria migrate inside connective tissue and release bone-resorbing mediators that induce osteoclastogenesis and bone loss.

71
Q

What is the temporal consideration in inflammation-induced bone loss?

A

Increased inflammatory mediators prolong the resorption phase of bone remodeling.

periodontics II (4 decks)

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