Periodontium Flashcards

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1
Q

What is the periodontium

A

Tissues surrounding and supporting the teeth

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2
Q

What is the purpose of the periodontium

A

Retain tooth in socket​

Resist masticatory loads​

Defensive barrier, protecting tissues against threats from the oral environment

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3
Q

What separates the body tissues from the oral environment

A

Junctional epithelium

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4
Q

What are the two divisions of periodontal diseases

A

Diseases of the gingiva alone
Diseases of all the periodontal tissues

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5
Q

What are the periodontal tissues

A

Cementum
Gingiva
Periodontal ligament
Alveolar bone

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6
Q

What are the properties of cementum

A

Covers root dentine​

Very similar in structure to bone​
-Collagen matrix​
-Lamellar arrangement​

Provides attachment for some periodontal fibres​

Two types:​
-Cellular cementum​
-Acellular cementum​

Laid down by cementocytes

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7
Q

What makes cementum

A

Cementocytes

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8
Q

What is the differnece between acellular and cellular cementum

A

Acellular cementum​
-No cells within​
-Usually adjacent to dentine​
-First formed (primary cementum)​

Cellular cementum​
-Contains cementocytes​
-Later formed (secondary cementum)​
-Present in apical part of root and in furcation regions

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9
Q

What happens to alveolar bone when teeth are lost

A

The alveolar process is resorbed leaving the ‘residual ridge’

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10
Q

What is the periodontal ligament

A

A connective tissue containing cells, extracellular matrix, fibres, nerves and blood vessels

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11
Q

What makes up the PDL matrix (ground substance)

A

Hyaluronate GAGs​

Glycoproteins​
-Fibronectin​

Proteoglycans​
-proteodermatan sulphate​
-chondroitin/dermatan SO4 hybrid

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12
Q

What behaves like a viscoelastic gel

A

Ground substance

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13
Q

What cells are found in the PDL

A

Fibroblasts
Cementoblasts
Osteoclasts & Cementoclasts
Epithelial cells (cell rests of malassez)
Defence cells

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14
Q

What is the breakdown of the nerves within the PDL

A

Sensory​
-Mechanoreceptors (A and Aδ fibres)​
Rapidly or slowly adapting​
Proprioception; chewing control​
-Nociceptors (Aδ and C fibres)​
Protective reflexes; ​
inhibit jaw elevator motor neurons​

Autonomic (sympathetic)​
-blood vessels control - vasoconstriction

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15
Q

What is the blood supply of the PDL

A

From inferior and superior alveolar arteries, passing into PDL from alveolar bone​

From lingual and palatine arteries, supplying gingivae

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16
Q

What is the ‘gingival’ ligament

A

Fibres mainly above the alveolar crest, including ‘free gingival’ fibres

17
Q

What does the periodontal ligament do

A

Attaches tooth to jaw ​

Transmits biting forces to alveolar bone​

Organised (regular) connective tissue​

Width of PDL is approx. 0.2mm

18
Q

What is the approx width of the PDL

A

0.2mm

19
Q

What fibres are present in the PDL

A

Collagen (type 1,3), support tooth
Oxytalan
Elastic (absent in humans)

20
Q

What are the principle PDL fibre groups

A

Alveolo-dental ligament:​
-Alveolar crest​
-Horizontal​
-Oblique​
-Apical​
-Interradicular (multi-rooted teeth)​

Interdental ligament​
-Transseptal fibres

21
Q

What fibre groups are within the gingival ligament

A

Circular
Alveolo-gingival
Dento-periosteal (dashed)
Dento-gingival

22
Q

What are intrusive forces

A

Mastication
Swallowing
Speech

23
Q

What are extrusive and horizontal forces

A

Sticky foods, orthodontic forces

24
Q

In which direction do the principal oblique fibres lie, relative to the alveolar bone and cementum?

A

They attach to the cementum apically and to the bone cervically

25
Q

What is the main protein in the principal (Sharpey’s) fibres?

A

Collagen I,III

26
Q

In which part of the root the cementum is thicker?

A

Apical region

27
Q

Are oblique fibres wavy or straight

A

Wavy

28
Q

What cells lie in the cementum surface?

A

Cementocytes

29
Q

On which side of the periodontal ligament are the Sharpey fibres bundled more closely?

A

They are bundled closely at the cementum and spread at the bone

30
Q

What are the epithelial cells found in periodontal ligament known to be the cause of?

A

Periapaical cyst

31
Q

What is the difference between a cyst and a granuloma

A
32
Q
A

Cyst moves tooth, granuloma engulfs tooth

33
Q

Why is a periapical cyst odontogenic

A

Related to odontogenic material (debree of malassez) used to form a tooth.

34
Q

What is a col

A

Region between two anterior teeth
non-keratinised,