Periodontium

Question 1

List the components of the periodontium

Answer 1

gingiva
periodontal ligament
cementum
alveolar bone

Question 2

Describe masticatory oral mucosa

Answer 2

keratinized
on attached gingiva and hard palate
immovable

Question 3

Describe specialized oral mucosa

Answer 3

found on the tongue papilla

Question 4

Describe lining oral mucosa

Answer 4

found on buccal, labial, alveolar mucosa, and floor of mouth

Question 5

Free/marginal gingiva

Answer 5

portion of the gingiva surrounding the neck of the tooth, is not directly attached to tooth

Question 6

Free gingival groove

Answer 6

shallow line or depression on the surface of the gingiva dividing the free gingiva from the attached gingiva

Question 7

Attached gingiva

Answer 7

portion of the gingiva that extends apically from the area of the free gingival groove to the mucogingival junction
-firmly bound to bone
-1-9mm (widest at incisors narrower at posteriors)

Question 8

Mucogingival junction

Answer 8

scalloped line dividing the attached gingiva from the alveolar mucosa
*may need to roll probe over area to find it

Question 9

Col

Answer 9

valley like depression which connects papilla and conforms to the shape of interproximal contact area

Question 10

What are the two parts of the dentogingival unit

Answer 10

junctional epithelium
firbous attachment of the connective tissue tissue (lamina propria)

Question 11

Describe junctional epithelium

Answer 11

precise zone of junction between epithelium and tooth
-non keratinized
-base of sulcus
-vascular

Question 12

Describe fibrous attachment of the connective tissue

Answer 12

these attachments to the cementum help maintain functional integrity
-gingival fibers do not insert into bone

Question 13

What is the function of the periodontal ligament

Answer 13

-ties tooth to all surrounding structures
-evenly distributed mechanical forces among teeth
-sharpeys fibers attach cementum to bone

Question 14

Normal vs disease gingiva (color)

Answer 14

normal: pale pink to coral
diseased: coral pink to bluish-red to deep blue

Question 15

Normal vs disease interdental papilla

Answer 15

normal: triangular fills embrasures, not bulging out
diseased: bulbous (slight ballooning due to inflammation)
blunted (flattened due to bone loss)
cratered (ditched out due to loss of cortical plate and septum)

Question 16

Normal vs diseased marginal gingiva

Answer 16

normal: envelopes teeth collar, thin knife edge around necks of teeth
diseased: edematous, rolled

Question 17

McCall’s festoon

Answer 17

enlargement of the margin like a lifesaver

Question 18

Stillman’s cleft

Answer 18

straight or apostrophe shaped indentation from from gingival margin along root surface
*trauma NOT pathogenic

Question 19

What is the least reliable tool is detecting changes of the periodontium?

Answer 19

loss of stippling texture to the gingiva

Question 20

Gingival vs Periodontal pocket

Answer 20

gingival: no apical migration (no changes in alveolar bones) pseudo pocket
periodontal: apical migration, loss of crestal bone, true pocket

Question 21

Localized

Answer 21

less than 30% of the mouth

Question 22

Generalized

Answer 22

more than 30% of the mouth

Question 23

List the causes of mobility

Answer 23

-loss of tooth support
-trauma from occlusion

Question 24

Describe when mobility is at its peak

Answer 24

when the patient wakes up, lessens throughout the day
*incisors have most mobility

Question 25

Class I mobility

Answer 25

movement 1mm buccal to lingual

Question 26

Class II mobility

Answer 26

movement 2mm buccal to lingual

Question 27

Class III mobility

Answer 27

movement 3mm buccal to lingual and apically (depressable into socket)

Question 28

Fremitus

Answer 28

palpable vibration of teeth *we only evaluate MAX not mand

Question 29

List the causes of bone loss

Answer 29

-local factors (biofilm/plaque, homecare) -chronic inflammation (gingivitis or perio) -trauma from occlusion

Question 30

Class I furcation involvement

Answer 30

root trunk can be felt with probe but probe cannot enter the furcation area

Question 31

Class II furcation involvement

Answer 31

probe is able partially enter furcation but not all the way to other side

Question 32

Class III furcation involvement

Answer 32

probe passes completely through the furcation

Question 33

Class IV furcation involvement

Answer 33

probe passes completely through furcation and the furcation entrance is visible above gingiva

Question 34

Normal vs diseased radiographic signs

Answer 34

normal: alveolar bone 1-2mm apical to CEJ, bone level follows CEJ tooth to tooth, crestal lamina dura intact, regular periodontal ligament space diseased: more than 2mm, fuzziness and break in crestal lamina dura, cupping and graying of interdental septum, widening or narrowing periodontal ligament space

Question 35

According to the AAP, a patient is a periodontitis case if…

Answer 35

-interdental clinical attachment loss is detectable at 2 or more non adjacent teeth or -facial and lingual clinical attachment loss of 3mm or more with pocketing greater than 3mm detectable at 2 or more teeth