Periodontium Flashcards
List the components of the periodontium
gingiva
periodontal ligament
cementum
alveolar bone
Describe masticatory oral mucosa
keratinized
on attached gingiva and hard palate
immovable
Describe specialized oral mucosa
found on the tongue papilla
Describe lining oral mucosa
found on buccal, labial, alveolar mucosa, and floor of mouth
Free/marginal gingiva
portion of the gingiva surrounding the neck of the tooth, is not directly attached to tooth
Free gingival groove
shallow line or depression on the surface of the gingiva dividing the free gingiva from the attached gingiva
Attached gingiva
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)
Mucogingival junction
scalloped line dividing the attached gingiva from the alveolar mucosa
*may need to roll probe over area to find it
Col
valley like depression which connects papilla and conforms to the shape of interproximal contact area
What are the two parts of the dentogingival unit
junctional epithelium
firbous attachment of the connective tissue tissue (lamina propria)
Describe junctional epithelium
precise zone of junction between epithelium and tooth
-non keratinized
-base of sulcus
-vascular
Describe fibrous attachment of the connective tissue
these attachments to the cementum help maintain functional integrity
-gingival fibers do not insert into bone
What is the function of the periodontal ligament
-ties tooth to all surrounding structures
-evenly distributed mechanical forces among teeth
-sharpeys fibers attach cementum to bone
Normal vs disease gingiva (color)
normal: pale pink to coral
diseased: coral pink to bluish-red to deep blue
Normal vs disease interdental papilla
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)
Normal vs diseased marginal gingiva
normal: envelopes teeth collar, thin knife edge around necks of teeth
diseased: edematous, rolled
McCall’s festoon
enlargement of the margin like a lifesaver
Stillman’s cleft
straight or apostrophe shaped indentation from from gingival margin along root surface
*trauma NOT pathogenic
What is the least reliable tool is detecting changes of the periodontium?
loss of stippling texture to the gingiva
Gingival vs Periodontal pocket
gingival: no apical migration (no changes in alveolar bones) pseudo pocket
periodontal: apical migration, loss of crestal bone, true pocket
Localized
less than 30% of the mouth
Generalized
more than 30% of the mouth
List the causes of mobility
-loss of tooth support
-trauma from occlusion
Describe when mobility is at its peak
when the patient wakes up, lessens throughout the day
*incisors have most mobility
Class I mobility
movement 1mm buccal to lingual
Class II mobility
movement 2mm buccal to lingual
Class III mobility
movement 3mm buccal to lingual and apically (depressable into socket)
Fremitus
palpable vibration of teeth
*we only evaluate MAX not mand
List the causes of bone loss
-local factors (biofilm/plaque, homecare)
-chronic inflammation (gingivitis or perio)
-trauma from occlusion
Class I furcation involvement
root trunk can be felt with probe but probe cannot enter the furcation area
Class II furcation involvement
probe is able partially enter furcation but not all the way to other side
Class III furcation involvement
probe passes completely through the furcation
Class IV furcation involvement
probe passes completely through furcation and the furcation entrance is visible above gingiva
Normal vs diseased radiographic signs
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
According to the AAP, a patient is a periodontitis case if…
-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
