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Oral Histology Exam II (BLW) > Periodontium > Flashcards

Periodontium Flashcards

1
Q

Name the scientist:

  1. Used simple microscopes
  2. Discovered “animalcules”
  3. Observed details of enamel, dentin (tubules),and bone
  4. Did NOT find cementum
A

Anton van Leeuwenhoek

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2
Q

Name the scientist:

  1. Observed malpighian corpuscles and pyramids of kidneys
  2. Noticed something on the roots: Substantia Tartarea
A

Marcello Malpighi

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3
Q

Name the scientist:

Observed Purkinje cells and fibers

A

Jan Purkinje

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4
Q

Name the scientist:

  1. Observed Striae of Retzius
  2. Investigated dentin tubules
A

Anders Retzius

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5
Q

What is Greene Vardiman Black known for?

A
  1. The functional understanding of cementum
  2. Classification of caries
  3. Amalgam preparations
  4. Foot powered drill
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6
Q

Who recognized….

Sharpey’s fibers in cementum and bone unite the periodontal complex

and described….

Reparative cementum for the first time

A

GV Black

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7
Q

TERM – consits of the root dentin, associated root canals, and pulp

A

Tooth Root

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8
Q

TERM – the support system for the tooth; contains:

  1. Cementum
  2. Alveolar Bone
  3. Periodontal Ligament
  4. Gingiva and associated ligaments
A

Periodontium

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9
Q

TERM – defines edge of enamel organ during bell stage

A

Cervical Loop

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10
Q

TERM –

  • defines the forming root
  • extension of enamel organ
  • bilayered structure of OEE and IEE
A

Herwig’s Epithelial Root Sheath

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11
Q

How does one tooth get multiple roots?

SIZE

SHAPE

NUMBER OF ROOTS

depends on…

A

HERS-

Cell Migration

& Cell Proliferation

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12
Q

HERS induce dental papilla cells to differentiate from ___________ to ___-_______

A

Ectomesenchymal Cells –> Pre-odontoblasts

(later becomes odontoblasts)

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13
Q

What stimulates the differentiation of the roots?

A

Epithelial - Mesenchymal signaling

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14
Q

What type of genetic disorder occurs in individuals with shortened roots, obliterated pulp chambers, and tooth mobility?

A

Dentin Dysplasia Type I

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15
Q

True or False?

Dentin Dysplasia Type I is Autosomal Recessive

A

False!

Autosomal Dominant

TF’s and SMOC2 are associated!!!

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16
Q

TERM – type of root developmental defect that results in a large pulp chamber at the expense of a root furcation

A

Taurodontism

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17
Q

TERM – type of root development defect that results in deformity in shape and/or direction

A

Dilaceration

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18
Q

True or False?

Developmental Root Defects can make teeth more prone to

  1. Breakage
  2. Exfoliation
  3. Ankylosis
  4. Difficulty extration
  5. Orthodontic movement
A

TRUE

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19
Q

______ disintegrats shortly after inducing root odontoblast differentiation… some remanents become epithelial rests of Malassez

A

HERS

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20
Q

True or False?

Epithelial rests of Malassez can cause cysts

A

True

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21
Q

Epithelial Rests of Malassez are surrounded by a _______ _______

A

Basement Membrane

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22
Q

True or False?

Root dentin is continuous with crown dentin

A

True

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23
Q

Instead of dentinogenesis of crown dentin IEE interacting with the enamel organ

Dentinogenesis of root dentin IEE interacts with _______?

A

HERS

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24
Q

List the rising order of how odontoblasts were differentiated from ectomesenchyme (4 names/steps)

A
  1. Ectomesenchymal Cells
  2. Dental Papilla
  3. Pre-Odontoblasts
  4. Odontoblasts
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25
Q

What are the two main types of Cementum?

A
  1. Acellular Cementum
  2. Cellular Cementum
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26
Q

How would you differentiate between the two types of cementum?

A
  1. If cells are in the matrix
  2. Origin of the collagen fibers in the matirx
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27
Q

Acellular cementum will have _____ fiber cementum and is known as _______ cementum

A

Extrinstic Fiber

Primary Cementum

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28
Q

Cellular Cementum will have _____ fiber cementum and is known as ________ cementum

A

Intrinsic

Secondary

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29
Q

Does acellular or cellular cementum form first?

A

Acellular (Primary)

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30
Q

Primary Acellular cementum covers _/__ of the root

A

2/3 coronal part of root

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31
Q

Secondary Cellular Cementum covers _/__ of the root

A

1/3 apical portion of root

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32
Q

Cementocytes will be present in

  • which type of cementum
  • location on the root?
A

Secondary (Cellular)

Apical 1/3

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33
Q

Name 4 functions of Cementum

A
  1. Attachment
  2. Protecting
  3. Adjusting
  4. Sealing
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34
Q

True or False?

Acellular cementum is primarily involved in attachment to the PDL

A

True

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35
Q

True or False?

Acellular cementum is responsible for adjusting tooth position

A

False - cellular cementum

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36
Q

Rank the 3 mineralized tooth tissues in order of hardness

A
  1. Enamel
  2. Dentin
  3. Cementum
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37
Q

How is cementum SIMILAR to bone?

A
  1. 50% inorganic (HA)
  2. 35% organic – type I collagen (90%) + III +VII, non-collagenous ptns., and glycosaminoglycans (10%)
  3. 15% water
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38
Q

How is cementum DIFFERENT than bone?

A
  1. Avascular
  2. Non-innervated
  3. No-turnover (Growth by apposition)
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39
Q

Name the mineral (inorganic) % of each mineralized tooth tissue

A
  1. Enamel – >95%
  2. Dentin – 70%
  3. Cementum – 50%
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40
Q

Name the 3 types of CEJ relationships

A
  1. Overlap – C>E
  2. Meet – C=E
  3. Gap – C—–E
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41
Q

What CEJ relationship can cause problems such as increased risk for caries?

A

Gap – dentin is exposed!

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42
Q

Rank the 3 types of CEJ relationships in order of least common to most common

A
  1. Gap - least
  2. Meet
  3. Overlap - most common
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43
Q

Where are cementoblasts derived from?

A

Dental Follicle – > Ectomesenchyme

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44
Q

Name the cell that is responsible for making acellular and cellular cementum

A

CementoBLASTS

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45
Q

Cementoblasts remain in the _____ close to the cementum surfact

A

PDL

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46
Q

Cementoblasts _______ slow cementum growth throughout life and direct cementum ______

A

Regulate

Repair

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47
Q

TERM – a subset of cementoblasts that becomes embedded in cellular cementum matrix

A

Cementocytes

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48
Q

True or False

The function of cementocytes is unknown

A

TRUE

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49
Q

What group of cells produce more products: Cementoblasts or Cementocytes?

A

Cementoblasts

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50
Q

Cementocytes

  • Reside in _________ in the maxtix
  • Have cell processes called ______ to communicate
A
  • Lacunae
  • Dendrites
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51
Q

True or False?

Cementocytes remain in the lacunae only for a small time frame

A

False– remain for life!

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52
Q

Name 3 cell types that the dental follicle gives rise to (ectomesenchymal origin)

A
  1. Cementoblasts
  2. PDL Fibroblasts
  3. Osteoblasts
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53
Q

What 2 actions must occur before cementum can form?

A
  1. Root Dentin formation – foundation
  2. HERS disintegration – exposes root dentin surface
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54
Q

____ _____ _____ are secreted by cementoblasts and intermingle with _______ dentin at the CDJ

A

Intrinsic Collagen Fibers

unmineralized

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55
Q

True or False?

Initial Collagen Fibers are short extrinsic fibers that are not yet connected with the PDL

A

False – intrinsic

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56
Q

Once the initial collagen fiber bundles intermingle with the dentin collagen fibers, dentin completes ________

A

mineralization

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57
Q

True or False?

The dental follicle was identified prior to the PDL via microscopy

A

True

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58
Q

TERM – cells that are responsible for producing primary collagen fiber bundles of PDL space

A

PDL Fibroblasts

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59
Q

A continuity of ______ fibers will extend from the initial _______ fibers

A

Extrinsic

Intrinsic

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60
Q

What become the mineralized Sharpey’s FIbers within the cementum?

A

Extrinsic fibers (extensions) + Initial Intrinsic fibers

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61
Q

True or False?

Intrinsic Fibers are the major fiber group for acellular cementum?

A

False – EXTRINSIC

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62
Q

Extrinsic fibers enter acellular cementum at high or low density?

A

HIGH

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63
Q

Extrinsic Fibers are critical to the _______ of acellular cementum

A

Function

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64
Q

TERM – mineralized collagen fiber bundles providing strong anchorage of tooth–PDL–Bone

A

Sharpey’s FIbers

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65
Q

What type of cells promote hydroxyapatite deposition between and within the collagen fibers curing cementogenesis?

A

Cementoblasts

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66
Q

Where can Sharpey’s fibers be found?

A
  1. Cementum
  2. They are continuous with the PDL
  3. Alveolar Bone
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67
Q

Acellular Cementum Mineralization Mechanisms:

  1. Collagen Substrate – fiber fringe at ___-____ interface
  2. Cells secrete ___-______ extracellular matrix proteins that participate in mineral precipitation
  3. Cells direct ______ inbetween collaten fibers
  4. Progressive mineralization of _______ collagen fibers
A
  1. Cementum-PDL
  2. Non-collagenous
  3. Mineralization
  4. Extrinsic
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68
Q

Give brief steps of acellular cementum mineralization

A
  1. Fiber Fringe is present = ready for mineralization
  2. FF becomes engulfed and mineralized
  3. Now = Sharpey’s Fibers
  4. Mineralization slowly continues over time
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69
Q

What is the rate at which cementum mineralizes?

A

~3 micrometers/year

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70
Q

True or False?

Acellular cementum will become thicker over time

A

True

71
Q

What cells are responsible for the mineralization of the cementoid matrix?

A

Secondary Cementoblasts

72
Q

True or False?

Cellular cementum mineralization occurs at a much faster rate than acellular does

A

True

73
Q

Secondary Cementoblasts produce many ______ collagen fibers and deposit the cellular cementum ECM

A

Intrinsic

74
Q

Cellular cementum is often minimal or absent in which of the following teeth?

A
  1. Incisors
  2. Canines
75
Q

TERM – maintains tooth in proper occlusal position by compensating for enamel attrition throughout life

A

Adaptive Cementum

76
Q

True or False?

Cellular Cementum can repair cementum resorption anywhere on the root

A

True

77
Q

What is the appearance of a cementoid?

A

a clear unmineralized area “blob”

78
Q

True or False?

Excess cementoid = hypermineralization of cementum

A

FALSE

Results in delayed mineralization

79
Q

As predentin is to dentin…

________ is to cementum

A

Cementoid

80
Q

As octeocytes are to bone…

__________ are to cementum

A

Cementocytes

81
Q

TERM – embedded in cellular cementum matric and are connected to one another and surface PDL

A

Cementocytes

82
Q

True or false?

Both acellular and cellular cementum continue growing slowly throughout life

A

TRUE

83
Q

What indicate successive layers in cementum?

A

Longitudinal lines/

Striations/

Appositional growth lines

84
Q

Would you classify the cementogenesis as a remodeling growth or appositional growth?

A

Appositional Growth

85
Q

What is the difference between appositional and remodeling growth?

A

Appositional – layering method

Remodeling – “exfoliate & renew” method

86
Q

True or False?

Resorption of cementum can occur

A

True

87
Q

What is the alternative hypothesis for cementum origin?

A
  1. Dental Epithelium
  2. HERS
  3. Epithelial-mesenchymal transformation
  4. Cementoblast
88
Q

What is the classical hypothesis for cementum origin?

know this one!!

A
  1. Ectomesenchyme
  2. Denal Follicle
  3. Cementoblast
89
Q

Which of the following is NOT a derivative of ectomesenchyme?

  1. Alveolar Bone
  2. Pulp
  3. Enamel
  4. Cementum
A

Enamel!! It is an ectoderm derivative

90
Q

Pick out the common origin of the following oral tissues

  1. Odontoblasts (dentin)
  2. Fibroblasts (pulp)
  3. Cementoblasts
  4. Fibroblasts (PDL)
  5. Osteoblasts (alv. bone)
A

Ectomesenchyme

91
Q

Is this line of events the alternative or classical hypothesis if cementum?

  1. Cementum
  2. Cementoblasts
  3. Dental Follicle
  4. Ectomesenchyme
A

Classical Hypothesis

92
Q

True or False?

Ameloblasts are derived from Ectoderm

A

True

93
Q

True or False?

The primary junctional epithelium and periodontal ligament have the same origin

A

FALSE

PJE – ectoderm

PDL – ectomesenchyme

94
Q

What is derived from the reduced enamel epithelium?

A

Primary Junctional Epithelium

95
Q

What is derived from HERS?

A

Root formation

96
Q

Name the 3 components of the tooth germ

A
  1. Enamel Organ
  2. Dental Papilla
  3. Dental Follicle
97
Q

Of the 3 components of the tooth germ, which is derived from ectoderm?

A

Enamel Organ

98
Q

Of the 3 components of the tooth germ, which is derived from ectomesenchyme?

A
  1. Dental Follicle
  2. Dental Papilla
99
Q

Name the type of cells that give rise to the PDL

A

Fibroblasts

100
Q

Crown Formation is the combination of ______ & ______ from the tooth germ.

Are they from the same origin?

A

Enamel organ & Dental Papilla

No

Enamel Organ – Ectoderm

Denal Papilla – Ectomesenchyme

101
Q

Cells of 4 layers give rise to the reduced enamel epithelium?

A
  1. OEE
  2. Stellate Reticulum
  3. Stratum Intermedium
  4. IEE
102
Q

What layer of the enamel organ are ameloblasts derived from?

A

IEE

103
Q

If there is too little of cementum, name the two consequenses:

1.

2.

A
  1. Cementum Aplasia
  2. Hypoplasia
104
Q

If there is too much of cementum, name the possible consequences:

A
  1. Hypercementosis
  2. Possibility leading to Ankylosis
105
Q

What is ankylosis??

A

The ankylosis of a tooth is defined as an anatomical fusion of alveolar bone with cementum and can occur any time during eruption, either before or after the tooth erupts into the oral cavity.

106
Q

Consequences of lost cementum?

1.

2.

A
  1. External Root Resorption
  2. Periodontal Disease
107
Q

Hypophosphatasia (HPP)

  1. Rare_____ disease
  2. Results in mutations in the ______ gene (encodes proteins: TNAP & TNSALP)
  3. These proteins break down __________ which is an __________ of mineralization
  4. Because of the mutations, there will be a _____ amount of PPi and
  5. In order for mineralization, PPi concentration must be maintained or reduced?
A
  1. Rare skeletal disease
  2. Results in mutations in the ALPL gene (encodes proteins: TNAP & TNSALP)
  3. These proteins break down pyrophosphate which is an inhibitor of mineralization
  4. Because of the mutations, there will be a High amount of PPi
  5. In order for mineralization, PPi concentration must be maintained or reduced?
108
Q

What will happen if a mutation occurs in the ALPL gene?

ALPL –> TNAP encoded –> PPi breakdown

  1. High or Low Mineralization?
  2. High or Low amount of PPi?
A
  1. Low
  2. High
109
Q

If there is a HIGH amount of Mineralization, the amount of PPi must be _____

A

LOW

110
Q

Hypophosphatasia will have _____ mineralization because of the ______ amount of PPi that inhibits mineralization

A

Low

High

111
Q

True or False?

Hypophosphatasia can affect bone, dentin, and enamel

A

TRUE

112
Q

Is acellular or cellular cementum most dramatically affected by hypophosphatasia?

A

Acellular

113
Q

Name a few consequences if there is defective or absent cementum

1.

2.

3.

A
  1. Tooth mobility
  2. Premature loss of primary teeth
  3. Loss of permanent teeth
114
Q

TERM – excessive cementum growth

A

Hypercementosis

115
Q

PPi levels:

Hypocementosis?

Hypercementosis?

A
  1. High
  2. Low
116
Q

True or False?

Hypercementosis can becaused by genetic disease, trauma, or can be idiopathic?

A

TRUE

Hypocementosis - genetic mutation ALPL gene

117
Q

Would hypercementosis make an extraction easier or more difficult?

A

MORE difficult because of ankylosis!!!

118
Q

True or False?

Hypercementosis is generally symptomatic

A

FALSE - asymptomatic

119
Q

TERM –

  • this protein was discovered in bone (1st), dentin, & cementum
  • Promotes HA mineral formation
  • Critical role in acellular cementum
  • research with knock-out mice
A

BSP – Bone Sialoprotein

120
Q

A BSP knock out mouse will have…

Hypoplasia or Hyperplasia?

PDL attachment?

Bone breakdown?

A

Cementum Hypoplasia

Detached PDL

Periodontal breakdown

121
Q

Name a few reasons root resorption/and or cervical burnout can occur

1.

2.

3.

4.

A
  1. Excessive ortho tx
  2. Trauma
  3. Severe Periodontitis
  4. Genetic Factors

** may be idiopathic

122
Q

What is the most effective treatment for root resorption?

A

There is no effective treatment!

Splint

123
Q

TERM – repair mechanism following cementum resorption by odontoclasts/osteoclasts

A

Repairative Cementum

124
Q

True or False?

Reparative cementum is often cellular reguardless of the location

A

TRUE

125
Q

The cortical plates of the mandible are located?

A

Buccal and Lingual sides of mandible

126
Q

True or False?

The mandible consists of trabecular/spongy bone

A

True - inferior to teeth, body of mandible

127
Q

TERM – bone lining the socket/inner aspect facing the tooth

A

Bundle Bone/ Alveolar Bone Proper

128
Q

Alveolar Bone includes ______ collagen fiber bundles which are mineralized Sharpey’s Fibers

A

extrinsic

129
Q

Primary fibers entering the bundle bone are (larger/smaller) in diameter and (less/more) dense versus cementum?

A

Larger

Less

130
Q

TERM – a radiopaque layer lining the socket of a tooth in the alveolar bone in a radiograph. Commonly seen after EXT.

A

Lamina Dura

131
Q

True or False?

Lamina Dura opacity is because of an increase in the amount of mineral content

A

FALSE

It is from thick bone without trabeculation

132
Q

On a radiograph,

PDL appears :

Lamina Dura :

A

PDL appears : Radiolucent

Lamina Dura : Radiopaque

133
Q

True or False?

Just because the alveolar bone is compact, does not mean it is entirely solid

A

TRUE - numerous perforations!

134
Q

TERM – a structural component in the alveolar socket that is pierced by many small hole which allow for blood vessels and nerves to enter the PDL space

A

Cribiform Plate

135
Q

Which of the following is derived from a monocyte/macrophage?

  1. Cementoblast
  2. Cementoclast
  3. Osteoblast
  4. Osteoclast
A

Osteoclast

136
Q

Bone remodeling occurs in response to ______?

What 2 cell types work in tandem?

A

Function

Osteoclast and Osteoblasts

137
Q

Pick out the abnormal function of osteoclasts

  1. Remodeling alveolar bone
  2. Bone resorption for tooth eruption
  3. Resorption of permanent teeth roots
  4. Resorption of deciduous teeth when exfoliated/erupting
A
  1. Resorption of permanent teeth roots
138
Q

The “Mechanostat” theory of the alveolar bone loading indicates:

  1. Bone loading causes?
  2. Bone unloading causes?
A
  1. Growth
  2. Loss
139
Q

True or False

An edentulous mandible will gradually lose alveolar bone

A

True

140
Q

TERM – soft fibrous connective tissue between tooth and alveolar bone

A

PDL

141
Q

What makes the periodontal ligament different than a typical ligament?

A

THE CONNECTIONS!!

PDL = tooth to bone

normal ligament = bone to bone

142
Q

What is a Gomphosis???

A

A unique joint tht connects bone to tooth (tooth socket)

143
Q

True or False?

The PDL varies by person-to-person, but is the same width for every tooth

Also what is the normal width?

A

FALSE!!

It does vary from person to person

AND

it varies between different teeth!

Normal width = 0.1 - 0.4mm

144
Q

Provide 6 Fuctions of the PDL

A
  1. Supportive
  2. Nutritive
  3. Sensory
  4. Defensive
  5. Maintenance/Reparative
  6. Adaptive
145
Q

True or False

After orthodontic tooth movement, the PDL returns to the same width as before ortho

A

True

146
Q

Composition of the PDL

1.

2.

3.

A
  1. Ground Substance
  2. Collagen Fibers
  3. Oxytalan Fibers
147
Q

What makes up the Ground Substance in the PDL?

A

proteins, proteoglycans, and water

148
Q

What types of collagen fibers are present in the PDL?

A

Type I, Type III, Type XII

“spliced rope”?

97% of PDL fibers are collagen fibers

149
Q

TERM –

  • small elastic fibers
  • support collagen fibers and blood vessel walls
  • 3% of fibers
  • NO elastic fiber bundles
A

Oxytalan Fibers

150
Q

True or False?

As a tooth is erupting, PDL collagen fibers change from a disorganized to organized arrangement as the root lengthens, cementum forms, alveolar bone forms…etc.

A

True

151
Q

Name the 6 PDL Principal Fiber Groups

** TAHOAI **

A
  1. Transseptal Ligament
  2. Alveolar Crest Group
  3. Horizontal Group
  4. Oblique Group
  5. Apical Group
  6. Interradicular Group

** TAHOAI **

152
Q

What is the most predominant group of the 6 PDL principal fiber groups?

A

Oblique – main group resisting occlusal loads (intrusive force)

153
Q

True or False?

The PDL is very cellular

A

TRUE

154
Q

Name some of the cells that are within the PDL

A
  1. Fibroblasts **majority
  2. Cementoblasts
  3. Osteoblasts & Osteoclasts
  4. Epithelial Rests of Malassez
  5. Stem Cells
  6. Immune Cells
155
Q

True or False

The PDL is very avascular

A

False!!

It is well vascularized!

There are superior and inferior alveolar arteries

156
Q

There are 3 types of routes that blood vessels use to suppy nutrients.

What are they?

Which is the most common?

A

Perforating, Apical, and Gingival

Most common: Perforating

157
Q

True or False?

Venous drainage flows in the axial direction

A

True!

158
Q

TERM – periodontal complex provides sensory feedback on tooth position, bite force, and presence of objects between teeth

A

Proprioception

159
Q

TERM – Masication can cause damage to teeth and supporting tissues unless controlled by __________ ________

A

Peripheral Feedback

160
Q

TERM – Large forces across short distances via hard teeth

A

Mastication

161
Q

Name the 4 types of nerve endings identified in the PDL

1.

2.

3.

4.

A
  1. Free endings
  2. Ruffini Endings
  3. Coiled Endings
  4. Ecapsulated Endings
162
Q

TERM – type of sensory receptor for painful stimuli

A

Nociceptor

163
Q

TERM – type of receptor that responds to mechanical stimuli

A

Mechanoreceptor

164
Q

Free Nerve Endings are found along the length of the root and consist of ______ & ______ receptors

A
  1. Nociceptors
  2. Mechanoreceptors
165
Q

Ruffini Nerve Endings are found near the apex of a tooth and consist of ___________ receptors

A

Mechanorecptors

166
Q

TERM – ectopic cementum in PDL attached or unattached

A

Cementicle

167
Q

Name the 3 types of epithelilium associated with the periodontium

A
  1. Oral Epithelium
  2. Sulcus Epithelium
  3. Junctional Epithelium
168
Q

The Junctional Epithelium serves as a barrier to _____ invasion

A

Microbial

169
Q

TERM – Collagen fiber bundles spanning from tooth/bone to gingiva/connective tissue (lamina propria)

Function: resisting gingival displacement

A

Gingival Ligament Groups

170
Q

Gingival Ligament Groups (4)

​** CDDA **

A
  1. Circular Group
  2. Dentogingival Group
  3. Dentoperiosteal Group
  4. Alveologinigval Group

** CDDA **

171
Q

Porphromonas gingivalis is the type of bacteria that causes ____________ _______

A

Periodontal Disease - Periodontitis

172
Q

Name 3 things that are lost when a patient has Periodontal Disease

1.

2.

3.

A
  1. Cementum
  2. PDL
  3. Alveolar Bone
173
Q

Name a few ways periodontal regeneration can occur/prevention

A
  1. Scaling
  2. Root Planing
  3. Antibiotic Therapy
  4. Guided Tissue Regeneration (Grafting)
  5. Emdogain
  6. Growth factors

*** ALL depend on presence of stem/progenitor cells

Oral Histology Exam II (BLW) (7 decks)

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