Periodontium Flashcards

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1
Q

Name functions of the periodontium (3)

A
  1. Retains tooth in socket
  2. Resists masticatory loads
  3. Defensive barrier: protecting tissues against threats from the oral environment
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2
Q

What is the junctional epithelium

A

The physical barrier separating the body tissues from the oral environment

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3
Q

How is periodontal disease classified? (2)

A
  1. Diseases of the gingiva alone

2. Diseases of all periodontal tissues

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4
Q

Name the periodontal tissues (4)

A
  1. Cementum
  2. Alveolar bone
  3. Gingiva
  4. Periodontal ligament
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5
Q

Functions of cementum (2)

A
  1. Covers root dentine

2. Provides attachment for some periodontal fibres

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6
Q

Structure of cementum?

A
  • Collagen matrix

- Lamellar arrangement

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7
Q

What cells produce cementum?

A

Cementum is laid down by cementocytes

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8
Q

Name the 2 types of cementum

A
  1. Acellular cementum

2. Cellular cementum

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9
Q

State 3 properties of acellular cementum

A
  1. No cells within
  2. Usually adjacent to dentine
  3. First formed (primary cementum)
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10
Q

State 3 properties of cellular cementum

A
  1. Contains cementocytes
  2. Later formed (secondary cementum)
  3. Present in apical part of root and in furcation regions
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11
Q

What type of cementum contains sharpey’s fibres?

A

Acellular extrinsic fibre cementum

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12
Q

What type of cementum does NOT contain sharpey’s fibres?

A

Cellular intrinsic fibre cementum

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13
Q

Location of acellular extrinsic fibre cementum?

A

Present on the cervical 2/3rd of roots

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14
Q

Function of cellular intrinsic fibre cementum?

A
  • No role in tooth attachment

- May represent a transitional form

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15
Q

What type of cementum is better at regeneration?

A

Acellular

- As it provides anchorage so its better at regeneration

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16
Q

Why is cellular intrinsic fibre cementum less successful at treating perio disease?

A

Lack of sharpey’s fibres

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17
Q

Formation of the alveolar bone

A
  • Cortical plate forms the inner lining of the tooth socket
18
Q

Function of the alveolar bone

A
  • Provides attachment for periodontal ligament fibres (sharpens fibres)
  • Alveolar bone support the teeth
  • penetrated by nutrient canals (Volkmanns)
19
Q

In terms of the alveolar bone, what happens when teeth are lost?

A

The alveolar process is resorbed, leaving a residual ridge

20
Q

What is contained within the periodontal ligament? (5)

A
  1. Cells
  2. Extracellular matrix
  3. Fibres
  4. Nerves
  5. Blood vessels
21
Q

What makes up the PDL matrix (ground substance?) (3)

A
  1. Hyaluronate GAGs
  2. Glycoproteins
  3. Proteoglycans

behave as a viscoelastic gel (capacity to return to original shape)

22
Q

What cells are present in the PDL? (5)

A
  1. Fibroblasts
  2. Cementoblasts
  3. Osteoclasts/cementoclasts
  4. Epithelial cells
    - Debris of malassez
  5. Defence cells
23
Q

What nerves are present in the PDL (2)

A
  1. Sensory

2. Autonomic (sympathetic)

24
Q

Function of sensory nerves in the PDL (2)

A

Mechanoreceptors (AB + A delta fibres)
- Proprioception; chewing control

Nociceptors (A delta + C fibres)

  • Protective reflexes
  • inhibit jaw elevator motor neurons
25
Q

Function of the autonomic nerves in the PDL

A

Blood vessel control - vasoconstriction

26
Q

What type of fibres are myelinated?

A

Fibres

27
Q

Function of adrenaline in LA?

A

Adrenaline in LA reduces blood flow and reduces clearance

28
Q

What is the blood supply for the PDL? (2)

A
  1. From inferior and superior alveolar arteries
    - Passing into the PDL from the alveolar bone
  2. From lingual and palatine arteries
    - Supplying the gingivae
29
Q

What are the types of periodontal LIGAMENTS present in the PDL? (2)

A
  1. True periodontal ligament
    - Fibres connecting the tooth to bone at or apical to the alveolar crest
  2. Gingival ligament
    - Mainly above the alveolar crest, including ‘free gingival’ fibres
30
Q

State functions of the periodontal ligament (3)

A
  1. Attaches the tooth to the jaw
  2. Transmits biting forces to the alveolar bone
  3. Organised (regular) connective tissue
31
Q

State the width of the PDL

A

Approx 0.2mm

32
Q

What are the types of periodontal FIBRES present in the PDL? (3)

A
  1. Collagen (Types I and III)
    > Principal fibres - true periodontal ligament
    > Supports tooth; load-bearing
  2. Oxytalan fibres
    > Present in human PDL
    > Function uncertain
  3. Elastic fibres
    > Absent in humans
33
Q

What are the PDL principal fibre groups, and what are they made up of? (2)

A

Alveolo-dental ligament

  1. Alveolar crest
  2. Horizontal
  3. Oblique
  4. Apical
  5. Interradicular (multi-rooted teeth)

Interdental ligament
1. Transseptal fibres

34
Q

State the function of oblique fibres in the PDL

A

Rotational activity of the tooth

35
Q

State the function of apical fibres in the PDL

A

Coil that receives the forces

36
Q

Function of the gingival fibre group in PDL

A

Supports the free gingivae

37
Q

Where is the gingival fibre group found?

A

Present in the lamina propria in the marginal gingiva:

> Dento-gingival
Alveolo-gingival
Dento-periosteal
Circular

38
Q

Compare free + attached gingivae

A

Free:
Gingivae that is not attached to bone

Attached
Gingivae that is attached to bone

39
Q

Function of the free gingival groove?

A

Separates the free and attached gingiva

40
Q

Name examples of intrusive forces that the PDL may be exposed to (4)

A
  1. Mastication
  2. Swallowing
  3. Speech
  4. Parafunction (e.g. clenching/grinding)
41
Q

Name examples of RARE extrusive forces that the PDL may be exposed to (2)

A
  1. Sticky foods

2. Orthodontic forces

42
Q

What are the effects of loading on a tooth? (4)

A
  1. Initial elastic component
  2. Later viscous ‘creep’
  3. Tension in PDL fibres
  4. Compression of ECF