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Plaque Related Disease > Periodontium- Anatomy And Function > Flashcards

Periodontium- Anatomy And Function Flashcards

1
Q

What are the 4 main structures making up the periodontium?

A

Gingiva
Periodontal ligament
Alveolar bone
Cementum

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2
Q

What is the function of the periodontium?

A

Attachment of teeth to jaws
Support during mastication
Shock absorbs during mastication

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3
Q

What are the two classifications of gingiva?

A

Free- coronal to epithelial attachment

Attached- tightly bound to underlying bone ( muco periosteum)

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4
Q

What is the function of the gingivae?

A

Attachment between oral mucosa and teeth

Prevents bacterial invasion of underlying tissues

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5
Q

Where is the gingival attached to the teeth?

A

At or just coronal to the ACJ

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6
Q

What is the gingivae made up of?

A

Fibrous connective tissue covered by epithelium

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7
Q

Describe the basic structure of the oral epithelium

A

Stratified squamous epithelium
Made up of 2 groups of cells
1- keratinocytes
2- non keratinocytes

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8
Q

What cells make up non keratinocytes?

A

Langerhan cells- antigen presenting
Melanocytes- produce melanin
Lymphocytes- provide immunity
Merkel cells- sensory touch receptor

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9
Q

What are the 4 layers of non keratinised sites?

A

Basal cell layer
Prickle cell layer
Intermediate layer
Surface layer

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10
Q

What are the 4 layers to keratinised sites

A

Basal cell layer
Prickle cell layer
Granular layer
Keratinised layer

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11
Q

What are MCGs and where are they synthesised?

A

Contain lipids which are discharged into Intracellular spaces
Forming an incomplete barrier to free permeability of water

Synthesised in granular layer and prickle layers

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12
Q

Describe the three regions of gingival epithelium

A

Oral gingival epithelium- free and attached gingiva
Oral soul ulnar epithelium- face tooth. Not attached
Junctional epithelium- in contact with tooth

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13
Q

Describe feature of the oral gingival epithelium

A

Stratified squamous epithelium
Usually orthokeratinised
The junction between gingival epithelium and underlying gingival connective tissue
Features connective tissue papillae and rete pegs

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14
Q

Describe features of oral sulcular epithelium

A

Lines gingival sulcus and crevice
Faces tooth surface
Non keratinised
Shallow rete peg formation

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15
Q

Describe features of the junctional epithelium

A

Form epithelial attachment to the tooth
Hemidesmosones anchor basal keratinocytes to the basement membranes

Formed by fusion of reduced enamel epithelium and oral epithelium on tooth eruption
Moves apically as tooth reaches occlusion
Stabilises at ACJ
cells turnover every 14-21 days
Readily permeable due to large intercellular spaces
Small number of neutrophils pass through JE to enter crevice

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16
Q

What are the two main components of the gingival connective tissues?

A

Collagen fibres
Extra cellular matrix

Both produced by fibroblasts

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17
Q

What cells are commonly found in gingival connective tissues

A

Fibroblasts
Macrophages
Polymorphs/ neutrophils
Lymphocytes and plasma cells

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18
Q

Describe the groups of fibres which collagen is arranged in

A

Circular fibres
Trans septal fibres- embedded in cementum
Dentino gingival fibres
Dento periosteal fibres
Crestal fibres- fan out of alveolar bone into attached gingiva

19
Q

Describes features of the extra cellular matrix

A 
Network of polysaccharides and proteins
Serves as structural element in tissues
Synthesised by fibroblasts
Includes gylcosaminoglycans GAG
proteoglycans
Glycoproteins
20
Q

What is GAG

A

Gylcosaminoglycans
Bind h2o
Act as hydrostatic cushion- resists compressive forces

21
Q

Describe features of the periodontal ligament

A 
Derived from dental follicle
Specialised vascular connective tissue
Inserts into cementum and alveolar bone
Made up of:
Principal fibres
Loose connective tissues
Blast and clast cells
Oxytalan fibres
Cell rests of molasses
22
Q

What is the function of the periodontal ligament?

A

Attachment of teeth to jaws
Absorbs forces
Role in tooth movement

23
Q

Describe the principle fibres of the PDL

A

Sharpey fibres- attach cementum to bone

Arranged in groups:
Oblique
Apical
Horizontal
Alveolar crest
Inter radicular
24
Q

What is collagen formed and broken down by?

A

Fibroblasts cells

25
Q

What type of collagen is present in the PDL

A

Type 1 , 3, 5

26
Q

What is the significance of type 3 collagen?

A

More extensible which accommodates tooth movement

27
Q

What is the importance of the extra cellular matrix?

A

Important re. Binding h2o re. Hydrostatic cushioning
Includes hyaluronic acid
Heparin sulphate
Chondroitin sulphates

28
Q

Why is nerve supply important around the periodontium?

A

Monitoring masticatory loading

Reflex re. Salivation

29
Q

Describes the blood vessels of the periodontium

A

Apical vessels- supply pulp
Perforating vessels- perforate socket wall - cribiform plate
Gingival vessels- from gingival tissues

30
Q

What blast cells are present in the periodontium and where are they derived from

A

Osteoblasts
Cement oblasts

Derived from undifferentiated connective tissue cells

31
Q

What clast cells are present in the periodontium?

A

Cementoclasts
Osteoclasts

Derived from bone marrow cells

32
Q

Describe feature of oxytalin fibres

A

Unique to the PDL
elastic nature
Insert into cementum
Run parallel and oblique to root surface

Function: maintain potency of blood vessels
Direct fibroblasts migration during eruption

33
Q

What are cell rests of Malassez

A

Remnants of epithelial tooth sheath of hertwig
Form plexus around tooth
Thought to prevent ankylosis

34
Q

Describe features of the alveolar bone

A

Cancellous trabecular/ spongy bone covered in thin layer of cortical bone
Sharpeys fibres insert into bone

35
Q

What is bundle bone?

A

The part of the bone which the tooth attached to-socket
Heavily perforated by blood vessels - cribiform plate
Radiographically seen as narrow white line (lamina dura)

36
Q

What is loss of lamina dura radiographically a sign of?

A

Disease

37
Q

What are the two types of cementum?

A

Cellular

Acellular

38
Q

What are stem cells in the basal layer of epithelium important for?

A

Renewal of the epithelium and tissue homeostasis

39
Q

What hormones are associated with tissue homeostasis ?

A

Oestrogen increases epithelial turnover

Adrenaline and corticosteroids reduce epithelial turnover

40
Q

What cytokines stimulate epithelial turnover?

A

Transforming growth factor

Epidermal growth factor

41
Q

What cytokines inhibit epithelial turnover?

A

Transforming growth factor beta

42
Q

How is tissue homeostasis regulated for connective tissue?

A

Fibroblasts are responsible for synthesis and breakdown of collagen and extra cellular matrix.
Fibroblasts secrete enzymes than breakdown collagen

43
Q

What cytokines are responsible for connective tissue turnover?

A

Platelet derived growth factor
Fibroblast growth factor
Transforming growth factor
All stimulate tissue turnover

Interleukin 1 and inferon gamma inhibit tissue turnover

Plaque Related Disease (18 decks)

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