Periodontium and Probe

Question 1

Oral mucosa types (3)

Answer 1

Masticatory
Lining
Specialized

Question 2

What makes up the periodontium?

Answer 2

Periodontal ligament
Cementum
Alveolar bone
Periodontal structures

Question 3

What groups of fibers is the PDL made up of?

Answer 3

Gingival fiber groups

Principal fiber groups

Question 4

Gingival Fiber Groups

Answer 4

Dentogingival (free gingival) fibers
Alveologingival (attached gingival) fibers
Circumferential (circular) fibers
Dentoperiosteal (alveolar crest) fibers
Transseptal fibers

Question 5

Principal Fiber Groups

Answer 5

Apical fibers
Oblique fibers
Horizontal fibers
Alveolar crest fibers
Interradicular fibers

Question 6

Cementum

Answer 6

thin layer of calcified connective tissue that covers tooth from CEJ to and around apical foramen.

Question 7

Function of cementum

Answer 7

Seal tubules of root dentin
Provide attachment for
perio fiber groups

Question 8

Characteristics of cementum

Answer 8

Thickness 50 to 200 μm
about the apex
30 to 60 μm about the
cervical area
Vascular & nerve connections
missing  cementum is
insensitive

Question 9

Alveolar bone

Answer 9

Consists of lamina dura and supporting bone

Needs constant trauma of tooth in order to grow. Otherwise will resorb.

Question 10

Functions of alveolar bone

Answer 10

Support teeth
Provide attachment for
PDL fibers

Question 11

Free gingiva

Answer 11

Free gingival groove - 1/3 of teeth in the mouth will show the groove when healthy
Oral epithelium
Gingival margin

Question 12

Causes of tissue changes

Answer 12

Alterations produced from disease
Role of biofilm in disease process
Inflammatory response initiation
Effects of inflammatory response

Question 13

Gingival sulcus

Answer 13

in health ave depth is 1.8mm

not a “pocket” until there is disease.

Question 14

Attached gingiva

Answer 14

attached to bone or root of tooth

Question 15

Mucogingival junction

Answer 15

marks line b/t attached ging and alveolar mucosa.

when recession / disease goes below MJ, it is considered “mucogingival involvement.”

Question 16

Descriptive Terminology - Severity and Distribution

Answer 16

Severity
-Slight, moderate, or severe

Distribution
Localized - involved only about a single tooth or specific group
Generalized - involved about all or nearly all teeth throughout mouth or specific group
Marginal - confined to the free or marginal gingiva
Papillary - involves papilla but not rest of free gingiva
Diffuse - spread out, dispersed

Question 17

The ging. description in health and disease - color and size

Answer 17

Color
Signs of health - pale pink
Changes in disease - red or bluish

Size
Signs of health - firm and flat
Changes in disease - enlarged, soft, spongy, fibrotic (hard), retraction
-Enlargement from drug therapy

Question 18

Shape of gingiva

Answer 18

sharp - in health

bulbous

cratered

McCalls Festoons

Clefted - flossing, V or slit shaped

Question 19

Bleeding

Answer 19

Comes from little ulcerations inside tissue

Signs of health
-No bleeding present

Changes in disease

• Spontaneous or bleeding on probing
• Localized or generalized (>30%)
• Diseased pocket epithelium

Question 20

Exudate

Answer 20

pus

amount is not an idicator - just its presence.

Signs of health
No exudate present

Changes in disease
Increased gingival sulcus fluid
Presence of exudate

Question 21

Periodontal codes

Answer 21

0 - healthy

1 - bleeding, 3.5 - 5.5 mm mark visible

2 - same as 1 + defective margins or calculus

3 - dark colored band (3.5 - 5.5 mm) partially covered

4 - band completely covered

Question 22

Mobility causes and codes

Answer 22

Causes - inflammation, loss of support, trauma

Codes:

N - normal - extremely slight mobility
1 or I - slight
2 or II - moderate, 1 mm displacement
3 or III - severe movement in all directions including vertical

Question 23

Fremitus - def and causes

Answer 23

Def - Palpable vibration/movement

Causes:
Tooth has excess contact – possibly related to premature contact

Excess contact forces the tooth to move

Question 24

Fremitus codes

Answer 24

N = normal (without vibration or movement).

+ = One-degree fremitus; only slight vibration can be felt.

+ + = Two-degree fremitus; the tooth is clearly palpable but movement is barely visible.

+ + + = Three-degree fremitus; movement is clearly observed visually.

Question 25

Bifurcation and Trifurcation - anatomic features and complications

Answer 25

Bifurcations

• Mand molars - accessible from facial & lingual
• Max first premolars - accesssible from mesial & distal
• Primary mand molars

Trifurcations

• Max molars (palatal root & 2 buccal roots - mesiobuccal & distobuccal) – accessible from mesial, buccal and distal
• Max primary molars

Anatomic complications
-Fused roots, anomolies (extra roots, low or high furcations

Question 26

Clinical Attachment Level vs. PD

Answer 26

CAL - measured from fixed point to attachment

PD measured from changeable point (the crest of the free gingiva) to attachment

Question 27

Recession vs Enlargement measuring procedure

Answer 27

Measurement from fixed point to junctional epithelium
Recession - add PD and distance from margin to CEJ
Enlargement - subtract distance from margin to CEJ from PD