Periodontum Flashcards

1
Q

Periodontal tissues of the tooth consist of

A
  1. Cementum
  2. Periodontal ligament connect tooth to BAP
  3. Bony alveolar processes
  4. Gingiva facing tooth
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2
Q

Tissues form ________ that binds teeth to bony sockets.

A

Gomphosis

Unique fibrous joint from ectomesenchyme of dental sac/follicle

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3
Q

The periodontium is a type of ______.

A

Fibrous joint

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4
Q

Why is the periodontal pocket important?

A

Gateway for biofilm bacteria to enter root system

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5
Q

Periodontal Pocket Severity

A

1-2 mm : GOOD

Inflammation response will open pocket further.

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6
Q

What is cementum made of?

A

Similar to bone

Primary and Secondary Cementum

ORGANIC material: 23%
Hydroxyapatite: 65%
Water: 12%

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7
Q

What is in the ___% organic material in cementum?

A

23%

Collagen 1,3,12(PDL), little of 6,5,14

Proteins:

Bone Sialoprotein
Osteopontin
Osteocalcin
Osteonectin
Dentin Matrix Protein 1
Dentin Sialoprotein

BOOODDS

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8
Q

Cementum is thicker ________. It is an intermediate between _______.

A

Apically

Dentin and bone tissue

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9
Q

Cementum is vascular. True or false?

A

FALSE

Vascular

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10
Q

What does the cementum cover?

A

Root of teeth

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11
Q

It is formed in two stages what are they?

A

The first stage is pre-functional or primary where the Dentin is covered. This occurs during root formation.

The second stage is functional or secondary, where it is formed when teeth are erupted and in occlusion.

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12
Q

What are the 3 function of cementum?

A
  1. Cover root dentin (and tubules)
  2. Site of attachment for periodontal fibers (teeth to bone)
  3. Compensate for changes in surrounding bone.
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13
Q

Primary cementum is acellular/cellular. It has __________ and covers________.

A

acellular

one or more layers covers entire root surface

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14
Q

Secondary cementum is acellular/cellular. It is involved with __________ and covers _________.

A

cellular

tooth movement, repair, readjustment to changes in bone

covers apical third of root and interradicular surfaces

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15
Q

Fibrillar cementum

A

Abundance Collagen I

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16
Q

Afibrillar cementum

A

without well defined Collagen Type 1

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17
Q

Extrinsic fiber cementum

A

Extrinsic collagen fibers from periodontal ligament

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18
Q

Intrinsic Fiber Cementum

A

Intrinsic collagen fibers made by cementoblasts

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19
Q

What does Cementum look and feel like?

A

Pale yellow, darker than enamel

Grainy compared with harder, smooth enamel

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20
Q

Primary cementum has _______ at the surface.

Junction with dentin is called _______.

Collagen fibers ___________ to _______ junction.

A

cementoblasts

Tomes Granular Layer

Perpendicular to cementodentine

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21
Q

What is another name for extrinsic fibers and what collagen is it made of?

A

Sharpey’s Fibers

Collagen Type I

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22
Q

_________ generate the matrix for primary cementum.

How does it do so?

A

Cementoblasts

They synthesize collagen fibers which intermingle with collagen fibers of dentin with the cementoid (organic) becoming mineralized.

23
Q

Striations of cementum in histology

A

Horizontal : PDL fibers

Parallel: Layering of cementum

24
Q

Secondary cementum covers the ____ of the root and is present in the _______ for teeth with ___ roots.

A

apical 1/3

interradicular region more than 1

25
Q

Teeth with 1 root do or do NOT have secondary cementum/

A

DO NOT (only some)

26
Q

In cellular intrinsic fiber collagen, _______ in lacunae are surrounded.

_________ is a ________ matrix deposited by cementocytes and is _________. How does it become mineralized?

A

cementocytes ( remember this makes in collagen)

Cementoid, collagen, unmineralized

Trapping cementoblasts

27
Q

What is the difference between cementoblasts(CB) and cementocytes (CC)

A

CB come from the ectomesenchyme and are on the surface of cementum

CC are in lacunae have have processes in canaliculi projecting towards PDL which vascularized. They transport nutrients to cell body.

CEMENTOCYTES LOOK LIKE OCTOPUS`

28
Q

Cementocytes look like _______. How do we know where the PDL is based on cementocytes

A

octopus

Tentacles face PDL towards tooth surface

28
Q

The CEJ is made of ______ cementum and has 3 forms.

A

Primary

  1. Cementum overlapping dentin - TIGHT SEAL
  2. Gap between dentin and enamel - BAD
  3. Cementum and enamel head butt against each other like mountains
29
Q

Hertwing’s epithelial root sheath is located at the ________________.

A

junction of the inner and outer enamel epithelium

30
Q

________ of Hertwing’s epithelial root sheath induces what?

A

Fragmentation as ameloblasts die off. Only dentin and cementoblasts is found near this apical portion where the root sheath is for this reason

predentin induces differentiation of cementoblasts AS WELL AS ameloblasts and odontoblasts

31
Q

Where are cementoblasts cells originating from?

A

Dental follicle or sac of ectomesenchymal cells (neural crest origin)

Rooth Sheath Cells

32
Q

HERs cells either ________ or ___________.

A

die or migrate away from the dentin toward the dental sac as cementum is laid down

Some become trapped in developing cementum and become the epithelial CELL OF MALASSEZ found in the PDL

33
Q

What do Malassez look like?

A

Clusters or long strands along cementum

34
Q

What is a cementicle?

A

Mineralized acellular cementum spheres at cemental root or in PDL.

ONLY acellular cementum formed later in life.

Increases with AGE and can be in/on cementum layer or free in PDL

35
Q

Hypercementosis

A

Too much cementum

Can result from occlusal trauma due to excessive occlusal forces

36
Q

Alveolar bone (___________) is supported by ____________ which is surrounded by a ________.

A

lamina dura (socket where teeth reside)
spongy bone
cortical plate (buccal and lingual)

37
Q

The cortical plate is in contact with the tooth. True or False

A

FALSE! It is the outer portion of the mandible and maxila that we can feel

38
Q

Alveolar bone is also known as ______-.

A

Bundle Bone

39
Q

The PDL will stick into the ________ and _______ via _______.

A

Cementum or Lamina Dura of alveolar bone via Sharpey’s fibers.

40
Q

PDL is high vascularized and innervated. True or false?

A

TRUE

41
Q

PDL does what for cementocytes?

A

Provide nutrients

42
Q

What are Volkmann’s Canals?

A

Hole in the alveolar bone with a neurovascular unit coming into the PDL

43
Q

Ectomesenchyme gives rise to _______.

A

Fibroblasts
Cementoblasts
Osteoblasts
Osetoclasts
Cementoclasts

Fred Cries Over Organic Chemistry

Fibers, amorphous ground substance
Collagen bunles (Type 1 and 3- elastic fibers)

44
Q

Osteoblasts will break down ______ cementum if something is wrong with tooth.

A

Secondary

45
Q

Describe the development of the PDL.

What does it happen concurrently with?

A

Root System Development

HERs is disrupted and cementoblasts form from ectomesenchymal cells of dental sac.

Collagen forms from dental sac cells.

OsteoBLASTS develop and form alveolar bone.

46
Q

Fiber Groups in PDL

A

Embedded in cementum of root and lamina dura of alveolar both : Sharpey’s

Fibers: Collagen I and III
Elastic Microfibril

47
Q

What will the PDL remodel in response to?

A

Use/Manipulation

Metabolic - Low Vitamin C causes impaired collagen production

Aging

48
Q

Fiber TYPES in Periodontal Ligament

Which one is found most often?

A

Alveolar Crest
Horizontal
Oblique - MOST
Apical
Interradicular

AlOHAI

49
Q

Additional Fiber Types

A

Dentogingival
Dentoperiosteal : Tooth to outer crest of alveolar bone
Alveolargingival: Alveolar bone to gingiva
Transseptal ligament: Adjacent teeth to one another over alveolar crest

50
Q

Periodontal Ligament Vascularization

BV form _______________ located in the _______________

A

single vascularized mesh in the middle of the periodontal space

Like a BASKET

51
Q

Nerves run from _______ to _______margin

A

apical to gingival

52
Q

4 Nerve Endings

A

Free :Nociceptors and Mechanoreceptors

Ruffini Endings: Mechanoreceptors

Coiled Ending: unknown
Encapsulated : Unknown