Surgical Anatomy Lecture Flashcards
1
Q
Periodontitis
A
Inflammation
• Characterized by loss of clinical attachment
– Destruction of PDL and bone
2
Q
Principal Gingival Fiber Groups
A
Dentogingival • Circular • Dentoperiosteal • Alveologingival • Transeptal
3
Q
Layers of epithelium
A
– Stratum corneum
– Stratum granulosum
– Stratum spinosum
– Stratum basale
4
Q
Sulcular Epithelium
A
Non-keratinized – Gingival crest to junctional epithelium – More permeable to bacteria – 3 Layers: stratum basale, stratum spinosum, superficial layer
5
Q
Junctional epithelium
A
– Non-keratinized – 2 cell layers • Stratum basale • Stratum spinosum – Large intercellular spaces – High renewal rate – First barrier to cell bacterial penetration
6
Q
Biologic Width
A
• Junctional epithelium – 0.97mm • Connective tissue – 1.07mm • Total biologic width – 2.04mm
7
Q
Biologic Complex
A
Biologic width plus
– Includes sulcus depth of
.69mm
8
Q
Connective Tissue Layers
A
Papillary layer
• Reticular layer
9
Q
Connective Tissue Composition
A
– 60% Collagen – Ground substance • proteoglycans, glycosaminoglycans, glycoproteins – Cells • fibroblasts, lymphocytes, PMNs, plasma cells
10
Q
Cementum Types
A
– Acellular- coronal 2/3 – Acellular extrinsic fiber cementum provides predominant support for tooth • Apical 1/3 is cellular
11
Q
Goals of Periodontitis Tx
A
Health
Comfort
Function
Esthetics
12
Q
Types of periods tx
A
Non Surgical
Surgical
13
Q
Non surgical therapy
A
ScRp
14
Q
Surgical Perio Therapy types
A
Pocket Elimination Regeneration Implants Functional Crown Lengthening Ridge Preservation
15
Q
Masticatory Mucosa
A
Gingival
Palatal
16
Q
Alveolar Mucosa
A
Buccal
Floor of the Mouth
Inferior Tongue
17
Q
Specialized Mucosa
A
Dorsum of tongue
18
Q
Histology of Masticatory Mucosa
A
Ortho/parakeratinized
Prominent Rete Ridges
19
Q
Alveolar Mucosa
A
Floor of the mouth, bucal, vestibules
Non Keratinized
Indistinct rete Ridges
20
Q
Specialized Mucosa
A
Papillae
Tast buds
on dorm of tongue
21
Q
Attached Gingiva in Facial
A
Variable range 1-9mm Max -widest in ant, narrowest in posterior Man widest in anterior, narrowest in canine/premolar
22
Q
Lingual attached gingiva
A
1-8 mm
narrowest in anterior, wider posteriorly
(man)
23
Q
Papillae
A
Interdental Tissue
24
Q
Gingival Col
A
Connects facial and lingual papillae
25
Keratinized Tissue Thickness
Free Gingiva 1.56 mm
Attached Gingiva...1.25mm
Overall 1.41 mm
26
Thin Biotype
Thinner gingival tissues
more ovoid tooth form
propensity of tissues for recession
27
Thick Biotype
Thick gingival tissues
| more square shaped form
28
Main artery for periods blood flow
Ext Carotid
29
Branches of Ext Carotid
Maxillary Artery
Facial Artery
Lingual Artery
30
Maxillary Artery
Inferior Alveolar
Descending Palatine
PSA
Infraorbital
31
Facial Artery Branch
Submental
32
Lingual Artery Branches
Sublingual
| Deep Lingual
33
Max Vasculature
Post Superior Alveolar ArteryInfraorbital
Greater Palatine
Naso Palatine
34
Posterior Superior Alveolar Artery
Supplies Max Bone, Teeth, and facial Soft tissues
35
Infraorbital Artery
Supplies ant mucosa
36
Greater palatine Artery
Supplies palatal Soft Tissue
| Poses a sig risk in palatal per surgical procedures
37
Nasopalatine Artery
Emerges from incisive canal at max midline
anastomoses with greater palatine artery
May present obstacle to flap reflection
38
Man Vasculature
Inferior alveolar artery
mental artery
Facial mucosa from submental
lingual mucosa from sublingual
39
IA artery
Supplies Man bone, dental arteries, and soft tissue in mandible
40
Mental artery
Cont of IA artery
exits mental foramen
can have ant loop
41
Facial Artery Sig
Position should be counted for prior to flap reflection, or block harvest
42
Submental artery
Supplies surrounding facial muscles
floor of mouth
skin in submental area
43
Sublingual artery
Suppliestongue
| lingual of ant mandible
44
Blood supply to gingiva and mucosa
Anastamoses from
PDL
Bone
Periosteum
45
Periodontal Innervation
Trigeminal Nerve
46
Max innervation
V2
47
V2 branches
```
•Zygomatic
•Pterygopalatine
•Greater palatine
•Posterior superior alveolar
•Infraorbital
–Middle superior alveolar
–Anterior superior alveolar
•Nasopalatine
```
48
Man innervation
V3
49
V3 Branches
–Inferior alveolar
–Lingual
–Long buccal
–Mental
50
Lingual Nerve
Ant 2/3 of tongue (sensory)
51
Buccinator
–Origin: Outer surface of the alveolar process of maxilla and mandible
–Insertion: Fibers of the orbicularis oris
52
Mylohyoid
–Origin: Midline raphe
| –Insertion: Forms ridge of mandible
53
Genioglossus
–Origin: Genial tubercles
| –Insertion: Tongue
54
Mentalis
–Origin: Mandibular symphysis
| –Insertion: Connective tissue of chin
55
Mailla
```
2nd larges bone of the face
•Four processes
A.Palatine
B.Zygomatic
C.Alveolar
D.Frontal
```
56
Maxillary tuberosity
–Size and thickness are important
| –Length will influence flap design for distal wedge
57
Palatal Tubercles
```
•Prevalence
–56%
•Location
–57% directly lateral to Greater Palatine Foramen
•Factors
–Male > Female
–Dentate > Edentulous
–Young > Old
```
58
Max Sinus
•33x33x23mm
•Total volume
–15 cc
59
Maxillary sinus septae
–28% 1 or more septa
| –3.5mm average height
60
•Anterior nasal spine
–Possible source of autogenousbone for grafting
61
•Palatine vault
* High: 17mm
* Average: 12mm
* Shallow: 7mm
62
Man Ramus
–Site of autogenousbone grafts
| –Limitations: Proximity may prevent adequate room for access, distal wedge procedures
63
Ext Oblique Ridge
–Attachment for buccinator, source of autogenousbone
| –Limitations: If prominent may make crown lengthening challenging
64
•Mental foramen
–Point of exit for mental nerve
| –Apical to second premolar 63% of the time
65
•Mandibular symphysis
–Thickness critical for harvesting autogenousbone
| –Thin symphysiscontraindicated for harvesting
66
•Lingula
–Entrance of IAN
| –Target for IAN block
67
•Submandibular fossa
–Location of submandibular gland
| –Prominence of mylohyoidridge may hinder flap reflection
68
•Supporting Bone
–Dense outer layer of bone into which periosteumand PDL attach
69
Non-supporting bone
(Trabecular or medullary)
| –Inner layer, less dense and more vascular
