test 6 Flashcards
Cell properties (5)
- Smallest living unit of organization in the body
- Each cell has a cell membrane, cytoplasm, organelles, and inclusions (can function without the aid of other cells)
- Cells interact with one another
- Cells with similar characteristics are grouped to form a tissue
- Various tissues are bound together to form an organ
cell > tissue > organ
define exocytosis
Active transport of materials from a vesicle within the cell to the extracellular environment
define endocytosis
The uptake of materials from the extracellular environment into the cell
define phagocytosis
engulfing/digesting solid waste and foreign materials by the cell through enzymatic breakdown of materials
what are the 4 basic tissues
Epithelial
Nervous
Muscle
Connective
define regeneration
Natural renewal of the tissue (dead cells are removed from the new tissue and new ones take their place)
define turnover time
The time newly divided cells take to be completely replaced (Aging and disease delay or prevent this process)
why is it important we understand the histology of basic tissues
To understand the pathological process of renewal/repair/aging of tissues and what that might look like clinically
what are the types of epithelium
Simple: squamous, cuboidal, columnar, pseudostratified
Stratified: squamous (keratinized, nonkeratinized), cuboidal, transitional
what are the types of connective tissue
Solid soft: connective tissue proper, specialized tissue (adipose, fibrous, elastic, reticular)
Solid firm: cartilage
Solid rigid: bone
Fluid: blood, lymph
epithelium
Tissue that _____ and _______ the _______ and _____ body surfaces
Functions: (5)
_____ or _________: can be different degrees
Renewal rates: _____ for epithelial tissue. ______ and ________ occur at the same rate
Tissue that COVERS and LINES the INTERNAL and EXTERNAL body surfaces
Functions: protective, covering, absorption, secretion, and sensory
Keratinized or nonkeratinized: can be different degrees
Renewal rates: HIGH for epithelial tissue. Mitotic activity and shedding occur at the same rate
Epithelium histology
_____ grouped cells surrounded by little or no _____ or ______
Capable of _______, ________ regenerative
_______: no blood supply of its own; gets blood from __________
Closely grouped cells surrounded by little or no intercellular substance or tissue fluid
Capable of renewal, HIGHLY regenerative
Avascular: no blood supply of its own; gets blood from connective tissue
Epithelium classification
Un-stratified (SIMPLE): _____ layer
Pseudostratified: cells are _____ and seem ______ but all are attached to the _________
Stratified epithelium: _______ layers; ______ epithelium (stretches)
un-stratified (SIMPLE):
- Single layer
- Simple squamous/cuboidal/columnar epithelium
Pseudostratified:
- cells are closely packed and seem arranged in layers but all are attached to the basement membrane
Stratified epithelium
- Two or more layers
- transitional epithelium (stretches)
Pseudostratified epithelium
Falsely appears to have multiple layers under low power magnification
On high power magnification, one can see that cells are on the same level but the nuclei are at different levels
types of epithelial cells
squamous
Flat (ex: endothelium)
Cuboidal
Cube-shaped (equal height, equal width) (ex: salivary gland)
Columnar cells
rectangular/tall cells (ex: salivary glands)
how many layers are in the basement membrane
what does each layer consist of
2 layers: basal lamina and reticular lamina
basal lamina: lamina lucida and lamina densa
reticular lamina: collagen fibers
BASEMENT MEMBRANE
______ structure located between _______ and __________
__________ (Superficial layer)
_________: close to epithelium
_________: close to connective tissue
_________ (deeper layer) : Deeper portion consisting of _______ produced by the underlying _______
Acellular structure located between epithelium and connective tissue
Basal lamina (Superficial layer)
Lamina lucida: close to epithelium
Lamina densa: close to connective tissue
Recticular lamina
Deeper portion consisting of collagen fibers produced by the underlying connective tissue
connective tissue
Most _____ type of basic tissue in the body by _____
Functions: (8)
Serves as a source of _______ to the ______
Besides cells and fibers, it contains _____ and _______
_______ and ________
Most abundant type of basic tissue in the body by weight
Functions: support, attachment, packing, insulation, storage, transport, repair, defense
Serves as a source of nutrients to the epithelium (blood supply)
Besides cells and fibers, it contains nerves and blood vessels
Renewable and vascular
connective tissue histology
_____ are the most common cell type in CT
- Synthesize _______ and _______
- Depending on the degree of mineralization, collagen tissues may be ____, _______, or _____
- It also is abundant in: (5)
- Can be more _____ when _______ (repair)
Different types of ______ fibers are found in CT histology
- ______ fibers: The most common collagen protein is _____ collagen which includes ______, ______, _______
- ________ fibers: occur in a very _____ type of tissue (soft palate)
- ______ fibers: forming a _____ in the tissue (lymph nodes)
Fibroblasts are the most common cell type
- Synthesize (make) collagen and intercellular substance
- Depending on the degree of mineralization, collagen tissues may be rigid (bone), compliant (tendon), or have a gradient from rigid to compliant (cartilage). It also is abundant in corneas, cartilage, bones, blood vessels, and dentin in teeth
- Can be more active when stimulated (repair)
Different types of protein fibers are found in CT histology
- Collagen fibers: The most common collagen protein is type 1 collagen which includes fibroblasts, osteoblasts, and odontoblast
- Elastic fibers: occur in a very elastic type of tissue (soft palate)
- reticular fibers: forming a network in the tissue (lymph nodes)
loose connective tissue
The superficial layers of the _____ and ______
Serves as _______ for deeper structures
No prominent _______ elements
The superficial layers of the skin dermis and lamina propria (basement membrane) of the oral mucosa
Serves as protective padding for deeper structures
No prominent connective tissue elements
dense CT
Deep to ______
______ packed with a more ______ arrangement
Primarily ______ fibers to give it ______
Deep to loose connective tissue
Tightly packed with a more regular arrangement
Primarily collagen fibers to give it strength
CT turnover time and repair
Turnover is due to the production of _______ and _________ by ________
With injury, CT goes through __________
First immature CT, known as ________tissue, forms and eventually matures of_____ fibers increase
Turnover is due to the production of fibers and intercellular substance by fibroblasts
With injury, CT goes through healing stages
First immature CT known as granulation tissue forms and eventaully matures of collagen fibers increase
specialized CT
- _______ connective tissue
Found in _____ beneath the skin and around ______ - ________ connective tissue
Provides _____ (like vocal cords) - _______ connective tissue
Forms the supportive framework/network of _________
- Adipose connective tissue
Found in fatty tissue beneath the skin and around organs and joints - Elastic connective tissue
Provides stretching (like vocal cords) - Reticular connective tissue
Forms the supportive framework/network of blood vessels and internal organs
cartilage (solid form)
Composed of ____ and a _____
Matrix is composed of primarily _____
what is the perichondrium
_______ : receives nutrients from the _______
_________ CT
Two types of cells (describe them)
1.
2.
Present in the ____
Composed of cells and a matrix
Matrix is composed of primarily collagen
Perichondrium: the CT surrounding most cartilage
Avascular: receives nutrients from the perichondrium
Nonmineralized CT
Two types of cells
1. Chondroblasts: immature, produce matrix
2. Chondrocytes: mature chondroblasts
Present in the TMJ
cartilage growth patterns
appositional vs interstitial growth
Appositional growth is layered growth on the outside of the tissue from the outer layer of chondroblasts within the perichondrium
Interstitial growth is growth from deep within the tissue by mitosis of each chondrocyte expanding the tissue from within
hyaline cartilage (4)
- most common
- only contains collagen fibers
- found in embryonic growth centers (mandibular condyle)
- allows limbs to grow
elastic cartilage (2)
- numerous elastic fibers (more than hyaline)
- Found in external ear, auditory tube, epiglottis, and portions of the larynx
fibrocartilage (6)
- never found alone, always found with other types merging gradually with hyaline cartilage
- Transitional type of cartilage between hyaline cartilage and dense CT of tendons and ligaments
- Contains a lot of collagen fibers
- Found in areas that receive a combination of compression and tension
- Has great tensile strength
- Found in intervertebral discs, TMJ
repair and aging of cartilage
Unlike bone, has some _______ but there is NO _____ material
Unlike most CT, it is _____: relies on surrounding tissue for _____ and _______; causes ______ to take longer
Has no ______ , even when traumatized, no extreme _____
As it ages it becomes less _____: becomes more ____ and ______ with time, losing ______
Unlike bone, has some flexibility but there is NO mineralized material
Unlike most CT, it is avascular: relies on surrounding tissue for nutrients and metabolites; causes repair to take longer (TMJ)
Has no nerve supply, even when traumatized, no extreme pain
As it ages it becomes less cellular: becomes more hard and brittle with time, losing flexibility
bone (solid rigid)
Makes up most of the ______
manufactures/creates _____ within ________
Undergoes the most ______ of all connective tissues
Storehouse for _________ and other minerals
Makes up most of the mature skeleton
manufactures/creates blood cells within bone marrow
Undergoes the most developmental differentiation of all connective tissues
Storehouse for calcium and other minerals
bone anatomy:
periosteum
compact bone
cancellous bone
endosteum
bone marrow
Periosteum: counterpart of bone
Outer layer: has blood vessels and nerves
Inner layer: has osteoblasts (bone forming cells)
Compact bone: deep to the periosteum, very dense
Cancellous bone: deep to compact bone, (spongy bone/trabecular bone)
Endosteum: lining the cavity of bone
Bone marrow: inner most part of bone, gelatinous, has B-cells, stem cells for blood and lymphocytes
bone histology
____ of bone is an ______ substance in a ______ formation of ________ that gives bone its hardness (same material in dental tissues: enamel, dentin, and cementum)
_______ material is packed ______ bone cells
Matrix is composed of ______ and _________
50% of bone is an inorganic substance in a crystalline formation of hydroxyapatite that gives bone its hardness (same material in dental tissues - varying % in enamel, dentin, and cementum)
Inorganic material is packed between bone cells
Matrix is composed of organic collagen fibers and intercellular substance
bone matrix is initially formed as ________
what are osteoblasts
what are osteocytes
what are cytoplasmic processes
bone matrix is initially formed as osteoid
Osteoblasts: arise from fibroblasts, produce osteoid (an unmineralized organic component of bone), involved in the mineralization of bone
osteocytes: fully mineralized bone trapped in a lacuna (small space containing osteocytes)
cytoplasmic processes: part of osteocytes that radiate out in all directions, located in tubular canals of the matrix (canaliculi)
Bone matrix is formed in closely apposed sheets called ________
________ are embedded within and between lamellae
Lamellae arrangement in compact bone is called a ________
Bone matrix is formed in closely apposed sheets called lamellae
osteocytes are embedded within and between lamellae
Lamellae arrangement in compact bone is called a haversian system
what is the haversian canal
what is the volkmanns canal
Haversian canal
- Central vascular canal within an osteon (carries blood and nerves)
- Canals communicate and carry nutrition for the bone
Volkmann’s canal
- Located in the outer part of the Haversian system
- These nutrient canals run obliquely (at right angles) to the Haversian canals
bone repair and remodeling
Repair of bone depends on: (3)
Bone is the body is _______ being remodeled
- _______ resorb bone which is located on the surface of ________ bone in _________
- Each osteoclast has a large number of _______ that discharge into the cytoplasm and break down bone
Bone mass density is lost as a person ____, especially in _______ as bones lose ______ and minerals (know as _______)
Repair of bone depends on
1. Vascular supply
2. Presence of the periosteum with active osteoblasts
3. Minerals and vitamins level
Bone is the body is constantly being remodeled
- Osteoclasts resorb bone which is located on the surface of secondary bone in howships Lacuna
- Each osteoclast has a large number of lysosomes that discharge into teh cytoplasm and break down bone
Bone mass density is lost as a person ages, especially in women as bones lose calcium and minerals (know as osteoporosis)
blood (fluid CT)
Plasma: the _________ in blood vessels that carries the _________ and _______
The fluid product (serum) is derived from plasma and contains ________
Blood cells: ______ of blood
Red blood cells (_______)
- _________ disc without a ________
- Function:
White blood cells (_____)
- Rounded cells with _____
- Function:
Platelets (thrombocyte)
- Cell ____ derived from a special line of blood cell
- Function:
Plasma: the fluid substance in blood vessels that carries the blood cells and metabolites
The fluid product (serum) is derived from plasma and contains clotting factors
Blood cells: formed elements of blood
Red blood cells (erythrocytes)
- biconcave disc without a nucleus
- Function: Bind and transport oxygen and carbon dioxide
White blood cells (leukocyte)
- Rounded cells with nuclei (many variations)
- Function: Inflammatory response and immune response
Platelets (thrombocyte)
- Cell fragments derived from a special line of blood cell
- Function: Clotting mechanism
oral mucosa
Overall, the _____ of the tissue reflects the ______, in both health and disease
Overall, the clinical appearance of the tissue reflects the underlying histology, in both health and disease
alterations in oral mucosa (4)
Diabetes, vitamin deficiency
Medications
Local effects of chronic tobacco or alcohol use
Trauma, inflammation, infection, and precancerous and cancerous lesions
regional difference in oral mucosa
Specific histological features are noted in _____ of the oral cavity
These are the _____ for differences observed clinically when these regions are examined
Novice dental professionals must look closely at the different regions of the oral cavity and compare them with the ______
Specific histological features are noted in different regions of the oral cavity
These are the basis for differences observed clinically when these regions are examined
Novice dental professionals must look closely at the different regions of the oral cavity and compare them with the histological presentation
overview of oral mucosa
Lines the ___
Composed of: (2)
Gingival fiber groups of the ___ are found in the _________ of the ______
Lines the oral cavity
Composed of:
- oral epithelium
- basement membrane overlying a connective tissue proper/ lamina propria
Gingival fiber groups of the PDL are found in the lamina propria of the marginal gingiva
what are keratinocytes
squamous epithelial cells that produce keratin
keratin
______, ______, ______, _______protein that is impervious to ______ and resistant to ______
Produced during the maturation of the _______ as they migrate from the ________ to the surface of the _______
Only occurs in _______ of the oral mucosa
_________ = keratinized tissue
________ = in previously keratinized tissue (EX: irritation fibroma)
Tough, fibrous, opaque, waterproof protein that is impervious to pathogenic invasion and resistant to friction
Produced during the maturation of the keratinocyte epithelial cells as they migrate from the basement membrane to the surface of the keratinized tissue
Only occurs in certain regions of the oral mucosa
Naturally low levels = keratinized tissue
Higher levels (trauma) = in previously keratinized tissue (EX: irritation fibroma)
lamina propria
Located deep to the _________
Contains: (4)
Other names: (2)
Has both ______ and ________layers (located in oral cavity)
Located deep to the basement layer
Contains: blood vessels, nerves, collagen, and elastic fibers
Other names: connective tissue proper and dermis
Has both loose connective tissue and dense connective tissue layers (located in oral cavity)
what are the layers of the lamina propria
- Papillary layer
- Consist of loose CT - Capillary plexus
- In between the layers
- Provides nutrition
- capillaries for CT - Dense layer
- Consisting of dense connective tissue (lots of fibers)
what are the 3 types of strat squamous in the oral cavity
nonkeratinzed
orthokeratinized
parakeratinized
describe the layers of nonkeratinized strat squamous
Basal layer
- Undergoes mitosis and replaces lost cells
Intermediate layer
- Superficial to the basal layer
- Cells are plump/large and contain large amounts of fluid within their cytoplasm
Superficial layer
- Stacked cells with outer cells flattened into squames
- Squames shed and are lost as they age
basic features of orthokeratinized strat squamous epithelium
- Least common
- Masticatory mucosa and specialized mucosa
- Nucleated cells that contain keratohyalin granules
- Keratin layer cells have no nuclei
describe the orthokeratinized epithelium layers
- Basal
- Same structure present in nonkeratinized - Prickle
- Appear prickly/spiky/starlike
- Makes up most of the orthokeratinized - Granular
- Flat and stacked in 3-5 nucleated layers
- Contain granules or spots called keratohyalin (causes cells to die)
- Keratohyalin is the precursor for keratin - Keratin
- Variable thickness
- The cytoplasm is filled with keratin
- Shedding when cells are no longer viable and due to new growth at deeper levels (renewal of tissue)
- Naturally occurring: soles of feet, fingers, masticory mucosa (hard palate)
describe parakeratinized epithelium (4)
- Present in mastacory mucosa of Attached gingiva and Dorsal surface of tongue
- Present in specialized mucosa of lingual papillae
- Same layers as orthokeratinized but the granular layer may not be distinguishable or absent altogether
- Big difference is cells in the keratin layer contain keratin and nuclei
what structures have LINING MUCOSA
Buccal and labial mucosa, alveolar mucosa, mucosa lining the floor of the mouth, ventral surface of the tongue and soft palate
characteristics of lining mucosa
Softer texture, moist, easily stretched and compressed
describe the layers of lining mucosa
Basal layer (stratum basal)
- Deepest layer of the 3
- Single layer of cuboidal epithelial cells overlying the basement membrane
- Superior to the lamina propria
intermediate layer (stratum intermedium)
- Superficial to the basal layer in nonkeratinized epithelium
- Composed of larger, stacked, polyhedral shaped cells
- Appear larger or plumper than the basal layer because they have larger amounts of fluid in their cytoplasm
- Makes up the bulk of nonkeratinized epithelium
Superficial layer (stratum superficiale)
- Most superficial layer in nonkeratinized epithelium
- Even larger, similarly stacked polyhedral cells
- Outer cells flatten into squames cells
- Dead cells shedding, or loss, as they age and die during turnover of the tissue
lining mucosa
- ________ deep to the ________ is usually present
- Overlies _____
- Histological features allow a movable base for ______, ______, ______ - ______ epithelium is noted in superficial layers of lining mucosa
Submucosa deep to the lamina propria is usually present
Overlies muscle
Histological features allow a movable base for speech, mastication, and swallowing
Non-keratinized stratified squamous epithelium is noted in superficial layers of lining mucosa
what structures are composed of masticatory mucosa
Attached gingiva, hard palate, and dorsal surface of the tongue
what structures are composed of specialized mucosa
Lingual papillae of the tongue (dorsal and lateral surface)
Filiform, fungiform, foliate, and circumvallate
labial and buccal mucosa
- nonkeratinized epithelium is very thick, obscures the extensive vascular supply of the lamina propria
- may contain melanin pigment
- submucosa contains adipose tissue and minor salivary glands, is firmly attached to the underlying muscle and functions as one unit
clinical consideration of labial and buccal mucosa: Fordyce spots (3)
Variable numbers of spots scattered throughout the tissue
Visible as small, yellowish elevations on the mucosa
Deeper deposits of sebum from trapped/misplaced sebaceous gland tissue usually associated with hair follicles
clinical consideration of buccal mucosa: linea alba (4)
Hyperkeratinization commonly occurs on the usually nonkeratinized buccal mucosa when linea alba forms
White ridge of calloused tissue
Extends horizontally where max and mand teeth occlude
Naturally occurring
what is another example of hyperkeratinization on the buccal mucosa
patients with bruxism habits
Their tissue will undergo hyperkeratinization
what is snuff keratosis (7)
Snuff pouch or smokeless tobacco keratosis is
Like nicotinic stomatitis
No longer considered a true leukoplakia
Semitranslucent appearance rather than a flat whiteness
Located in areas of direct contact with snuff or chewing tobacco
Almost always completely reversible when the patient quits their habit
Precancerous entity
More wrinkled and more intensely white keratoses are considered to be a higher grade
alveolar mucosa
Lines the _____
________ epithelium: thin, allows______ to show through
Lamina propria: connective tissue papillae are often _____
Many elastic fibers allowing for _____
Submucosa: _______ to muscle or bone w/ minor ________ compared to buccal and labial mucosa
Overlies an extensive _______ in the lamina propria > makes it ______ than labial/buccal mucosa
Lines the vestibules
Nonkeratinized epithelium: thin, allows lamina propria to show through
Lamina propria: connective tissue papillae are often absent
Many elastic fibers allowing for mobility
Submucosa: loosely attached to muscle or bone w/ minor salivary glands compared to buccal and labial mucosa
Overlies an extensive vascular supply in the lamina propria > makes it redder than labial/buccal mucosa
ventral surface of the tongue AND floor of the mouth
Nonkeratinized epithelium: _____
Lamina propria: _______
Floor of the mouth: papillae is very _____, allows for _______
Ventral tongue: numerous ______, some ______ fibers
Clinical appearance:
Floor of the mouth has ______
Ventral surface of tongue is _______ yet it allows some ______ along with the _______
The mucosa are both classified as _______
Nonkeratinized epithelium: very thin
Lamina propria: very visible (will often see veins)
Floor of the mouth: papillae is very broad, allows for mobility
Ventral tongue: numerous papillae, some elastic fibers
Clinical appearance
- Both appear reddish pink with vascular blue areas of veins
- Moist, shiny, and compressible
Floor of the mouth has mobility
Ventral surface of tongue is firmly attached yet it allows some stretching along with the tongue muscles
The mucosa are both classified as lining mucosa
soft palate
Nonkeratinized epithelium
1
Lamina propria
3
Submucosa
3
Nonkeratinized epithelium
- thin
Lamina propria
- thick
- numerous defined CT papillae
- distinct very elastic layer for mobility during speech and mastication
Submucosa
- Thin, firmly attached to underlying muscle for speech and swallowing
- Contains adipose tissue that gives the soft palate a yellow hue
- allows mucosa and muscle to move as one unit
masticatory mucosa
structures
what type of epithelium
characteristics (4)
bound to
submucosa
what happens when it overlies bone
Attached gingiva, hard palate, and dorsal surface of tongue
Keratinized stratified squamous epithelium
Resilient, rubbery surface, Highly interdigitated, many rete ridges
Mostly bound down to bone or muscle
Submucosa is extremely thin or absent
When it overlies bone, with or without a submucosa, it increases the firmness of the tissue
attached gingiva
epithelium present
lamina propria
acts as ______
submucosa
clinical appearance in health
what type of mucosa is it
Epithelium: thick keratinized obscuring the vascular supply (pinkish appearance)
Lamina propria: very distinct papillae making a strong attachment to underlying bone
Acts as the periosteum > mucoperiosteum
submucosa not present
Stippling, Opaque pink, When dried, tissue is dull, firm, and immobile
masticatory mucosa
what is gingiva recession
what is it cause by (5)
FGM apical to the CEJ
Periodontal disease, Tooth position, Abrasion, Strong frenal attachments, Aging process
what is gingival hyperplasia and its causes
Affects both epithelium and lamina propria
Overgrowth of the interproximal gingiva
Causes:
Drugs for seizure control
Certain antibiotics
Specific heart medications
hard palate
type of epithelia
Lamina propria
Submucosa
posterior portion of the hard palate has?
Orthokeratinzied epithelium: thick layer
Lamina propria: the medial area of the hard palate the lamina propria will serve as the mucoperiosteum to the underlying bone
Submucosa: thinner than other area
Only the lateral portions of the hard palate have adipose tissue
posterior area of hard palate has minor salivary glands
clinical consideration for the hard palate: Nicotinic stomatitis (3)
Whitened by hyperkeratinization due to the heat from tobacco OR hot liquid consumption
Heat also causes inflammation of the duct openings of minor salivary glands of the palatal area, they become dilated and inflamed
inflammation is seen clinically in the red macules scattered on the whiter background
what structures contain specialized mucosa
Lingual papillae of tongue (dorsal and lateral surface)
what type of mucosa and epithelium is present on the dorsal surface of the tongue
Masticatory mucosa:
- Orthokeratinized stratified squamous epithelium that covers the muscle tissue of the tongue
- Granular layer and keratin layer (containing nuclei)
Specialized mucosa:
- Both orthokeratinized and parakeratinized epithelium associated with lingual papilla
taste buds
extends from?
renewal time?
what are taste cells?
what happens when they contact food?
what type of neurons are present?
Extends from the basement membrane to the epithelial surface of lingual papilla
Renewal time of 10 days
Taste cells located in the central portion of the taste bud, taste cells have taste receptors in the taste pores
Contact food and give off a taste sensation
Sensory neurons are present and communicate with the central nervous system
what are the 4 fundamental taste sensations
Sweet
Sour
Salty
Bitter
mean turnover time for oral tissues
Hard palate:
Floor of mouth:
Buccal and labial mucosa:
Attached gingiva:
Taste buds:
Junctional epithelium:
Skin:
Hard palate: 24 days
Floor of mouth: 20 days
Buccal and labial mucosa: 14 days
Attached gingiva: 10 days
Taste buds: 10 days
Junctional epithelium: 10 days
Skin: 27 days
clinical observations of aging (6)
Reduction of stippling on attached gingiva
Increase in Fordyce spots
Increased vasosities on ventral surface of tongue
Taste buds may be reduced
Mouth may become drier due to medications
Repair and renewal decreases
what is irritation fibroma (4)
specialized formations
treatment
Painless, localized, mass producing proliferation of dense fibrous scar tissue
Results from a single traumatic episode, chronic inflammation, or infection
Lesions can become more than 3 cm in size but is usually less than 1 cm
Occurs at all ages and in both genders
specialized forms occur during:
- Under dentures/along denture edges
- Inflamed gingiva
Treatment
- Surgical/laser removal, small change of recurrence
free gingival groove (2)
Slight depression separating the attached gingiva from the marginal gingiva
May not always be clinically visible
what is the col (4)
Apical to the contact area, the interdental gingiva assumes a nonvisible concave shape between the facial and lingual surfaces, forming a gingival col
Col means saddle-shaped
Varies in width and depth
Broader in posterior teeth; becomes narrow as you move to premolars and anterior teeth
two types of grafting
grafting reduces gingival recession
- Subepithelial connective tissue graft
- Consists of only lamina propria CT taken from the surrounding keratinized attached gingiva/hard palate and then grafted directly to the root - Free gingival graft
Consists of the entire surface and underlying CT (both CT and overlying epithelium)
what is the dentinogingival junction
- Junction between the tooth surface and gingival tissue
- Together sulcular epithelium and junctional epithelium form the dentogingival junctional tissue
what is sulcular epithelium (crevicular)
(4)
Stands away from the tooth creating a gingival sulcus
Filled with gingival crevicular fluid
Lines the wall of the gingival sulcus; is NOT attached to the tooth surface
Close up view: nonkeratinized or rarely parakeratinzed; interface between it and the lamina propria is relatively smooth
what is the junctional epithelium (5)
*turnover of the junctional epithelium is 1 week, much faster than most tissues in the body, has a high mitotic rate
Deeper extension of the sulcular epithelium
Lines the floor of the gingival sulcus and is attached to the tooth surface by way of epithelial attachment
Overlies the enamel
Deep to the junctional epithelium is the connective tissue of the periodontal ligament
what are hemidesmosome intercellular junctions
Involves attachment of cells to an adjacent tooth (noncellular surface)
gingival crevicular fluid
Seeps from between epithelial cells and gets into the gingival sulcus
Contains immunologic cells that act in the body’s defense system
- PMNs monitor for bacteria/irritants; Low in number in healthy tissue
- WBS
- Immunoglobulins (IgG, IgM, IgA) produced by plasma cells
- Complement factors - help to initiate the immune response to plaque but can also damage the periodontal tissues
Implant dentinogingival junction tissue
Tissue around implants always originates from epithelial cells of the oral mucosa
As opposed to the junctional epithelium located around natural teeth which originates from reduced enamel epithelium (REE)
bleeding on probing
can occur due to disruption of increased blood vessels in the capillary plexus of the lamina propria
Ulceration of the JE
Inflamed gingiva can bleed spontaneously from finger pressure or from probing even if the probe doesn’t puncture the tissue
In patients who smoke, gingival tissue rarely bleeds because of unknown factors, NOT related to dental biofilm and calculus formation
