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Clinical Practice > The Periodontium Anatomy > Flashcards

The Periodontium Anatomy Flashcards

1
Q

what is the periodontium comprised of?

A

gingiva
PDL
alveolar bone
cementum

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2
Q

what is the function of the periodontium?

A

attachment of teeth to jaws

effective support during mastication

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3
Q

what are the 2 parts the gingiva is divided into?

A
  • Attached

- Free

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4
Q

what is free gingiva?

A

Coronal to the epithelial attachment

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5
Q

what is the attached gingiva?

A

tightly bound to the underlying bone = muco-periosteum

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6
Q

function of the gingiva?

A

attachment between mucous membranes and teeth

prevents bacterial invasion of the underlying periodontal tissues

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7
Q

in health where are the gingiva attached to the teeth?

A

coronal to the ACJ

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8
Q

what are the gingiva comprised of?

A

fibrous CT covered by epithelium

extends from mucogingival junction to the tooth surface

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9
Q

what is the basic structure of the oral epithelium?

A

Stratified squamous epithelium

Keratinocytes (90%) and Non Keratinocytes

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10
Q

4 types of clear/non keratinocytes found in the oral epithelium?

A

Langherhans cells - defense
Melanocytes - pigment melanin
Lymphocytes
Merkel cells - sensory touch receptors

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11
Q

4 hisotlogical layers in keratinised epithelium?

A

1 - basal cell layer
2- prickle cell layer
3- granular layer
4- keratinized layer

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12
Q

where does cell division occur in the keratinized areas?

A

cell division occurs in the basal layer
cells move through the epithelium and shed
as this happens cells increase in size/flatten and keratin is produced

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13
Q

what is differentiation?

A

process packing cells together in the keratinized layer

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14
Q

example of non keratinized epithelium?

A

alveolar mucosa

lacks granular and keratinized layers = intermediate and surface

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15
Q

what is an MCG and when are they produced?

A

mucous coating granules - formed in prickle and granular layers
contains lipids released into intercellular spaces in keratinised/non k = forms barrier to water

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16
Q

3 areas of gingival epithelium?

A
  • oral gingival epithelium - faces oral cavity - free/attached
  • oral sulcular ep - faces tooth but not attached
    junctional ep - attached to tooth
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17
Q

oral gingival epithelium structure?

A

stratified squamous ep

orthokeratinized - cells flat + no nuclei

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18
Q

what is the junction like between the oral gingival epithelium and the underlying connective tissue?

A

wavy course of connective tissue papillae and rete pegs of the epithelium project into each other

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19
Q

describe the sulcular epithelium?

A 
lines sulcus
faces tooth
non keratinized
shallow rete peg pattern
not directly involved in attachment
20
Q

what does the junctional epithelium allow? and how does it do this?

A

forms epithelial attachment to tooth

by hemi desomosomes anchoring basal keratinocytes to the basement membrane

21
Q

how is the JE formed?

A

by fusion of the reduced enamel epithelium with the oral epithelium on eruption
moves down tooth as tooth erupts, stabilises near the ACJ

22
Q

where does the JE terminate and what is its cell arrangement like?

A

terminates coronally in the base of the gingival crevice
JE cells orientate themselves parallel to the tooth
Rapid turnover of cells

23
Q

how does cell division occur in the JE?

A

division occurs throughout, cells shed into sulcus

24
Q

is the JE permeable?

A

poorly differentiated and do not synthesize MCG’s

also has large intercellular spaces so is readily permeable

25
Q

what are the 2 main components of gingival connective tissue?

A

Collagen fibres/Extracellular matrix - produced by fibriblasts
highly vascular

26
Q

cell types in gingival CT?

A

fibroblasts
macrophages
polymorphs/neutrophils
lymphocytes/plasma cells

27
Q

how is collagen arranged?

A 
circular fibres
trans septal fibres
dento gingival 
dento periosteal
crestal
28
Q

where do crestsal fibres stem from?

A

alveolar bone into attached gingiva

29
Q

most common type of collagen in CT?

A

type 1

30
Q

what is the extracellular matrix in gingival CT?

A

network of polysachharides and proteins secreted by cells

31
Q

what is the periodontal ligament?

A

specialized vascular connective tissue
continuous with gingiva and pulp
derived from dental follicle

32
Q

what is the pdl width?

A

ranges from 0.15-0.38
thinnest in middle third
decreases with age

33
Q

role of the principal fibres in the pdl?

A

attachment of cementum to bone

34
Q

groups of principal fibres?

A 
oblique
apical
horizontal
alveolar crest
inter radicular
35
Q

cells found in loose connective tissue?

A

fibroblasts
undifferentiated mesenchymal cells
defence cells

36
Q

the extracellular matrix binds with water which is important for?

A

hydrostatic cushion

withstand mastication

37
Q

blood vessels of pdl?

A

apical vessels
perforating/lamina dura
gingival vessels

38
Q

what are cementoblasts?

A

line surface cementum and lay down cementum

39
Q

what are osteoblasts?

A

line endosteal and periosteal alveolar surfaces, lay down bone

40
Q

what are cementoclasts?

A

line surface cementum and break it down

41
Q

what are osteoclasts?

A

line endosteal and periosteal surfaces - breakdown

42
Q

what are oxytalin fibres?

A 
unique to pdl
elastic
insert into cementum
run parallel/oblique
maintain potency of blood vessels during masticaiton
43
Q

what are the cell rests of Malassez?

A

remnants of epithelial root sheath of hertwig

forms plexus around tooth - prevents ankylosis

44
Q

what is bundle bone?

A

part of bone where tooth attaches
cribiform plate - heavily perforated with vessles/nerves
radiopaque lamina dura

45
Q

types of cementum?

A

cellular

acellular

46
Q

epithelial turnover affected by what hormones?

A

oestrogen
adrenaline
corticosteroids

47
Q

what do TIMP’s do?

A

inhibit tissue damage by collagensases

Clinical Practice (22 decks)

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