The Role of the Periodontium in Relation to Dental Caries Flashcards
Consists of both soft and hard dental tissues that support the tooth in its relationship to the alveolar process
Periodontium
Appositional growth of dentin in root area
Root formation
The HERS disintegrate to produce the epithelial rests of Malassez
True
Residual cells of HERS that did not completely disappear
Epithelial Rests of Malassez
What is the cementum matrix?
Cementoid
Avascular, multiunit, mineralized connective tissue derived from the mesoderm
Cementum
Which CEJ interface can lead to the difficulty of discerning the CEJ from calcular deposits?
Overlap
Which CEJ interface is normal and has no problems?
Meet
Which CEJ interface exposes the dentin?
Gap
An acellular cementum is the first layer deposited on top of the dentin, and formed at a faster rate.
False (slower rate)
The cellular cementum can widen overtime and layers can be added.
True
Appears in radiographs as the periodontal ligament space between the lamina dura and the cementum
Periodontal ligaments
Pain, touch, pressure, and temperature sensations in PDL
Proprioception
Most common cells in the PDL
Fibroblasts
Regulate collagen-sensory and collagen remodeling
Mechanosensing
Inserts mesiodistally or interdentally into the cervical cementum of neighboring teeth and resists rotational forces and hold the teeth in interproximal contact
Interdental ligament
The interdental ligament is coronal to the alveolar crest and has no bony attachment
True
Ectomesenchyme of the dental sac mineralize
Alveolar process development
Hard, mineralized tissue with the components of other bone tissue, and more easily remodeled than the cementum
Alveolar process
Formative cells of the enamel
Ameloblasts
Embryoloic background of the alveolar process and cementum
Dental sac
Masticatory mucosa that is bound to the teeth and covers the alveolar processes
Gingiva
Unattached and often characterized by the sulcus depth
Free gingiva
Firmly attached to the periosteum of the alveolar process
Attached gingiva
Where is the widest band of the attached gingiva?
Facial aspect of central and lateral incisors
Where is the narrowest band of the attached gingiva?
Facial area of canines and first premolars
Formed by the sulcular epithelium and junctional epithelium.
Dentogingival junctional tissue
Stands away from the tooth and creates the gingival sulcus (filled with gingival crevicular fluid)
Sulcular epithelium
Contains blood and immunologic cells
Gingival Crevicular Fluid (GCF)
Attached to the tooth surface by epithelial attachment and forms the floor of the gingival sulcus.
Junctional epithelium
Located in the lamina propria of the marginal gingiva and support only the gingival tissue in order to maintain gingival integrity
Gingival fiber group
Ligament that encircles tooth
Circulara ligament
Ligament that is the most extensive
Dentogingival ligament
Helps to attach the gingiva to the alveolar bone
Alveologingival ligament
Anchors the tooth to the bone and protects the deeper PDL
Dentoperiosteal ligament
Immune-inflammatory infection of the tooth-supporting structures; major cause of tooth loss among adults
Periodontal disease
Gingival inflammation
Gingivitis
Deep probing depths, inflammation, subgingival calculus and plaque, alveolar bone loss
Periodontitis
Control of periodontitis in severe cases
Antibiotic therapy
Periodontal surgery
Fibrous overgrowth of gingival tissues due to intake of certain drugs and poor homecare
Gingival hyperplasia
Recession due to tight frenal attachment
Gingival recession
Gingival biotype that often shows transparency within gingival sulcus when a probe is inserted, often associated with tapered/triangular anatomic crowns, and responds to gingival inflammation with gingival recession
Thin and Scalloped biotype
Gingival biotype that often shows more pronounced ‘orange peel’ surface of the attached gingiva, often associated with square anatomic crowns with broad interproximal contact areas and responds to gingival inflammation with deep pocket depth formation
Thick and Flat biotype
Excess restoration from margin
Overhang
Fragment of cementum that detaches from the tooth, usually after trauma, causing isolated bone loss (vertical bone defects)
Cemental tears
Developmental anomaly in which an infolding of the IEE and HERS creates a groove from the cingulum of the maxillary incisors apically onto the root
Palatal groove
Genetically driven structure, combined vertical dimension of the junctional epithelium and the supra-alveolar connective tissue. Acts as a seal around the cervical portion of the tooth
Biologic width
Does not involve hard tissue but rather just gingival excess removal to expose the clinical crown
Gingivectomy
Control of etiology to prevent rebound
Gingival overgrowth
Commonly performed on the distal surface of molars to facilitate hygiene
Distal wedge
Needs 3 mm of sound tooth structure from the margin of the final cavity preparation (not the caries lesion)
Subgingival caries/Access for proper restoration
Esthetics must be carefully considered during treatment planning. Crown lengthening is almost always necessary, but it might compromise esthetics.
Tooth fracture
Significant amount of anatomic crown is covered by gingiva due to failure of proper apical migration of the soft tissue that covers the crown
Altered passive eruption
Effects of restorative treatment on the periodontium
Biologic width violation
Dental materials
Provisional restorations and restorative margins
Retraction cord and impressions
