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Periodontics > week 2 > Flashcards

week 2 Flashcards

1
Q

healthy gingiva
color:
contour:
consistency:
texture:

A

pale pink/salmon pink/coral pink

knife edged, scallop

firm

stippling

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2
Q

should gums bleed when you brush or floss?

A

no

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3
Q

macro-anatomy parts of the gingiva

A

marginal gingiva

attached gingiva

interdental papilla

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4
Q

what is the marginal gingiva in between?

A

the gingival sulcus ad marginal groove

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5
Q

what is the attached gingiva between?

A

the marginal groove and mucogingival junction

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6
Q

width of the attached gingiva

facial: greatest in the ______ region, narrower in the _______ region

linguals of mandible: greatest in _______; narrowest in the _______

A

incisor, posterior

molars, incisors

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7
Q

when will width of inadequate attached gingiva in childhood correct itself?

A

6-12 yrs

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8
Q

interdental papilla shape

anterior:
posterior:

A

pyramidal

col shaped

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9
Q

periodontal ligament space shape

shape depends on:

A

hour glass
- widest at apex and cervix, narrowest in middle

age and tooth function

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10
Q

if there is trauma to the tooth/periodontum, what happens to the PDL?

A

it can widen/change shape

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11
Q

PDL physical function

A

resistance to impact of occlusal force

transmission of occlusal force to bone

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12
Q

PDL formative and remodeling function

A

formation and resorption of bone and cementum

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13
Q

PDL nutritional function

A

via blood vessels; lymphatic drainage

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14
Q

PDL sensory function

A

transmitting tactile, pressure and pain

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15
Q

4 main functions of PDL

A

physical function

formative and remodeling function

nutritional function

sensory function

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16
Q

why is PDL important in implants?

A

the PDL is missing around implants
–>

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17
Q

what does the cementum cover?

A

the root surface

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18
Q

where do the fibers of the PDL attach?

A

to the cementum (Sharpey’s fiber)

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19
Q

is the cementum distinguishable on an X ray?

A

no

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20
Q

cementum is thickest at _______ and thinnest at ______

A

Apex

CEJ

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21
Q

what does the cementum do as a person ages?

A

thickens

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22
Q

What is Sharpey’s fiber?

A

Where the PDL attaches to cementum

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23
Q

what does the alveolar bone do?

A

Housing for the roots of the teeth

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24
Q

the alveolar process is part of the ______ and _________

A

maxilla

mandible

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25
Q

the morphology of the alveolar bone is ______ dependent

A

tooth

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26
Q

the shape of the alveoli (socket) follows the?

A

root

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27
Q

alveolar bone structure: 3 parts (inner to outer)

A

1) alveolar bone proper (lamina dura): cribriform plate
2) trabecular bone
3) compact bone

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28
Q

trabecular bone supports the:

A

alveolar bone proper

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29
Q

compact bone formed by:

A

haversian bone and bone lamellae

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30
Q

dehiscence vs fenestration

A

dehiscence:
- no bone from top to bottom
- will find deep pockets
- no bone –> gingival recession

fenestration:
- isolated bone loos, still see some bone on cervical
- more genetic
- won’t effect clinical outcome as much
- don’t usually find deep probing depth

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31
Q

where does the vascular supply come from for the maxilla? (4)

A

Anterior superior alveolar artery (incisors, canines)

posterior superior alveolar artery (premolar, molar)

infraorbital artery

greater palatine artery

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32
Q

where does the vascular supply come from for the mandible?

A

inferior alveolar artery and branches

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33
Q

vascular supply of the periodontum comes from what main artery?

A

maxillary artery

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34
Q

what is the pathway of blood supply to the periodontum once it reaches the alveolar artery?

A

alveolar artery –> dental artery –> intraseptal artery –> PDL vessels and supraperiosteal vessels

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35
Q

what lymph node is correlated with the lower incisors?

A

submental LN

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36
Q

what lymph node is correlated with the 3rd molars?

A

Jugulodigastric LN

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37
Q

what lymph node is correlated with the palatal gingiva?

A

the deep cervical LN

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38
Q

what does the trigeminal nerve sense?

A

pressure, touch, temperature, pain

proprioception from PDL

  • tooth position, movement
  • thickness between teeth in occlusion
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39
Q

what are the main cells in the gingival epithelium?

A

Keratinocytes

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40
Q

what do keratinocytes do?

A

produce tonofilaments

soft tissue renewal

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41
Q

majority of gingival epithelium is?

A

stratified squamous epithelium

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42
Q

what are the non-keratinocytes in the gingival epithelium?

A

langerhans cells

merkel cells

melanocyte

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43
Q

what do langerhans cell do?

A

antigen presenting cells

44
Q

what do merkel cells do?

A

tactile preceptors

45
Q

what do melanocytes do?

A

produce melanin/skin pigmentation

46
Q

Epithelial Cell layers

ortho-K:
all 4 layers?
nuclei?

Para K:
all 4 layers?
nuclei?

Non K
all 4 layers?
nuclei? `

A

ortho k:
- all 4 layers, no nuclei seen in stratum corneum (keratinized layer)

Para K:

  • nuclei found in stratum corneum
  • missing stratum granulosum/granular layer

Non-K
- missing stratum corneum and stratum granulosum

47
Q

layers of epithelium surface to deep

A

stratum corneum

stratum granulosum

stratum spinosum/prickle cell layer

stratum basale/basal cell layer

48
Q

how does tissue renewal work in epithelial cells?

A

cells loose ability to divide

  • -> produce increased protein
  • -> loose organelle (for protein synthesis and energy production)
  • -> cell degradation (degenerate into stratum corneum)
  • -> cell sloughs away
49
Q

epithelial turn over time

A

10 days

50
Q

oral epithelium faces:

A

the oral cavity

51
Q

oral epithelium extends from ______ to ______

A

gingival margin, MGJ

52
Q

types of cells in the oral epithelium

A

keratinocytes (serves as a barrier)

53
Q

3 types of gingival epithelium

A

oral

sulcular

junctional

54
Q

sulcular epithelium extends from ______ into _______

A

oral epithelium

sulcus

55
Q

sulcular epithelium does not have _______ or _______ layers

A

stratum corneum, granulosum

non keratinized!

56
Q

junctional epithelium attaches _______ to _____

A

gingival epithelium, tooth

57
Q

junctional epithelium important in ____ and ______

A

disease, health

58
Q

in the junctional epithelium, there are less ______ between cells

A

adhesion

59
Q

in the junctional epithelium, it allows ____ to pass

A

fluids

60
Q

junctional epithelium is thin/thick

A

thin

61
Q

Junctional Epithelium:

______ layers of basal lamina and what are they

what is the external basal lamina attached to?

what is the internal basal lamina attached to?
- what does it provide a barrier against?

A

2

external and internal basal lamina

external attached to connective tissue

internal attached to tooth

provides barrier against plaque and bacteria

62
Q

the junctional epithelium is highly permeable, which gives access to: (3)

A

gingival fluid,

inflammatory cells

immunologic host defense

63
Q

does the junctional epithelium renew a lot?

if so what is the turnover rate?

A

yes

4-6 days

64
Q

oral epithelium:
location

length

keratinized?

A

outer layer, crest, marginal gingiva and attached gingiva

0.2-0.3mm

K or para K

65
Q

sulcular epithelium
location:

length:

keratinized?

prone to infection?

A

gingival sulcus

0.5mm

thin non K

susceptible to infection

66
Q

junctional epithelium
location:

length:

keratinized?

prone to infection?

A

attaches gingival epithelium to tooth (along tooth)

0.25-1.35mm

non K

defensive to bacteria

67
Q

majority of connective tissue fibers are:

A 
collagen fibers (60%) 
- type I and IV
68
Q

other connective tissue fibers

A

elastic fiber
reticular fiber

69
Q

what are the 2 layers of the connective tissue?

A

papillary layer: next to epithelium

reticular layer: next to periosteum of bone

70
Q

what is the main cell type in connective tissue and what does it do

A

fibroblasts
- collagen synthesis and degradation regulation

71
Q

besides connective tissue fibers and cells, what else makes up the connective tissue?

A

ground substance between fibers and cells

72
Q

2 functions of the connective tissue interface

A

ensure sufficient adhesion

provide nutrition and waste disposal
- diffusion between epithelial layer and connective capillary loops within connective tissue projection

73
Q

connective tissue is in between ______ and ______

A

epithelial layer

bone

74
Q

2 layers of the epithelial connective junction

A

lamina lucida

lamina densa

75
Q

2 layers of the epithelial connective junction

location of lamina lucida and lamina densa

A

lucida: immediately beneath basal cell membrane

densa: underneath lamina lucida
- connects to connective tissue

76
Q

2 layers of the epithelial connective junction

lamina lucida is made of:
lamina densa is made of:

A

lucida: proteoglycan laminin
densa: type IV collagen

77
Q

what is collagen made of?

A

protein with different amino acids

78
Q

function of collagen

A

framework maintenance

maintain the tissue tone

79
Q

collagen is synthesized by:

A

fibroblasts, chondroblasts, osteoblasts, odontoblasts, etc

80
Q

what type of collagen is most common?

A

type I

81
Q

gingiva-gingival fibers are a system of:

A

collagen fiber bundles

82
Q

what type of collagen is the gingiva-gingival fibers made of?

A

type I

83
Q

function of the gingiva-gingval fibers (3)

A

brace the marginal gingiva against the tooth

provide rigidity for masticatory force

unite the free gingiva margin with cementum and attached gingiva

84
Q

PDL composition is made up of what types of collagen? what is the majority?

A

I and III

I is majority (80%)

85
Q

what is in between the collagen fibers in the PDL? (4)

A

loose connective tissue

vessels

PDL cells

Nerve

86
Q

what is the most common cellular element of the PDL and what does it do?

A

fibroblasts
- regulate collagen turnover

87
Q

other types of cells in the PDL besides fibroblasts

A

cementoblasts

osteoblasts

epithelial rests of malassez

defense cells

cells associate with neurovascular elements

88
Q

6 principle fibers of PDL

A

1) alveolar crest fibers
2) oblique fibers
3) transseptal fibers
4) horizontal fibers
5) interradicular fibers
6) apical fibers

89
Q

which principle fiber of the PDL prevents tooth extrusion, resists lateral tooth movement

A

alveolar crest fibers

90
Q

which PDL fiber bears and transforms the brunt of vertical masticatory stresses

A

oblique fibers

91
Q

what PDL fiber is over the alveolar bone crest with no osseous attachment

A

transseptal fibers

92
Q

what PDL fibers do NOT occur in incomplete formed roots

A

apical fibers

93
Q

the cementum does not have _______ and there is only ________ (this is why it thickens with age)

A

vascularization

deposition

94
Q 
cementum composition
Inorganic content (45-50%): Mainly \_\_\_\_\_\_\_\_\_

Organic content:

  • Type __ collagen (90%)
  • Type ___ collagen (5%)
  • Non-collagenous component:
A

hydroxyapatite

I
III
proteoglycans, glycoproteins, phosphoproteins

95
Q

Acellular/Primary cementum
location:

formed after or before the tooth reaches the occlusal plane?

more or less sharpey’s fibers, more or less calcified

A

cervical 1/3-1/2

before

more sharpey’s, more calcified

96
Q

Cellular/Secondary cementum
location

formed after or before the tooth reaches the occlusal plane?

more or less sharpey’s fibers, more or less calcified

A

apical 2/3-1/2

after

less sharpey’s, less calcified

97
Q

alveolar bone is ______, _______, and _______

alveolar bone is constantly _____-

A

mineralized, vascular, and innervated

remodeling

98
Q

outer surface of bone

has ____ layers:

covered by:

inner layer contains what 2 cells?

outer layer contains what?

A

2, inner and outer layer

periosteum

inner layer contains osteoblasts and osteoprgogenitor cells

outer layer contains blood vessels, nerves, fibroblasts, and collagen

99
Q

inner surface of bone

covered by:

single layer of _______

small amounts of ______-

A

endosteum

single layer of osteoblasts

connective tissue

100
Q

bone composition organic vs inorganic amounts:

A

organic = 1/3

inorganic = 2/3

101
Q

organic bone composition is mostly made of:

the noncollagenous proteins are:

A

collagen type I

osteocalcin
Osteonectin
Bone morphogenetic protein
Phosphoproteins
Proteoglycans
Osteoponin & bone sialoprotein:
cell-adhesive protein

102
Q

inorganic bone composition

mainly the minerals _____ and _____ in the form of _______

cells are (3):

A

calcium

phosphate

hydroxyapatite crystals

osteoblasts
osteocytes
osteoclasts

103
Q

bone vs cementum % inorganic

A

bone = 60%

cementum = 45-50%

104
Q

bone vs cementum lamination

A

both are laminated

105
Q

bone vs cementum remodeling

A

bone = remodeling

cementum = deposition only

106
Q

bone vs cementum vascularization

A

bone = vascularization

cementum = non-vascularization

107
Q

describe the process of bone remodeling

A

osteoblasts produce osteoid (soft type of bone)

–> calcifies to form real bone that contains osteocytes

–> after bone is triggered, osteoclasts take away bone

Periodontics (5 decks)

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