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D1 Spring - Histopathology > Week 5 - Periodontal & Gingival Fiber Ligaments > Flashcards

Week 5 - Periodontal & Gingival Fiber Ligaments Flashcards

1
Q

Where are gingival fiber ligaments located?

A

Coronally

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2
Q

What does the gingival fiber ligament do for the marginal gingiva?

A

Provide rigidty and density to the marginal gingiva

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3
Q

What does the gingival fiber ligament act as for the alveolar bone?

A

Periosteum (attachment zone) for the interproximal crestal alveolar bone

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4
Q

What width does the gingival fiber ligament provide?

A

One half of the biologic width
- 2mm barrier space between restoration and edge of pocket depth

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5
Q

What does the gingival fiber ligament do in terms of protection?

A

Protective barrier for the crestal alveolar bone against the spread of gingival inflammation apically

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6
Q

What does gingival fiber ligament inhibit?

A

The apical migration of the junctional epithelium
- to keep the pocket depth at a minimum

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7
Q

What are the fiber groups of the GFL?

A
  • alveologingival
  • circular (alveolar crest to gingival tissue)
  • dentogingival (tooth to gingiva)
  • dentoperiosteal (tooth to periosteum (alveolar crest))
  • semicircular (stabilize buccal lingually)
  • transseptal (tooth to tooth; keep stable mesiodistally)
  • transgingival (buccal to lingual papilla to stay in tact)
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8
Q

What is the biological width?

A

The area of the junctional epithelium and gingival fiber ligament attached to the root of a tooth

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9
Q

Where does the biological width extend from?

A

The most coronal attachment of the junctional epithelium to the crestal alveolar bone

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10
Q

What does violation of the biological width due to placement of overextended restoration margins result in?

A

Chronic inflammation and induce loss of supporting alveolar bone with formation of a diseased periodontal pocket
- ‘body saying you are too close to the alveolar crest, i need that 2mm of space so back off’

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11
Q

Describe the measurements of the biological width

A

Junctional epithelium:
0.98mm
- Used in measuring pocket depth. Where probe is pushed down and cannot go farther
Gingival fiber ligaments:
1.02
= 2.00mm of biological width results

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12
Q

What happens if there is violation of the biologic width?

A

Chronic irritation and possibility to do crown lengthening

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13
Q

Where is the periodontal ligament?

A

More apical than GFL

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14
Q

What are the functions of the PDL?

A
  • supportive (suspends tooth in socket)
  • regenerative (undifferentiated cells for repair and cementum/bone repair)
  • nutritional (blood vessels to deliver)
  • sensory (tactile receptors)
  • protective (cushioning tooth)
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15
Q

What cells if the PDL derived from?

A

Ectomesenchymal cells (neural crest) in the intermediate zone of the dental follicle

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16
Q

What do cells in the most peripheral zone (outer) of the dental follicle give rise to?

A

Alveolar bone proper

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17
Q

What do cells in the most proximal (inner) give rise to?

A

Cementoblasts

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18
Q

How does the PDL help with development?

A

As tooth grows, the PDL fibers contract and push tooth up into mouth

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19
Q

How is the PDL made?

A

Due to interlocking branches from both sides
- embedding of collagen fibers of the PDL into cementum

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20
Q

What are the embedding of collagen fibers of the PDL into cementum?

A

Sharpey’s fibers

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21
Q

What provides support for the principle fiber groups of the PDL?

A

Indifferent fiber plexus of small diameter collagen fibers in random orientations

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22
Q

What are resident cell populations of the PDL?

A
  • fibroblasts (repair collagen)
  • osteoblasts (repair bone)
  • cementoblasts (repair cementum)
  • macrophages (immune response, resorption)
  • undifferentiated mesenchymal cells (backup to make mature cells)
  • endothelial cells (line blood vessels)
  • epithelial cells (come form gingiva)
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23
Q

What are the PDL fiber groups?

A
  • alveolar crest
  • horizontal
  • oblique
  • apical
  • interradicular (in furications of multirooted teeth)
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24
Q

What do x-sectional views of the PDL show?

A

The arrangement of fibers that resist torque-like force on the tooth

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25
Q

What is the function of apical fiber groups?

A

Resist vertical force

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26
Q

What is the function of oblique fiber groups?

A

Resist intrusive force

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27
Q

What is the function of horizontal fiber groups?

A

Resist horizontal and tipping force

28
Q

What is the function of alveolar crest fiber groups?

A

Resist vertical force

29
Q

What is the function of interradicular fiber groups?

A

Resist vertical and lateral force

30
Q

What do all PDL fiber groups together tend to resist?

A

Rotational forces

31
Q

What is the function of transseptal fiber groups?

A

Resist tooth separation

32
Q

What is the function of dentogingival fiber groups?

A

Resist gingival displacement

33
Q

What is the function of alveologingival fiber groups?

A

Resist gingival displacement

34
Q

What is the function of circumferential fiber groups?

A

Resist gingival displacement

35
Q

What is the function of semicircular fiber groups?

A

Resist gingival displacement and tooth separation

36
Q

What fibers can succumb to orthodontic relapse?

A

Transseptal fibers
Semicircular fibers
PDL principle fiber groups

37
Q

What are interstitial spaces?

A

Areas centered around vascular spots

38
Q

What are PDL interstitial spaces a soruce of?

A

Mesenchymal cells that can differentiate into cementoblasts, osteoblasts, and fibroblasts

39
Q

What is the function of cementoblasts?

A

Regeneration and repair of cementum following injury
- continuous physiologic deposition of cementum

40
Q

What is the function of osteoblasts?

A

Continuous physiologic remodeling of supporting alveolar bone
- Regeneration and repair of bone following orthodontic therapy or disease

41
Q

What is the function of fibroblasts?

A

involved in collagen production and physiologic collagen degradation

42
Q

What is ankylosis?

A

Fusion of cementum directly with the surrounding alveolar bone, without the intervening PDL

43
Q

When do tissues use ankylosis?

A

As a reparative response to PDL injury

44
Q

What dictates the type of response when using anyklosis?

A

Degree of injury and type of cells that respond

45
Q

How do cells respond in a significant injury?

A

the cells that respond are from the surrounding alveolar bone, the result will be ankylosis

46
Q

How do cells respond in a slight injury?

A

responding cells are from the PDL (i.e. undifferentiated cells), these cells have the potential to regenerate all tissues involved in tooth support, and the PDL will be restored

47
Q

What are the steps of ankylosis injury repair?

A
  1. site of injury
  2. Undifferentiated mesenchymal cell
  3. Macrophages and fibroblasts
  4. PMN response (inflammatory reaction to remove damaged tissue)
  5. Restored PDL or loss of PDL depending on severity
48
Q

What is the wound healing response of the PDL?

A
  1. Undifferentiated cells migrate into the area, as
    macrophages and PMN’s remove damaged
    tissues.
  2. Fibroblasts and/or osteoblasts replace the
    damaged tissue.
  3. A mast cell response is usually present, in
    which heparin and histamine are released –
    this inflammatory response helps the
    necessary cells reach their target
49
Q

How can the PDL be used in wound healing?

A

“Flap surgery”
- scrape bone so cells can come in and cause tissue to form when bleeds

50
Q

How can PDL be used in guided tissue regeneration?

A

A surgical technique of regenerating the periodontal attachment
apparatus on periodontally involved teeth, which uses the differentiation of mesenchymal cells in the interstitial spaces of
the PDL and marrow spaces of adjacent alveolar bone

51
Q

How does the membrane work in guided tissue regeneration?

A

The membrane excludes
gingival epithelial tissues from the deeper part of the wound, and allows only cells from the existing PDL to repopulate the wound
- they want cells to grow up NOT down

52
Q

What are epithelial rest cells of malassez?

A

Remains of hertwig’s root sheaths when some areas don’t fuse, duct like appearance

53
Q

What is the purpose of epithelial rest cells of malassez?

A

Unknown purpose

54
Q

Where are epithelial rests more prevelent?

A

In apical areas of adolescents

55
Q

What may epithelial rests have an effect on?

A

Cementogenesis

56
Q

What is a lateral periodontal cyst?

A

It is believed to arise from epithelial rests (epithelial rest of Malassez in the PDL), when stimulated

57
Q

Where does a lateral periodontal cyst occur?

A

Along the lateral root surface
tx: surgical removal

58
Q

What is the gingival cyst derived from?

A

Odontogenic epithelial when the epithelial rests of serres cells become active

59
Q

Where is the gingival cyst?

A

Connective tissue of the gingiva known as the epithelial rests of Serres (remainders of dental lamina)

60
Q

What is treatment for gingival cysts?

A

Surgical intervention

61
Q

What does orthodontic tooth movement result in?

A

Compression of the PDL on the side of the root corresponding to the direction of movement

62
Q

What does compression of the PDL result in?

A

loss of principle fiber orientation and resorption of adjacent bone

63
Q

What is the PDL on the tooth root opposite the compression side characterized by?

A

tension or stretching of the PDL principle fibers

64
Q

What does controlled tension result in?

A

Bone apposition

65
Q

What is trauma from occlusion?

A

excessive functional stresses placed on a tooth by an antagonist (or removable prosthesis) that exceeds the limits of physiologic adaptation

66
Q

What are examples of trauma from occlusion?

A
  • Resorption of alveolar bone parallel to the long axis of the root
  • A PDL that is wider than normal average width (i.e., > 0.17 mm in
    adult)
  • Tooth mobility
67
Q

What is disuse atrophy?

A

A tooth with no occlusal antagonist will exhibit:
* A significant decrease in density of bony trabeculae
* Decreased width of the PDL (< 0.17 mm)
* Loss of orientation of the principle fibers of the PDL
* Increased volume of the bone marrow spaces

D1 Spring - Histopathology (14 decks)

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