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PERIO
Stack #81681
| Question | Answer |
|---|---|
| What is the periodontium? | A functional system of tissues that surrounds the teeth and attaches them to the bone. |
| What are the tissues of the periodontium? | Gingiva, Alveolar bone, Periodontal ligament , Cementum |
| What are the five functions of the periodontium? | Provides a seal around the cervical portion of the tooth, holds the tissue against the tooth during mastication, suspends and maintains the tooth in the socket, protects the underlying dentin, surrounds and supports the roots of the teeth |
| What two layers is the gingiva composed of? | epithelium layer and connective layer |
| What is the function of the gingiva? | Provides a seal around the cervical portion of the teeth and covers the alveolar processes |
| What is the layer of soft connective tissue that covers the root of the tooth and attaches it to the bone of the tooth socket? | Periodontal ligament |
| What are the functions of the periodontal ligaments? | Support, Sensory, Nutritive, Formative, Resorptive |
| What is the layer of hard, mineralized tissue that covers the root surface? | Cementum |
| What is the boney projection that surrounds and supports the roots of the teeth? | Alveolar bone |
| Fenestration | holes in the facial plate |
| Dehisscence | the facial plate disappears |
| What is another name for alveolar bone proper? | lamina dura |
| What is an alveolus? | Bony socket |
| Which cranial nerve supplies the periodontium? | Trigeminal V |
| What are the nerves that innervate the maxillary teeth and PDL? | Superior alveolar |
| What are the nerves that innervate the teeth and PDL of the mandibular arch? | Inferior alveolar |
| What is the function of the lymphatic system? | removes invading MO and abnormal cells |
| What drains most of the periodontal tissues? | submandibular nodes |
| What drains the palatal gingiva? | Deep cerivical nodes |
| What drains the gingiva of the mandibular incisors? | Submental nodes |
| What drains the gingiva of the third molars? | Jugulodigastric nodes |
| What is the layer of compact bone that forms the outside wall of the mand. and max.? | cortical bone |
| What is the layer of connective soft tissue that covers the mandible and max? | periosteum |
| What is the nerve that intervenes the maxillary molars except the mesial of the first molar? | Posterior superior alveolar |
| What are the parts of the cell? | Nucleus, Cell plasma membrane, cytoskeleton, lysosomes, extracellular matrix |
| What are the tissues of the body? | epithelium, connective tissue, muscle, nerve |
| What is the material that surrounds the cell called? | Extra cellular matrix |
| What is the composition of the extra cellular matrix? | protein fibers, ground substance, tissue fluid |
| What are the functions of the extra cellular matrix? | Holds the cells together, helps to transport water, nutrition, and electrolytes |
| What kind of cells is the oral cavity made up of? | Stratified squamous |
| What attaches a cell to it's neighbor cell and their cytoskeletons? | Desmosomes |
| What connects epithelial basal cells to the basal lamina? | Hemidesmosomes (half of a desmosomes) |
| What is the boundary where epithelium and connective tissue meet? | Epithelial connective tissue interface |
| What is the surface of the connective tissue papillae? | increase surface |
| What are the keratinized tissues? | Free gingiva, attached gingiva |
| What are the non keratinized tissues? | sulcular epithelium, interdental col tissue, junctional epithelium |
| What are the three areas of gingival epithelium? | Oral epithelium, Sulcular epithelium, Junctional epithelium |
| Which tissues (in health) do not have epithelial ridges? | JE and SE |
| What is the width of the junctional epithelium? | 15-30 cells at coronal, 4-5 cells at apical |
| What are the three surfaces of the junctional epithelium? | Internal, external, coronal |
| What are the three functions of the junctional epithelium? | Attach gingiva to enamel or cementum, Provide a protective barrier from plaqe and connective tissues, release substances that activate the bodies immune system |
| What is another name for connective tissue? | Lamina Propria |
| What are two of the functions of the lamina propria or connective tissue? | Provides solidity to the gingiva, attaches the gingiva to the cementum and alveolar bone |
| What are the functions of the gingival fibers? | Brace free gingiva to tooth, provide rigidity to free gingiva, unite free gingiva with cementum and bone, connect adjacent teeth to one another |
| List the gingival fibers: | Circular fibers, alveolgingival fibers, dentogingival fibers, periostiogingival fibers, intergingival, intercircular, interpapillary, transgingival, transseptal |
| What is the biological width? | Distance from the base of the sulcus to the alveolar bone |
| How big is the biological width? | approx. 2mm-1 mm JE, 1 mm fiber bundles |
| Periodontal ligament fiber groups(from top to bottom) | Alveolar, Horizontal, Oblique, Apical, Inter-radicular |
| What is the function of sharpey's fibers? | Connect the periodontal ligament to the cementum |
| Where is the periodontal attachment level located in health? | CEJ |
| What is the function of cementum? | seal and cover tubules, attaches perio fibers to tooth, compensates for attrition |
| What are the two types of cementum and where are they located? | Acellular-1/2 to 1/3 cervical area of root, Cellular-apical portion of root |
| What is the most common relationship of cementum and enamel? | Cementum overlaps enamel 60% |
| Describe the JE in health: | JE at CEJ, tight intercellular junction |
| Describe the JE in gingivitis: | JE still at CEJ, but epithelial extensions into connective tissue |
| Describe the JE in periodontitis: | JE apical to CEJ with epithelial extensions into connective tissue |
| Describe the Connective tissues in health: | Intact, supragingival fibers provide support for gingiva and JE |
| Describe the Connective Tissue in gingivitis: | Connective tissue damage |
| Describe the Connective tissue in periodontitis: | Destruction of the supragingival fiber bundles |
| Describe the PDL in health: | Intact-attaches root to bone of the socket |
| Describe the PDL in gingivitis: | still intact |
| Describe the PDL in periodontitis: | Destruction of PDL fibers-exposes cementum to pocket |
| Describe the bone in health: | Intact-supports and protects the root |
| Describe the bone in gingivitis: | Still intact |
| Describe the bone in periodontitis: | Destruction of bone, eventual tooth loss |
| List the bodies reactions to injury: | heat, redness, swelling, pain, loss of function |
| Inflammatory response that begins suddenly and is of short duration (two weeks or less) | acute inflammation |
| Long lived inflammation response that continues for more than a few weeks. Occurs when the body is unable to eliminate MO | Chronic inflammation (warning signs may be absent) |
| Inflammatory disease that results in REVERSIBLE damage to the gingiva | Gingivitis |
| Inflammatory disease proces that results in some extent of PERMANENT destruction to the tissues of the periodontium | Periodontitis |
| What are the signs of subclinical gingivits? | There are no clinical signs, microscopic changes in 2-4 days |
| Bone height in health | Crest located 1-2mm apical to CEJ |
| What are the two pathways of inflammation? | -Pathway to crestal bone loss -Pathway directly into the periodontal ligament space |
| What type of bone loss results from the pathway to the crestal bone? | Horizontal bone loss |
| What is the most common type of bone loss? | Horizontal bone loss |
| What type of pocket occurs with horizontal bone loss? | Suprabony pocket |
| What type of bone loss occurs from the pathway directly into PDL? | Vertical bone loss |
| What type of pocketing occurs with vertical bone loss? | Infrabony pocketing |
| What is the thin, tough sheet of tissue that seperates the epithelium from the underlying connective tissue? | basal lamina |
| What is the study of all factors that may be involved in the development of a disease? | Etiology |
| The study of prevalence, incidence and etiology of disease within the total population | Epidemiology |
| The number of cases of a disease that can be identified within a specific population at a given point in time | Prevalence |
| The number of NEW disease cases in a population that occur during a given interval of time | Incidence |
| Indices for measuring Prevalence | probing depths, CAL, bone levels |
| Host Bacterial Interaction theory | current practice -treatment: debridement to manage bacteria, maintenance scheduled on as needed basis |
| Intermittent disease progression | Current theory, periods of activity and inactivity |
| How many MO are believed to cause periodontal disease? | 12 |
| True or False: Sights previously infected are most likely to become infected again | TRUE |
| Host Inflammatory and Immune Response: | Body's response to bacteria is responsible for the tissue destruction |
| Innocuous | Species of bacteria that are NOT harmful |
| Pathogenic | Capable of causing disease in humans |
| Gram postitive | thick, single cell wall, retain purple color |
| Gram negative | Double cell walls, do not stain purple, believed to play roll in tissue destruction |
| Thin, bacteria free layer which forms within minutes on a clean tooth surface | pellicle |
| The way that the human body responds to periodontal pathogens | host response |
| A substance that causes the body to produce specific antibodies or sensitized T cells | Antigen (Ag) |
| Proteins made in response to an antigen | Antibody (Ab) |
| Differential White Cell count from greatest to least: (Never Let Monkeys Eat Bananas) | Neutrophils 60-70%, Lymphocytes 20-25%, Monocytes 3-8%, Eosinophils 2-4%, Basophils 0.5-1% |
| A Neutophil is also known as what? | PMN |
| Lysosomes | Bacteriacidal and digestive enzyme |
| What is the largest leukocyte? | Macrophage |
| Components of Phagocytes: | Lymphocytes are phagocytes, first line of defense, short lived, pus at injection site |
| What are most numerous in chronic periodontitis? | macrophages |
| Components of macrophages: | Long lived, stays for clean up of tissue, most numerous in periodontitis |
| Steps of Phagocytosis: | Phagocyte adheres to bacteria, surrounds and engulfs bacteria, bacteria is digested by phagolysosome, phagocyte discharges waste |
| B-lymphocytes (B-cells) | secrete antibodies into blood stream, neutralize bacteria, coat bacteria, activate the compliment system |
| Protein response to antigens | immunoglobulins |
| FIVE major groups of immunoglobulins: | immunoglobulins-igM, immunoglobulins-IgD, Immunoglobulin-IgG, immunoglobulin-IgA, immunoglobulin-IgE |
| Immunoglobulins-IgM | first antibody to the scene, short lived, MACRO, remains in blood, initiates the compliment cascade |
| Immunoglobulins-IgD | trace antibody, thought to activate B cells, initiation of immune response |
| immunoglobulins-IgG | second to scene, remains the longest, most predominate, opsonization-coats antigen for destruction, prepares other antigens for destrusction for killer cells |
| immunoglobulin-IgA | principle immunoglobulin in exernal excretions of mucosal surfaces, tears, saliva, bile, urine and respiratory excretions |
| immunoglobulin-IgE | binds to mast cells and basophils, stimulates release of histamines and prostaglandins, plays role in immediage hypersensitivity reaction |
| Lymphocytes-T cells (thymus) | functions to intensify the response of other immune cells |
| Types of lymphocytes-T cells | memory, helper, suppressors, cytotoxic, delayed |
| Complement System: | Facilitates phagocytes(opsonsization, recruit additonal macrophages, destroy pathogens) |
| Opsonsization | recognize, coat, engulf, destroy |
| Inflammatory mediators: | Cytokines, prostaglandins, matrix metalloproteinases |
| Cytokines-cell protein | transmits information and signals for additonal phagocytes to site of infection |
| Function of cytokines: | recruit cells to the site, increase vascular permeability, initiate tissue destruction, chemical messenger between WBC |
| Cytokine IL-1 | recruits PMN, stimulates lymphocyte proliferation, increase vascular permeability, stimulates osteoclasts |
| Cytokine IL-6 | activates lymphocytes-increase antibody production, stimulates bone resorption, inhibits bone formation, stimulates production of mast and B cells |
| Cytokine IL-8 | Attracts PMN, macrophages and lymphocytes |
| Cytokine TNF-a | recruits PMN's, increases vascular permeability, stimulate PMN degranulation, stimulate prostaglandins release, stimulates connective tissue destruction, stimulates bone resorption |
| A hormone-like substance that is released by damaged cells, intensifies inflammation and the effects of histamine. | Prostoglandis E series |
| Functions of Prostaglandins E series: | Increase vascular permeability and vasodilation, trigger osteoclasts, promote over production of MMP enzymes, major mediators of alveolar bone loss |
| Matrix Metalloproteinases | 12 different enzymes-break down connective tissue |
| Page and Schroeder Stages: | subclinical, early lesion, established lesion, advanced lesion |
Created by:
karmstrong1