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Chapter 2 Perio
| Question | Answer |
|---|---|
| ______________ is the tissues that surround support, and attach to the teeth | Periodontium |
| Structures of the periodontium | Gingiva,Periodontal Ligament,Cementum,Alveolar bone |
| Visible component of periodontium inside the mouth. Described as coral pink, pink, pale pink and pigmented (darker when melanin pigmentation is present | Gingiva |
| Between the mucogingival junction and attached gingivaContains frenum and muscle attachmentsKeratinizedStippled or non-stippled | Gingiva |
| surrounds the tooth and creates a cuff or collar extending coronally about 1.5mm; MOST commonly in the mandibular anterior and bicuspid area | Free gingiva |
| slight depression on the gingiva corresponding to the depth of the sulcus | Free Gingival groove |
| gingiva that fills the embrasure | Papillae |
| proximal surfaces created below the contact area of teeth (aka.interdental gingiva) | Embrasures |
| slight depression of tissue between the buccal and lingual interdental papillae | Col |
| thin, flat plate that joins the gingival epithelium and underlying connective tissue. | Basal Lamina |
| ridges of epithelium that serve a connection between the free and attached gingiva and the underlying connective tissue | Rete pegs |
| makes up the surface tissue of the oral cavity | Stratified squamous epithelium |
| Keratinocytes, Langerhans cells, Merkel cells and melanocytes also included in the | tissue of the oral cavity |
| -when keratinocytes migrate from the basal layer to the surface. The cells become increasingly flattened, develop granules in the subsurface, and produce a superficial layer that is similar to skin where no cell nuclei are present | Keratinization |
| ___________are part of the phagocytic system (ingest or engulf micro-organisms, cells, or other substances by other cells | Langerhan cells |
| __________contain nerve endings and are associated with tactile sensitivity. | Merkel cells |
| ______________phagocytized and remains in the epithelium and gives the appearance of pigmentation to the epithelium | Melanin |
| extends from the free gingival groove to the mucogingival junction; It is attached to the bone by collagen fibers | Attached gingiva |
| Thin nonkeratinized or parakeritinizedFrom outer epithelium to gingival sulcusJunctional epithelium (forms the gingival wall of the sulcus); no rete pegs, permeable, gingival crevicular fluidHealthy; 1-3mm deep | Sulcular epithelium |
| __________ is believed to perform several functions: cleansing the sulcus, improving the epithelial cells adherence to the tooth surface, anti-microbial and immune properties. | Sulcular or Gingival Crevicular Fluid |
| Separates periodontal ligamentNonkeratinized, stratified squamous Protects attachment15 to 20 cells thickHealthy .25 to 1.35mmContinual renewingSupports free marginal gingivaConsidered the dentogingival unit | Junctional epithelium |
| 2 layers:Collagen fibrils & Fibroblasts | Lamina propria |
| form fiber bundles which make up 60% of the lamina propria | Collagen fibrils |
| undifferentiated mesenchymal cells, mast cells, macrophages, blood vessels, nerves are the other elements in CT | Fibroblasts |
| Gingival ligament=fiber bundles | -Protect, support, maintain tone |
| Five principal fiber groups: | Dentogingival, Alvelogingival, Dentoperiosteal, Circular, Transsepta |
| maintain relationship between teeth | Transsepta |
| support free gingiva | circular |
| anchor tooth to bone and protect PDL | dentoperiosteal |
| attach gingiva to bone | alvelogingival |
| support gingiva | Dentogingival |
| Cushion between the tooth and bone made up of CT, fiber bundles & cellsGenerate pericementum & periosteumCementicles form from calcified material in the PDL or from displaced bits of cementum or bone | Periodontal Ligament |
| Functions of Periodontal Lig. | tooth anchorage, Fibrous tissue development and maintenance, Calcified tissue development and maintenance, nutritive and metabolite transport, sensory functions (touch, pressure, pain, and proprioception(displacement sensitivity) |
| are made of collagen, and arranged in bundles with the other cellular, vascular, and nerve tissues | fibrous bundles |
| Attach tooth to bone, transmit occlusal forces to bone, resist occlusal forces, protect the vessels and nerves from injury | fibrous bundles |
| attached to the cementum as brush-like fibers | Sharpey’s fibers- |
| Movement throughout lifeWear of proximal and occlusal tooth surfaces1 cm in a lifetime | Physiologic Mesial Migration/Drift |
| Cover root surface, calcified, formed by cementoblastsAnchors teeth, maintains occlusal relationship, seals dentinal tubulesContains Sharpey’s fibersNo vascular or nerve connections so there is transmission of pain sensations5 types | perio. cementum |
| Support, extension of bone from body of mandible and maxilla, lines sockets of teethLamina dura- walls of socket when viewed on a radiographRadio-opaqueAlveoli-tooth sockets | Alveolar Process |
| Alveolar Process Components | 1. Alveolar bone2. Compact bone3. Trabecular & cancellous bone |
| Tooth socketsLined by cribriform plateThousands of poresSupplied with nerves and bloodEach root has its ownBone lining alveoli contain Sharpey’s fibers or “bundle bone” | Periodontium Alveoli |
| Cortical plates of the jawDepends on alignment of teethFollows contour of the rootHeight and thickness determined by alignment & angulation | Compact Bone |
| Between cortical plates & alveolar boneAKA-SpongiosumMore in the maxillaBlends without demarcation | Cancellous Bone |
| resorbed area; occurs in pt’s with labailly inclined roots | Dehiscences |
| opening or window in the bone covering the facial root surface or between two adjacent roots | Fenestrations |
| Superior alveolar arteries | maxilla |
| Inferior alveolar arteries | mandible |
| trigeminal | sensory |
| Clinical Conditions of Periodontal Tissue Characteristics | ColorTextureSizeShapeConsistencySulcus Depth |
| Gingiva; thinsConnective tissue; more dense & coarsePDL; thicker, irregular structureCementum; thicker 10xAlveolar Bone; less regular surfaceDecrease dexterity may affect care | Aging and the Healthy Periodontium |
| Signals inflammatory cells to areas of trauma or microbial influence | Chemotaxis |
| act of ingesting or engulfing micro-oraganisms, cells or other | Phagocytize |
| aka neutrophils, make up 70% of circulating leukocytes; have granules that are filled with enzymes that when released cause ts. destruction | Polymorphonuclear Leukocytes (PMN’s |
| important in mediating inflammatory response; permeability increase | Mast Cells- |
| scavenger, digest enzymes | Macrophages |
| react to cytokines, cause allergic reactions | Auxiliary Cells |
| Made up of protein, bacteriolysis (destruction of bacteria), promotion of immune response, mediates degranulation of mast cells | Complement |
| Communication that mediates disease & healing, resorption, can be cytotoxic when plaque bacteria antigens are present for long periods | Cytokines |
| Histamine, local or systemic, life threatening | Type I - Anaphylaxis |
| Break down of tissue or blood cells, product of AB reacting directly to AG | Type II – Cytotoxic |
| AG high, activates complement, local tissue damage | Type III – Immune complex |
| AG to T Lymphocytes, 2nd exposure increased | Type IV – Cell Mediated |
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TinaHygiene
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