Perio Midterm
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| Normal: Retrocuspid Papilla Gingival fibrous Nodules at MGJ | show 🗑
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| show | soft CT between bone & tooth
.4- 1.5mm space (4) Functions:
SUPPORTIVE- suspends & maintains tooth in socket SENSORY- Pressure & Pain NUTRITIVE- nutrients to Cementum & Bone RESORPTIVE- 'remodel' the alveolar bone in response to pressure (Ortho)
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| show | Gingiva, PDL, Cementum, Alveolar Bone
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| Gingiva: | show 🗑
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| Interdental G. | show 🗑
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| show | Healthy: 1-3mm
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| show | mesechimal CT 45-50% Inorganic
*more resistant to resorption than bone(good for Ortho, root remains)
Anchors PDL fibers to tooth (Sharpey's) Protects Dentin (seals Tubules), Compensates for occlusal attrition (forms at apical area of root
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| Alveolar Bone or Process | show 🗑
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| show | Compact, outside wall, max. &mand. Thicker in molar regions, NOT seen radiographically
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| show | Healthy: 1-2mm below CEJ, follow contours of CEJ
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| show | Interior, between cribiform plate(alv. bone proper) and the Cortical bone
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| Alveolar Bone Proper OR Cribiform Plate OR Lamina Dura | show 🗑
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| Gingiva Innervation | show 🗑
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| PDL & Teeth Innervation | show 🗑
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| Periodontium Vascular Supply (gingiva,PDL, Alveolar Bone) | show 🗑
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| Teeth & Periodontal Tissues Blood Supply | show 🗑
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| Submandibular Lymph Nodes | show 🗑
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| show | Drains Palatal Gingiva of Maxilla
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| show | Drains gingiva in Mand. Incisors
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| show | Drains gingiva in 3rd Molar area
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| Basal Lamina | show 🗑
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| show | No Nuclei, tough
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| show | Nuclei, soft/flexible cushion,
*Epi. tissues receive blood supply from CT
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| Desmosomes | show 🗑
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| show | cell junction connecting epi cells to basal lamina
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| Periapical Cemental Dysplasia (NOT true Cementoma) PULP test for vitality to avoid unecessary RCT | show 🗑
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| show | Alveolar bone proper w/ Sharpey's fibers inserted
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| Interdental Septum | show 🗑
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| show | deepening of sulcus-solely from gingival enlargement(tissue swelling or increased collagen fibers in CT). JE remains coronal to CEJ, No PDL destruction
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| show | Pathologic deepening of sulcus
Suprabony-Horizontal bone loss
Infrabony- Vertical bone loss (uneven)
PDL & bone destroyed
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| Fenestrations | show 🗑
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| Dehiscence | show 🗑
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| Wolf's Law | show 🗑
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| show | Grade 1: up to 1mm
Grade 2: more than 1mm
grade 3: F,L,M,D
horizontal & vertical displacement
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| show | Inactive: little or no bleeding, minimal fluid and bacterial flora
Active: More bleeding, Large amounts of fluids/exudates and bacteria
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| show | (4)Phases
1.adheres to glycoprotein pellicle
2. Initial colonization within 2dys w/ gram+
3. Secondary Colonization- slime layer produced, bacteria multiply
4. Mature biofilm-Pedunculated,gram -,anaerobes
*Must mature to cause perio damange
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| Epithelium attached biofilm | show 🗑
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| show | Healthy: 100-1000, 75%-80% gram+, non-motile, mostly Cocci
Gingivitis: 1,000-100,000, Equal gram-& gram+
Periodontitis:100,000-100,000,000
more Gram- anaerobes,motile,asaccralytic
small % are perio pathogens
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| show | harmful proteins
Gram - have Lipopolysaccharides (cell walls)
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| show | Tooth Anatomy, Nutrition, Malocclusion, Medication i.e. Dilatin, Hormones/birthControl, xerostomia, Faulty dentistry, Disease i.e. diabetes, HIV
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| show | 1st- increase in crevicular fluid
MOST DETECTABLE- Bleeding
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| show | CT cells, Fibroblasts(collagen), Osteoblasts, osteoclasts, Cementoblasts
-Epi Rest cells (Malassez)remnants of Hertwig's root sheath
-Defense cells
-Neurovascular Cells
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| 6 Principal fibers | show 🗑
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| Fremetus | show 🗑
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| Periodontal Disease Bacteria | show 🗑
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| show | Acute, Anaerobic glycolysis=acidity
leaves axial stream->pavementing
Lysosomes- can kill/digest bacteria after phagocytosis
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| show | 10X more blood
increased permeability
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| Edema fluid (Exudate BEFORE Cellular Phase) | show 🗑
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| show | not as many but live longer, no memory
phagocytosis
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| B cells->plama cells->Antibodies | show 🗑
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| show | powerful protein mediators: recruits cells, increase permeability, can cause tissue destruction in chronic cases
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| show | powerful inflammatory mediators, trigger osteoclast activity-> Destroys Bone, Promotes overproduction of MMP
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| show | 12+ enzymes, collagen destruction
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| Complement System | show 🗑
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| show | Thick Single Cell Wall, Purple
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| Gram - | show 🗑
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| show | 1. Initial Colonization, 2dys mainly Gram+ 2. Secondary Colonization: Slime layer (protects, adheres), bacteria multiplies 3. Mature- complex mushroom microcolonies, extremely resistant antibiotics/microbials- Mechanical Removal!
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| show | harmful proteins i.e. leukotoxins (AA), hydrogen sulfide, ammonia
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| show | I: curvature felt w/probe, penetrates<1mm II: penetrates, but not completely through, III: Completely through IV: same as III but visible because of recession
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| Oxytalin and Eulanin | show 🗑
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| COL: | show 🗑
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| Epi Cells | show 🗑
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| show | more in coronal half of root, mostly calcified Sharpeys fibers
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| show | More apical root portion, Increases w/ age in apical and furcations
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| show | age 40, 5mm loss in Q length from 3rd Molar to midline
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| show | capillaries from Endothelia cells (BV) feed/bring fibroblasts, fragile, Granulation tissue forming
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| Fibroblastic Proliferation | show 🗑
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| Dark Field Microscopy | show 🗑
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| show | Ca, Phosphorus, carbonate, Sodium, Magnesium, Potassium...S
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| Saccrolytic Asaccrolytic | show 🗑
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| Unattached Plaque | show 🗑
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| Tooth attached plaque | show 🗑
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| Virulence | show 🗑
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| Vasodilation | show 🗑
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| ARESTIN | show 🗑
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Created by:
michelleleigh33
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