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Perio Midterm

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Question
Answer
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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show Covers alveolar processes of jaw, cervical portions of teeth (4)Anatomical Areas: Free G., Gingival Sulcus, Interdental G., Attached G.  
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Interdental G.   show
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Gingival Sulcus   show
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Cementum (16-60microns) OMG Overlap 60%, Meet Margin 30%,Gap 10% 45-50% Organic + h20, 45-50% Inorganic   show
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show upper & lower jaw. surrounds & supports roots of teeth. Forms the Alveoli (sockets) NO teeth NO Alveolar Process  
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Cortical Bone:   show
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Alveolar Crest   show
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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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show MAX: Superior Alveolar Nerves (Anterior, Middle, Posterior) MAND: Inferior Alveolar Nerve  
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Periodontium Vascular Supply (gingiva,PDL, Alveolar Bone)   show
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show MAX: Superior Alveolar arteries MAND: Inferior Alveolar artery  
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show drains MOST of the periodontal tissues  
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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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show separates epithelium sheets from underlying CT (thin, tough sheet)  
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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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show specialized cell junction-connects neighboring epi cells  
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show cell junction connecting epi cells to basal lamina  
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show 1. Osteolitic-bone loss, replaced by ,appears as PA lesion 2. Cementoblastic-excessive cementoblastic activity, specule deposits(like matrix) 3. Mature- Excessive irregular cementum deposited Xray- well defined radiopacity w/ radiolucent border  
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Bundle bone   show
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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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show bone will adapt to load placed  
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Mobility   show
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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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Endotoxins   show
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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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1st changes/clinical signs of Gingivitis   show
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PDL cells   show
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6 Principal fibers   show
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show Vibrations when occluding +slight ++barely visible +++clearly visible  
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show AA:parent->child,aggressive perio (25%chronic) *Fusobacterium nucleatum: early stage gingivitis, subg plaque in perio w/ severe attach loss *Porphyromonas g-grows in JE, perio, destroy bone *Bacteroides forsythus-subg plaque,Deep pockets, aggressive pe  
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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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show Antibodies:Neutralize bacteria, Coat bacteria for easier phagocytosis, Activate complement system  
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show powerful protein mediators: recruits cells, increase permeability, can cause tissue destruction in chronic cases  
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Prostaglandins (mainly PMNs and Macrophages produce)   show
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show 12+ enzymes, collagen destruction  
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Complement System   show
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Gram +   show
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show Double cell Wall, doesn't stain purple  
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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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Exotoxins   show
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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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show immature elastin, parallel to root surface, regulates vascular flow  
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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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Calculus   show
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show loves Carbs= caries loves proteins (more dangerous by products)  
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Unattached Plaque   show
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show gingival margin almost to JE, Gram+, Caries  
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Virulence   show
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Vasodilation   show
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show  
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