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Patient Care III > Anatomy of the periodontium > Flashcards

Anatomy of the periodontium Flashcards

1
Q

Tissues of the periodontium include:

A
  1. gingiva
  2. cementum
  3. periodontal ligament
  4. alveolar bone
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2
Q

Oral mucosa consists of 3 zones, these include:

A
  1. the gingiva & covering of the hard palate (masticatory mucosa)
  2. dorsal of the tongue (specialized mucosa)
  3. oral mucous membrane lining remainder of oral cavity
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3
Q

Oral mucosa of the gingiva & covering of the hard palate:

A

masticatory mucosa

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4
Q

Oral mucosa of the dorsum of the tongue:

A

specialized mucosa

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5
Q

Masticatory mucosa that covers alveolar bone and tooth root coronal to the CEJ:

A

gingiva

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6
Q

Gingiva is divided into what three categories?

A
  1. marginal gingiva
  2. attached gingiva
  3. interdental areas
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7
Q

Free, or unattached, cufflike tissue surrounding the teeth on facial, lingual, and inter proximal surfaces:

A

marginal gingiva

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8
Q

Marginal gingiva may be ___ or ____

A

free or unattached

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9
Q

Where is the marginal gingiva located?

A

surrounds teeth on facial, lingual, and interproximal surfaces

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10
Q

The most coronal portion of the gingiva; scalloped outline of teeth:

A

gingival margin

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11
Q

Space formed by tooth and sulcular epithelium (laterally) and the coronal end of the JE (apically):

A

gingival sulcus

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12
Q

What forms the space of the gingival sulcus laterally?

A

tooth and sulcular epithelium

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13
Q

What forms the space of the gingival sulcus apically?

A

the coronal end of the JE

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14
Q

Sulcular measurement of ___ are considered WNL of gingival health

A

2-3mm

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15
Q

Interdental gingiva may also be referred to as:

A

papilla

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16
Q

Interdental gingiva (papilla) is part of:

A

free gingiva

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17
Q

Occupies the interdental space (fills embrasure space apical to tooth contact)

A

interdental gingiva

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18
Q

The interdental gingiva (papilla) is attached to the tooth by the ____ & ____

A

JE & connective tissue fibers

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19
Q

Valley-like depression of the inter proximal contact areas:

A

the gingival col

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20
Q

The gingival col connects:

A

lingual and buccal interdental papilla

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21
Q

When the gingival col absent

A

when teeth are not in contact

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22
Q

The gingival col is comprised of:

A

nonkeratinized

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23
Q

The gingival col is susceptible to ____ and ____

A

Inflammation; disease progression

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24
Q

Gingiva that is attached to the alveolar bone and cementum by connective tissue fibers and epithelial attachment:

A

attached gingiva

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25
Q

Attached gingiva is attached to the ____ & ___ by connective tissue fibers and epithelial attachment

A

alveolar bone & cementum

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26
Q

Boundary of attached gingiva are apically demarcated by:

A

mucogingival junction (MGJ)

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27
Q

Boundary of attached gingiva are coronally demarcated by:

A

the base of the gingival sulcus

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28
Q

The width of attached gingiva varies from ____ to ____ mm

A

1 to 9 mm

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29
Q

Attached gingiva is widest in the facial aspect of the ___ and narrowest in the facial areas of the ____.

A

maxillary central incisors; mandibular premolars

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30
Q

Where should attached gingiva NOT be measured?

A

on the palate

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31
Q

any changes in the width of the attached gingiva results from changes at the ___ end

A

coronal

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32
Q

Example of when their is a change in width of the attached gingiva at the coronal end:

A

recession

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33
Q

What is the formula for measuring the attached gingiva?

A

width of attached gingiva = total width of gingiva - probing depth

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34
Q

What would the measurement of attached gingiva be?

Total width of gingiva from the GM to the MGJ: 6mm

Probing depth: 2 mm

A

4mm

(6mm-2mm= 4 mm)

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35
Q

What would the measurement of attached gingiva be?

Total width of gingiva from the GM to the MGJ: 5mm

Probing depth: 5mm

A

0 mm

(5mm - 5mm = 0mm)

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36
Q

Moveable tissue, loosely attached to the underlying bone; separate from attached gingiva at the MGJ:

A

alveolar mucosa

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37
Q

Describe the type of tissue that comprises the alveolar mucosa:

A

thin, nonkeratinized epithelium

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38
Q

What color is the alveolar mucosa, why?

A

darker shade of red than the gingiva; due to rich blood supply

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39
Q

Visible line where the pink keratinized gingiva meets the more vascular alveolar mucosa:

A

Mucogingival junction (MGJ)

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40
Q

Describe what the MGJ represents:

A

The division between where the gingiva meets the alveolar mucosa

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41
Q

The MGJ is found on the ____ and the _____ and _____ areas

A

maxillary facial; mandibular facial; lingual

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42
Q

Looking at the gingiva under a microscope, it is composed of ____ & ____

A

Stratified squamous epithelium; connective tissue

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43
Q

Looking at the gingiva under a microscope, the epithelium is mostly ____ in nature

A

Cellular

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44
Q

Looking at the gingiva under a microscope the connective tissue is less ____ and mostly composed of ____ and ____

A

Cellular; collagen fibers; ground substance

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45
Q

What are the four functions of the gingival epithelium?

A
  1. Physical barrier of infection
  2. Participate actively in responding to infection (signals host response)
  3. Allows selective interchange with the oral environment
  4. Protection of deep structures
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46
Q

Epithelium covering the free gingiva may be differentiated into: (3)

A
  1. oral/outer epithelium
  2. sulcular epithelium
  3. junctional epithelium
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47
Q

Nonkeratinized epithelium surrounding and attaching to the tooth on one side, and the gingival connective tissue on the other side:

A

Junctional epithelium

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48
Q

Junctional epithelium can be described as being found at the:

A

Base of sulcus/pocket

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49
Q

Serves as a route of passage of fluid and cells from connective tissue into the sulcus for bacteria/bacterial products from sulcus to connective tissue:

A

Junctional epithelium

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50
Q

The JE is more permeable to:

A

Cells and fluid

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51
Q

The JE serves as a route of passage of fluid and cells from ____ into the ___ for bacteria/bacterial cell products

A

Connective tissue into the sulcus

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52
Q

The junctional epithelium is easily penetrated by the periodontal probe, especially:

A

When gingiva is inflamed

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53
Q

What is the length of the junctional epithelium?

A

0.25 - 1.35 mm

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54
Q

Correlation of clinical and microscopic features:

A
  1. color
  2. size
  3. contour
  4. shape
  5. consistency
  6. surface texture
  7. position
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55
Q

The gingiva (both attached/marginal) is generally ___ in color

A

coral pink

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56
Q

Why is the gingiva (both attached/marginal) generally coral pink?

A

due to vascular supply and thickness/ degree of keratinization and the presence of pigment-containing cells

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57
Q

Compared to individuals with dark-complexion & dark hair, the gingival blonde-haired individuals with fair complexion is:

A

lighter in color

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58
Q

Alveolar mucosa can be described appearance-wise as:

A
  1. red
  2. smooth
  3. shiny
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59
Q

Why does the alveolar mucosa have a more red color compared to gingiva?

A

epithelium is thinner and nonkeratinized & blood vessels are more numerous

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60
Q

____ is responsible for normal pigmentation of the skin, gingiva, and reminder of the oral mucous membrane

A

melanin

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61
Q

_____ is present in all people, but it can be absent or severely diminished in ____

A

melanin; albinos

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62
Q

Melanin pigmentation in the oral cavity is prominent in ____ individuals

A

black

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63
Q

Appears as diffuse, deep-purplish discoloration or as irregularly shaped brown and light-brown patches

A

melanin pigmentation

64
Q

What can be seen in the following image?

A

melanin pigmentation

65
Q

The size of the gingiva corresponds with the:

A

number of cellular/intercellular elements and vascular supply

66
Q

What does a change in size of the gingiva indicate?

A

gingival disease

67
Q

Contour of the gingiva varies depending on the:

A

shape & alignment of teeth

68
Q

Marginal gingiva follows a ____ outline

A

scalloped

69
Q

What does it mean to say that the “biotype varies” when discussing the contour of gingiva?

A

thickness of the tissue varies

70
Q

The shape of the ____ is governed by contour of proximal tooth surfaces, location, and shape of embrasures

A

interdental gingiva

71
Q

The shape of the interdental gingiva is governed by: (3)

A
  1. contour of proximal tooth surfaces
  2. location
  3. shape of embrasures
72
Q

The interdental papilla can appear ____ in form or ___ depending on location

A

pyramidal; flattened

73
Q

Describe the consistency of the gingiva:

A

firm & resilient (except the free margin)

74
Q

What determines the firmness of attached gingiva?

A

collagen fibers and gingival fibers

75
Q

Describe the surface texture of gingiva:

A

as stippled as an orange peel

76
Q

When is the stippling of the gingiva best viewed?

A

after drying the tissue

77
Q

____ gingiva is stippled, ____ gingiva is NOT stippled

A

attached; marginal

78
Q

Stippling is less prominent on ___ than ___ surfaces

A

Lingual; facial

79
Q

Calcified connective tissue covering the roots of the teeth:

A

cementum

80
Q

The lease mineralized of the calcified tissues of the tooth

A

cementum

81
Q

What are the two types of cementum?

A
  1. Acellular (primary)
  2. Cellular (secondary)
82
Q

The 2 types of cementum (both acellular & cellular) consist of ___ and ___.

A

calcified interfibrillar matrix & collagen fibrils

83
Q

What is the function of cementum?

A

to attach fibers of the PDL to the tooth (like cement) & to seal the tubules of the root dentin

84
Q

Functions to attach fibers of the PDL to the tooth (like cement):

A

cementum

85
Q

Functions to seal the tubules of the root dentin:

A

cementum

86
Q

What is not present in the cementum?

A
  1. blood vessels
  2. lymph vessels
87
Q

Describe the deposition of cementum:

A

continuously deposited in the apical area of the root throughout life

88
Q

First cementum formed:

A

acellular cemetum

89
Q

Cementum formed after the tooth reaches occlusal plane:

A

cellular cementum

90
Q

Cementum that covers approximately the cervical third or half of the root:

A

acellular cementum

91
Q

Cementum that is “less calcified:

A

cellular cementum

92
Q

Cementum that does not contain cells:

A

acellular cementum

93
Q

Cementum that is deposited throughout the life of the tooth:

A

cellular cementum

94
Q

Cementum formed before the tooth reaches the occlusal plane:

A

acellular cementum

95
Q

Cementum that is deposited at intervals, producing arrest lines:

A

cellular cementum

96
Q

When is cellular cementum formed?

A

after the tooth reaches the occlusal plane

97
Q

When is acellular cementum formed?

A

before the tooth reaches the occlusal plane

98
Q

Cellular cementum is deposited in intervals, producing:

A

arrest lines

99
Q

Label the following diagram of the different types of cementum:

A

A) Coronal cementum
B) Radicular cementum
C) Acellular cementum
D) Cellular cementum

100
Q

Local abnormal thickening of parts of the cementum:

A

hypercementosis

101
Q

Hypercementosis is typically found in the:

A

apical region

102
Q

Hypercementosis may be seen as a result of: (4)

A
  1. chronic inflammation of the tooth
  2. no opposing tooth
  3. additional eruption
  4. tooth becoming fused to surrounding alveolar bone proper
103
Q

This image shows a tooth with:

A

hypercementosis

104
Q

CEJ:

A

cementoenamel junction

105
Q

Understanding the relationship between the ___ & ___ is of. clinical important in scaling and root planing procedures

A

cementum and enamel junction

106
Q

What are the 3 relationships involving the cementum that may exist at the CEJ:

A
  1. space
  2. end-to-end
  3. overlap
107
Q

If we classify someone as having “space” when referring to the CEJ, we are describing:

A

space between the enamel and cementum with he dentin exposed

108
Q

If we classify someone as having “end-to-end” relationship when referring to the CEJ, we are describing:

A

the enamel and cementum being edge-to-edge

109
Q

If we classify someone as having an “overlap” relationship when referring to the CEJ, we are describing:

A

cementum overlapping the enamel

110
Q

List the percentages of the following CEJ relationships:

  1. Space
  2. End-to-end
  3. Overlap
A

Space= 10%
End-to-end= 30%
Overlap= 60%

111
Q

Label the CEJ relationship shown:

A

Space

112
Q

Label the CEJ relationship shown:

A

End-to-end

113
Q

Label the CEJ relationship shown:

A

Overlap

114
Q

Fibrous connective tissue surrounding and attaching roots of teeth to bone:

A

PDL

115
Q

The PDL is located in:

A

periodontal space between cementum and bone

116
Q

Located in the periodontal space between the cementum and bone:

A

PDL

117
Q

The PDL is composed of:

A

connective tissue cells and intracellular substance

118
Q

Composed of connective tissue cells and intracellular substance:

A

PDL

119
Q

The fibers inserted into the cementum on one side and bone on the other are called:

A

sharpey’s fibers

120
Q

The functions of the periodontal ligament (PDL) include: (4)

A
  1. supportive
  2. formative
  3. nutritive
  4. sensory
121
Q

What function of the PDL is being described below:

anchors tooth to bone

A

supportive

122
Q

What function of the PDL is being described below:

helps maintain biologic activity of bone and cementum

A

formative

123
Q

What function of the PDL is being described below:

Supplies nutrients and removes waste products via blood and lymph vessels

A

Nutritive

124
Q

What function of the PDL is being described below:

Capable of transmitting tactile pressure and pain sensations:

A

Sensory

125
Q

Sharpey’s fibers are the portion of the PDL that insert into bone and cementum and therefore contribute to the PDL’s ___ function

A

Supportive

126
Q

Portion of the PDL that insert into bone and cementum:

A

Sharpey’s Fibers

127
Q

PDL Width is seen only in:

A

radiographs

128
Q

PDL width depends on: (4)

A
  1. age
  2. stage of eruption
  3. function of tooth
  4. angle of film
129
Q

The arrows in this image are pointing out:

A

PDL Width

130
Q

PDL fiber groups around the cervical area within the gingival tissues:

A

Gingival fiber groups

131
Q

PDL Fiber groups surrounding the root:

A

Principal fiber groups

132
Q

What are the two main categories of PDL fiber groups?

A
  1. gingival fiber groups
  2. principal fiber groups
133
Q

List the PDL fibers that are considered gingival fiber groups: (5)

A
  1. dentogingival fibers
  2. alveologingival fibers
  3. circumferential fibers
  4. dentoperiosteal fibers
  5. transeptal fibers
134
Q

List the PDL fibers that are considered principal fiber groups: (5)

A
  1. apical fibers
  2. oblique fibers
  3. horizontal fibers
  4. alveolar crest fibers
  5. interradicular fibers
135
Q

PDL fibers: free gingival

A

dentogingival fibers

136
Q

PDL fibers: attached gingival

A

alveologingival fibers

137
Q

PDL fibers: circular

A

circumferential fibers

138
Q

PDL fibers: alveolar crest

A

denoperiosteal fibers

139
Q

PDL fibers from the cementum in the cervical region into the free gingiva to give support to the gingiva:

A

Dentogingival fibers (free gingival)

140
Q

PDL fibers from the alveolar crest into the free and attached gingival to provide support:

A

Alveologingival fibers (attached gingival)

141
Q

PDL fibers that are continuous around the neck of the tooth to help maintain tooth position:

A

Circumferential fibers (circular)

142
Q

PDL fibers from the cervical cementum over the alveolar crest to blend with fibers of the periosteum of the bone:

A

Dentoperiosteal fibers (alveolar crest)

143
Q

PDL fibers from the cervical area of one tooth across to an adjacent tooth (on t the mesial or distal only) to provide resistance to separation of teeth:

A

Transseptal fibers

144
Q

Label the following image:

A

A: Circular Group
B: Dentogingival Group
C: Dentoperiosteal Group
D: Alveologingival Group
E: Alveolar Bone

145
Q

Label the following image:

A

A) alveologingival fibers
B) Dentogingival fibers
C) Circumferential fibers
D) Dentoperiosteal fibers
E) Cementum

146
Q

Principal fiber group from the root apex to adjacent surrounding bone to resist vertical forces:

A

Apical fibers

147
Q

Principal fiber group from the root above the apical fibers obliquely toward the occlusal to resist vertical and unexpected strong forces:

A

Oblique fibers

148
Q

Principal fiber group from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth:

A

Horizontal fibers

149
Q

Principal fiber group from the alveolar crest to the cementum just below the CEJ to resit intrusive forces:

A

Alveolar crest fibers

150
Q

Principal fiber group from cementum between the roots of multicoated teeth to the adjacent bone to resist vertical and lateral forces:

A

Interradicular fibers

151
Q

Label the following image:

A

Purple: alveolar crest fibers
Blue: horizontal fibers
Red: interradicular fibers
Green: oblique fibers
Orange: apical fibers

152
Q

Label the fibers the following image:

A

Turquoise: interradicular group
Lime Green: apical group
Sunshine yellow: oblique group
Anaranjado: horizontal group
Rojo: alveolar crest group

153
Q

Bone that forms and supports the alveoli (tooth sockets)

A

alveolar bone (alveolar process)

154
Q

Alveolar bone (alveolar process) consists of:

A

alveolar bone proper and supporting bone

155
Q
A

Patient Care III (16 decks)

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