Lecture 3 questions

Question 1

what makes up keratinized gingiva?

Answer 1

attached gingiva and marginal gingiva

Question 2

what separates the attached gingiva and the marginal gingiva?

Answer 2

free gingival groove

Question 3

what is past the mucogingival junction?

Answer 3

alveolar mucosa

Question 4

when bone is resorbed, what happens to the junctional epithelium?

Answer 4

apical migration, it moves down on root surface

Question 5

what is the diagnosis of periodontitis based on?

Answer 5

attachment loss, NOT probe depths

Question 6

when the gingival margin is coronal to the CEJ, is the number given to it a negative or positive number?

Answer 6

negative. almost all of us have negative recession

Question 7

total attachment loss is

Answer 7

pocket depth and gingival recession

Question 8

What is the biologic width?

Answer 8

• attachement apparatus of the tooth
• junctional epithelium and CT underneath it
• need at least 2 mm of it (from CEJ to the bony crest)
• if we don’t have this distance, do crown lengthening

Question 9

When do we not do crown lengthening?

Answer 9

when a patient has 60%+ bone loss

Question 10

to do a crown lengthening what do we need to know?

Answer 10

where the new crown margin will be, then have new bone margin and gingiva 2 mm below the new crown margin

Question 11

What are the gingival phenotypes?

Answer 11

scalloped-thin and flat-thicc

Question 12

What are the characteristics of thin phenotype?

Answer 12

increased recession, more vulnerable to trauma, more inflammation, less favorable treatment outcome

Question 13

when would we recommend gingival grafts?

Answer 13

a. when recession causes symptoms, when there are subgingival restoration margins on thin biotype, and pre-orthodontic therapy
b. we refer patients for graft when recession reaches CEJ (Which would affect dentin, hurts when you eat ice cream)

Question 14

how are the characteristics of the gingiva determined?

Answer 14

genetically, rather than being the result of functional adaption to environment stimuli

Question 15

how are epithelial characteristics determined?

Answer 15

connective tissue

Question 16

difference between early grafts and grafts today

Answer 16

early: free gingival graft, from the palate, gingiva will never recede again
now: CT graft, getting CT from underneath palate, slide graft inside the gum like a pita pocket

Question 17

what happens when you develop antibodies to the basement membrane?

Answer 17

the BM dies, epithelium then floats up and all we see are blisters. Touch it and you’ll break it and it’ll get bloody and nasty

Question 18

alveolar bone consists of bone formed by both..?

Answer 18

cells from the dental follicle and cells independent of tooth development

Question 19

alveolar bone has these types of bones?

Answer 19

cancellous, cortical, and marrow (with adipocytes, vasculature, and undifferentiated mesenchymal cells)

Question 20

how does bone heal after extraction?

Answer 20

clotting, then wound cleansing –> new vasculature –> mesenchymal cells from PDL for granulation tissue –? provisional CT –> immature bone forms –> bundle bone (socket proper) is resorbed –> would is filled with woven bone –> bone maturation

Question 21

how do we keep socket from shrinking?

Answer 21

we pack bone in the extraction site to preserve socket

Question 22

what are the cells in PDL?

Answer 22

a. fibroblasts: aligned along principle fibers
b. osteoblasts: line bone surface
c. cemetoblasts: line cemented surface
d. osteoclasts: multinucleated, create ruffled surface of bone
e. epithelial cells
f. nerve fibers
g. epithelial cell rests of mallassez: remnants of the HERS

Question 23

what other technique do we use to regenerate socket?

Answer 23

barrier membranes