ANATOMY AND PHYSIOLOGY OF THE PERIODONTIUM

Question 1

periodontal disease

Answer 1

General term used to describe a chronic infectious inflammatory process that affects the supporting structures of the dentition.
It is the most common chronic infection in humankind

Question 2

gingivitis

Answer 2

inflammation involving only the gingival (gum) tissues 90% of population

Question 3

Chronic Periodontitis:

Answer 3

Chronic Periodontitis: Progress of inflammation resulting in loss of collagen attachment to the root surface, apical migration of the pocket epithelium, formation of deepened periodontal pockets and resorption of alveolar bone.

Question 4

PERIODONTUM=

Answer 4

Periodontal Attachment Apparatus + Gingiva

Question 5

Periodontal Attachment Apparatus

Answer 5

Alveolar Bone
Periodontal Ligament
Cementum

Question 6

Periodontium: Histologically includes:

Answer 6

Periodontium: Histologically includes: Attached gingiva, oral epithelium, sulcular epithelium, Junctional epithelium, periodontal ligament, cementum, and alveolar bone

Question 7

masticatory mucosa

Answer 7

25% of total mucosa
free attached and interdental gingiva
keratinized

Question 8

lining mucosa

Answer 8

veral(underside of tongue , alveolar mucosa, cheeks, lips,and soft palate
NON KERATINIZED

Question 9

Types of gingiva

Answer 9

Marginal
- Attached
Interdental

Question 10

free/marginal

Answer 10

Coral pink/physiologic pigmentation in health
Surrounds teeth in a collar like manner
Forms soft wall of the gingival sulcus

Question 11

gingival groove

Answer 11

depression on the facial surface of the gingiva

Separates the unattached gingiva (free gingiva) from the attached gingiva

Question 12

when can the gingival be seen

Answer 12

in 50% of patients

not seen during inflammation

Question 13

gingival sulcus

Answer 13

Shallow, “v” shaped crevice/space that surrounds the tooth
Its measurement (in health 0-3 mm) is a diagnostic clinical parameter

Question 14

gingival sulcus boundries

Answer 14

Laterally: the tooth and free gingiva
Coronally: the margin of the free gingiva
Apically: junctional attachment epithelium

Question 15

attached gingiva extends ..

Answer 15

Extends apically from the free gingival groove to the mucogingival junction

Question 16

attached gingiva

facial / lingual :widest and narrowest regions

Answer 16

Facial widest: Maxillary incisor region
Facial narrowest: Mandibular PM region
Lingual widest: Mandibular molar region
Lingual narrowest: Mandibular incisor region

Question 17

attached gingiva

Answer 17

Firmly bound down to the underlying periosteum of the alveolar bone

Question 18

col ?

Answer 18

valley like depression that connects facial and linguial papilla

Question 19

MUCOGINGIVAL JUNCTION locations ?

Answer 19

Maxillary buccal, Mandibular buccal and lingual.

Question 20

where can’t MUCOGINGIVAL JUNCTION be found

Answer 20

There is NO MGJ on palate because palatal tissue is

all bound down to periosteum of the hard palate, there is NO alveolar mucosal tissue on the palate.

Question 21

alveola mucosa

Answer 21

Non-keratinized
Movable
Loosely connected to the underlying tissues
Smooth surface
Darker color than gingiva due to proximity to underlying blood vessels and lack of keratinization

Question 22

composition of gingiva

Answer 22

Collagen fibers and ground substancfe

overlying stratified squamous epithelial surface

Question 23

3 distinct areas of gingival epithelium

Answer 23

outer, sulcular and junctional

Question 24

outer gingival epithelium

Answer 24

4 stratum layers(all except lucidum)

Question 25

sulcar epithelium

Answer 25

Lines the sulcus Acts as a semi-permeable membrane through which bacterial byproducts pass from the gingiva (via the sulcus) into the gingival tissue fluids

Question 26

SULCULAR EPITHELIUM contain what kind of cell

Answer 26

langerhan

Question 27

what type of epithelium is found in junctional epi

Answer 27

Band of stratified squamous non-keratinized epithelium

Question 28

junctional epithelium

Answer 28

Part of the attachment between tooth and gingiva. Firmly attached to the tooth surface forming an epithelial barrier against bacterial plaque invasion Permable to passage of gingival fluid, host defense inflammatory cells to the gingival margin AVASCULAR

Question 29

layers of the junctional epithelium

Answer 29

2 layers thick: basal layer and prickle layer

Question 30

GINGIVAL CONNECTIVE TISSUE COMPOSITION?

Answer 30

Composed of fibers, fiberblasts, blood vessels, nerves and ground substance

Question 31

Fibers of GINGIVAL CONNECTIVE TISSUE?

Answer 31

Type I collagen: predominant fiber type-add stability | Other fiber types: Reticular, Elastic, Oxytalan

Question 32

ground substance of GINGIVAL CONNECTIVE TISSUE?

Answer 32

Ground substance: water, sugars, proteins

Question 33

PDL

Answer 33

Vascular and cellular connective tissue that goes around the root and connects the tooth to the bone .25mm

Question 34

Sharpey's fibers

Answer 34

Calcified insertions of bundles of PDL fibers into cementum and bone

Question 35

GINGIVAL FIBER GROUPS?

Answer 35

Dentogingival, dentoperiosteal, circular, circumfrential, intercircular, intergingival

Question 36

fibers of gingiva: | Dentogingival vs dentoperiosteal

Answer 36

Dentogingival On the facial, lingual and interproximal surfaces Extend from the cementum to the gingiva Provide gingival support and Dentoperiosteal Extend from the cementum to the periosteum

Question 37

fibers of gingiva: circular intercircular intergingival

Answer 37

Circular/Circumferential Encircle the tooth in a ringlike manner Maintain the contour & position of the free marginal gingivaInterpapillary Provides support for the interdental gingiva Intercircular Stabilizes the tooth within the arch Intergingival Provides support and contour of the attached gingiva

Question 38

Principle Fibers of the PDL

Answer 38

Type I collagen (80%), Type III collagen (20%) Oxytalan fibers: function in supportive, developmental and/or sensory role associated with blood vessels and nerves, not attached to bone and cementum

Question 39

Six PDL fiber groups (Dentoalveolar) | transeptal, alveloar crest and horizontal

Answer 39

PDL fiber groups (Dentoalveolar) | transeptal, alveloar crest and horizontal ,oblique, apical and interradicular

Question 40

PDL fiber groups (Dentoalveolar) | transeptal, alveloar crest and horizontal

Answer 40

Transseptal – prevent teeth from losing contact Alveolar Crest-help prevent extrusion (keeps tooth in alveolus), resist lateral tooth movement and protect deeper PDL structures Horizontal- opposes lateral forces

Question 41

PDL fibers : oblique, apical and interradicular

Answer 41

Oblique - largest fiber group, bears the brunt of vertical chewing forces Apical – prevents tooth from tipping and extruding, protects blood vessels and nerve supply to the tooth Interradicular - prevents tooth from tipping and extruding

Question 42

Epithelial Rests of Malassez

Answer 42

Epithelial Rests of Malassez are remnants of Hertwig’s Epithelial Root Sheath that occur as nests of cells within the periodontal ligament. These cells may proliferate and form a cyst

Question 43

PDL FUNCTIONS

Answer 43

Supportive, Transmission of occlusal (biting) forces to the bone, Attachment of the teeth to the bone, Shock absorber Formation and resorption Nutritional and Sensory

Question 44

CEMENTUM

Answer 44

Calcified, avascular, mesenchymal tissue that covers the anatomic root