Anatomy of the periodontium Flashcards
(155 cards)
1
Q
Tissues of the periodontium include:
A
- gingiva
- cementum
- periodontal ligament
- alveolar bone
2
Q
Oral mucosa consists of 3 zones, these include:
A
- the gingiva & covering of the hard palate (masticatory mucosa)
- dorsal of the tongue (specialized mucosa)
- oral mucous membrane lining remainder of oral cavity
3
Q
Oral mucosa of the gingiva & covering of the hard palate:
A
masticatory mucosa
4
Q
Oral mucosa of the dorsum of the tongue:
A
specialized mucosa
5
Q
Masticatory mucosa that covers alveolar bone and tooth root coronal to the CEJ:
A
gingiva
6
Q
Gingiva is divided into what three categories?
A
- marginal gingiva
- attached gingiva
- interdental areas
7
Q
Free, or unattached, cufflike tissue surrounding the teeth on facial, lingual, and inter proximal surfaces:
A
marginal gingiva
8
Q
Marginal gingiva may be ___ or ____
A
free or unattached
9
Q
Where is the marginal gingiva located?
A
surrounds teeth on facial, lingual, and interproximal surfaces
10
Q
The most coronal portion of the gingiva; scalloped outline of teeth:
A
gingival margin
11
Q
Space formed by tooth and sulcular epithelium (laterally) and the coronal end of the JE (apically):
A
gingival sulcus
12
Q
What forms the space of the gingival sulcus laterally?
A
tooth and sulcular epithelium
13
Q
What forms the space of the gingival sulcus apically?
A
the coronal end of the JE
14
Q
Sulcular measurement of ___ are considered WNL of gingival health
A
2-3mm
15
Q
Interdental gingiva may also be referred to as:
A
papilla
16
Q
Interdental gingiva (papilla) is part of:
A
free gingiva
17
Q
Occupies the interdental space (fills embrasure space apical to tooth contact)
A
interdental gingiva
18
Q
The interdental gingiva (papilla) is attached to the tooth by the ____ & ____
A
JE & connective tissue fibers
19
Q
Valley-like depression of the inter proximal contact areas:
A
the gingival col
20
Q
The gingival col connects:
A
lingual and buccal interdental papilla
21
Q
When the gingival col absent
A
when teeth are not in contact
22
Q
The gingival col is comprised of:
A
nonkeratinized
23
Q
The gingival col is susceptible to ____ and ____
A
Inflammation; disease progression
24
Q
Gingiva that is attached to the alveolar bone and cementum by connective tissue fibers and epithelial attachment:
A
attached gingiva
25
Attached gingiva is attached to the ____ & ___ by connective tissue fibers and epithelial attachment
alveolar bone & cementum
26
Boundary of attached gingiva are apically demarcated by:
mucogingival junction (MGJ)
27
Boundary of attached gingiva are coronally demarcated by:
the base of the gingival sulcus
28
The width of attached gingiva varies from ____ to ____ mm
1 to 9 mm
29
Attached gingiva is widest in the facial aspect of the ___ and narrowest in the facial areas of the ____.
maxillary central incisors; mandibular premolars
30
Where should attached gingiva NOT be measured?
on the palate
31
any changes in the width of the attached gingiva results from changes at the ___ end
coronal
32
Example of when their is a change in width of the attached gingiva at the coronal end:
recession
33
What is the formula for measuring the attached gingiva?
width of attached gingiva = total width of gingiva - probing depth
34
What would the measurement of attached gingiva be?
Total width of gingiva from the GM to the MGJ: 6mm
Probing depth: 2 mm
4mm
(6mm-2mm= 4 mm)
35
What would the measurement of attached gingiva be?
Total width of gingiva from the GM to the MGJ: 5mm
Probing depth: 5mm
0 mm
(5mm - 5mm = 0mm)
36
Moveable tissue, loosely attached to the underlying bone; separate from attached gingiva at the MGJ:
alveolar mucosa
37
Describe the type of tissue that comprises the alveolar mucosa:
thin, nonkeratinized epithelium
38
What color is the alveolar mucosa, why?
darker shade of red than the gingiva; due to rich blood supply
39
Visible line where the pink keratinized gingiva meets the more vascular alveolar mucosa:
Mucogingival junction (MGJ)
40
Describe what the MGJ represents:
The division between where the gingiva meets the alveolar mucosa
41
The MGJ is found on the ____ and the _____ and _____ areas
maxillary facial; mandibular facial; lingual
42
Looking at the gingiva under a microscope, it is composed of ____ & ____
Stratified squamous epithelium; connective tissue
43
Looking at the gingiva under a microscope, the epithelium is mostly ____ in nature
Cellular
44
Looking at the gingiva under a microscope the connective tissue is less ____ and mostly composed of ____ and ____
Cellular; collagen fibers; ground substance
45
What are the four functions of the gingival epithelium?
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
46
Epithelium covering the free gingiva may be differentiated into: (3)
1. oral/outer epithelium
2. sulcular epithelium
3. junctional epithelium
47
Nonkeratinized epithelium surrounding and attaching to the tooth on one side, and the gingival connective tissue on the other side:
Junctional epithelium
48
Junctional epithelium can be described as being found at the:
Base of sulcus/pocket
49
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:
Junctional epithelium
50
The JE is more permeable to:
Cells and fluid
51
The JE serves as a route of passage of fluid and cells from ____ into the ___ for bacteria/bacterial cell products
Connective tissue into the sulcus
52
The junctional epithelium is easily penetrated by the periodontal probe, especially:
When gingiva is inflamed
53
What is the length of the junctional epithelium?
0.25 - 1.35 mm
54
Correlation of clinical and microscopic features:
1. color
2. size
3. contour
4. shape
5. consistency
6. surface texture
7. position
55
The gingiva (both attached/marginal) is generally ___ in color
coral pink
56
Why is the gingiva (both attached/marginal) generally coral pink?
due to vascular supply and thickness/ degree of keratinization and the presence of pigment-containing cells
57
Compared to individuals with dark-complexion & dark hair, the gingival blonde-haired individuals with fair complexion is:
lighter in color
58
Alveolar mucosa can be described appearance-wise as:
1. red
2. smooth
3. shiny
59
Why does the alveolar mucosa have a more red color compared to gingiva?
epithelium is thinner and nonkeratinized & blood vessels are more numerous
60
____ is responsible for normal pigmentation of the skin, gingiva, and reminder of the oral mucous membrane
melanin
61
_____ is present in all people, but it can be absent or severely diminished in ____
melanin; albinos
62
Melanin pigmentation in the oral cavity is prominent in ____ individuals
black
63
Appears as diffuse, deep-purplish discoloration or as irregularly shaped brown and light-brown patches
melanin pigmentation
64
What can be seen in the following image?
melanin pigmentation
65
The size of the gingiva corresponds with the:
number of cellular/intercellular elements and vascular supply
66
What does a change in size of the gingiva indicate?
gingival disease
67
Contour of the gingiva varies depending on the:
shape & alignment of teeth
68
Marginal gingiva follows a ____ outline
scalloped
69
What does it mean to say that the "biotype varies" when discussing the contour of gingiva?
thickness of the tissue varies
70
The shape of the ____ is governed by contour of proximal tooth surfaces, location, and shape of embrasures
interdental gingiva
71
The shape of the interdental gingiva is governed by: (3)
1. contour of proximal tooth surfaces
2. location
3. shape of embrasures
72
The interdental papilla can appear ____ in form or ___ depending on location
pyramidal; flattened
73
Describe the consistency of the gingiva:
firm & resilient (except the free margin)
74
What determines the firmness of attached gingiva?
collagen fibers and gingival fibers
75
Describe the surface texture of gingiva:
as stippled as an orange peel
76
When is the stippling of the gingiva best viewed?
after drying the tissue
77
____ gingiva is stippled, ____ gingiva is NOT stippled
attached; marginal
78
Stippling is less prominent on ___ than ___ surfaces
Lingual; facial
79
Calcified connective tissue covering the roots of the teeth:
cementum
80
The lease mineralized of the calcified tissues of the tooth
cementum
81
What are the two types of cementum?
1. Acellular (primary)
2. Cellular (secondary)
82
The 2 types of cementum (both acellular & cellular) consist of ___ and ___.
calcified interfibrillar matrix & collagen fibrils
83
What is the function of cementum?
to attach fibers of the PDL to the tooth (like cement) & to seal the tubules of the root dentin
84
Functions to attach fibers of the PDL to the tooth (like cement):
cementum
85
Functions to seal the tubules of the root dentin:
cementum
86
What is not present in the cementum?
1. blood vessels
2. lymph vessels
87
Describe the deposition of cementum:
continuously deposited in the apical area of the root throughout life
88
First cementum formed:
acellular cemetum
89
Cementum formed after the tooth reaches occlusal plane:
cellular cementum
90
Cementum that covers approximately the cervical third or half of the root:
acellular cementum
91
Cementum that is "less calcified:
cellular cementum
92
Cementum that does not contain cells:
acellular cementum
93
Cementum that is deposited throughout the life of the tooth:
cellular cementum
94
Cementum formed before the tooth reaches the occlusal plane:
acellular cementum
95
Cementum that is deposited at intervals, producing arrest lines:
cellular cementum
96
When is cellular cementum formed?
after the tooth reaches the occlusal plane
97
When is acellular cementum formed?
before the tooth reaches the occlusal plane
98
Cellular cementum is deposited in intervals, producing:
arrest lines
99
Label the following diagram of the different types of cementum:
A) Coronal cementum
B) Radicular cementum
C) Acellular cementum
D) Cellular cementum
100
Local abnormal thickening of parts of the cementum:
hypercementosis
101
Hypercementosis is typically found in the:
apical region
102
Hypercementosis may be seen as a result of: (4)
1. chronic inflammation of the tooth
2. no opposing tooth
3. additional eruption
4. tooth becoming fused to surrounding alveolar bone proper
103
This image shows a tooth with:
hypercementosis
104
CEJ:
cementoenamel junction
105
Understanding the relationship between the ___ & ___ is of. clinical important in scaling and root planing procedures
cementum and enamel junction
106
What are the 3 relationships involving the cementum that may exist at the CEJ:
1. space
2. end-to-end
3. overlap
107
If we classify someone as having "space" when referring to the CEJ, we are describing:
space between the enamel and cementum with he dentin exposed
108
If we classify someone as having "end-to-end" relationship when referring to the CEJ, we are describing:
the enamel and cementum being edge-to-edge
109
If we classify someone as having an "overlap" relationship when referring to the CEJ, we are describing:
cementum overlapping the enamel
110
List the percentages of the following CEJ relationships:
1. Space
2. End-to-end
3. Overlap
Space= 10%
End-to-end= 30%
Overlap= 60%
111
Label the CEJ relationship shown:
Space
112
Label the CEJ relationship shown:
End-to-end
113
Label the CEJ relationship shown:
Overlap
114
Fibrous connective tissue surrounding and attaching roots of teeth to bone:
PDL
115
The PDL is located in:
periodontal space between cementum and bone
116
Located in the periodontal space between the cementum and bone:
PDL
117
The PDL is composed of:
connective tissue cells and intracellular substance
118
Composed of connective tissue cells and intracellular substance:
PDL
119
The fibers inserted into the cementum on one side and bone on the other are called:
sharpey's fibers
120
The functions of the periodontal ligament (PDL) include: (4)
1. supportive
2. formative
3. nutritive
4. sensory
121
What function of the PDL is being described below:
anchors tooth to bone
supportive
122
What function of the PDL is being described below:
helps maintain biologic activity of bone and cementum
formative
123
What function of the PDL is being described below:
Supplies nutrients and removes waste products via blood and lymph vessels
Nutritive
124
What function of the PDL is being described below:
Capable of transmitting tactile pressure and pain sensations:
Sensory
125
Sharpey's fibers are the portion of the PDL that insert into bone and cementum and therefore contribute to the PDL's ___ function
Supportive
126
Portion of the PDL that insert into bone and cementum:
Sharpey's Fibers
127
PDL Width is seen only in:
radiographs
128
PDL width depends on: (4)
1. age
2. stage of eruption
3. function of tooth
4. angle of film
129
The arrows in this image are pointing out:
PDL Width
130
PDL fiber groups around the cervical area within the gingival tissues:
Gingival fiber groups
131
PDL Fiber groups surrounding the root:
Principal fiber groups
132
What are the two main categories of PDL fiber groups?
1. gingival fiber groups
2. principal fiber groups
133
List the PDL fibers that are considered gingival fiber groups: (5)
1. dentogingival fibers
2. alveologingival fibers
3. circumferential fibers
4. dentoperiosteal fibers
5. transeptal fibers
134
List the PDL fibers that are considered principal fiber groups: (5)
1. apical fibers
2. oblique fibers
3. horizontal fibers
4. alveolar crest fibers
5. interradicular fibers
135
PDL fibers: free gingival
dentogingival fibers
136
PDL fibers: attached gingival
alveologingival fibers
137
PDL fibers: circular
circumferential fibers
138
PDL fibers: alveolar crest
denoperiosteal fibers
139
PDL fibers from the cementum in the cervical region into the free gingiva to give support to the gingiva:
Dentogingival fibers (free gingival)
140
PDL fibers from the alveolar crest into the free and attached gingival to provide support:
Alveologingival fibers (attached gingival)
141
PDL fibers that are continuous around the neck of the tooth to help maintain tooth position:
Circumferential fibers (circular)
142
PDL fibers from the cervical cementum over the alveolar crest to blend with fibers of the periosteum of the bone:
Dentoperiosteal fibers (alveolar crest)
143
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:
Transseptal fibers
144
Label the following image:
A: Circular Group
B: Dentogingival Group
C: Dentoperiosteal Group
D: Alveologingival Group
E: Alveolar Bone
145
Label the following image:
A) alveologingival fibers
B) Dentogingival fibers
C) Circumferential fibers
D) Dentoperiosteal fibers
E) Cementum
146
Principal fiber group from the root apex to adjacent surrounding bone to resist vertical forces:
Apical fibers
147
Principal fiber group from the root above the apical fibers obliquely toward the occlusal to resist vertical and unexpected strong forces:
Oblique fibers
148
Principal fiber group from the cementum in the middle of each root to adjacent alveolar bone to resist tipping of the tooth:
Horizontal fibers
149
Principal fiber group from the alveolar crest to the cementum just below the CEJ to resit intrusive forces:
Alveolar crest fibers
150
Principal fiber group from cementum between the roots of multicoated teeth to the adjacent bone to resist vertical and lateral forces:
Interradicular fibers
151
Label the following image:
Purple: alveolar crest fibers
Blue: horizontal fibers
Red: interradicular fibers
Green: oblique fibers
Orange: apical fibers
152
Label the fibers the following image:
Turquoise: interradicular group
Lime Green: apical group
Sunshine yellow: oblique group
Anaranjado: horizontal group
Rojo: alveolar crest group
153
Bone that forms and supports the alveoli (tooth sockets)
alveolar bone (alveolar process)
154
Alveolar bone (alveolar process) consists of:
alveolar bone proper and supporting bone
155
