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Perio Midterm > Anatomy, Structure and Function > Flashcards

Anatomy, Structure and Function Flashcards

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1
Q

the periodontium consists of

A
  • gingiva
  • periodontal ligaments
  • cementum
  • alveolar bone
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2
Q

what are the periodontal phenotypes?

A
  • thin-scalloped
  • thick-flat
  • thick-scalloped
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3
Q

what is periodontal phenotype?

A

also called biotype or morphotype to describe the clinical variations in the gingival thickness, the amount of keratinized tissue width, bone morphotype and the shape of the tooth

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4
Q

how is the periodontal phenotype influenced?

A
  • genetic traits
  • environmental factors (can cause changes over time)
  • phenotype modification therapy
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5
Q

how does the periodontal phenotype affect disease progression?

A

may play an important role in gingival recession and bone resorption

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6
Q

what are the three zones of the oral mucosa?

A
  • masticatory mucosa
  • specialized mucosa
  • lining mucosa
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7
Q

what is masticatory mucosa?

A

the gingiva covering of the hard palate and the alveolar processes of the jaws and surrounds the necks of the teeth

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8
Q

what is specialized mucosa?

A

mucosa found on the dorsum of the tongue

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9
Q

what is lining mucosa?

A

mucosa that covers the remainder of the oral cavity

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10
Q

what are the clinical features of the periodontal gingiva?

A
  • marginal gingiva
  • gingival sulcus
  • attached gingiva
  • interdental gingiva
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11
Q

what is the marginal gingiva?

A

unattached or free gingiva at the terminal edge/border of the gingiva that surrounds the teeth

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12
Q

what is the free/marginal gingival groove?

A

a shallow linear depression that separates the marginal gingiva from the attached gingiva

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13
Q

what are the characteristics of the marginal gingiva?

A
  • about 1mm wide
  • forms the soft tissue wall of the gingival sulcus
  • can be separated from the tooth surface with a probe
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14
Q

what is the gingival zenith?

A

most apical point of the marginal gingival scallop

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15
Q

what is the gingival sulcus?

A

shallow crevice around the tooth bound to tooth on one side and epithelium lined and free on the other used for diagnosis of periodontal diseases

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16
Q

what is the normal probing depth of the gingival sulcus?

A

ideal 0mm to normal 3mm

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17
Q

what is the attached gingiva?

A

firm and resilient gingiva continuous with the marginal gingiva and alveolar mucosa and bound to the underlying periosteum of the alveolar bone

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18
Q

how is the width of the attached gingiva measured?

A

distance between the mucogingival junction and the projection on the external surface of the gingival sulcus/periodontal pocket

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19
Q

what is the keratinized gingiva and non-keratinized gingiva?

A

Keratinized: the marginal gingiva AND the attached
Non-keratinized: alveolar mucosa

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20
Q

what is the mucogingival junction?

A

the line of demarcation between the keratinized gingiva and the non-keratinized alveolar mucosa

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21
Q

how does the width of the attached gingiva change based on the location in the mouth?

A
  • greatest in width in the incisor region
  • narrower in width in the posterior region
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22
Q

what is the interdental gingiva?

A

pyramidal or col shaped gingiva occupies the gingival embrasure or the space beneath the contact point

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23
Q

what does the shape of the interdental gingiva depend on?

A
  • presence or absence of a contact point
  • distance between the contact point and osseous crest
  • presence or absence of some degree of recession
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24
Q

what affects the shape of the interdental gingiva?

A
  • larger contact point = col shape
  • smaller contact point = pyramidal shape
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25
what are the microscopic features of the gingiva?
overlying stratified squamous epithelium (cellular) with an underlying central core of connective tissue (less cellular; collagen)
26
what joins the epithelium and connective tissue of the gingiva?
the basal lamina/basement membrane
27
what are the features of the gingival epithelium?
- contains three layers the oral, sulcular and junctional epithelium comprised mainly of keratinocytes but also langerhans, merkel and melanocytes
28
what is the main function of the gingival epithelium?
protect the deep structures while allowing for a selective interchange with the oral environment through proliferation and differentiation of keratinocytes (ocurring in basal layers; sometimes suprabasal)
29
what are the most and least keratinized layers of the oral epithelium?
palate (most keratinized) gingiva ventral aspect of the tongue cheek (least keratinized)
30
what are langerhans cells?
dendritic cells belonging to the mononuclear phagocyte system as modified monocytes from bone marrow located among keratinocytes in all suprabasal layers
31
what is the normal amount of langerhans cells in each layer of the epithelium?
- found in the oral epithelium of normal gingiva - fewer numbers in the sulcular epithelium - probably absent from the junctional epithelium of normal gingiva
32
what are melanocytes?
cells that give the oral mucosa its color pigment in a wide range of shades based on the rate of production and breakdown of melanin NOT the number of cells
33
what are merkel cells?
cells that harbor nerve endings (tactical receptors) for pain transmission in the deep layers of the epithelium
34
what are the main roles of the oral, sulcular and junctional epithelium?
- Oral epithelium and the sulcular epithelium are largely protective in function - Junctional epithelium serves many more roles and is of considerable importance in the regulation of tissue health
35
where is the oral epithelium located and what are its components?
- found at the crest and outer surface of the marginal gingiva and the surface of the attached gingiva Composed of four layers: - Stratum basale (basal layer) - Stratum spinosum (prickle cell layer) - Stratum granulosum (granular layer) - Stratum corneum (cornified layer)
36
what are the main characteristics of the oral epithelium?
- 0.2-0.3 mm thick - either parakeratinized (has nuclei) or keratinized - loses its keratinization if placed in contact with the tooth
37
where is the sulcular epithelium located and what are its components?
- lines the gingival sulcus from the coronal limit of the junctional epithelium to the crest of the gingival margin Composed of: - Stratum basale (basal layer) - Stratum spinosum (prickle cell layer)
38
what are the main characteristics of the sulcular epithelium?
- thin, non-keratinized stratified squamous without rete pegs - has the ability to keratinize if exposed to oral cavity or if the protective bacterial flora is totally eliminated from the sulcus
39
where is the junctional epithelium located and what are its components?
- located from CEJ to the sulcular epithelium that attaches the connective tissue to the enamel Composed of two strata: - basal layer (faces CT) - suprabasal layer (extends to tooth surface)
40
what are the main characteristics of the junctional epithelium?
- collar-like bands of non-keratinized stratified squamous epithelium 0.97-1.14mm thick - 3-4 layers in early life and 10-20 as age increases - layers taper from its coronal end (10 to 29 cells wide) to one or two cells wide at its apical termination
41
what does the oral epithelium rely on for continuous renewal?
proliferation of basal cells
42
How is the thickness of the oral epithelium maintained?
balance between new cell formation in the basal and spinous layers and the shedding of old cells at the surface where the mitotic rate is higher in nonkeratinized areas and increased in gingivitis
43
what is gingival fluid and how does it differ in healthy and inflamed suclus?
- transudate or exudate fluid - in healthy sulcus the amount of fluid present is small but during inflammation the flow increases
44
how does the gingival fluid contibute to the host defense?
- cleansing particles from the sulcus - containing antimicrobial peptides - exerting antibody activity to defend the gingiva
45
what are the major components of the gingival connective tissue?
extracellular matrix consisting of - collagen (60%) - other proteins (35%) - fibroblasts (5%) - vessels and nerves
46
what are the three types of connective tissue fibers present in the gingiva?
collagen reticular elastic
47
what is the role of collagen type I and type IV in the connective tissue?
- type I forms and provides the tensile strength - Type IV branches between type I and is continuous with the basement membrane and blood vessel walls
48
what are gingival fibers?
type I collagen fibers of the marginal gingiva
49
what are the functions of the gingival fibers?
- brace the marginal gingiva against the tooth - provides rigidity needed to withstand mastication force - unites the free marginal gingiva with the cementum and attached gingiva
50
what are gingivodental fibers?
gingival fibers on the facial, lingual and inter-proximal surfaces embedded in the cementum just beneath the epithelium at the base of the gingival sulcus and junctional epithelium
51
what are circular fibers?
gingival fibers that course through the connective tissue of the marginal and interdental gingivae and encircle the tooth in a ring like fashion
52
what are the transseptal fibers?
gingival fibers located interproximally, form horizontal bundles that extend between the cementum of the approximating teeth
53
what is the predominant cell of the gingival connective tissue and what is its role?
fibroblast - plays a major roll in the development, maintenance and repair by synthesizing collagen, elastic fibers and regulates collagen degradation
54
what are the other cells present in the gingival connective tissue and what are their roles?
- mast cells, macrophages, adipose, eosinophils - neutrophils; seen in relatively high numbers in the sulcus and gingival CT but present in small amounts in normal gingiva
55
Is the regenerative capacity better in the connective tissue or PDL?
PDL
56
what are the three sources of blood supply to the gingiva?
- supraperiosteal arterioles - vessels of the periodontal ligaments - arterioles which emerge from the crest of the interdental alveolar bone
57
how is the color of the gingiva influenced?
range of colors due to - vascular supply (more BV= more red) - thickness (thicker=darker) - degree of keratinization (keratinized=darker) - pigment containing cells (melanin)
58
what does the contour of the gingiva depend on?
the shape of the teeth and their alignment in the arch, the location and size of the area of proximal contact, and the dimensions of the facial and lingual gingival embrasure
59
what are the two main phenotypes of gingival tissue and what population are they found in?
- thin clear gingiva; 1/3 of the population and primarily women - thick clear gingiva; 2/3 of the population and primarily men
60
what influences the shape of the gingiva?
location of the proximal contacts
61
how does the surface texture vary between the areas of the gingiva?
stippling can be seen on attached gingiva but NOT on marginal, and is less prominent on lingual surfaces than facial

Perio Midterm (6 decks)

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