Flashcards in Applied Anatomy Deck (39):
The sulcus is also known as ________ gingiva.
If your patient didn't go through passive eruption, what does that mean? Is it detrimental?
The JE did not move apically after coronal eruption was completed. The teeth will appear short but it is not detrimental.
Healthy gingival sulcus is _________ _____.
In health, to where does the probe penetrate?
free gingival groove
In disease, to where does the probe typically penetrate?
Past the JE and into connective tissue
Why does probe depth increase in inflammation?
Swelling and softening of the tissue will increase probe depths even though there is NO ATTACHMENT LOSS
What is the only true indicator of periodontitis?
Describe the process associated with periodontitis.
Tertiary bacteria adhere to the tooth surface and cause inflammation. Attachment is lost then bone resorbs
Why is bone loss not a good indicator of periodontitis?
Trauma from occlusion could cause bone loss in a healthy patient
Why is visible cementum not a good indicator of periodontitis?
Recession can occur in a healthy mouth and does not involve progression of disease through bacteria and inflammation.
Why is it so difficult to convince a patient that periodontitis is a disease?
Often it does not hurt and the progression is slow. 0.2mm of attachment is lost per year...meaning it takes 5 years for 1mm
What is the formula for calculating clinical attachment loss?
pocket depth + gingival recession
Together, the contact relationships between teeth, the width of approximal tooth surfaces, and the course of the CEJ will determine the shape of the _________.
What is the "col"?
concavity of nonkeratinized epithelium that is seen in contact areas of premolar and molars
The position and the dimension of the ______ determine probe angulations in posterior teeth.
Once you find the interproximal contact and guide the probe along the root, you must open the angulation by how many degrees?
Initial beliefs regarding recession: width of keratinized tissue less than _____ predisposes to recession because gingiva cannot protect from friction.
Current beliefs regarding recession: gingival health CAN be maintained regardless of its _______.
*narrow gingiva has the same resistance to attachment loss as wide gingiva
What are the two gingival phenotypes determined by dimension (B-L Thickness)?
In which phenotype is stippling more visible?
Which gingival phenotype sees less favorable treatment outcomes?
-more vulnerable to trauma
When would gingival grafts be indicated for thin phenotype individuals (3 situations)?
1. when recession causes symptoms
2. subgingival restoration margins
3. prior to orthodontic treatment (teeth position buccally)
Is tissue differentiation in the adult influenced by environmental or genetic factors?
characteristics of the gingiva are genetically determined rather than being the result of functional adaptation to environmental stimuli
Early thinking (which is wrong) indicated that gingiva will become keratinized in response to _______.
_________ determines epithelial characteristics of the gingiva.
How has gingival grafting improved due to the understanding that CT determines epithelial prototype rather than friction.
Free gingival grafts were replaced by "Connective Tissue Grafts" which have much greater success in esthetics and function.
How does Necrotizing Ulcerative Periodontitis present itself?
Bone is exposed because JE cells died
The soft tissue attachment to tooth has two parts: _______ and ______.
What is the distance between the CEJ and the alveolar crest?
2 mm... Biologic Width
The distance from crown margins to alveolar crest must be maintained at 2 mm, otherwise you must do __________ before proceeding with a restoration.
If a crown margin must be placed apical to the CEJ, what should be down prior to preparing the tooth?
After extraction of a tooth, new granulation tissue/vasculature is formed by ________ cells from the ______
After extraction of a tooth, what are the first two steps of the healing process?
1. Clot formation
2. Wound cleansing via PMNs, monocytes, and macrophages
During the healing process after extraction, provisional connective tissue is replaced by immature bone, then the bundle bone (socket proper) is resorbed and the wound is filled with ________ bone.
What are the 8 stages of healing after tooth extraction?
1. clot formation
2. wound cleansing
3. new vasculature
4. temporary connective tissue
5. immature bone formation
6. resorption of bundle bone
7. wound filled with woven bone
8. bone maturation
What does GBR stand for and why is it important after tooth extraction?
Guided Bone Regeneration
-important for socket preservation and preserving bone morphology
-direct the growth of new bone by using barrier membranes
What is Guided Tissue Regeneration?
Use of barrier membranes in order to direct the growth of epithelial tissue at sites having insufficient volumes/dimensions of tissue or bone for proper function, esthetics or prosthetic restoration
What is a Barrier Membrane?
a device used in oral surgery and periodontal surgery to prevent epithelium, which regenerates relatively quickly, from growing into an area in which another, more slowly growing tissue type, such as bone, is desired.