attachement and regeneration Flashcards
what is new attachement?
union of connective tissue with previously pathogenically altered tooth surface
what is regeneration
attachement of PDL cells to new cementum
coronal re growth of alveolar bone
for new attachment to take place, what must there be?
root surface must be biologically compatible with healing
reduction in plaque
smooth root surface
what are features of the junctional epithelium
attaches directly to root surface
normally 2mm at ACJ
hemidesmosonal attachement
what are the effects of mechanical plaque control on microflora?
marked decrease in total number of organisms
gram -ve anaerobes greatly reduced
residual flora is gram +ve
what bacteria are most destructive in perio disease?
gram -ve
name gram -ve bacteria
actinomyces spp porphyromonas gingivalis prevotella intermedia tannerella forsynthia fusobacterium spp
what indicates healing in the periodontal pocket?
general features of chronic inflammation decreased vasodilation decreased gingival crevicular fluid decreased PMNs neutrophils decreased ulceration of pocket
describe the process of healing in the pocket
fibroblasts migrate to site
collagen laid down
limited re modelling of alveolar crest takes place
pocket epithelium begins to attach to root surface
what indicates successful RSD
formation of new Junctional Epithelium
how does ne JE form?
formation of basement membrane and hemidesmosomal attachment
keratinocytes held to the cementum
formation of long epithelium attachment
gradual closure of pocket up to months after tx
what indicates healing clinically?
reduction in redness and swelling
BOP reduced
ulcers in pockets healed
gingivae becomes increasingly pink and firm
as inflammation subsides there may be shrinkage of tissues
when can you probe safely post RSD
6-8 weeks
what is gingival shrinkage due to ?
tightening of the gingival cuff
what is the function of cytokines?
released during healing, chemical messengers attract fibroblasts
