Chapters 1-3 Flashcards
(113 cards)
1
Q
what is the col? and where is it found?
A
directly apical to the contact area……it is the concave area that connects the lingual and buccal papilla
2
Q
what components are found in GCF?
A
calcium, sodium, potassium, and phosphorus, along with cells and bacteria
3
Q
Gingival crevicular fluid (GCF) rate of flow depends on what?
A
dependent on the absence or presence of inflammation in the connective tissue of the gingiva. The flow is minimal to absent in health, but increases due to inflammation from accumulation of plaque in the gingival crevice
4
Q
what is gingival crevicular fluid (GCF)?
A
fills the sulcus, originates from blood vessels within the underlying connective tissue (lamina propria)
5
Q
what lines the gingival crevice?
A
nonkeratinized stratified squamous epithelium
6
Q
what is the gingival crevice?
A
the space between the free gingiva and the tooth surface (sulcus)
7
Q
in health gingival margin is located on the enamal approx. ? (measurement)
A
0.5 to 2 mm coronal to the cementoenamel junction (CEJ)
8
Q
gingival connective tissue is also called?
A
lamina propia
9
Q
what kind of tissue is found underneath the stratified squamous epithelium ?
A
connective tissue
10
Q
outer surface of gingiva consists of what type of epithelium ?
A
stratified squamous epithelium
11
Q
periodontium consist of?
A
gingiva, periodontal ligament, cementum, and alveolar and supporting bone of the teeth
12
Q
The periodontium, translated in Latin mean
A
around the tooth
13
Q
gingiva subdivided into?
A
free gingiva, attached gingiva, and interdental papilla
14
Q
gingiva is salmon pink due to?
A
keratin
15
Q
what is keratin?
A
protein that is also involved in forming hair, skin, and fingernails
16
Q
3 papilla found on dorsum on tongue?
A
filiform, fungiform, and circumvallate
17
Q
where are taste buds located on papilla
A
on the sides
18
Q
describe filliform papilla
A
slender and most abundant; no taste buds
19
Q
describe fungiform papilla
A
broad and flat; edges of the tongue
20
Q
is the gingival epithelium vascular or avascular?
A
avascular; relies on lamina propria for blood supply`
21
Q
avascular means?
A
no blood vessels
22
Q
layers of oral epithelium
A
Stratum basale or stratum germinativum (basal cell layer); deepest layer next to the lamina propria.
Stratum spinosum (spinous cell layer).
Stratum granulosum (granular layer).
Stratum corneum (keratinized/cornified cell layer; also called the superficial cell layer)
23
Q
Three grades of keratinization
A
keratinized, parakeratinized, or nonkeratinized
24
Q
layers of keratinized epithelium
A
all four layers (basale, spinosum, granulosum, and corneum)
25
which cells make majority of oral epithelial ?
Keratinocytes
26
Merkel cells are found and associated with?
in the basal cell layer and are associated with nerve endings acting as touch-sensory cells
27
White blood cells such as ______________are transiently found in the epithelial layers in health but increase in numbers in periodontal disease, functioning to defend the body against bacteria and other invaders.
lymphocytes and neutrophils or polymorphonuclear leukocytes (PMNs)
28
is the sulcus keratinized or Parakeratinized?
generally nonkeratinized and thin but can become parakeratinized if exposed to the oral environment
29
what is the junctional epithelium
and of epithelial cells that surrounds the tooth and creates a “seal” at the gingival crevice to hold it firmly in place....."collar around the neck of tooth"
30
Rate of turnover for cells of the JE
every 4 to 7 days
31
The main component of the gingival connective tissue is
collagen fibers, accounting for about 60%
32
different types of collagen fibers found in gingival tissue
Types I (95%) and III (5%)
33
Type I collagen fibers give the gingiva
firmness and resiliency
34
lamina propria provides
mechanical support and nutrients for the avascular epithelium
35
remainder of gingival connective tissue consists of
ground substance, which is composed of proteins termed proteoglycans, in which the collagen fibers, cells (5%), nerves, and blood vessels (65%) are embedded
36
Proteoglycans have a protein core with
carbohydrate side chains (glycosaminoglycans) of chondroitin sulphate, heparin sulphate, and hyaluronic acid. The ground substance also allows for the transportation of water and nutrients through the tissue.
37
Fibroblasts synthesize
ground substance, collagen, and collagenase
38
Collagenase is an enzyme responsible for
the breakdown of collagen during remodeling.
39
fibroblasts play a chief role
the maintenance and remodeling of connective tissue
40
Other cells in the lamina propria include
red blood cells, PMNs, macrophages, lymphocytes, and mast cells, which are involved in the defense of the host against toxins
41
desmosome consists of
two adjacent attachment plaques, which are continuous with the innermost leaflet of the cell membrane
42
Electron micro-scopy has demonstrated that epithelial cells are held together
intercellular bridges or desmosomes
43
junctional epithelium has how many fewer desmosomes than oral epithelium?
four times fewer.....the intercellular spaces are wider.
44
Biologic width is important when
evaluating a tooth for a crown. There must be an adequate amount of biologic width (soft tissue attachment) for periodontal health
45
attachment apparatus includes?
periodontal ligament, cementum, and alveolar and supporting bone constitute the attachment apparatus
46
attachment apparatus function
support and anchor the teeth within the alveolar process
47
Attachment level refers to
level of attachment of the junctional epithelium to the tooth surface
48
periodontal ligament is primarily composed of
collagen fibers and islands of loose connective tissue
49
primary cell of the periodontal ligament is
fibroblast
50
fibroblast synthesize
collagen, collagenase, and ground substance
51
fibers that are embedded into alveolar bone and cementum, are termed
sharpeys fibers
52
periodontal ligament functions include
Suspensory: attaching the tooth to the alveolar bone
Shock absorption: transmitting occlusal forces to the alveolar bone
Remodeling: function by providing cells that are involved in the formation and resorption of cementum and bone and itself
Formative: Carries a blood supply to the rest of the periodontium for nutrition
Sensory: Transmits tactile pressure and pain perception via the trigeminal nerve
Proprioceptive: Allows the feeling of localization of pain and pressure to be transmitted through proprioceptive nerve endings
53
epithelial rests of Malassez are considered to be remains of
epithelium of Hertwig’s epithelial root sheath, which plays an important role in the development of the cementum and the shape of the roots
54
Cementicles are
calcified bodies of cementum seen in the periodontal ligament of older adults (embedded within the cementum, or not associated with the root. It is unknown if cementicles present any clinical significance)
55
Remember that cementum does not contain nerves or blood vessels. When a patient complains of sensitivity to cold, take a look at the tooth. Usually, there is gingival recession, and the exposed tooth structure is not cementum, but dentin
REMEMBER
56
Two kinds of cementum
Acellular cementum
| Cellular cementum
57
Acellular cementum
formed before tooth eruption, is found on the coronal two-thirds of the root and is approximately 0.1 mm in thickness, with the cementoenamel junction being the thinnest area
58
Cellular cementum
covers the apical third of the root and furcations, has a thickness of about 0.5 mm and is formed much faster than acellular cementum. Cellular cementum can be laid down on top of acellular cementum, or it can comprise the entire thickness of the cementum
59
two parts to the alveolar process
the alveolar bone proper and the supporting bone
60
The alveolar bone proper or cribriform plate is
hard compact bone that lines the tooth socket, which is contained within the alveolar process
61
The supporting bone is composed of two parts
compact bone and cancellous bone (also called spongy or trabecular bone)
62
Compact bone, which covers the alveolar process, consists of
buccal (outer) and lingual (inner) cortical plates that are continuous with the cribriform plate.
63
Cancellous bone fills the area between
the buccal and lingual cortical plates and between the alveolar bone proper of adjacent teeth
64
By following the contour of the cementoenamel junction, the alveolar bone crest is
relatively flat in the posterior and more convex and pointed in the anterior.
65
The slope of the alveolar bone crest follows an imaginary parallel line connecting the
cementoenamel junction of adjacent teeth and is approximately 2 mm apical to it if the biologic width is taken into consideration, but this relationship may vary
66
relationship of the cementum to the enamel margin varies
60% to 65%: cementum overlaps the enamel
30%: cementum meets exactly with the enamel
5% to 10%: the cementum and enamel do not meet
67
The blood to the gingiva is primarily supplied by
the vessels of the periosteum (supraperiosteal), periodontal ligament, and alveolar bone
68
Frequently, the bone may not completely encircle prominent roots of teeth that are rotated, in facioversion, in lingoversion, tipped, or crowded. The resulting defects take the form of windows known as ______ and clefts known as ______
fenestrations; dehiscences
69
Epidemiology is
the study of health and disease in the human population
70
Population surveys evaluate
representative samples of individuals within a study population to assess the true risk for disease and quantify how many individuals are or will be affected by disease
71
quantification of disease in population surveys are referred to as
disease prevalence and incidence
72
Prevalence is
the proportion or number of individuals in a population having the disease (both old and new cases) at a given time.
73
Incidence is defined as
the rate of new cases occurring within a certain period of time
74
Severity is defined as
the degree or amount of periodontal disease involvement and quantifies the amount of attachment loss, bone loss, or probing depth
75
The extent of periodontal disease refers to
the number or percentage of diseased teeth or sites per individual
76
what is an index?
76
what is an index?
A screening tool designed to quantify and simplify the disease assessment in population surveys. Examples include plaque, debris, calculus, and periodontal destruction.
77
criteria for indices
simplicity/ease, quick to perform and practical and sensitivity (detects small changes), validity (measures what is intended); reliability, acceptable to subjects; statistical analysis; clinically significant and meaningful to researchers
78
Indices are important for patient assessment because
indices are intended to be reproducible by other clinicians
79
CPITN Stands for
The Community Periodontal Index of Treatment Needs
80
oleary index
all teeth; plaque; disclosing agent; time consuming; private practice
81
plaque index
plaque, all teeth, Measures the thickness or amount of plaque along the gingival margin; score: 0123; clinical studies epidemiologic surveys
82
Simplified Calculus Index
calculus; 6 teeth, quantifies calculus; epidemiologic studies
83
Gingival index
Gingival inflammation; patient education
84
periodontal index
all teeth; measures perio condition, inflammation pocket depth
85
Community Periodontal Index of Treatment Needs
Periodontal pockets, calculus, gingival bleeding; 10 teeth; epidemiologic surveys
86
Periodontal Screening and Recording (PSR)
all teeth; Periodontal pockets, calculus, bleeding, and defective restorations; private practice
87
The sampling methodology for population studies differs from
that used in clinical periodontics and can influence the accuracy of the data obtained.
88
National surveys have helped build our knowledge of
the prevalence, severity, and extent of periodontal diseases in the United States
89
the most common form of periodontal disease found in individuals of all ages?
Gingivitis
90
In the NHANES III study gingival bleeding was present in _____ and _____ of all sites examined bled on probing
63% and 12%
91
When compared with earlier national surveys, gingivitis has declined in the United States, most likely due to
the current focus on oral hygiene as part of a daily personal hygiene routine
92
Chronic periodontitis found in what age?
not commonly found among young individuals and is more prevalent with age
93
Attachment loss is defined as
the loss of collagen fiber attachment to the tooth with subsequent apical migration of the junctional epithelium.
94
The NHANES III study found that over ______ of individuals over age 13 had some attachment loss, with only _____ of the population having advanced disease (defined as 5 mm or more of attachment loss).
90%
| 15%
95
Risk indicators are
demographic, behavioral, and socioeconomic characteristics that are associated with disease but not considered causal for the disease
96
Aging is considered a risk indicator for periodontal disease, but
does not cause periodontal disease. With increasing age, the prevalence of periodontal disease increases, but the aging process is not responsible for the disease. It is believed that there is more disease with age because there is more exposure to plaque-induced inflammation over time
97
risk factors for periodontal disease
diabetes, tobacco use, and biofilm
98
what may play a role in disease expression but are not causally linked to periodontal disease
Gender, race, and age
99
what happens when biofilm develops ?
the host mounts an inflammatory response as a result of the bacterial challenge from the dental biofilm at the tooth/gingival interface, resulting in inflammatory periodontal disease
100
bacteria cells represent what % of biofilm volume
15% to 20%
101
the molecules that are absorbed on the tooth surface in the 1st event of dental biofilm derive from where?
molecules are derived mainly from saliva, but in the subgingival environment they originate from the gingival crevicular fluid
102
is biofilm found just in the mouth?
Biofilm are found everywhere, not only in the mouth. Biofilm are also found on solid material submerged in or exposed to an aqueous solution. For example, biofilm grow in hot, acidic pools in Yellowstone National Park and on glaciers in Antartica
103
A biofilm is a complex aggregation of
microorganisms marked by the excretion of a protective and adhesive matrix.
104
what represents the remaining of biofilm volume after bacteria?
glycocalyx, composed predominately of water and aqueous solutes, representing the remaining 75% to 80% of the volume. Exopolysaccharides (EPS) produced by the bacteria in the biofilm make up 50% to 95% of the dry weight
105
how many bacterial species reside in the mouth
700
106
Periodontal diseases, like many other chronic diseases, appear to follow the microbial shift hypothesis. This shift, more commonly known as
dysbiosis
107
transition from periodontal health to disease, there is an oral microbiota shift from
a population that is predominately gram-positive aerobes to a population predominated by gram-negative anerobes.
108
The biofilm present when the gingiva is healthy and noninflamed consists mainly of
gram-positive, saccharolytic, and facultative anaerobic bacteria that contain Streptococcus and additional species including Actinomyces, Veillonella, Bacteroides, and Capnocytophaga. Streptococci and Actinomyces may comprise over 85% of the microbial flora in health
109
Gingivitis has been characterized by a shift from a
Streptococcus-dominated plaque to an Actinomyces-dominated plaque.
110
Developing gingivitis has been associated with increased numbers of
Actinomyces israelii and Bacteroides, especially Porphyromonas gingivalis.
and increase in motile bacteria and spirochetes
111
Prevotella intermedia has been associated with
pregnancy gingivitis
112
moore associated gingivitis with what flora ?
specific Actinomyces, Streptoccocus, Fusobacterium, Veillonella, and Treponema
