Exam 1 Flashcards

(47 cards)

1
Q

Can bacteria alone cause PD

A

No, bacteria are ESSENTIAL but insufficient to cause disease

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2
Q

What host factors play a role in periodontitis?

A
  1. Heredity
  2. Environmental factors (smoking)
    - Equally important as bacteria in determining disease occurrence and severity of disease outcome
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3
Q

Bacteria and host factors (heredity, env. factors) are equally important in determining what two things?

A
  1. Disease occurrence

2. Severity of disease outcome

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4
Q

3 microbial risk factors to periodontitis

A
  1. Specific microorganism
  2. Total microbial burden
  3. Biofilm pathogenicity
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5
Q

System risk factors to periodontitis

A
  1. Diabetes
  2. Genetic factors
  3. Sex/race
  4. HIV
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6
Q

What is the most common form of PD?

A

Slight (mild) PD

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7
Q

What is important in diagnosing PD?

A

Clinical Attachment Loss

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8
Q

What are the tissues of the periodontium

A
  • Gingiva and alveolar mucosa

- Periodontal attachment apparatus (PDL, Cementum, Alveolar Bone)

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9
Q

T or F, The MGJ can recede along with periodontitis but cannot be restored

A

False, the MGJ does not change, that line is permanent

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10
Q

Where is the MGJ located?

A

At base of gingival mucosa and the top of the alveolar mucosa

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11
Q

Describe the MGJ as far as keratinized or non-keratinized epithelium

A

The point at which keratinized and non-keratinized epithelium meet

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12
Q

T or F, keratinized tissue extends from the gingival margin to the MGJ

A

True

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13
Q

How is attached gingiva measured?

A

From the gingival sulcus (GM) to the MGJ minus PD

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14
Q

Keratinized gingiva and mucosal epithelium is separated by what?

A

The MGJ

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15
Q

Where in the mouth is the tissue most keratinized and least keratinized?

A

Most: Hard palate
Least: Cheek

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16
Q

Describe the progression of teeth with most keratinized tissue to those that have the least amount.

A

Incisors > Molars > Premolars

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17
Q

Where would you find the most attached tissue and least attached tissue in the mouth?

A

Most attached gingiva –> Junctional epithelium

Least attached tissue –> Crevicular epithelium

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18
Q

What are the 2 mathematical equations to determine the attached gingiva

A
  1. AG=KG - Probing depth

2. AG=(GM to MGJ) - Probing depth

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19
Q

What are the 3 different types of epithelium

A

Crevicular (Sulcular) epithelium
Oral or outer epithelium
Junctional Epithelium

20
Q

Junctional epithelium

  • Keratinized?
  • Thickness
  • Length
  • Turnover
A
  • Non-keratinized
  • 2-30 cells thick
  • 0.25-1.35 mm length
  • Turnover 1-6 days
21
Q

How do hemidesmosomes play a role in junctional epithelium?

A

The attach:

  • Cell to tooth/implant
  • Cell to connective tissue
22
Q

Describe the attachment for junctional epithelium

A
  • Internal basal lamina
    • To tooth or implant
    • Lamina densa
    • Lamina lucida
  • External basal lamina
    • To connective tissue
23
Q

Oral or outer epithelium

  • Keratinized?
  • Turnover
A

Keratinized or parakeratinized

Turnover 10-12 days

24
Q

Crevicular Epithelium

- Keratinized?

A

non-keratinized (has potential to keratinize), thin and without rete pegs

25
What is Stippling?
Depressions/raised areas in surface of attached gingiva | - Occurs at sites of rete pegs
26
Junctional epithelium - keratinized? - Turnover?
Non-keratinized | Turnover 1-6 days
27
What is the PDL?
a group of principal fibers that insert into cementum and the alveolar bone
28
What are the terminal fibers of the PDL called?
Sharpey's fibers
29
PDL is composed of what type of cells?
Connective tissue cells - (Fibroblasts, cementoblasts, & osteoblasts) Host defense cells Rests of malassez (isolated clusters of epithelium)
30
PDL function
To transmit forces & maintain attachment
31
PDL width
0.1-0.2 mm
32
Is PDL found in implants?
No, implants form hemidesmosomes with the alveolar bone
33
What is the gingival fiber group made up of and their functions?
Circular: support & contour to free gingiva Gingivodental group - Dentogingival: support of gingiva - Dentoperiosteal: anchors tooth to bone - Alveologingival: attaches gingiva to alveolar bone Transseptal fibers: keep teeth in alignment and protects bone; continuously reform as bone and fibers are destroyed
34
Which of the gingival fiber groups are not on implants?
Dentogingival Dentoperiosteal Transseptal
35
What is the periodontal fibers group made up of and their functions?
Alveolar crest: resists lateral movement Horizontal: opposes lateral forces Oblique: absorbs occlusal forces (largest group) Apical: resists tipping of tooth Interradicular: resists forces of luxation (pulling out) and tipping
36
What is biological width?
Physiologic zone of gingival tissue coronal to the alveolar bone crest - Also called gingival attachment, physiologic dentogingival junction
37
What is biological width composed of?
epithelial attachment and the gingival connective tissue attachment
38
Biological width - Junctional epithelium distance - Connective tissue distance - Total biological width
- JE - 0.97 mm - CT - 1.07 mm - BW - 2.04 mm
39
3 violations of the biologic width
1. Inflammation 2. Increasing probing depth 3. Inconsistent resorption of alveolar bone
40
Be able to calculate clinical attachment loss via numbers or words
Probing depth measurement + Gingival margin level (+ if apical to CEJ or - if Coronal to CEJ) = CAL
41
Two different types of gingivits
Plaque induced | Non-plaque induced
42
What are the systemic factors for plaque induced gingivitis
``` Endocrine (puberty, pregnancy, diabetes) Blood dyscrasias (leukemia) ```
43
What drugs contribute to plaque induced gingivitis
Treatment via cauterizing the tissue/vessels (dec. bleeding) will come back as long as pt is on the medication - Anti-seizure meds (Dilantin) - Ca channel blockers (Nifedipine) - Immunosuppressants (cyclosporin) - Oral contraceptives
44
How does malnutrition contribute to plaque induced gingivitis
Rare in US - Vit deficiency - Scorbutic gingivitis (scurvy)
45
What microorganisms contribute to non-plaque induced gingivitis
Bacteria: E. coli, Strep, Neisseria, Treponema Viruses: Herpes Fungal infections: Candidiasis, Histoplasmosis
46
What systemic diseases contribute to Non-plaque induced gingivitis
Systemic diseases: Benign mucous membrane Pemphigoid, anywhere there is a mucous membrane
47
Other than microorganisms and systemic diseases, what three other things can contribute to Non-plaque induced gingivitis
Trauma: toothbrush abrasion Foreign body reactions: popcorn kernel, dental materials, ortho brackets Genetic: Hereditary gingival fibromatosis