.4-1.5 mm space between the tooth and the bone which is visible radiographically
periodontal ligament
spirals..have one or more axial firils and incorporated into their cell walls.. most agressive
spirochetes
produce more antibody and are effective against virus and tumor cells
Natural Killer Lymphocytes
calculus occurs in approx. how many adults?
1/3 of adults
these fibers course from periosteum of alveolar bone and spread into connective tissue, the function is to attach gingiva to bone.
periostogingival
how much hydroxyapatite, enamel and dentin make up the cementum
60%
97%
70%
what are the three types of lymphocytes
T
B
NK
What was hippocrates advice about bad breath for women?
burn the head of a Hare and 3 mice, removing the intestine of 2 of them but leaving the liver and pound a stone into mortar with some marble and whitstone and apply with a greasy wool
gingival index of loe and silness
sulcus bleeding index
gingival bleeding indices
what is epithelium?
stratified squamous cells mostly keratinocytes but with some langerhans cells and merkel cells and melanocytes
what does smoking cause of perio disease?
suppresses the vascular reaction masking the signs of inflammation
this is the study of health and disease and the associated factors in population in reference to hereditary, biology, environment, society and behavior..etc
epidemiology
how many principal fiber groups consist the PDL?
5 principal
6 minor
Who were some of the first craftsmen, that could have been dentists?
Paul revere, woofendale, mills, baker, flagg and greenwood
this is comprised of the cribriform plate encompassing the alveoli and the adjacent cancellous bone
alveolar bone
these fibers span interdental space, with ends inserted into the cementum of the teeth. the function is to maintain relationship between teeth
transseptal
these fibers run apocalypse into bone from the furcation
interadicular
What did ancient skulls that had been found, show?
caries alveolar bone loss supernumerary teeth impacted teeth periapical abscesses
these compare individuals with a disease to those without and compare the risk factors, etc.
case control studies
This is defined as the tissues that surround, support and attach to the teeth
Periodontium
Who described the use of scrapers for the cleaning of teeth around 330 BC?
Asristotle
the cocci formation changes the environment to allow other bacteria the right to succeed.. as the filamentous bacteria begin to join, the number of occi decreases
microbial succession
perio is more common in men than women, with the exception of what disease?
HIV.. more common in women
this means to resorb bone
osteoclasts
all plaque is a homeogenous mass of bacteria and all plaques have the potential for disease regardless of the type.. inflammation is related to age and the quantity of plaque present
nonspecific plaque hypothesis
Who was Alfred C Fones?
He was a dentist who trained the first hygienist because of time constraints
gingiva is knife edge papillae and not blunted
shape
When and what was the name of the first dental hygiene school?
In 1913, Fones created the School in Bridgeport Connecticut
when stained and counter stained retain the initial crystal violet stain bc of the permeability of the cell wall
gnerally have larger glycan layer
in our mouth
gram positive
what are the characteristics of PMNs?
aka neutrophils
make up to 70% of leukocytes
phagocytize microbes
the by product of this are the enzymes, collage made and elastase which cause tissue destruction
what has increased periodontal problems?
tobacco use
obesity
alcohol consumption
in 1985, who increased the curriculum time allotted to periodontics?
The ADA and the council on dental education increased to 7.1 percent
Who discovered dentinal tubules when looking through the microscope in which he invented?
Anton Van Leeuwenhoek in 1600’s
these fibers course from mesial surface to distal surface of same tooth. the function is to support free gingiva
semicircular
gingiva is firm, stippled, not spongy
texture
When were dentists granted license?
1841
this is the most common, forms into chains, spherical shaped
cocci
When and what was the name of the first dental school?
1840, Baltimore College of Dental Surgery
1867, harvard
what makes up the clinical observation of gingiva?
color texture size shape consistency
people with periodontal problems are more likely to have an increased risk for…
heart disease and to give birth to low birth weighted babies
this is a loose gel liek polysaccharide substance, called glucan.. and glucan aids in bacterial adherence..
glycocalyx
bacteria that requires carbon dioxide for growth
capnophiles
What else is Periodontoclasia referred to as?
Pyorrhea Alveolaris
in 1877 by FH Rehwinkel
gingiva is not swollen, not resorbed or receded
size
When were the earliest medical texts that contain dental treatments and dental hygiene instructions?
3000 BC
composed of cocci and appears in rows much like a corncob
corncob formation
these are long, fine, wavy filament used for movement.. they appear similiar to fibriae but have different function.. both gram pos and gram neg contain these
flagella
these fibers run from apex of root into alveolar bone, both lateral and apical to root apex
apical
What we’re used as teeth cleaners by the early Mohammedans and by people in early saudia arabia?
siwaks
miswaks
also known as scavenger cells
Macrophages
these fibers course from cementum, near CEJ, across to alveolar crest. the function is to anchor tooth to bone and protect the PDL
Dentoperiosteal
bacteria that REQUIRES oxygen
aerobes
these fibers encircle the entire tooth coronal to the alveolar crest. the function is to support free gingiva
circular
What do the Practice Community requires detailed periodontal records for?
- Provide evidence of evaluation
- provide for the treatment of perio disease
- provide care for pt
- protect against malpractice
Who was the first dentist to be allowed to apply for membership in the college of surgeons in paris?
Ambroise Pare in the 1500’s
bacteria that can use oxygen but can live well with out it
facultative anaerobes
if the cells retain in their nuclei, what is this process?
parakeratinization
what is the tissue beneath the gingiva?
Lamina Propria/connective tissue
this is the study of the host response to disease?
immunology
these fibers run from distal, facial, and lingual surfaces of one tooth, around adjacent tooth, and insert on mesial surface of tooth beyond adjacent tooth. the function is to maintain arch form
intercircular
this more likely to occur in black males
localized aggressive periodontitis (LAP)
this can occur in the posteriors and may be a depressed area of tissue that is nonkeratinized… usually buccal to lingual
COL
this was developed by the american academy of periodontology and there american dental association, it is important because of its use and the fact these two organizations agreed
PSR- Periodontal Screening and Recording
this occurs when microorganisms form a layer on almost any surface, plaque on teeth, in the dental water lines, ring around the bathtub, drip pan under refrigerator.. can be visible or invisible
biofilm
these fibers run from the cementum, just social to the CEJ
alveolar crest
what is the oral epithelium composed of?
attached gingiva, papillae, and the outer portion of the free gingiva
what is the function of inflammatory cells
phagocytize bacteria and damaged tissue and to secrete products that affect cell permeability which cause lysis (cell death)
This varies from 1-9 mm and is attached to the collagen fibers
attached gingiva
with gram negative anaeroes, what do the lippopolysaccharides do?
they are released when the cell wall is broken and affects the host tissue via response
this means to build bone
osteoblasts
what percentage of fiber bundles is the lamina propria composed of?
up to 60% of collagen fibrils
the other 40% is made up of fibroblasts, mast cells, nerve cells, blood cells,etc..
these fibers are composed of gingival ligaments
this is the gingiva between the teeth that fills the embrasures or space between two adjacent teeth
papillae
aka interdental gingiva
bacteria that do not use oxygen but can tolerate it
aerotolerant anaerobes
Who was Irene Newman?
in 1906, She was the first hygienist to be trained
both gram positive and gram negative contain these.. which are protein type projections on the external surface of the bacteria for the function of hydroxyapatite
pili
these fibers are the largest group of fiber bundles and transfer occlusal stresses to bone
oblique
inital plaque is composeed of what type of bacteira?
cocci type
a slight depression on the gingiva corresponding to the sulcus depth.. where the free gingiva becomes attached gingiva
free gingival groove
what kind of tissue are ridges in rete pegs?
connective tissue
these are often the first to recognize the antigen as foreign and therefore begins the inflammatory response… they are important in perio disease because of histamine thereby setting off an allergic reaction
Macrophages
this is where the attached gingiva meets the mucosa(which is moveable)
mucogingival junction
Who wrote about the curability of the diseases of the mouth, which one of the first names of perio disease was named after?
John Riggs in 1845
thread like but have tapered ends
fusiforms
microbial studies are more able to defferentiate between bacteiral types.. as many as a dozen different types of bacteria may be responsible for periodontitis
specific plaque hypothesis
what 2 ways is gingiva categorized?
keratinized and parakeratinized
what should healthy interndal papilla look like?
come to a point
not healthy will be swollen or inflamed
what does cancellous bone mean
spongiosum
rod shaped, may be curved, uneven in diameter, club shaped ends, or thread like filaments
bacilli
plaque index of silness and loe
simplified oral hygiene index of green and vermillion
plaque debris indices
in periodontal disease, what is mostly caused from the host response?
tissue destruction
the function of these fibers is to retain the tooth in the socket and oppose lateral forces
alveolar crest
These fibers run directly across PDL space
Horizontal
These contain melanin which gives a pigmented appearance of color
melanocytes
these lymphocytes are produced in the thymus.. used in cell mediated respond (humoral/antibody mediated) also occur as T helper cells to the B lymphocytes. they produce antibody or to act as cytoxic T cells which stimulate macrophage activity
T lymphocytes
sometimes, gram negative are present on the dorsum of the tongue and associated with bad breath and perio.. what is it usually oassociated with?
porphymoronas gingivalis
what are the 5 principal gingival fiber groups?
dentogingival
alveologingival
dentoperiosteal
circular
transseptal
Who is considered to be the first periodontist?
Leonard Koecker of London
this is a network of channels and canals that allow nutrient exchange.. it also provides some physical protection
glycocalyx
this studies a population or a subset of the population over time (usually years)
cohort studies
these fibers are probably suspensory and protection of interadicular bone present in only multirooted teeth
interadicular
the PDL is composed of fiber bundles… what are their function?
- anchor the tooth
- allow fibrous tissue to develop and maintain itself
- allow the calcified tissue to maintain development
- allow the nutritive and metabolites ease of transport
- allow the sensory functions (touch, pressure, pain and proproception)
this is the movement of teeth gradually over time often throughout life in a mesial direction and usually via osteoclastic and osteoblastic action
Physiologic Mesial Migration
this is known as the “cuff” around the tooth
free gingiva
what is the lamina propria made up of?
papillary later which is the projections between the rete pegs
reticular later which extends to the periosteum
these fibers run mesiodistally in connective tissue immediately beneath gingival epithelium. the function is support attach gingiva
intergingival
what does epidemiology study?
the entire population to determine incidence, prevalence, and risk factors
these fibers are found in papillae, coronal to transseptal fiber bundles. the function is to support the papillary gingiva
interpapillary
these show the red safranin counter stain.. their outer membrane is composed of receptor proteins (which help adherence and complex lippopolysacharrides)
gram negative
calculus index of OHI-S
Volpe Manhold Probe Method of Calculus
this is the one used to measure tartar control toothpastes is studies and uses the mandibular anteriors
calculus indices
this is the level of the disease
severity
what are the alveolar process components?
alveolar bone
compact bone which makes up facial and lingual cortical plates
trabecular and cancellous bone between the cortical plates
oral mucoasa usually have what type of bacteria?
gram positive streptococci
what does saliva do?
lubricates, protects, buffers, cleanses and helps with demineralization of teeth and is antimicrobial
these cells mediate the inflammatory response process with increased vascular permeability
Mast cells
predominant antibody in saliva and inhibits bacterial attachment
Immunoglobulin A
what does the epithelium consist of?
oral(or outer) epithelium, sulcular epithelium, junctional epithelium, and gingival connective tissue
these fibers run oblique (slanted) direction across the PDL
Oblique
what are the 6 roles the ADHA defines for hygienist?
clinician educator or health promoter consumer advocate change agent researcher
this is the rate of new occurrences in a population over a given period of time
incidence
What does the periodontium include?
Gingiva
PDL
cementum
alveolar bone
these cells are phagocytic
langerhans cells
these fibers formed between teeth, coronal to CEJ. function is to support marginal gingiva
transgingival
these fibers are probably suspensory because it does not occur erupting teeth
apical
what are the allergic reactions?
type 1- anaphylaxis (histamine released, most dangerous, tissue destruction, anaphylactic shock syndrome)
type 3 Cytoxic break down of tissues
type 3 immune complex (arthus reactions and antigens persist)
type 4 cell mediated (can be delayed up to days later)
what is the miller index of tooth mobility?
0-no movement
1-barely moves
2- 1mm movement
3- over 1mm movement or the tooth is depressable
gingiva is firm, reslilient and returns to normal when compressed quickly
consistency
the majority of the bacteria on the tongue are gram positive streptococcus… what are they usually?
S. Salivarius and S. sanguis
what are cytokines
provide communication between cells assisting in the development and regulation of immune effector cells
what are the characteristics of the junctional epithelium?
separates the PDL from the oral environment
aka sulcular fluid
gingival fluid
What cells are associated with nerve cells?
Merkel cells
Who is considered to be the Father of Modern Dentistry and lived in America?
GV Black
composed of filamentous bacteria and gram negative rods
test tube (bristle brush)
where does the basal lamina connection occur?
in the rete pegs which are ridges in the connective tissue
these are a complex set of microorganisms which produce a sticky extracellular matrix called glycocalyx
plaque biofilms
these people are two to three times more likely to have periodontal problems?
insulin dependent people
What are the 5 principal fiber bundles attached to the cementum by sharpeys fibers and run across the bone?
alveolar crest
horizontal
apical
interadicular
this studies an entire population that is a representative of the population and is studied at a given point in time
cross sectional
this is loosely adhered bacteria and cellular debris.. it can be removed with a strong water spray.. this is not a biofilm except when it is not readily removed by rinsing.. then this layer is defined as dental plaque or biofilm
material alba
Who formed the Academy of Periodontology?
Grace Rogers and Gillette Hayden in 1914
what are the characteristics of the sulcular epithelium?
non or parakeratinized
extends from the outer epithelium into the gingival sulcus to the junctional epithelium
NO rete pegs
1-3 mm in health
permeable in fluids
this is an amorphous tenacious film on tooth surfaces.. composed of the formation of salivary proteins attracted oppositely charged calcium and phosphate ions of hydroxyapatite
pellicle
this process is when the keratinocytes migrate from the basal layer to the surface, they flatten and produce a keratohyaline granula layer where no cell nuclei are present
keratinization
russell’s perio index
periodontal disease index of ramfjord
periodontal disease indices
these are the ratio of measurements to allow for interpretation
indices or indexes
what are the most associated species of perio disease?
porphyromonas and prevotella
these fiber groups radiate from the cementum into the free and attached gingiva and the function is to support the gingiva
dentinogingival
what is joined to underlying connective tissue by the basal laminar by fibrils?
gingiva epithelium
the exposures, behaviors, characteristics, etc. associated with a disease
risk factors
where does supragingival plaque begin with?
pellicle
these are effector molecules that help elminate foreign bodies
antigens
this is the process of signaling inflammatory cells to areas of trauma or infection
chemotaxis
antigens are recognized by what?
lyphocytes
bacteria that lives without oxygen
anaerobes
developed by WHO and is a gingival fluid flow index
community index of periodontal treatment needs
what do inflammatory cells include
PMN (polymorphonuclear leukocytes)
macrophages
plasma cells
lymphocytes
what are the functions of cementum
- anchors teeth
- maintains the occlusal relationship
- provides a seal for the dentinal tubules
- contains sharpeys fibers
In what year, and who definite periodontoclasia as a degenerative disease of the periodontium?
In 1840, H.J. Leonard
In 1678-1761, who was considered to be the father of dentistry?
Pierre Fauchard
bacteria that cannot survive in oxygen
obligate anaerobes
What was calculus referenced by, by the middle ages around 1500?
Albucasis
how many classes are immunoglobbins
9
gingiva is pink, coral pink in health?
color
When did periodontal probes come into wide use?
1948-1958 after World War 2 because so many soldiers had trench mouth
these fiber groups radiate from the periosteum into attached gingiva. their function is to attach gingiva to underlying bone
alveologingival
these lymphocytes serve as receptor sites for antigens and are precursors of plasma cells which produce antibodies. Also stimulate production of more T cells. Both B and T responses lead to NK lymphocytes
B lymphocytes
what is the function of the epithelium?
to protect and allow selective interchange most often with drugs into the blood stream
this is the number of cases of the disease in the population at a single point in time
prevalence
what are the secondary gingival fiber groups?
periostogingival
interpapillary
transgingival
intercircular
semicircular
intergingival
these PDL fibers attach the root surface to the alveolar bone
horizontal
