Gingiva

Question 1

Periodontium consists of what?

Answer 1

Gingiva, periodontal ligament, cementum and alveolar bone

Question 2

Periodontal phenotype is considered as the

Answer 2

combination of the gingival phenotype and bone morphotype

Question 3

Periodontal phenotype can change over time due to environmental factors or by

Answer 3

Phenotype modification therapy

Question 4

Periodontal phenotype may play an important role in disease progression such as

Answer 4

gingival recession and bone resorption

Question 5

Oral mucosa consists of what 3 zones?

Answer 5

• Masticatory mucosa
• Specialized mucosa
• Lining mucosa

Question 6

Masticatory mucosa

Answer 6

Gingiva covering of the hard palate and the alveolar processes of the jars and surrounds the necks of the teeth

Question 7

Specialized mucosa

Answer 7

Dorsum of the tongue

Question 8

Lining mucosa

Answer 8

Covers the remainder of the oral cavity

Question 9

What is the marginal or unattached, free gingiva?

Answer 9

Terminal edge or border of the gingiva that surrounds the teeth in a collar-like fashion

Question 10

How wide is marginal gingiva typically?

Answer 10

1mm

Question 11

The most apical point of the marginal gingiva scallop is called what?

Answer 11

Gingival zenith

Question 12

The attached gingiva is continuous with the

Answer 12

marginal gingiva

Question 13

Attached gingiva is firm, resilient and

Answer 13

tightly bound to the underlying periosteum of the alveolar bone

Question 14

Facial aspect of the attached gingiva extends to the

Answer 14

relatively loose and movable alveolar mucosa (demarcated by the mucogingival junction)

Question 15

Width of the attached gingiva is the distance between

Answer 15

mucogingival junction and the projection of the external surface to the bottom of the gingival sulcus or the perio pocket

Question 16

What is the mucogingival junction?

Answer 16

Line of demarcation between keratinized gingiva and nonkeratinized alveolar mucosa

Question 17

Attached gingiva width is generally greatest in what area?

Answer 17

Incisor region (3.5-4.5 maxilla and 3.3-3.9 mandible)

Question 18

Where is the attached gingiva generally narrower?

Answer 18

Posterior segments (1.9mm in max PM and 1.8 in Mand 1st M)

Question 19

The interdental gingiva occupies what?

Answer 19

The gingival embrasure

Question 20

The shape of the interdental gingiva depends on what?

Answer 20

• Presence or absence of a contact point between the adjacent teeth
• Distance between contact point and osseous crest
• Presence or absence of some degree of recession

Question 21

Gingiva is composed of the overlying stratified squamous epi and the underlying

Answer 21

central core of CT

Question 22

What is the principal cell type of the gingival epi?

Answer 22

Keratinocyte

Question 23

Other than keratinocyte, what are other cells found in the epi?

Answer 23

Langerhans cells, Merkel cells and melanocytes

Question 24

What is the main function of the gingival epi?

Answer 24

Protect the deep structures while allowing for a selective interchange with the oral environment

Question 25

Proliferation of keratinocytes takes place by what?

Answer 25

Mitosis in the basal layer and less frequently in the suprabasal layers

Question 26

What is the order of oral mucosa from most keratinized to least?

Answer 26

Palate --> Gingiva --> Ventral aspect of tongue --> Cheek

Question 27

What type of cells are Langerhans cells?

Answer 27

Dendritic cells

Question 28

Where are langerhans cells located?

Answer 28

Among keratinocytes at all suprabasal levels

Question 29

Langerhans cells present antigens to

Answer 29

lymphocytes

Question 30

Where are Langerhans cells probably absent?

Answer 30

from jucntional epi of normal gingiva

Question 31

Where are Merkel cells located?

Answer 31

In deeper layers of the epi

Question 32

Describe merkel cells

Answer 32

Harbor nerve endings, have been identified as tactile preceptors

Question 33

What are the 4 layers of oral epi?

Answer 33

- Stratum basale - Stratum spinosum - Stratum granulosum - Stratum coerneum

Question 34

On average, what is the thickness of the oral epi?

Answer 34

0.2-0.3mm

Question 35

Does orthokeratinized have nuclei?

Answer 35

No

Question 36

Does parakeratinized have nuclei?

Answer 36

Yes

Question 37

What is sulcular epi?

Answer 37

Lines the gingival sulcus. Thin, non-keratinized stratified squamous without rete pegs

Question 38

As with other nonkeratinized epi, the sulcular epi lacks what?

Answer 38

Granulosum and corneum strata

Question 39

The junctional epi consists of a

Answer 39

Collar like band of stratified squamous nonkeratinized epi

Question 40

The length of the junctional epi ranges from

Answer 40

0.97 to 1.14 mm

Question 41

Oral epi undergoes continous renewal that relies on the proliferation of what?

Answer 41

Basal cells

Question 42

Mitotic rate is higher in what areas?

Answer 42

Nonkeratinized (and in gingivitis)

Question 43

During inflammation, what happens to gingival fluid?

Answer 43

Flow increases

Question 44

How does gingival fluid contribute to the host defense?

Answer 44

- Cleansing particles from the sulcus - Containing antimicrobial peptides - Exerting antibody activity to defend the gingiva

Question 45

What are the major components of the gingival connective tissue?

Answer 45

The extracellular matrix consisting of collagen fibers, other proteins of the ECM, fibroblasts, vessels and nerves

Question 46

What are the 3 types of CT fibers?

Answer 46

Collagen, reticular and elastic

Question 47

What provides the tensile strength to the gingival tissue?

Answer 47

Collagen type I

Question 48

What type of collagen branches between the collagen type I bundles and it is continuous with fibers of the basement membrane and the blood vessel walls?

Answer 48

Type IV collagen

Question 49

Gingival fibers have what functions?

Answer 49

- Brace the marginal gingiva firmly against tooth - Provide rigidity necessary to withstand the forces of mastication - Unite the free marginal gingiva with the cementum of the root and adjacent attached gingiva

Question 50

Where are the gingivodental fibers?

Answer 50

Those on the facial, lingual and interproximal surfaces. Embedded in cementum just beneath the epi at the base of the sulcus and junctional epi

Question 51

What is the predominant cell?

Answer 51

Fibroblast

Question 52

Fibroblasts play a major role in what?

Answer 52

Development, maintenance and repair of gingival CT

Question 53

What do fibriblasts synthesize?

Answer 53

Collagen and elastic fibers

Question 54

Why does the CT of the gingiva have remarkable healing and regenerative capacity?

Answer 54

Because of the high turnover rate

Question 55

What are the 3 sources of blood supply to the gingiva?

Answer 55

- Supraperiosteal arterioles along the facial and lingual surfaces of the alveolar bone - Vessels of the periodontal ligament - Arterioles which emerge from the crest of the interdental alveolar bone and extend parallael to the crest of the bone to anastomose with vessels of the PDL, with capillaries in the gingival crevicular areas and the supraperiosteal arterioles

Question 56

Range of colors results from what?

Answer 56

- Vascular supply - Thickness and degree of keratinization - Pigment containing cells

Question 57

Epi of alveolar mucosa is

Answer 57

thinner and nonkeratinized (no rete pigs)

Question 58

CT of the alveolar mucosa is

Answer 58

loosely arranged and the BV are more numerous

Question 59

Is the attached gingiva stippled?

Answer 59

yes

Question 60

Is the marginal gingiva stippled?

Answer 60

No

Question 61

Where is stippling less prominent?

Answer 61

On the lingual rather than the facial. Can sometimes be absent too