Lecture 3 questions Flashcards
what makes up keratinized gingiva?
attached gingiva and marginal gingiva
what separates the attached gingiva and the marginal gingiva?
free gingival groove
what is past the mucogingival junction?
alveolar mucosa
when bone is resorbed, what happens to the junctional epithelium?
apical migration, it moves down on root surface
what is the diagnosis of periodontitis based on?
attachment loss, NOT probe depths
when the gingival margin is coronal to the CEJ, is the number given to it a negative or positive number?
negative. almost all of us have negative recession
total attachment loss is
pocket depth and gingival recession
What is the biologic width?
- attachement apparatus of the tooth
- junctional epithelium and CT underneath it
- need at least 2 mm of it (from CEJ to the bony crest)
- if we don’t have this distance, do crown lengthening
When do we not do crown lengthening?
when a patient has 60%+ bone loss
to do a crown lengthening what do we need to know?
where the new crown margin will be, then have new bone margin and gingiva 2 mm below the new crown margin
What are the gingival phenotypes?
scalloped-thin and flat-thicc
What are the characteristics of thin phenotype?
increased recession, more vulnerable to trauma, more inflammation, less favorable treatment outcome
when would we recommend gingival grafts?
a. when recession causes symptoms, when there are subgingival restoration margins on thin biotype, and pre-orthodontic therapy
b. we refer patients for graft when recession reaches CEJ (Which would affect dentin, hurts when you eat ice cream)
how are the characteristics of the gingiva determined?
genetically, rather than being the result of functional adaption to environment stimuli
how are epithelial characteristics determined?
connective tissue
difference between early grafts and grafts today
early: free gingival graft, from the palate, gingiva will never recede again
now: CT graft, getting CT from underneath palate, slide graft inside the gum like a pita pocket
what happens when you develop antibodies to the basement membrane?
the BM dies, epithelium then floats up and all we see are blisters. Touch it and you’ll break it and it’ll get bloody and nasty
alveolar bone consists of bone formed by both..?
cells from the dental follicle and cells independent of tooth development
alveolar bone has these types of bones?
cancellous, cortical, and marrow (with adipocytes, vasculature, and undifferentiated mesenchymal cells)
how does bone heal after extraction?
clotting, then wound cleansing –> new vasculature –> mesenchymal cells from PDL for granulation tissue –? provisional CT –> immature bone forms –> bundle bone (socket proper) is resorbed –> would is filled with woven bone –> bone maturation
how do we keep socket from shrinking?
we pack bone in the extraction site to preserve socket
what are the cells in PDL?
a. fibroblasts: aligned along principle fibers
b. osteoblasts: line bone surface
c. cemetoblasts: line cemented surface
d. osteoclasts: multinucleated, create ruffled surface of bone
e. epithelial cells
f. nerve fibers
g. epithelial cell rests of mallassez: remnants of the HERS
what other technique do we use to regenerate socket?
barrier membranes
