Periodontal Anatomy Flashcards

(42 cards)

1
Q

What are the 3 parts of evidence based dentistry

A

dentist’s expertise
scientific evidence
Patient needs and preferences

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2
Q

What is PICO

A

Population to be examined
Intervention that is to be inspected
Comparison to what is currently known
Outcome to be evaluated

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3
Q

What are the steps for making an evidence based decision in practice

A
Formulate a PICO question
Research the PICO question and collect evidence
Analyze the data that has been collected
Apply the data to the dental practice
Evlauate the results
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4
Q

What is the ranking of scientific evidence

A
Systematic review/meta analysis
RCT
Controlled trials
Cohort studies
Case-control studies
Cross-sectional studies
Case report studies
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5
Q

What is the difference between sensitivity and specificity

A

Sensitivity is the ability of a test to correctly identify diseased individuals
Specificity is the ability of a test to correctly identify a healthy individual

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6
Q

Internal validity vs external validity

A

Internal validity is the soundness of the study, including bias and statistics
External validity is how much the study relates to the general population

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7
Q

Where does the vascular supply of the periodontium originate

A

The external carotid artery and its main branches, lingual, facial, and maxillary arteries.

Locally the blood supply comes from the supra-periosteal vessels and the vessels from the PDL and bone

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8
Q

What is the main innervation for the periodontium

A

The trigeminal nerve and its branches

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9
Q

What is attached gingiva

A

The gingiva from teh base of the sulcus to the mucogingival junction
Consists of thick lamina propria and deep rete pegs
Goaslind et al reported the gingival thickness is 1.25mm+/- 0.42mm

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10
Q

Where does keratinized attached gingiva extend

A

Gingival margin to the mucogingival junction

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11
Q

What is alveolar mucosa

A

non-keratinized covering of the alveolar bone, from the mucogingival jumction apical

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12
Q

What is Ante’s law?

A

The root surface area of the abutment teeth must be equal or greater than that of teeth being replaced with pontics, which determines the number of teeth required for a bridge.

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13
Q

What are the characteristics of healthy gingiva?

A

Coral pink, firm, follows the CEJ of the teeth, may be stippled or pigmented.

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14
Q

What are the 5 types of gingival fibers

A
Dentogingival group
Alveologingival group
Dentoperiosteal fibers
Circular group
Transseptal group
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15
Q

What is the composition of the oral mucosa

A
masticatory mucosa (gingiva/hard palate)
Lining mucosa (alveolar mucosa, floor of mouth)
Specialized (dorsum of tongue)
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16
Q

Oral (masticatory) epithelium characteristics

A

Orthokeratinized stratified squamous
surface cells lose nuclei and contain keratin
Extends to the sulcular epithelium

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17
Q

Oral sulcular epithelium characteristics

A

Epithelium that lines the sulcus
No rete pets in healthy tissue
nonkeratinized

18
Q

Junctional epithelium characteristics

A

Attaches to the tooth via hemidesmosomal layer and basal lamina
nonkeratinized
permeable
most apical part lies at the CEJ in healthy tissue

19
Q

What are the 4 layers of the masticatory epithelium

A
Stratum Basale (cuboidal cells at the basement membrane)
Stratum Spinosum (spines contain Langerhans cells for immune surveillance)
Stratum granulosum (cells appear flat, keratinocytes migrating from stratum spinosum known as granular cells)
Stratum corneum (outermost layer, dead cells that are ortho and Para keratinized)
20
Q

Where is the widest and narrowest zones of gingiva?

A

Widest in the Maxillary anterior area

Narrowest facial of Mandibular premolars

21
Q

Composition of connective tissue

A

fibrous, mostly type 1 collagen, ground substances, mucopolysaccharides. Contains WBC, lymph, and nerves
average width greater than 1mm

22
Q

What determines of epithelium is keratinized or nonkeratinized

A

The underlying connective tissue.

23
Q

What is periosteum and what is its function

A

Periosteum is highly vascular connective tissue covering all boney surfaces except joints and muscle attachments
Consists of an inner cambium layer (containing osteoblasts and osteoprogenitor cells) and an outer fibrous layer
Involved in bone healing and bone regeneration. Also a channel for blood supply and nutrients for bone tissue

24
Q

Where is the average width of PDL the greatest and where is it the narrowest

A

Greatest at the apex, and narrowest in the middle

Average widthe of PDL is 0.2mm, wider as you age

25
What provides blood supply to the PDL
Superior and inferior alveolar arteries. | PDL is vascular tissue
26
What are the functions of the PDL
protect vessels and nerves Transmit occlusal forces Attach the tooth to bone Perform formative and remodeling functions
27
What are the fibers of the PDL
alveolar crest, horizontal, oblique, interradicular, and apical Oblique most numberous
28
Describe and define Ankylosis
fusion of cementum and alveolar bone with obliteration of the PDL Occurs after chronic periapical inflammation, tooth reimplantation, and occlusal trauma
29
What is the composition of alveolar bone
Cortical bone Calcellous trabeculae Alveolar bone proper
30
What are cellular and acellular cementum
acellular cementum is located on the enamel at the CEJ. No cementocytes and forms slowly Cellular cementum is located at the apical 1/3 of the root, is more irregular and forms rapidly. It's width increases with age
31
How does cementum join the enamel
60% the cementum and enamel overlap 30% cementum and enamel form a butt joint 10% of the cementum and enamel are separated by a gap
32
What is the difference between intrinsic and extrinsic cementum
intrinsic is cementum fibers produced by cementoblasts | extrinsic is made of sharpeys fibers from the PDL
33
How does the junctional epithelium attach to the cementum
Via hemidesmosomes and replicates every 5 days
34
What is the composition of the TMJ disc
dense connective tissue
35
Describe the movement of the TMJ
Upper compartment has a translational movement | Lower compartment has rotational movement
36
What is meniscal derangement with and without reduction
with reduction - the disc as well as the posterior band of the meniscus is anteriorally placed, but moves into proper position during opening without reduction - the meniscus remains anteriorly displaced at full opening
37
Describe the 4 types of collagen
Type I - skin, tendon, vascular ligature, organs, bone Type II - Cartilage Type III - reticular fibers, found alongside type I and in smooth muscle Type IV - forms basis of cell basement membrane
38
Supracrestal tissue attachment height
Garguilo connective tissue 1.07mm Junctional Epithelium 0.97mm Sulcus 0.69mm
39
What happens when the supracrestal attachment is violated
periodontal bone loss and inflammation may occur The body will try to re-create the supra-crestal attachment Gunay study found more BOP and PD interproximal when the margin was less than 1mm from the bone
40
What is the most common area of recurrent pockets
mesial aspect of maxillary first premolars and first molars
41
What is the relationship between tooth support and root morphology
Root curvatures and concavities increase periodontal support due to multi-directional fiber orientation multirooted teeth have increased support and resistance to applied forces divergent roots increase stability and allow for more bone support Conical roots have less attachment area and are not as stable Enamel pearls can weaken periodontal attachment Root fractures can lead to periodontal destruction
42
Which muscles elevate and depress the mandible
elevate - temporalis, medial pterygoid, and masseter | Depress - Lateral pterygoid, digastric, and mylopyoid