Periodontium in Health and Disease Flashcards
(30 cards)
what is gingiva?
the part of masticatory mucosa that covers the alveolar process and surrounds the cervical portion of teeth
what are the three different types of gingiva?
- attached
- interdental
- marginal
what are the three type of epithelium that make up the gingiva from most outer to inner?
- oral
- sulcular
- junctional
what are the types of cells that are contained within the gingiva?
keratinocytes
melanocytes
langerhans
merkel
what are melanocytes involved in and where are they located in the gingva?
involved in melanin production, gingiva defense and located in basal and spinosum layers of the gingival epithelium
what are dendritic/langerhan cells and where are they located?
they are phagocytic antigen presenting cells that are located among keratinocytes at all supra-gingival layers EXCEPT the basal layer
what are merkel cells and where are they located?
cells that harbor nerve endings (tactical receptors) involved in the sensory mechanisms of the gingiva and are located in deep layer sof the epithelium
what are the two main components of the junctional epithelium?
- basal lamina: containing lamina lucida, lamina densa, lamina fibroreticular
- hemidesmosomes
what are the key proteins and molecules that make up the basal lamina?
- type IV collagen
- type VII collagen
- laminin
- proteoglycan heparan sulfate
- fibronectin
- entactin
- proteoglycan perlecan
what are the gingiva connective tissue layers?
- dentogingival
- dentocrestal
- crestogingival
what are the periodontal fibers and what do they connect?
- Alveolo Gingival: Alveolar crest → Free gingiva
- Dentino Gingival: Cervical dentin → Free gingiva and attached gingiva
- Inter-Radicular: root furcation → Interradicular bone
- Circumferential: encircle the tooth like a cuff, within the gingiva
- Trans-Septal: cementum of one tooth → cementum of the adjacent tooth
- Alveolar Crest: cementum just below CEJ → Alveolar crest
- Horizontal: cementum → Alveolar bone
- Oblique: cementum → Alveolar bone
- Apical: apex of root → alveolar bone
what are the clinical characteristics of gingiva?
- contour
- dimensions
- color
- surface texture
what are the anatomical landmarks of the gingiva?
gingival margin
mucogingival junction
alveolar mucosa
what is the mucogingival junction?
the junction that separates the detached tissue from the alveolar mucosa
are the attached gingiva and alveolar mucosa keratinized or non-keratinized?
- alveolar: not keratinized
- attached: keratinized
what are the differences between the alveolar mucosa and keratinized (attached) gingiva?
AM: thin epithelium, loose connective tissue and rich in elastic fibers
AG: thick epithelium, dense connective tissue and rich in collagen
what portion of the gingiva remains unchanged throughout a patients life?
mucogingival junction
what gingiva is not attached to the tooth or bone and is 1mm wide?
marginal gingiva
what is the marginal gingiva?
soft tissue wall of the gingival sulcus
what is unique about the palatal aspect of the gingiva?
there is no mucogingival junction
what are the three main elements of the soft tissue architecture?
contour (zenith, marginal level)
papillae
phenotype
what is zenith positioning?
highest point of the gingival margin (gum line) around a tooth
is the zenith position centered?
no, the zenith position is usually distal to the center of the tooth (0.9 mm for central, 0.35mm for laterals and 0.08mm for canines)
what is zenith leveling?
clinical adjustment of the gingival zeniths (the highest points of the gum margins) across multiple anterior teeth to make them even across the zenith line
