Quiz 4 Fundamentals of the Periodontium Flashcards Preview

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Flashcards in Quiz 4 Fundamentals of the Periodontium Deck (67):
1

Oral Mucosa

Masticatory Mucosa
Lining Mucosa
Specialized Mucosa

2

Masticatory Mucosa

affected by eating, keratinized, attached gingiva
ex: roof of mouth

3

Lining Mucosa

Labial/Buccal mucosa, tissue under tongue
Non-keratinized

4

Specialized Mucosa

Dorsum of the tongue
Papilla/taste buds b/c differential they're specialized

5

What is Black hairy tongue?

Enlarged Filiform papillae

6

Fibrosis

Chronic inflammation
Pertains to smokers

7

Hyperkeratosis and Hyperplasis

Increase in cells

8

Keritinization

Cheek chewer

9

Components of the Periodontium

Periodontial Ligament
Gingiva (attached)
Cementum
Bone

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Gingiva (Attached gingiva)

Gingival Fiber Groups
Principal Fiber Groups
*Stabilize teeth

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Cementum

Thin layer calcified connective tissue, provides attachment for cover CEJ to apical foramen
No nerves/vascularity

12

Bone

Provides supporting system
Will absorb when we take away job

13

Parts of the tooth

Clincial: goes to sulcus
anatomic: anything initially covered w/ cementum

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Functions of the PDL

Fibrous Connective tissue
Provides support and attachment for tooth
Surrounds root
Shock absorber
Provides blood and nerve supply
In B/w tooth and sulcus

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Sharpey's Fibers

Provide attachment b/w tooth and bone

16

What happens if there is no cementum?

No attachment

17

PDL and Gingival Fiber groups

Dentogingival (stability)
Alveologingival (Support to papillae)
Circumferentail (tightly bound, make sure tooth won't fall)
Dentoperiosteal
Transseptal (Go from tooth to tooth, keep from tipping/falling over)

18

PDL and Principal Fiber Groups

Apical (@ apex, helps w/ forces coming in)
Oblique (Biting wrong and vertical forces)
Horizontal (stabilize for tipping)
Alveolar Crest ( work w/ gingival fibers. Gate keeper/protects bone)
Interradicular (Helps w/ stability)

19

Functions of the cementum

Thin layer of calcified connective tissue that covers root of tooth
Provides attachment for perio fiber groups
Not vascular/no nerves
Seals the dentin tubules

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Functions of the bone

Support teeth and provide attachment for the PDL fibers

21

What is free gingiva?

Gingival margin, follows line of tooth
Keratinized where probe goes in sulcus

22

What is alveolar mucosa?

Covers bone, not attached
Soft and shiny
non-keratinized
usually redder

23

What is attached gingiva?

Attached to underlying bone, varies in width
Max=more
Mand=less

24

Healthy characteristics for Gingiva/Papilla

Pink, Melanotic
Flat, Firm, Smooth
Stippled, Pointed

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Healthy characteristics of marginal gingiva

Pink Melanotic
Flat, Firm, Smooth

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Healthy characteristics of attached gingiva

Pink, melanotic
Flat, Firm, Smooth
Stippled, Shiny

27

Col area

Below contact area
Depression on the proximal sides of teeth
Not usually keratinized
Most periodontal infections start here first
Harder to reach bacteria, colonizes quicker

28

Periodontal Case types

1-4

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Perio case 1

Gingival disease: bleeding in a couple spots, healthy patient

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Perio case 2

Early Periodontitis, couple 4mm pockets in each quadrant

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Perio case 3

Moderate Periodontitis

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Perio case 4

Advanced Periodontitis

33

When does bone loss usually occur?

5mm, usually 4mm is inflammation of the gums

34

What happens if the bone is involved?

It goes straight to periodontitis which is irreversible

35

What is the importance of perio probing?

Detection of initial bone loss (should be up at CEJ)
Diagnosis w/ radiographs
*Absolute must

36

What are the different types of pockets?

Suprabony (Normal, Gingival, Periodontal)
Intrabony (periodontal)
Is the pocket depth below or above bone?

37

Changes in alveolar bone height
Health

Crest of the alveolar bone is approx. 2 mm apical to the CEJ

38

Changes in alveolar bone height
Disease

Crest of the alveolar bone is more than 2 mm apical to the CEJ
Anything less than 2mm is bone less/disease

39

Classifications of Furcations

Bone loss happening b/w roots
1-4 all have some sort of bone loss/disease

40

What is the clinical picture of health?

Pink, Firm, No bleeding

41

What does a healthy sulcus consist of?

JE coronal to CEJ (high and healthy)
Supragingival fibers intact
Alveolar bone intact
PDL intact

42

What is the clinical picture of gingivitis?

Red
Swollen
Bleeding is likely

43

What does the gingival pocket look like (gingivitis)?

Supragingival fiber destruction
Alveolar bone intact
PDL intact
Still reversible @ this time

44

What is the clinical picture of periodontitis?

Pink(chronic)purplish(acute/active)
Swollen or fibrotic
Bleeding entire time of probing

45

What does a perio pocket consist of?

JE on cementum
Fiber detruction
Alveolar bone destruction
PDL destruction
Motility
Can't restore but can maintain

46

Development of Gingival and Perio infections

Initial, Early (reversible)
Established, Advanced Lesions (problem w/ the bone)

47

Initial Lesion

2-4 days, usually can't see

48

Early Lesion

4-14 clinically visible, breakdown continues and neutrophils come in

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Established Lesion

Rolling, lost contours

50

Advanced Lesions

Doesn't bleed, chronic state of disease

51

Factors involved in disease development

Etiologica, Predisposing, Contributing, Risk, Can be local or systemic

52

Etiologic Factor

Cause of disease (bacteria, medications, biofilm, toxins)

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Predisposing Factor

Systemic problem (makes them more susceptible)

54

Contributing Factor

Malalignment, poor diet, smoking (add to condition)

55

Risk Factory

Age, Gender F>M, stress, race

56

Local contributing factors in disease development

Bacterial plaque, Areas of Retention, Iatrogenic, mastication, Oral habits, Everyday habits, plaque control, systemic, Genetic predisposition, Effects of certain drugs

57

Complication of pocket formation furcation and Mucogingival involvement
(Furcation covered by tissue)

Difficult to clean
Accessibility limited
Increase bone loss
Infection/Abscess
Diseases progression increases, can spread
Ultimate loss of tooth

58

Untreated decay

Root caries, not every cavities will arrest or go full blown

59

Palatogingival groove

Where bacteria and calculus is usually missed

60

Root Concavity

Have to flap up the tissue

61

Food impaction

Sometimes the lingual side looks good whereas the buccal would be a challenge

62

Bulky Crown

Need a good biological width in order to maintain healthy tissue
Some base metals are incompatible w/ tissue (roll, bleed, don't lay down)

63

Pregnancy Gingivitis

Goes away when not prego
Sensitive
Vicious cycle
Isn't super common or rare

64

Periodontitis and Down Syndrome

Physical ability compromised
Homecare isn't good
Maligned
Dexterity (not very efficient)

65

Gingival overgrowth

Certain medications cause this
Overgrown tissue
Can do surgery every couple of months

66

Drug induced

More fibrotic
Dense tissues, not fluid filled
Heart problem medications result

67

Associated w/ smoking

Stain itself isn't a problem
Stain is sticky which attracts biofilm