Periodontology Andy Board Review

What are the four parts of the periodontium?

Gingiva, periodontal ligament, cementum, alveolar bone

What is another name for the periodontium?

attachment apparatus

Which anatomy of the periodontium refers to the tissues that cover the cervical portion of the teeth and the alveolar processes of the jaws?

a. PDL

b. gingiva

c. cementum

d. alveolar bone

b. gingiva

Which anatomy of the periodontium refers to the fibers that surround the root of the tooth?

a. PDL

b. gingiva

c. cementum

d. alveolar bone

a. PDL

Which anatomy of the periodontium refers to the thin layer of mineralized tissue that covers the root of the tooth?

a. PDL

b. gingiva

c. cementum

d. alveolar bone

c. cementum

Which principle fiber group extends from cementum into the gingiva and supports the gingiva?

a. dentogingival

b. alveologingival

c. dentoperiosteal

d. circular

e. transseptal

a. dentogingival

Which principle fiber group extends from periosteum of alveolar crest into the attached gingiva ?

a. dentogingival

b. alveologingival

c. dentoperiosteal

d. circular

e. transseptal

b. alveologingival

Which principle fiber group extends from cementum, near CEJ and across alveolar crest and anchors tooth to bone and protects PDL?

a. dentogingival

b. alveologingival

c. dentoperiosteal

d. circular

e. transseptal

dentoperiosteal

Which principle fiber group encircles the entire tooth to the alveolar crest and supports the free gingiva?

a. dentogingival

b. alveologingival

c. dentoperiosteal

d. circular

e. transseptal

circular

Which principle fiber group extends from cementum of one tooth to the adjacent tooth and maintains relationship between teeth in arch?

a. dentogingival

b. alveologingival

c. dentoperiosteal

d. circular

e. transseptal

e. transseptal

Which anatomy of the periodontium surrounds and supports the roots of the teeth?

a. PDL

b. gingiva

b. cementum

c. alveolar bone

c. alveolar bone

The unattached portion of the gingiva that surrounds the tooth in the region of the CEJ is known as?

a. attached gingiva

b. gingival sulcus

c. gingival margin

d. free gingiva

d. free gingiva

The space between the tooth and the free gingiva is known as?

a. attached gingiva

b. gingival sulcus

c. gingival margin

d. free gingiva

b. gingival sulcus

The gingiva that fills the interdental embrasures between two adjacent teeth apical to the contact area is known as?

Interdental gingiva

Which gingiva continues with the free gingiva and is part of gingiva that is firm, dense and tightly bound to cementum on the cervical third of the root is known as?

a. attached gingiva

b. gingival sulcus

c. gingival margin

d. free gingiva

a. attached gingiva

The coronal most portion of the gingiva that follows the contours of the teeth creating a scalloped outline is known as?

a. attached gingiva

b. gingival sulcus

c. gingival margin

d. free gingiva

c. gingival margin

The scalloped linear area denoting the approximation or separation of the attached gingiva to the loosely attached and moveable alveolar mucosa is known as the?

mucogingival junction

Where is the attached gingiva the widest?

a. premolar area

b. incisor area

c. molar area

d. both b & c

d. both b & c

Where is the attached gingiva the narrowest?

a. premolar area

b. incisor area

c. molar area

d. canine area

a. premolar area

True or False: The width of the attached gingiva calculates the palatal surfaces along with the buccal.

False: does not calculate palatal surfaces

What are the five principe gingival fiber groups?

1. dentogingival

2. alveologingival

3. dentiperiosteal

4. circular

5. transseptal

What are the 6 secondary gingival fiber groups?

1. periosteogingival

2. interpapillary

3. transgingival

4. intercircular

5. semicircular

6. intergingival

Name two structures that are keratinized or parakeratinized?

free gingiva and attached gingiva

Name two structures that are non-keratinized:

COL and mucosa

A valley like depression of tissue between the buccal and lingual interdental papillae is known as?

COL

A tough fibrous structural protein that occurs in the outer layer of the skin and the oral epithelium is known as?

Keratin

What are the three layers of alveolar bone?

Alveolar bone proper, cortical bone, cancellous bone

Tooth sockets lined by cribriform plate are commonly called?

alveoli

The wall of the sockets when viewed radiographically is termed?

lamina dura

Which layer of alveolar bone is a thin layer of bone lining the sockets that surrounds the root of the tooth where fibers of the PDL insert?

a. alveolar bone proper

b. cortical bone

c. cancellous bone

d. alveolar process

a. alveolar bone proper

The outer wall of bone of the jaws on the facial and lingual aspects is?

a. alveolar bone proper

b. cortical bone

c. cancellous bone

d. alveolar process

b. cortical bone (compact bone)

True or False: The cortical plate of cortical bone will not show up radiographically.

True

Lattice-like bone between the cortical bone and the alveolar bone proper, and is surrounded by marrow is?

a. alveolar bone proper

b. cortical bone

c. cancellous bone

d. alveolar process

c. cancellous bone (spongey)

True or False: There is less proportion of cancellous bone in the maxilla than the mandible.

False: in mandible than maxilla

The crest of the alveolar process follows what?

CEJ

How many millimeters is crest of the alveolar process apical to the CEJ?

2-3mm

True or False: Alveolar process is in a constant state of remodeling.

True: accommodates physiologic tooth migration, bone apposition and resorption

What are two variations in normal bone structure?

dehiscence and fenestration

A window of bone loss bordered by alveolar bone on its coronal aspect is known as?

a. bone loss

b. dehiscence

c. fenestration

d. occlusal trauma

c. fenestration

True or False: Fenestration is not commonly associated with recession.

True

Loss of alveolar bone on one aspect of the tooth, typically the facial aspect, that leaves the area of the root covered by soft tissue only is known as?

a. bone loss

b. dehiscence

c. fenestration

d. occlusal trauma

b. dehiscence

Dehiscence occurs in which type of patients?

labially inclined roots

What are the three features of dehiscence?

1. gingival recession

2. alveolar bone loss

3. root exposure

Bone builders or bone formers are known as?

osteoblasts

Bone consumers are known as?

osteoclasts

What forms the major component of the alveolar bone ?

collagen fibers and gel like substances

True or False: Alveolar bone does not contain blood vessels or nerve innervation.

False: DOES have

A layer of soft connective tissue that covers the root of the tooth and attaches it to the bone of the tooth socket is known as?

PDL

What are the main cells in the PDL?

Fibroblasts with some cementoblasts and osteoblasts

What are the 3 roles of the PDL?

1. physical

2. formative/resorptive

3. nutritive

Which structure provides nutrients to the cementum, bone, and gingiva via blood vessels?

PDL

What are the five PDL fiber bundle group?

1. alveolar crest

2. horizontal fibers

3. oblique fibers (**main support)

4. apical fibers

5. interradicular fibers

Which PDL fiber bundle provides the main support?

oblique

The ends of the PDL fibers that are embedded in the cementum and alveolar bone are known as ?

sharpey's fibets

Thin layer of hard, mineralized connective tissue that covers the surface of the root is known as?

cementum

True or False: Cementum is softer than dentin.

True: and than enamel too

Which structure attaches the PDL to the tooth?

cementum

True or False: Cementum does not have blood vessels or nerves and therefore will receive its nutrients from the PDL.

True

What are the three types of relationships at the CEJ?

1. overlap ***most common)

2. meet

3. gap

What are the two types of cementum?

acellular and cellular

Which type of cementum forms before teeth are in occlusion?

acellular

Which type of cementum forms after teeth have reached occlusion?

cellular

Which type of cementum covers the cervical 2/3 of root?

acellular

Which type of cementum covers the apical 1/3 of root?

cellular

Which type of cementum does not have cells?

acellular

Which type of cementum plays an important role in tooth support?

acellular

Which type of cementum compensates for active eruption and normal tooth wear by continuous deposition of cementum?

cellular

What are the two types of collagen fibers of cementum?

extrinsic (sharpeys) and intrinsic (creates cementum matrix)

After how many days does gingivitis develop after discontinuation of oral hygiene?

10-21

Gingival inflammation resolves in approximately how many days with initiation of oral hygiene?

7 days

True or False: Oral biofilm is easily removed through rinsing.

False: not easily removed

Communication between the bacteria organized in a biofilm is known as ?

quorum sensing

True or False: The acquired pellicle protects the enamel from acidic activity and forms within minutes after cleaning.

True

Which type of plaque is predominately gram positive aerobic cocci and rods?

supragingival

Which type of plaque is predominately gram negative anaerobic?

subgingival

List 4 biofilm characteristics in disease:

1. gram neg

2. motile

3. spirochetes and rods

4. anaerobic

List 4 biofilm characteristics in health:

1. gram pos

2. non-motile

3. cocci and rods

4. aerobic

Microorganisms that can exists and grow in only partial or complete absence of oxygen are known as?

anaerobic

Name the three red complex bacteria:

1. p. gingivalis

2. T. forsythia

3. t. denticola

The way that an individuals body responds to an infection is known as?

host response

What are the two types of immunity?

innate and adaptive

Which type of immunity is present at birth and is not antigen specific?

innate

Which type of immunity is always present immediate after infection and will NOT improve with repeated exposure to an infectious agent?

innate

Which cells are mostly associated with innate immunity? (5)

1. neutrophils

2. macrophages

3. mast and dendritic cells

4. NK cells

5. basophils/ eosinophils

Which cells are mostly associated with adaptive immunity? (3)

t cells

B cells

plasma cells

Which type of immunity develops throughout life and is antigen specific?

adaptive (memory)

Which type of immunity develops memory?

adaptive

What is the first cell to arrive in an infection?

neutrophils

What are the second cells to arrive in an infection?

macrophages

Which type of cell is the most numerous in chronic inflammation?

macrophages

Which two main type of lymphocytes are important in defense against bacteria in plaque biofilms ?

T and B cells

What are the four histologic stages in the development of periodontal disease?

1. initial lesion

2. early lesion

3. established lesion

4. advanced lesion

Which stage of development of periodontal disease develops within 2-4 days after biofilm accumulation with NO clinical changes?

initial lesion

Which stage of development of periodontal disease develops within 4-7 days with clinical signs of gingivitis present such as erythema and edema?

early lesion (stage 2)

Which stage of development of periodontal disease has slight collagen destruction and PMNs are now in the sulcus?

early lesion (stage 2)

Which stage of development of periodontal disease develops after a 21 day mark and plasma cells dominate the area?

Established gingivitis/lesion (stage 3)

Which stage of development of periodontal disease involves an apical migration of biofilm and pocket epithelium formation ?

Established gingivitis/lesion (stage 3)

True or False: In the established lesion of the development of periodontal disease, slight bone loss is present.

false: no bone loss

Which stage of development of periodontal disease involves extensive collagen destruction with edema and BOP increasing?

Established gingivitis/lesion (stage 3)

Which stage of development of periodontal disease involves subgingival plaque?

Established gingivitis/lesion (stage 3)