Session #2 - Questions from the Book

What are tori and exostoses?

- Tori are small bone swellings that occur on the lingual surface of the mandible or the palatal surface of the maxilla at the midline.

- Exostoses are small bone swellings that are present on the facial surface of either the maxilla or mandible.

What clinical complication might tori cause?

Film or sensor placement during the taking of dental radiographs, taking of mandibular alginate impressions, and tori must be considered during denture construction

Define the boundaries of the vestibule.

- Bordered by the lips

- Laterally by the cheeks

- Superiorly and inferiorly by the maxillary and mandibular mucobuccal folds

-Posteriorly by the buccal alveolar bone, gingiva, and teeth.

Are muscles contained in the frenum attachments of the lips?

A frenum is a fold of connective tissue in the vestibule. It contains no muscle tissue.

Why is the alveolar mucosa redder than the gingiva?

Because of the blood vessels underneath the tissue.

What are the divisions of the palate? What are the transverse ridges in the anterior palate?

The roof of the mouth can be divided into the hard and soft palate. The hard palate can be further divided into the anterior and posterior portions. The soft palate extends from the posterior nasal spine to the uvula. On the anterior portion of the hard palate are transverse ridges of epithelial and connective tissue known as rugae. They are covered with keratinized epithelium.

Where and what is the posterior nasal spine?

It is the anatomic division of the hard and soft palates at the midline of the mouth. It is the anatomic landmark for the construction of a maxillary denture.

Which muscle supports the floor of the mouth?

Mylohyoid muscles

What and where is the sublingual caruncle?

The sublingual caruncle is the intraoral opening for the submandibular and sublingual salivary glands. It is located at the base of the lingual frenum. (where saliva comes from)

What makes up the anterior and posterior pillars? What lies between them?

They are formed by the palatoglossal muscles. The posterior pillars are formed by the palatopharyngeal muscles. The palatine tonsils are positioned between the anterior and posterior pillars.

What are the fauces?

The posterior extent of the oral cavity. They are the space between the left and right tonsils and their anterior and posterior pillars.

What are the two parts of the oral cavity?

The vestibule and the oral cavity proper.

What are the boundaries for the oral cavity proper?

Superiorly from the roof of the mouth to the floor of the mouth, inferiorly. The lateral borders of the oral cavity proper are the alveolar bone, teeth, and gingiva. The posterior border is the palatine tonsils, anterior and posterior pillars, and fauces.

Name three generalized disease states that can be detected by the presence of oral signs or oral lesions.

Measles appears first as spots in the oral cavity. Oral cancers, such as Kaposi sarcoma, are consistent with infections of HIV/AIDS. Cancer at other body locations can spread to the mouth; a patient with excellent oral hygiene who experiences gingival bleeding when brushing might be tested for leukemia. A painful reddened tongue can be a sign of vitamin deficiencies.

What are Fordyce granules? Describe the appearance of Fordyce granules.

Small yellowish granular structures embedded in the buccal mucosa, labial mucosa, or retromolar pads. These Fordyce granules are misplaced sebaceous glands.

Small, localized growths of bone on the buccal cortical plate are known as ___.

a. torus mandibularis

b. exostoses

c. torus palatinus

d. both a and c

e. none of the above

B. Exostoses

What is the location of the fovea palatine?

a. in the posterior lateral palate over the opening of the greater palatine foramen

b. In the anterior palate over the incisive foramen

c. On either side of the posterior nasal spine

d. Between the anterior and posterior tonsillar pillars

e. None of the above

C. On either side of the posterior nasal spined.

The space between the left and right palatine tonsils is known as

Fauces

If denture flanges are overextended, which of the following muscles may cause displacement of the mandibular denture?

A. Styloglossus

B. Hyoglossus

C. Mylohyoid

D. All of the above

E. None of the above.

C. Mylohyoid

When the tongue comes forward, which of the following may inhibit its movement?

A. Mandibular condyle

B. Labial frenum

C. Torus mandbibularis

D. Lingual frenum

E. None of the above

D. Lingual frenum

Which of the following structures is often the cause of a diastema?

A. Maxillary lingual frenum

B. Mandibular lingual frenum

C. Maxillary labial frenum

C. Maxillary labial frenum

Rugae are located on which landmark in the oral cavity?

Hard palate

Which term is commonly called "tongue-tied" and refers to a short lingual frenum, limiting tongue movement?

A. Sublingual caruncle

B. Lingual flange

C. Ankyloglossia

D. Fovea lingual

C. Ankyloglossia

The oral cavity is divided into which two parts?

Oral cavity proper and vestibule

T or F: The buccinator is a muscle of the cheek.

True

T or F: The red margin of the lip is known as the mucogingival junction.

False. It is the mucocutaneous junction.

T or F: Small bony growths that may be found on the buccal mandible or maxilla are known as endostoses.

False. They are exostoses.

T or F: A cleft lip would form at the lateral junction of the philtrum.

True

T or F: The incisive papilla is the anterior part of the hard palate.

True

The ______ is posterior to the last mandibular molar:

Retromolar pad

Another name for the inside of the cheek is the?

Buccal mucosa

Yellowish spots on the buccal and labial mucosa are most often:

A. Fovea palatine

B. Traumatic lesions

C. Salivary ducts

D. Sebaceous glands

D. Sebaceous glands

Which structure could cause difficulty in constructing a denture?

Torus palatinus

The ______ is a pathway to the respiratory and digestive systems.

A. Oral pharynx

B. Laryngeal pharynx

C. Nasal pharynx

D. Tonsillar pillars

E. Both a and b

E. Oral pharynx and laryngeal pharynx

The ______ is a structure that can make it difficult to take maxillary posterior radiographs as well as maxillary impressions.

Coronoid process

The transverse ridges of epithelial and connective tissue in the hard palate area are known as?

Rugae

The opening for the submandibular salivary gland is known as the ___?

Sublingual caruncle.

The anterior pillar is located?

Anterior to the palatine tonsil

The oral cavity can manifest symptoms of?

A. Measles,

B. Kaposi's sarcoma

C. Childhood cancer

D. Vitamin deficiencies

E. All of the above

E. Measles, Kaposi's sarcoma, childhood cancer, vitamin deficiencies

Case Study: An 8-year-old boy came into the dental office. His mother made the appointment because her son has "a large space" forming between his maxillary front teeth. An oral examination confirms that there is a diastema between his maxillary central incisors. What is the probable reason for the separation of the maxillary central incisors?

A firm, taut labial frenum can affect the position of erupting maxillary central incisors, causing a space between them.

Which of the following are true about the attached gingiva?

A. The tissue is soft and movable.

B. The epithelium is thick and keratinized.

C. The tissue can have a stippled texture.

D. The tissue is fixed and firmly attached to the bone and the cementum.

B, C, and D.

Which is most true of cementum?

A. Sharpey's fibers are embedded in it

B. It's always smooth

C. Acellular cementum covers the apical end of the tooth

D. It is resorbed as easily as bone

A. Sharpey's fibers are embedded in it

Which is true of Sharpey's fibers?

A. They can embed in bone only

B. They can embed in cementum only

C. They can embed in either bone or cementum

D. The same fiber could embed in bone at one end and in cementum at the other

C and D

When the tooth is subjected to occlusal stress, it relieves this stress by which of the following mechanisms?

S. The periodontal ligament tenses

B. The fluids in the periodontal ligament absorb some force

C. The walls of the alveolus spread the force and divide it over a wider area

A, B, and C

Define rete peg formation.

Irregular binding of the epithelium to the bone by collagen fibers. These collagen fibers connect the epithelium and the underlying connective tissue, resulting in a dimpled effect on the attached gingiva because of the spacing of the attaching fibers.

Define stratified squamous epithelium.

The most common of the multiple-layeredepithelium. It is composed of the following layers of epithelium: stratum corneum, stratum granulosum, stratum spinosum, and stratum basale.

Which statements are true about fibers A, B, and C in Fig. 8-7 (SEE BOOK)?A. They are called Sharpey's fibers

B. They attach only the free gingiva to the cementum.

C. They are called transseptal fibers.

D. They are embedded in the cementum.

D. They are embedded in the cementum.

Which tissues are not keratinized?

A. The sulcular epithelium of the free gingiva

B. Alveolar mucosa

C. Attached gingiva

D. The outer layer of free gingiva

E. Both a and b

E. Both a and b

T or F: The free gingiva extends from the gingival margins to the base of the gingival sulcus.

True

T or F: The attached gingiva extends from the gingival sulcus to the interdental space.

False

T or F: The gingival sulcus is the space between the tooth and the mucogingival fold.

False

T or F: The gingival papilla is located in the interdental space.

True

T or F: The alveolar bone when seen on the x-ray is called the lamina dura.

True

T or F: The dimpled texture of the attached gingiva is caused by rete peg formation.

True

T or F: Free gingiva is nonmobile because of the lamina propria below it.

False. Attached gingiva are nonmobile because of the underlying lamina propria.

T or F: Sharpey's fibers are embedded in bundle bone.

True

T or F: Healthy free gingiva appears as stippled.

False. Free gingiva is not stippled; attached gingiva is.

T or F: There are no fibroblast cells in the periodontal ligament.

False. There are fibroblasts, osteoblasts, and cementoblasts.

T or F: Oblique fibers are those periodontal fibers running between the roots of multirooted teeth.

False. Oblique fibers are periodontal ligament fibers that run obliquely from cementum to bone.

Collagen fibers are formed by ___.

Fibroblasts

Periodontal fibers embedded in a bone are called __.

Sharpey's fibers

Sharpey's fibersPeriodontal fibers embedded in cementum are called ___.

Sharpey's fibers

When viewed on a radiograph, the compact alveolar bone that surrounds a tooth is called ___.

Lamina dura

The blood is supplied to the gingival tissue by the ___ vessels.

Supraperiosteal

Cementoblasts trapped in their own cementum are called ___.

Cementoytes

The periodontal fibers between the roots of multirooted teeth belong to the ____ periodontal ligament group.

Interradicular

The type of cementum found at the apex that can add onto itself is ___.

Cellular cementum

The bony thickening of the alveolar wall caused by numerous additions of bone with Sharpey's fibers is called ____.

Bundle bone

Which of the following is not true of the attached gingiva?

a) it is composed of thick epithelial tissue b) it displays a texture like an orange peel

c) it is keratinized

d) has no rete peg formation.

d) has no rete peg formation.

Which of the following is/are true of the alveolar mucosa?

a) it is movable

b) it is smooth

c) it is reddish

d) it has rete peg formation

a) it is movable

b) it is smooth

c) it is reddish

Which of the following is true about cementum?

a) it grows by the apposition of new layers

b) it contains collagen fibers

c) it is surrounded by alveolar mucosa

d) it is formed by cementoblasts

a) it grows by the apposition of new layers

b) it contains collagen fibers

d) it is formed by cementoblasts

Which of the following is not one of the formative functions of the periodontal ligament?

a) activating the apposition of bone

b) activating osteoclasts

c) regenerating periodontal fibers

d) initiating cementoblast activation

b) activating osteoclasts

Which of the following is not true about the nutritive function of the periodontal ligament?

a) it supplies nutrients to cementum

b) it provides vascularity to the periodontal ligament

c) it senses pressure on the tooth

d) it provides nutrition to the bone

c) it senses pressure on the tooth

How can a root canal tooth tell pressure, pain, and temperature change?

a) the rot canal still has some nerve tissue in it

b) periodontal ligament has resorptive abilities

c) periodontal ligament has sensory capabilities

d) the attached gingiva does all of the tooths sensory gathering

e) the nerve remains active in the tooth after root canal therapy

c) periodontal ligament has sensory capabilities

In normal healthy tissue the free gingiva should be

a) firmly attached to cementum

b) slightly separated from the tooth

c) covered with lining mucosa

d) about 3.5 mm within the gingival sulcus

b) slightly separated from the tooth

The interradicular group of periodontal fibers is found on the

a) maxillary central incisor

b) maxillary canine

c) mandibular first premolar

d) mandibular first molar

d) mandibular first molar

Which type of force can cause mobility in a tooth with little or no bone remodeling?

a) active eruption

b) masticatory occlusal forces

c) orthodontic corrective forces

d) traumatic occlusal forces

d) traumatic occlusal forces

Name the five periodontal ligament fiber groups.

Alveolar crest group, apical group, horizontal group, interradicular group, and oblique group

Alveolar crest group apical group horizontal group interradicular group oblique group

What are the three divisions of the oral mucosa, and where are they located?

1. Specialized mucosa = mucosa on the upper surface of the tongue - lingual papillae on dorsal of tongue

2. Masticatory muscosa - comprises the gingiva and the hard palatal tissue; undergoes trauma or compression during mastication - free gingiva - attached gingiva - hard palate - dorsal tongue

3. Lining mucosa - all other areas of oral mucosa. - buccal - labial - alveolar - floor of mouth - ventral of tongue - soft palate

What are the three variations of stratified squamous epithelium?

Keratinized, parakeratinized, and nonkeratinized.

What are the changes in layers evident in these variations?

Between stratum spinosum and stratum granulosum.

What factors determine the mobility of the mucosa?

- Nonkeratinized to parakeratinized - Rests on connective tissue with a basement membrane between - Connective tissue is loose enough to allow the epithelium to be fairly moveable - Interdigitation between epithelium and connective tissue allows mobility - Ridges and pegs of connective tissue interdigitate - Length of the ridges and pegs determine how tightly the epithelium is attached and how moveable the epithelium is.

What are the general causes of change in mucosal color? What is indicated by mucosa that appears red in color? What is indicated by mucosa that appears white in color?

- Diseased interdental papilla: swollen (edema), blunted, red - Healthy attached gingiva: stippled or dimpled appearance; pink - Diseased attached gingiva.: loss of stippling, swelling, red, white, ulcerations, or outgrowths

What structure can be found in the submucosa?

Blood vessels, nerves, connective tissue and tends to contain: fatty tissue, minor salivary glands, or both

What is the average depth of the gingival sulcus?

2 mm

What is the function of the interdental papilla?

Prevent food from impacting interproximally beneath the contact areas of teeth; prevents food from getting impacted between teeth

What is the col?

A valley-shaped depression in the gum tissue that sits directly under the contact point between two adjacent teeth, connecting the facial and lingual papillae.

What is the descriptive term used for normal gingival appearance?

Stippled or dimpled

Describe the relationship of the attachment epithelium to the tooth in the four stages of eruption.

Stage 1 - attached. epithelium at base of gingival sulcus resting entirely on enamel

Stage 2 - attachment epithelium primarily on enamel with a bit on cementum

Stage 3 - attachment epithelium extends from cementoenamel junction (CEJ) onto cementum Stage 4 - Attachment epithelium entirely on cementum apical to the CEJ

T or F: Specialized mucosa is found on all surfaces of the tongue.

False. It is only found on the dorsum of the tongue and the posterolateral borders).

T or F: Masticatory mucosa is found on the hard palate, the gingiva, and the alveolar mucosa

False. It is only found on the hard palate and the gingiva.

T or F: Lining mucosa can be found on the floor of the mouth among other areas.

True

T or F: In keratinized epithelium, the stratum corneum is made up of dead cells

True

T or F: The stratum corneum of lining mucosa displays cells with somewhat intact nuclei

True

T or F: Lining mucosa is a stiff, tight tissue.

False. It is a loose, moveable tissue.

T or F: The col is located on the interdental papilla

True

T or F: The attached gingival groove separates the free gingiva from the attached gingiva.

False. The free gingival groove separates the free gingiva from the attached gingiva.

T or F: Lining mucosa is generally found in protected areas or less stimulated areas.

True

T or F: Based on the degree of stimulation, the col and the gingival sulcus are two areas of the thinnest lining mucosa

True

T or F: Submucosa usually contains connectivetissue, nerves, and blood vessels.

False