pohc exam 3

What is the oral mucosa?

The lining of the oral cavity, made of connective tissue covered with stratified squamous epithelium.

What are the 3 divisions of oral mucosa?

Masticatory, Lining, Specialized.

What is the anatomic crown?

The part of the tooth covered by enamel.

What is the clinical crown?

The part of the anatomical crown visible in the mouth, not covered by gingiva.

What is the anatomic root?

The part of the tooth covered by cementum.

What is the clinical root?

The part of the anatomical root visible in the oral cavity, not covered by gingiva (exposed in recession).

Where is masticatory mucosa found?

on areas of the mouth exposed to the forces of chewing, specifically the hard palate, the attached gingiva (gums), and the dorsal (top) surface of the tongue/Covers gingiva and hard palate

Describe the epithelium of masticatory mucosa.

Keratinized and firmly attached (except at free gingival margin).

Where is lining mucosa found?

Inner surface of lips, cheeks, floor of mouth, underside of tongue, soft palate, alveolar mucosa.

Describe the epithelium of lining mucosa.

Not usually keratinized, loosely attached.

Where is specialized mucosa found?

Dorsum of the tongue.

What structures does specialized mucosa contain?

Papillae and taste buds.

Name the types of papillae.

Filiform, fungiform, circumvallate, foliate.

What is the periodontium?

Tissues surrounding and supporting the teeth/the specialized group of tissues that surround and support the teeth, anchoring them in the jawbone

What are the two sections of the periodontium?

Gingival unit and attachment apparatus.

What is included in the attachment apparatus?

Cementum, periodontal ligament, alveolar bone.

What is gingiva?

Masticatory mucosa surrounding the neck of teeth, attached to teeth and alveolar bone.

Name the parts of gingiva.

Free gingiva, attached gingiva, interdental papilla.

What is the histological feature of gingiva?

Outer layer of keratinized stratified squamous epithelium over dense fibrous connective tissue.

What is the papillary gingiva?

Pointed part between teeth; shaped by contacts and width of adjacent teeth.

What is the marginal (free) gingiva?

Most coronal portion of gingiva; entrance to gingival sulcus, 1.5-2 mm coronal to CEJ.

What is the col?

Non-keratinized concavity of papilla beneath contact; connects facial and lingual gingiva.

What is the gingival sulcus?

Space between tooth and internal portion of free gingiva.

What is attached gingiva?

Extends from free gingival groove to alveolar mucosa; firm, not movable.

What is the free gingival groove?

Shallow linear groove separating free gingiva from attached gingiva.

What is sulcular epithelium?

Lines gingival sulcus, faces tooth but not in contact, thin, non-keratinized, semi-permeable.

What is alveolar mucosa?

Lining mucosa; non-keratinized, movable, loosely attached.

What is the mucogingival junction (MGJ)?

Separates alveolar mucosa and attached gingiva; darker red, highly vascularized.

What are frena?

Folds of mucous membrane connecting movable tissue to fixed tissue (2 labial, 2 buccal, 1 lingual).

What is junctional epithelium?

Cuff-like epithelium around tooth; thin, not keratinized; seals base of sulcus.

What is gingival crevicular fluid (GCF)?

Serum-like fluid from connective tissue through sulcular epithelium; defense mechanism; increases with inflammation.

What is the PDL (periodontal ligament)?

Fibrous connective tissue attaching tooth root to alveolar bone.

What are the functions of PDL?

Secures tooth, supports formation/breakdown of periodontium, carries nutrients.

Name the gingival fiber groups.

Dentogingival, Dentoperiosteal, Transeptal, Alveologingival, Circumferential (circular).

What is the function of dentogingival fibers?

Cementum to gingiva; support gingiva.

What is the function of dentoperiosteal fibers?

Cementum to bone; anchor tooth.

What is the function of transeptal fibers?

Cementum of one tooth to adjacent tooth; alignment and protects interproximal bone.

What is the function of alveologingival fibers?

Alveolar crest to connective tissue; attaches gingiva to alveolar bone.

What is the function of circumferential fibers?

Encircles tooth to support the free gingiva

What are the principal fiber groups of the PDL?

Alveolar crest, Horizontal, Oblique, Apical (Periapical), Interradicular, Transceptal.

What is the function of alveolar crest fibers?

Cementum to alveolar crest; resists lateral tooth movement/ preventing the tooth from moving upward and away from its socket (extrusion)

What is the function of horizontal fibers?

Cementum to bone; resist horizontal movement and tipping forces on a tooth

What is the function of oblique fibers?

cementum is connected to the bone apical to the horizontal fibers, where it helps absorb occlusal forces.

What is the function of apical (periapical) fibers?

Cementum to bone at apex; resists tipping forces.

What is the function of interradicular fibers?

Bone to cementum in furcation area; resists luxation and tipping.

What is cementum?

Thin, mineralized, avascular, bone-like connective tissue covering roots from CEJ to apex.

What are the functions of cementum?

Seals dentinal tubules; provides attachment for PDL fibers.

What is alveolar bone?

Bone surrounding the tooth socket; includes compact (cortical) and spongy bone.

What is lamina dura?

Compact bone lining the tooth socket.

What is the function of alveolar bone?

Supports teeth and provides attachment for PDL fibers.

Where is the alveolar crest located?

Parallel to adjacent CEJs.

What are the 7 parameters evaluated in a gingival exam?

Color, Size, Contour, Consistency, Surface Texture, Position, Exudate.

What are normal gingiva characteristics?

Pink, knife-edged, stippled, firm, resilient, no bleeding on probing.

What influences gingival color?

Vascular supply, thickness of keratinized tissue, melanin, health, epithelium location.

What is normal gingival color?

Healthy pink (can vary from pale pink to reddish/blue).

What is melanin?

Brownish pigment seen in darker-complexion individuals.

What is the normal free gingiva size?

Flat, fits snugly around the tooth.

What is the normal attached gingiva width?

1-9 mm; wider in maxilla vs mandible, anterior vs posterior, narrowest at canines/premolars.

What can affect gingival size?

Certain drugs can cause enlargement, poor hygiene, and inflammation

What determines gingival contour?

Shape of teeth, alignment, size/location of contacts, gingival health.

What is the normal contour of gingiva?

Knife-edged, closely attached to tooth.

What is gingival consistency?

Resiliency of gingival tissue to palpation.

What is the normal consistency of gingiva?

Firm and resilient.

What factors affect gingival consistency?

Health, tissue density, chronic inflammation (can cause firm/hard tissue).

What is stippling?

Orange-peel texture of attached gingiva; free gingiva is smooth.

What does sponginess indicate in gingiva?

less firm gingiva/ inflammation and the early stages of gum disease

What is the difference between apparent and actual gingival position?

Apparent: gingival margin 1-2 mm above CEJ. Actual: level of attachment determined by probing.

What is recession in gingiva?

Apical migration of junctional epithelium.

How does gingiva in health differ from disease regarding exudate?

Healthy: no bleeding or exudate on pressure. Disease: spontaneous bleeding, pus/white fluid on pressure.

What are the characteristics of gingival enlargement?

Loss of stippling, redness, bulbous/rolled margins, spongy consistency.

What does 'location' refer to in a gingival exam?

Whether the condition is localized (specific area) or generalized (entire mouth or arch).

How is severity described in a gingival exam?

Slight, moderate, or severe.

What does 'distribution' refer to in a gingival exam?

The pattern of involvement: marginal, papillary, or diffuse/ refers to the extent or area of the mouth affected by a specific condition such as inflammation, recession, or pigmentation. It describes where the condition is located

What is marginal distribution in gingiva?

Involves only the free gingiva at the gingival margin/the location and extent of the marginal (unattached) gingiva, which is the border of gum tissue immediately surrounding the teeth

What is papillary distribution in gingiva?

Involves only the interdental papilla.

What is diffuse distribution in gingiva?

Involves the free gingiva, attached gingiva, and alveolar mucosa.

What are the three main types of tooth deposits?

Soft deposits (non-mineralized), hard deposits (mineralized), stains.

What are examples of soft deposits?

Acquired pellicle, dental biofilm (plaque), materia alba, food debris.

What is an example of hard deposits?

Calculus (tartar).

What is the significance of bacterial biofilm (plaque)?

Primary etiologic factor for caries and periodontal disease.

What is the significance of calculus and stains?

Provide rough surfaces that facilitate biofilm accumulation.

What is the acquired pellicle?

Acellular, amorphous organic membrane on tooth surfaces; composed mainly of salivary glycoproteins.

What are the functions of the acquired pellicle?

Protects against acids, lubricates tooth, aids bacterial adhesion, site for calculus attachment.

How quickly does the pellicle reform?

Begins immediately after cleaning; fully formed in 30-90 minutes.

What are the types of pellicle?

Supragingival (clear or stained), subgingival (imbedded in tooth, continuous with surface pellicle).

What is dental biofilm?

Dense, non-mineralized mass of bacterial colonies in a gel-like matrix adhering to teeth, calculus, and restorations.

How many bacterial species can plaque contain?

Over 700 species, including bacteria, mycoplasmas, yeasts, protozoa, and viruses.

What are the stages of biofilm formation?

Pellicle formation → bacterial colonization → matrix formation → biofilm growth → plaque maturation.

What does biofilm metabolism with sucrose produce?

Acid, intracellular polysaccharides, extracellular polysaccharides.

What are the types of biofilm?

Cariogenic (S. mutans, Lactobacillus), periodontal disease-producing (A. actinomycetemcomitans, P. gingivalis), calculogenic.

What factors affect biofilm accumulation?

Crowded teeth, rough surfaces, malocclusion, gingival deviations, defective margins, caries, xerostomia, diet, medications, mouth breathing, deposits.

How is plaque detected?

Direct vision, explorer, disclosing agents; older plaque may appear thick/fur-like.

What is materia alba?

Loosely attached oral debris: epithelial cells, leukocytes, salivary proteins, lipids, microorganisms.

What is the appearance and removal of materia alba?

White, yellow, or gray, cottage cheese-like; easily removed.

Where does food debris accumulate?

Between teeth, at gingival margins.

How is food debris removed?

Tooth brushing, interdental cleaning, irrigation.

What is the significance of materia alba and food debris?

Indicate poor oral hygiene and supply nutrients to plaque bacteria.

What is calculus?

Mineralized biofilm; cannot be removed by brushing or flossing.

What are the types of calculus?

Supragingival (yellow-white, chalky), subgingival (gray-black, flint-like).

What is the significance of calculus?

Provides rough surface for biofilm, hinders hygiene, impairs tissue healing, aids inflammation.