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607 Terms
what is the periodontium?
a system of tissues that surround the teeth and attaches them to bone
what are the parts of the periodontium?
PDL
cementum
alveolar bone
gingiva
what are the types of cells that make up tissue?
epithelial
connective
nerve
muscle
what kind of tissue is extracellular matrix?
epithelial and connective
what is connective tissue made of?
supragingival fiber bundles
what kind of tissue has many cells and is mainly composed of cells?
epithelial tissues
what kind of tissue is extracellular matrix mostly composed of?
connective tissue
what kind of tissue is extracellular matrix composed of but very little?
epithelial tissue
what kind of tissue has no blood supply?
epithelial tissue
what kind of tissue has a rich blood supply?
connective tissue
what is the purpose of the gingiva?
to provide a tissue seal around cervical part of the tooth
what kinds of tissue is the gingiva made of?
epithelial and connective
what are the types of cell junctions in gingiva?
desmosomes and hemidesmosomes
what cell junction joins epithelial cells to their neighboring cells?
desmosomes
what do desmosomes do?
join epithelial cells to their neighboring cells
which cell junction joins epithelial cells to the basal lamina?
hemidesmosomes
what are hemidesmosomes?
cell junctions that join epithelial cells to the basal lamina
what kind of boundary do epithelial meet the underlying connective tissue at?
wavy boundary
what is the purpose of a wavy boundary?
creates a strong joint between epithelial and connective tissue
allows epithelial tissue to receive nutrients from connective tissue
where is the free gingiva in relation to CEJ?
coronal
what is the gingival sulcus?
the space between the free gingiva and the tooth surface
what is the space between the free gingiva and the tooth surface?
gingival sulcus
is the gingival sulcus keratinized or non-keratinized?
non-keratinized
what is the base of the gingival sulcus formed by?
junctional epithelium
is the junctional epithelium keratinized or non-keratinized?
non-keratinized
what is the purpose of the junctional epithelium?
attachment
barrier
host defense against infection
in a healthy periodontium, the junction epithelium attaches where in relation to the cementoenamel junction?
coronal
what is gingival crevicular (sulcular) fluid?
fluid from connective tissue
what is gingival crevicular fluid used for?
as an index for gingival inflammation
how much gingival crevicular fluid is there in a healthy tissue?
small amounts
what increases the amount of gingival crevicular fluid?
inflammation
what is the interdental gingiva?
part of the gingiva that is between adjacent teeth apical to contact area
what is the first line of defense against periodontal disease?
junctional epithelium
what is the interdental gingiva an extension of?
the gingival margin
what are the types of interdental papillae?
facial and lingual
what is col?
a valley-like depression in the interdental gingiva
when would col be absent?
if teeth are missing
if there is recession
why is col significant?
bacteria can easily get trapped
where is attached gingiva?
between free gingiva and alveolar mucosa
where is attached gingiva the widest?
around incisor and molar regions
where is attached gingiva the narrowest?
premolar regions
what is the range of attached gingiva for incisor/molar regions?
3.3-3.9
what is the range of attached gingiva for premolar regions?
1.8-1.9
what is the purpose of the attached gingiva?
prevents free gingiva from getting pulled away from tooth when tension is applied
what does attached gingiva do for gingival tissue?
allows them to withstand mechanical forces
what are examples of mechanical forces?
chewing, brushing
where is the attached gingiva not measured?
palatal surface
why is the attached gingiva not measured on the palatal surface?
it is hard to differentiate attached gingiva from palatal mucosa
how to determine level of attached gingiva?
level of attached gingiva (mm) - probe depth
what is the healthy gingiva range for probe depths?
1-3 mm
what is cementum?
a thin layer of hard and mineralized tissue covering the root surface of teeth
what kind of tissues does cementum have?
cellular and acellular
what are the functions of PDL?
maintains gingival tissue position
transmit pain/pressure feelings to teeth
gives nutrients to cementum and bone
attaches teeth to bone
remodels alveolar bone in response to pressure
absorbs shock for nerves and vessels
how does the PDL maintain position of gingival tissue?
suspends and maintains the tooth in the socket
how does the PDL attach teeth to bone?
builds and maintains cementum and alveolar bone
how does the PDL act as a shock absorber for nerves and vessels?
resists impact of occlusal pressure
what are PDL fibers?
collagenous fibers
what are sharpey fibers?
ends of PDL fibers that are embedded into the cementum and alveolar bone
what are the principal fiber groups of the PDL?
transeptal
alveolar crest
oblique
horizontal
apical
interradicular
which of the principal fibers extend interproximally over alveolar crest?
transeptal
which of the principal fibers extend from the cementum and goes coronally to bone?
oblique fibers
which direction do oblique fibers withstand masticatory stress in?
vertical
which of the principal fibers are only found in multi-rooted teeth extending from cementum to bone in furcation areas?
interradicular fibers
which of the principal fibers extend from the apical part of cementum to the base of the tooth socket?
apical fibers
which of the principal fibers are apical to the JE and extend obliquely from cementum to alveolar bone?
alveolar crest fibers
which of the principal fibers extend at right angles to long axis of the tooth?
horizontal fibers
which of the principal fibers is the largest and most significant fiber group?
oblique fibers
what does the alveolar bone do?
supports the roots of the teeth in the jaw
what does alveolar bone surround?
roots of teeth in the jaw
what happens to alveolar bone if there is a missing tooth?
bone will resorb
what is the alveolus?
a bony socket that houses the root of the tooth
where are the ends of PDL fibers embedded?
in alveolar bone proper
why does alveolar bone proper appear to have large pores?
that is where blood vessels connect structures
what does cortical bone do?
forms the hard outer wall of thaws on facial and lingual aspects
supports alveolar bone proper sockets
what forms the hard outer wall of the jaws on the facial and lingual aspects?
cortical bone
what does cortical bone surround?
alveolar bone proper
why does cortical bone surround alveolar bone proper?
to support the socket
will cortical bone show up on radiographs?
no
what is the most coronal part of cortical bone?
alveolar crest
what is cancellous bone?
spongey bone filler between cortical bone and alveolar bone proper
what does cancellous bone do?
forms support for alveolar bone proper
what nerve branch innervate the periodontium?
trigeminal nerves
how does the periodontium get its blood supply?
blood vessels anastomose to create a complex system
what does anastomose mean?
to connect, join, or intercommunicate
what is periodontal disease?
bacterial infection affecting all periodontal tissue
what is gingivitis?
a type of periodontal disease
what is gingivitis characterized by?
changes in color
contour
consistency of gingival tissue
when is gingivitis observed clinically after plaque biofilm accumulates in the gingival sulcus?
4-14
where does plaque biofilm accumulate in gingivitis?
gingival sulcus
what causes epithelial attach to migrate apically?
periodontitis
what are histological characteristics of gingivitis?
supragingival fiber destruction
alveolar bone and PDL are still intact
in gingivitis, where is the JE in relation to the CEJ?
coronal
what does JE stand for?
junctional epithelium
what does CEJ stand for?
cementoenamel junction
how does gingivitis look clinically?
red, bleeding, swollen gums
what is acute gingivitis characterized by?
fluid in gingival connective tissue
how do tissues look with acute gingivitis?
swollen
what forms more with chronic gingivitis?
collagen fibers
what does more collagen fibers forming with acute gingivitis result in?
fibrotic tissue
can gingivitis be present for many years without progressing to periodontitis?
yes