Oral Physiology M3 - PHYSIOLOGY OF THE TEETH AND ITS SUPPORTING STRUCTURES IN RELATION TO THE PATHOLOGIC PROCESSES OF THE ORAL STRUCTURES

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Lesson 1 - Teeth Lesson 2 - Structures Lesson 3 - Pathologic Conditions

175 Terms

1

Covered with enamel

Crown

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2

Crown with/have incisal ridges or edges

Anterior Teeth

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Crown with/present cusps

Posterior teeth

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Used to punch and cut food material during mastication.

Incisal ridge/edge

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Teeth with incisal ridge/edge

Central and Lateral incisors

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Used to shear and tear food support the incisors and premolars

Single cusp

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Teeth with single cusp

Canines/ Cuspids

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Used to grind food support the canines

TWO CUSPS PREMOLARS/BICUSPIDS

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used to grind/triturate food

THREE CUSPS AND MORE (MOLARS)

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covered with cementum

Root

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The length and number of roots depends on the size and function of the teeth. T/F

T

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GIVE ALL MONO-ROOTED TEETH

  • Incisors

  • Canines

  • Premolars (Max 2nd; Mandi 1st & 2nd)

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GIVE ALL BI-ROOTED TEETH

  • Max. 1st PM

  • Mandibular molars

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GIVE ALL MULTI-ROOTED TEETH

ALL MAXILLARY MOLARS

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15

Positive contact relation mesially and distally of one tooth with another while they are on their respective position in the dental arch importance

PROXIMAL CONTACT AREA (PCA)

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2 importance of PCA

  1. keep food from packing in between the teeth

  2. stabilize the dental arches by the combined anchorage

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PCA ASPECT that will demonstrate the relative position of the contact areas cervico-incisally or cervico-occlusally

Labial / Buccal aspects

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anterior teeth; proximal contact areas are ___________

not at the same level

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Lateral PCA is higher than central. T/F

T

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Canine’s PCA is lower than lateral. T/F

F

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posterior teeth; PCA are at the _______

Same level

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Canine to PM – both PCA is at the same level. T/F

T

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PCA ASPECT that will show the relative position of the contact areas labio-lingually or bucco-lingually

INCISAL / OCCLUSAL ASPECTS

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They are formed by the proximal surfaces in contact. Are triangularly shaped spaces in between teeth

and normally are filled by the gingival tissue

Interproximal spaces

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IPS - There is normally a separation of ________ between the enamel and alveolar bone

1- 1 1⁄2 mm

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26

When two teeth in the same arch are in contact, their curvatures adjacent to the contact areas forms

spillway spaces called embrasures

EMBRASURE

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2 kinds of embrasure

  1. Labial or Buccal and Lingual Interproximal

  2. Incisal or occlusal Interproximal

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Its purpose is:

  • It makes a spillway for the escape of food during mastication

  • It prevents food from being forced through the contact area

Embrasure

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29

Approximately ______ is the normal curvature from the cementoenamel junction (CEJ) to the crest of the contour

0.5 mm

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2 Physiologic importance of Cervical Ridge

  1. Holds the gingiva under definite tension

  2. Protects the gingival margins by deflecting food material away from the margins during mastication

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Gingival tissue may be driven apically resulting to gum recession and possible pathologic changes

ABSENCE OR MINIMAL CURVATURE OF CERVICAL RIDGE

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  • Gingiva is protected too much and loses tissue “tone” under the exaggerated contour

  • Food material and debris will be packed around the gingiva

  • Stagnation of foreign material leads to chronic inflammation of the gingiva

TOO MUCH CURVATURE OF CERVICAL RIDGE

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Cervical ridge curvature that food will just deflect

Normal Curvature

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34

Mesial CEJ is deeper than the Distal CEJ. T/F

T

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35

The curvature of the cervical line (CEJ) of most teeth will be approximately _____ less distally than mesially

1 mm

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PDL is ________ attaching the tooth to the alveolar bone

DENSE CONNECTIVE TISSUE

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Thickness varies between 0.1 - 0.25 mm

Periodontal Ligament

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Functions of PDL

  • Supportive and protective

  • Formative

  • Sensory

  • Nutritive

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39

Formative reaction from the PDL could signal the activation of __________________

Osteoblasts, cementoblasts, and fibroblasts

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40

Nutritive due to the presence of blood supply from the branches of the ________________

Alveolar and interradicular arteries

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PRINCIPAL PERIODONTAL FIBER GROUPS

  1. TRANSSEPTAL

  2. ALVEOLAR CREST

  3. HORIZONTAL

  4. OBLIQUE

  5. APICAL

  6. INTERRADICULAR

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Embedded into the cementum of adjacent teeth and extends interproximally over the alveolar crests

TRANSSEPTAL FIBERS

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extends obliquely from the cementum beneath the junctional epithelium to the alveolar crest. From cementum to alveolar crest

ALVEOLAR CREST FIBERS

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Surgery involving PDL fibers

CSF (Circumferential Supracrestal Fiberotomy)

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extends at right angle to the long axis of the tooth between cementum and alveolar bone

Horizontal fibers

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largest group of principal periodontal fibers, extending from the cementum obliquely to the alveolar bone

Oblique fibers

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radiates from the apical cementum to the alveolar bone at the base of the socket. Also known as the “fundus

Apical fibers

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courses over the crest of the interradicular septum in the furcations of multirooted teeth

INTERRADICULAR FIBERS

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49

Mineralized connective tissue that covers the roots of teeth

CEMENTUM

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50

secrete cementum to help keep the tooth stable within the socket

Cementocytes

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51

removal of the cementum

Cemtoclasts

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Cementum consists of:

  • Cementoblasts

  • cementoclasts

  • cementocytes

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ACCORDING TO LOCATION - cementum

■ Radicular Cementum

■ Coronal Cementum

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ACCORDING TO CELLULARITY - cementum

■ Cellular Cementum

■ Acellular Cementum

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ACCORDING TO PRESENCE OR ABSENCE OF COLLAGEN FIBRILS - cementum

■ Fibrillar Cementum

■ Afibrillar Cementum

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covers the coronal half of the root; devoid of cells

ACELLULAR FIBRILLAR CEMENTUM

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■ covers the apical half of the root and the furcation of multirooted teeth

■ cementocytes are noted

CELLULAR FIBRILLAR CEMENTUM

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extension of enamel beyond the cervical margin

ENAMEL PROJECTIONS

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■ cemental dysplasia

■ excess cementum is formed on the root, most commonly affecting the apical third

HYPERCEMENTOSIS

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droplets of ectopic enamel occasionally found on the roots of teeth, most commonly in the

bifurcation or trifurcation areas

ENAMEL PEARL

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small foci of calcified tissue, not necessarily true cementum, which lie free or attached in the PDL of the lateral and apical root areas; Radiopaque in the x-ray

CEMENTICLES

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part of maxilla and mandible that forms and supports the teeth

ALVEOLAR BONE

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ALVEOLAR BONE CONSISTS OF:

osteoblasts, osteoclasts, and osteocytes

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PARTS OF ALVEOLAR BONE

  1. ALVEOLAR BONE PROPER

  2. SUPPORTING BONE

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consists of thin lamella of bone immediately surrounding the root; radiopaque lamina dura in radiograph

ALVEOLAR BONE PROPER

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surrounds the alveolar bone proper and provides additional functional support

SUPPORTING BONE

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Consists of vascular connective tissue contained within the rigid dentinal walls

PULP

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PULP CONTAINS:

fibroblasts (for collagen formation), odontoblasts, and defensive cells

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FUNCTIONS OF PULP:

  • FORMATIVE

  • NUTRITIVE

  • SENSORY

  • DEFENSIVE

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70

majority of sensory receptors on the dental nerves are ____________

free nerve endings

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DEFENSIVE PULP provides inflammatory and immune response via ________________

  • histiocytes/wandering cells,

  • undifferentiated mesenchymal cells,

  • polymorphonuclear leukocytes,

  • lymphocytes,

  • plasma cells,

  • eosinophils

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__________ in cellular components, ________ in the number and quality of blood vessels and nerves, __________ in size and volume of the pulp owing to continued dentin deposition and reparative dentin formation in relation to Pulp response to aging.

DECREASE

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Pulpal response to aging

Dentinal Sclerosis

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_________ in number and thickness of collagen fibers, ________ of pulp stones and dystrophic mineralizations, in relation to pulp response to aging.

Increase

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Part of the oral mucosa that covers the alveolar processes and surrounds the cervical region of the teeth

GINGIVA

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3 REGIONS OF GINGIVA

  1. MARGINAL GINGIVA / UNATTACHED

  2. ATTACHED

  3. INTERDENTAL PAPILLA / GINGIVA

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Border of the gingiva surrounding the teeth in a collar fashion

MARGINAL GINGIVA

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Firm, resilient and tightly bound to the underlying alveolar periosteum

ATTACHED GINGIVA

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Occupies the interproximal space between the areas of adjacent tooth contact

INTERPROXIMAL GINGIVA

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80

LAYERS OF GINGIVAL EPITHELIUM (3)

  1. ORAL EPITHELIUM

  2. SULCULAR EPITHELIUM

  3. JUNCTIONAL EPITHELIUM

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The outer epithelium that covers the crest and outer surface of the marginal gingiva and the surface of the attached

ORAL EPITHELIUM

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WHICH LAYER OF GINGIVAL EPITHELIUM IS THE ONLY KERATINIZED

ORAL EPITHELIUM

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Lines the gingival sulcus; A thin layer of non-keratinized squamous epithelium that extends from the coronal limit of the junctional epithelium to the crest of the gingival margin

SULCULAR EPITHELIUM

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Comprises a collar-like band of non-keratinized squamous epithelium. The tooth is reinforced by the gingival fibers that brace the marginal gingiva against the tooth surface

JUNCTIONAL EPITHELIUM

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GROUPS OF GINGIVAL FIBERS (8)

  1. DENTOGINGIVAL

  2. DENTOALVEOLAR

  3. ALVEOLOGINGIVAL

  4. CIRCULAR

  5. SEMICIRCULAR

  6. TRANSSEPTAL

  7. TRANSGINGIVAL

  8. INTERGINGIVAL

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Embedded into the cementum just beneath the epithelium at the base of the gingival sulcus; The fibers then spread in fan-like fashion into the periosteum, crest of interdental gingiva, and attached gingiva

DENTOGINGIVAL

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Fibers extend to the outer surface of the alveolar bone

DENTOALVEOLAR

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Fibers extend from the alveolar crest to the lamina propria of free and attached gingiva

ALVEOLOGINGIVAL

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Fibers that encircle the tooth in a ring-like fashion

CIRCULAR

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Fibers that emanate from the cementum near the CEJ, cross the free gingival margin, and insert into a similar position on the tooth's opposite side

SEMICIRCULAR

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Forms horizontal bundles between the cementum of approximating teeth into which they are

embedded; They lie in the area between the epithelium at the base of the gingival sulcus and the crest of the interdental bone

TRANSSEPTAL

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Seen in and around the teeth within the attached gingiva

TRANSGINGIVAL

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Seen within the attached gingiva adjacent to the basement membrane extending mesiodistally, providing support and contour for the attached gingiva

INTERGINGIVAL

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The connective tissue of the gingiva that is densely collagenous

LAMINA PROPRIA

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A ____________ subjacent to the epithelium consisting of papillary projections between the epithelial rete pegs

papillary layer

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A ______________ connecting with the periosteum of the alveolar bone

reticular layer

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Blood supply of Gingiva

  • Supraperiosteal arterioles from facial and lingual alveolar bone

  • vessels of PDL

  • arterioles emerging from crest of interdental septa

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Nerve supply of Gingiva

  • fibers from PDL

  • Labial, buccal, lingual nerve

  • Unspecialized nerve-endings, MEISSNER-type, KRAUSE-type specialized nerve endings

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Color of gingiva

COLAR PINK

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100

Due to_______________ occurs as a diffuse deep purple discoloration or irregular brown pigmented areas

MELANOCYTES

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