Week 1 Chapter 1 C16D16 (4)

Chapter Overview

• Title: Periodontium: The Tooth Supporting Structures

• Author: Ms. Cindy Yeon Hee Lee RDH, BSc, Cert. Adult Ed.

• Last edited: January 2025

• Copyright © 2024 by Jones & Bartlett Learning, LLC.

• Website: www.jblearning.com

Course Schedule

• Week 1 (February 4, 2025): Chapter 1

• Week 2 (February 11, 2025): Chapter 2

• Week 3 (February 18, 2025): Chapter 3

• Week 4 (February 25, 2025): Chapters 4, 5

• Week 5 (March 4, 2025): Test 1 (15%)

• Week 6 (March 11, 2025): Chapter 5

• Week 7 (March 18, 2025): Chapter 6

• Week 8 (March 25, 2025): Chapters 7, 9

• Week 9 (TBA): Midterm (25%)

• Week 10 (April 8, 2025): Chapters 8, 10

• Week 11 (April 15, 2025): Chapter 11

• Week 12 (April 22, 2025): Chapter 12

• Week 13 (April 29, 2025): Chapter 13

• Week 14 (May 6, 2025): Test 2 (15%)

• Week 15 (May 13, 2025): Chapter 14

• Week 16 (May 20, 2025): Chapter 16

• Week 17 (May 27, 2025): Chapters 19, 20

• Week 18 (June 3, 2025): Exam Prep / Review

TCDHA Program Learning Outcomes

1. Adhere to regulatory guidelines, Code of Ethics, and Standards of Practice.

2. Apply the Dental Hygiene ADPIE framework to provide personalized care for diverse populations.

3. Utilize effective information retrieval and communication methodologies for current, evidence-based practice.

4. Ensure safe and respectful professional practice through effective management principles.

5. Foster open communication among healthcare providers and communities for optimal culturally safe client care.

6. Promote health education and behavior changes through an intercultural health approach.

7. Advocate for the dental hygiene profession and address oral health inequities.

8. Understand cultural competency for Indigenous health needs.

• Relation to Periodontics I: Addresses Program Outcomes 1, 2, 3, 4.

Learning Objectives (Overview)

• Describe learning expectations for the Periodontics I course including tests and assignments.

• Explain the link between Periodontics I and TCDHA Program Outcomes.

• Discuss the role of periodontal assessments in Dental Hygiene Process of Care.

• Highlight the importance of baseline indices in compliance with CDHO Standards of Practice.

• Identify and define structures of the periodontium.

• Discuss the gingiva's function and detail its structural characteristics.

• Explain the locations and features of the free gingival margin and gingival sulcus, including depth and boundaries.

Structures of the Periodontium

• Periodontium: A functional system of tissues that surround teeth, anchoring them to the jawbone.

  • Also known as: Supporting tissues of teeth, Attachment apparatus.

Health Periodontium Components:

• Gingiva: Surrounds cervical portions of teeth; covers alveolar processes.

• Periodontal Ligament: Suspends and maintains the tooth in its socket.

• Cementum: Protects the dentin of the root and anchors ligament fibers.

• Alveolar Bone: Supports and surrounds the roots of teeth.

Gingiva Overview

• Composed of mucosa surrounding teeth.

• Four anatomical areas of gingiva:

  1. Free Gingiva

  2. Attached Gingiva

  3. Interdental Gingiva

  4. Gingival Sulcus

• Function: Protects underlying periodontium structures from the oral environment using saliva and immune responses.

Key Characteristics of Gingiva:

• Contour and Shape: Follows the scalloped curvature of the cementoenamel junction (CEJ); may vary with age.

• Attached by Junctional Epithelium: Comprises outer epithelium and connective tissue layers.

Free Gingiva

• The unattached portion surrounding the tooth in the CEJ region.

• Marginally meets tooth in a scalloped outline following CEJ contours.

• Gently retractable with a periodontal probe, creating the lateral wall of the gingival sulcus.

Attached Gingiva

• Continuous with free gingiva and tightly bound to cementum and periosteum of alveolar bone.

• Width varies: Widest in incisor/molar regions, narrowest in premolar regions.

• Color can be pale or light coral pink; may exhibit pigmentation.

Interdental Gingiva

• Fills space between adjacent teeth apical to contact area.

  • Consists of papillae (facial and lingual).

  • Prevents food packing during chewing.

• Interdental Col: A depression connecting facial and lingual papillae; absent in cases of large spaces or notable recession.

Gingival Sulcus

• A V-shaped, shallow space encircling the neck of the tooth.

• Depth ranges 1-3 mm when clinically healthy.

• Gingival Crevicular Fluid: Importance increases with stimulation; indicates health status.

Periodontal Ligament (PDL)

• A network of connective tissue fibers attaching tooth roots to the bone.

• Functions include:

  1. Supportive: Maintains tooth positioning; cushions forces.

  2. Sensory: Relays sensory information to the body.

  3. Nutritive: Supplies the tooth with vital nutrients.

  4. Formative: Aids in regeneration and maintaining attachment apparatus.

  5. Remodeling: Adapts to mechanical pressures.

Cementum

• Covers root surface, softer than dentin/enamel.

• Two types: Acellular (covers cervical two-thirds) & Cellular (covers apical one-third).

• Functions to anchor PDL fibers, seal dentinal tubules, and compensate for occlusal wear.

Alveolar Bone

• Surrounds and supports the roots of teeth; forms bony sockets.

  • Mineralized connective tissue contents: 60% inorganic, 25% organic, 15% water.

• Dependent on teeth presence; resorbs when teeth are lost.

Layers of Alveolar Process:

• Alveolar Bone Proper: Thin layer lining the tooth socket.

• Cortical Bone: Forms outer wall of mandible/maxilla; varies in thickness depending on location.

• Cancellous Bone: Spongy bone filling interior of alveolar process.

Key Terminology

• Sharpey's Fibers: Connective tissue fibers attaching periodontal ligament to cementum and alveolar bone.

• Hypercementosis: Excessive formation of cementum, potentially obstructing the apical foramen.

Importance in Dental Hygiene

• Understanding the anatomy and functioning of the periodontium is critical for effective periodontal assessment and treatment planning in dental hygiene practice.