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Perio Module 1
Chapters 1-3
| Question | Answer |
|---|---|
| What anatomical structure forms the base of the sulcus? | junctional epithelium |
| What anatomical structure is located at the base of the tooth socket? | alveolar bone proper |
| Which anatomical area of the periodontium could be removed from the root after years of heavy instrumentation? | cementum |
| A thin layer of yellow, hard, mineralized tissue that is attached to dentin of the root refers to which tissue? | cementum |
| During mastication, the tooth is cushioned from occlusal forces by the: | periodontal ligament (PDL) |
| What anatomical structure keeps a tooth from falling out of its socket? | periodontal ligament (PDL) |
| Innervation of the teeth and periodontal ligament of the maxillary arch is from which alveolar nerve? | superior |
| Innervation of the teeth and periodontal ligament of the mandibular arch is from which alveolar nerve? | inferior |
| What is the lattice-like bone that fills the interior portion of the alveolar process? | Cancellous bone |
| Lymph from the periodontal tissues is drained to lymph nodes located where? | head and neck |
| Nerve supply to the periodontium is derived from branches of which nerve? | trigeminal |
| What population does physiologic pigmentation more frequently appear in? | dark-skinned people |
| What is gingival stippling? | it appears texturally as a bumpy area in healthy gingival tissues. |
| What part of the mouth is stippling more often seen? | anterior regions. |
| Where is the alveolar crest located? | it follows the contours of the cementoenamel junctions of teeth |
| What is the col and where is it located? | The col is the interproximal contact of 2 adjacent teeth. It is a space that lies directly apical to the contact area. |
| What tissue is distinguished by its dark red color and smooth, shiny surface? | alveolar mucosa |
| What is the depth of a clinically normal gingival sulcus? | Under 3 mm |
| What is the free gingiva? | Free gingiva is unattached |
| What is the attached gingiva? | attached gingiva is tightly connected to cementum |
| The existence of alveolar bone is dependent on what? | the presence of teeth. |
| What happens to alveolar bone when teeth are extracted? | alveolar bone resorbs. |
| How many interdental papillae does the interdental gingiva have? | two; one on the facial and one on the lingual |
| What does the periodontal ligament do in response to pressure. | remodel alveolar bone |
| The periodontal ligament can provide nutrients to what? | cementum and bone. |
| What is the space between the free gingiva and tooth surface called? | gingival sulcus |
| What is the space in alveolar bone called that houses the roots of teeth? | periosteum |
| What is the thin layer of bone that lines the socket to surround the root of the tooth called? | Alveolar bone proper |
| The width of attached gingiva is narrowest in which area? | premolars |
| What shallow linear depression separates the free and attached gingiva? | Free gingival groove |
| What are the functions of the periodontal ligament? (PDL) | Suspend the tooth in its socket, provide feeling to the tooth, and build and maintain cementum |
| What do the lymph nodes filter out? | bacteria, fungi, and viruses |
| What are the layers of the alveolar process? | Alveolar bone proper, cortical bone, and cancellous bone |
| Which lymph nodes drain most of the periodontal tissues? | submandibular |
| What is the junctional epithelium and where is it located? | a specialized type of epithelium that attaches to the tooth surface, it forms the base of the sulcus, and it is the point that can be measured with a probe |
| What structure holds the gingival tissue against the tooth during mastication? | gingiva |
| What are the parts of the periodontium? | PDL, gingiva, and cementum |
| When open spaces are present in a patient's mouth, which anatomical area of the gingiva is "missing" in the contact area? | Interdental gingiva |
| What does cementum do? | it anchors the ends of PDL fibers to the tooth. Without cementum, the tooth would fall out of the socket. |
| When probing a pocket, one side of the working end of the probe touches the tooth surface as the probe is inserted. What does the other side of the probe is touch? | Sulcular epithelium |
| Which anatomical structure forms the base of the periodontal pocket? | junctional epithelium |
| Which type of cell junction allows the cell to attach to the basal lamina? | hemidesmosome |
| What are the anatomical areas of the gingival epithelium? | Free gingival epithelium, junctional epithelium, and oral epithelium |
| Name some examples of connective tissue. | Lymph nodes, bone marrow, cartilage |
| What are the functions of cementum? | covers the dentinal tubules, attaches periodontal fibers to the tooth, compensates for loss of tooth tissue caused by attrition |
| What are the functions of gingival fibers? | connect adjacent teeth to control tooth position, provide free gingiva with rigidity needed to withstand frictional forces during chewing, and unite free gingiva with cementum of the root |
| What are the functions of the PDL? | It attaches the tooth to the bony socket, it provides sensory and nutritive function, and it produces osteoclasts to resorb bone |
| What are the functions of sulcular epithelium? | It is permeable, allowing for flow of crevicular fluid |
| What are the characteristics of keratinized tissue? | they have no nuclei, they are waterproof, and the heaviest keratinized epithelium of the body is found on the palms of hand and soles of feet |
| What is the process where alveolar bone is sensitive to mechanical forces and inflammation can either resorb or reform? | bone remodeling |
| How would the interface of the JUNCTIONAL epithelium with the gingival connective tissue appear in a healthy periodontium? | It would have a smooth interface |
| What happens to acellular cementum after it is removed during periodontal instrumentation? | It never regenerates |
| What living parts does cementum contain? | Cementum contains no blood vessels or nerves |
| What does the strong adhesion of epithelium do? | allows skin to resist mechanical forces. |
| Does epithelium ALWAYS meets connective tissue in a smooth pattern? | NO |
| What are the characteristics of epithelium? | is a vital tissue that does require nourishment to maintain cells, but it does not contain blood vessels. |
| What is the difference between cementum and alveolar bone? | Cementum has no blood vessels and nerves; alveolar bone does have blood vessels and nerves |
| What are osteoblasts? | cells that initiate mineralization of bone |
| What are osteoclasts? | they remove mineral materials from bone. |
| What makes up the dentogingival unit? | junctional epithelium and gingival fibers |
| What are the differences between a desmosome and hemidesmosome? | A desmosome connects two cells together, and hemidesmosome connects a cell to the basal lamina |
| What are the ends of periodontal ligament fibers that embed in bone and cementum known as? | Sharpey fibers |
| What is the epithelium that joins the gingiva to the tooth surface at the base of the sulcus? | junctional epithelium |
| What is the extracellular matrix? | is a mesh-like material that surrounds the cells and provides a framework, it gives connective tissue the strength to withstand mechanical force, and without it, the gingival connective tissues would be very weak and tend to fall apart |
| What is the mat of extracellular matrix that separates epithelial sheets from underlying connective tissue called? | Basal lamina |
| Two neighboring epithelial cells in the gingival epithelium are attached to one another by which type of cell junction? | Desmosome |
| Which fibers attach the gingiva to bone? | Alveologingival, periosteogingival |
| What do circular fibers do? | encircle the tooth in a ring-like manner |
| What is connected to neighboring epithelial cells by desmosomes? | junctional epithelium |
| What is true of the cementum/enamel relationship? | are collectively referred to as OMG, and all of the various arrangements can be present in any one tooth |
| What is the result when there is a gap between the cementum and the enamel? | may cause discomfort during instrumentation |
| Name a tooth structures that is an example of epithelial tissue. | enamel |
| Without this tooth structure, there can be no tissue reattachment after scaling and root smoothing. | cementum |
| What are the characteristics of periodontitis? | the gingival margin does not adapt closely to the tooth, Interdental papillae may not fill the embrasure spaces, and there may be bleeding upon gentle probing |
| What periodontal indices are commonly used in periodontal studies of a population? | CPITN, EIBI, GBI, GI, and PSR |
| What condition can last for years, can cause the body to form collagen fibers in gingival connective tissue, and may cause excess collagen fibers that could conceal redness? | chronic gingivitis |
| A patient that exhibits a bacterial infection in all parts of the periodontium has what condition? | periodontitis |
| What are two types of periodontal disease? | gingivitis and periodontitis |
| If a patient's gingiva is pink in color, there is no recession of the gingival margin, and the plaque biofilm on the teeth is light, what is the condition of the mouth? | it is impossible to tell the microscopic state of the periodontium with just a visual inspection |
| If the junctional epithelium is apical to the cementoenamel junction on cementum, what condition does the patient have? | periodontitis |
| What does continued apical migration of the junctional epithelium indicate? | Site of active disease |
| What does it mean by prevalence of periodontal disease? | the number of all cases of disease identified within a specific population at a given point in time |
| What is the earliest that gingivitis can be observed after discontinuing oral care such as brushing or flossing? | 4 days |
| If the alveolar crest of bone is located 2 mm apical to CEJ of teeth, this would indicate: | health |
| What condition does the patient have if microscopically, the coronal-most portion of the junctional epithelium is detached from the tooth surface? | periodontitis |
| What is the first condition where the junctional epithelium has extended epithelial ridges into the gingival connective tissue? | gingivitis |
| In what condition is there is permanent destruction of some or all of the periodontal ligament fibers and alveolar bone? | periodontitis |
| What are some variables associated with periodontal disease? | 70% of all US adults have it, more males have it, as age increases so does disease, greater incidence with underdeveloped countries |
| What risk factors are associated with periodontal disease? | Personal behaviors, heredity, gender, age |
| Where is the base of a suprabony pocket located? | coronal to the alveolar crest. |
| Where is the base of an infrabony pocket located? | below the alveolar crest. |
| What is the difference between a gingival pocket and a periodontal pocket? | A gingival pocket is a result of gingival enlargement, and a periodontal pocket is a result of apical migration of junctional epithelium and alveolar bone loss |
| What is the pathologic deepening of a gingival sulcus by the periodontal disease process called? | Periodontal pocket |
| What is the sequence of events that occurs during the development of periodontal disease called? | pathogenesis |
| When would there be an intact band of transseptal fibers present above the remaining bone? | This would be present even when there is severe horizontal bone loss |
| What type of bone resorption occurs in an uneven oblique direction affecting only one tooth? | infrabony defect |
| In horizontal bone loss, inflammation spreads through tissue and ends where? | periodontal ligament |
| in vertical bone loss, inflammation spreads through tissue and ends where? | alveolar bone |
| What is the most common pattern of bone loss? | horizontal |
| Which type of bone loss creates infrabony pockets? | vertical |
| If microscopically, the patient's junctional epithelium is attached to the enamel coronal to the cementoenamel junction but the patient has bleeding on probing, what condition do they have? | gingivitis |
| If microscopically, damage has occurred to the supragingival fiber bundles and there is no bone loss but there is bleeding on probing, what is the condition? | gingivitis |
| In what type of patient might you observe stippling? | In some, but not all periodontally healthy individuals |
| Where in the mouth would you observe stippling if it is present? | On healthy attached and interdental gingiva |
| Vessels of the periodontium anastomose (link) into a complex network to do what? | Supply rich amounts of blood |
| What is interdental col? | It is a space that lies directly apical to the contact area |
| Which tissue is visible adjacent to the crown of the tooth when looking at a cross section of the periodontium? | Gingiva |
| What is the thin layer of yellow, hard, mineralized tissue called that is attached to dentin of the root? | Cementum |
| What locks a cell and its cytoskeleton to its neighboring cell or to the basal lamina? | cell junction |
| What are some pattern types for how the epithelium meets connective tissue? | Tight interdigitation pattern, smooth, non-interdigitating interface |
| What does the strong adhesion of epithelium do for a patient? | It allows the skin to resist mechanical forces. |
| What does the junctional epithelium do? | It provides a protective barrier between plaque biofilm and connective tissue. |
| In a healthy patient, how would the junctional epithelium look? | Smooth and even with no epithelial ridges; not wavy |
| How would the interdigitation of the epithelial layer and the underlying connective tissue appear in most places of the body? | As interlocked grasped hands |
| What effect does keratinization have on epithelial cells? | Makes them stronger and waterproof |
| Which fiber group of the periodontal ligament is located closest to the crown of a tooth? | Alveolar crest fibers |
| Which structure in the mouth forms and supports the sockets of the teeth? | Cementum |
| Which structure separates the gingival fibers from the enamel of a tooth? | Cementum |
Created by:
BrendaAlberts