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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
What are the classification of Periodontal diseasesGingival lesions Periodontal lesions Diagnosis, Prognosis and Treatment plan
The term periodontium arises from the Greek word meaning aroundperi
field of dentistry that focuses on the prevention, diagnosis, and treatment of periodontal diseases (and conditions) and on the placement of dental implants to treat edentulismPeriodontology
The various diseases of the periodontium are collectively termed asperiodontal diseases.
"tissues investing and supporting the teeth"periodontium
periodontium is composed of 2 hard tissues:alveolar bone and cementum
2 soft tissues of periodontiumperiodontal ligament and supporting gingiva
covers the alveolar bone & tooth root to a level just coronal to the cementoenamel junction.gingiva
this type of gingiva is free or unattachedmarginal gingiva
located between adjacent teethInterdental papillae
The most apical point of the marginal gingival scallop is calledgingival zenith.
The most coronal portion of gingiva. well-adapted to tooth surface but not attached to it.Marginal(free) gingiva
firmly bound to the underlying tooth & alveolar bone.Attached Gingiva
portion of free gingiva located in inter-proximal space created by contact between two adjacent teeth.Interdental gingiva (papilla)
The shape of interdental papilla depends on:the presence or absence of a contact point between the adjacent teeth, the distance between the contact point & the osseous crest Presence or absence of some degree of recession.
Facial & lingual papillae are connected together by a valley-like depression called _____ made up from non keratinized epithelium & represents the most frequent site for initiation of disease process."Col"
a -V- shaped shallow crevice around the tooth, bounded by the tooth surface in one side & the epithelial lining the marginal gingiva on the other side.gingival sulcus
Clinical normal gingival sulcus depth:0-3 mm
Gingival Pocket-periodontal disease
There is a fluid secreted from gingival C.T into the sulcus through the thin sulcular wall termed asgingival fluid.
Components of sulcular fluid1. Cellular elements 2. Electrolytes 3.Organic compounds 4.Metabolic & bacterial products 5.Enzymes
Functions of Gingival (Crevicular) Fluid■ Its flow washes out irritants & prevent bacterial penetration. ■ Its plasma proteins improve epithelial adhesion to the teeth. ■ Has antibacterial effect upon many oral microorganisms. ■ Has defense mechanism by its immunoglobulin contents. ■ Essential growth factor for many microorganisms
Cells of the gingival epitheliumKeratinocytes
non keratinocytes:Melanocytes Langerhans cells Merkel cells
keratinized stratified squamous epithelium arranged in 4 layers:Stratum basale, Basal cell layer (The deepest) Stratum Spinosum, prickle cell laye Stratum granulosum, granular cell layer Stratum corneum, Keratinized cell layer
lines the gingival sulcus facing the tooth extending from coronal limit of junctional epitht. the crest of gingival marginSulcular Epithelium
the tissue that joins the tooth on one side and to sulcular epith& C.T on the otherIt forms the base of the sulcusJunctional Epithelium (Epithelial attachment)
Attachment of the junctional epith. to the tooth is reinforced by thegingival fibers
the junctional epith. and the gingival fibers are considered a functional unit, referred to as thedentogingival unit.
Three zones in junctional epith. have been describedapical, coronal and middle
Lamina propria consist of:■mainly Collagen fibers (60%) ■ Cells mainly fibroblasts(5%) ■Intercellular ground substance ■Blood vessels, lymphatic, Nerves
Primary gingival fibers:Circular fibers: Dentogingival fibers: Alveologingival fibers: Dentoperiosteal fibers: Transseptal fibers:
Secondary Gingival FibersSemicircular fibers (SCF): from mesial surface of a tooth to distal surface of same tooth in a half circle Transgingival fibers (TGF): these fibers traversing from CEJ to free gingiva of adjacent tooth Intergingival fibers (IGF): extend along facial and lingual marginal gingiva from tooth to tooth.
They are the predominant cells, they are functioning to: 1.Synthesize and secrete collagen fibers, elastin, non-collagenous proteins, glycoprotein 2. Renewal of collagen fibers and other constituents 3. Regulation of gingival wound healing.Fibroblast
nerve supply of the gingivamaxillary and mandibular branches of trigeminal nerve.
Average width of PDL space is about0.25mm
The most important elements of PDL are theprincipal fibers type I collagen
considered remnants of the Hertwig root sheath, which disintegrates during root development.The epithelial rests of Malassez
Immune system cells:neutrophils,lymphocytes, macrophages, mast cells & cosinophils.
Functions of PDL1. Provision of a soft-tissue "casing" to protect the vessels & nerves from injury by mechanical forces 2. Transmission of occlusal forces to the bone 3. Attachment of the teeth to the bone 4. Maintenance of the gingival tissues in their proper relationship to the teeth 5. Resistance to the impact of occlusal forces (shock absorption
Application of large forces results in _____ of PDL & alveolar bonenecrosis
Calcified avascular tissue that forms the outer covering of the root of the teeth & provide attachment to the periodontal ligamentCementum
Has no vascular or nerve connection.Cementum
Functions of cementumprovide anchorage, maintaining occlusal relationships
occurs in Paget's diseasehypercementosis
are globular calcified masses adherent to or detached from the root surface.Cementicles
Fusion of the cementum & alveolar bone with obliteration of PDL.Ankylosis
T or F. Cementum is similar to bone but has no nerves. Therefore it is non-sensitive to paintrue
2/3 inorganic matter mainly calcium + phosphate in the form of hydroxyapatite crystals 1/3 organic matrix mainly collagen type IExtracellular matrix
the tissue lining the internal bone cavities is calledendosteum
flattened cells, in a plane parallel to the gingival surfacestratum granulosum
associated with kratin formation 1 micrometer in diameter, round in shape and appear in the cytoplasm of the cellkeratohyaline granules
stratum cornea retainspyknotic nuclei
cohesion between cells is provided by numerous structures calleddesmosomes
sensory in nature- respond to touchtactile perceptors
forms the bulk of lamina propria, provides tensile strength to the gingival tissuecollagen type I
the periodontal ligament space has the shape of an _______hourglass
the width of periodontal ligament is approximately0.25mm (range 0.2-0.4 mm)
principal fibers of the periodontal ligament follow a____ course when sectioned longitudinallywavy
formative cellsfibroblast osteoblasts cementoblasts
resorptive cellsfibroblasts osteoclasts cementoclasts
epithelial cellsremnants of hertwig epithelial root sheath
immune system cellsneutrophils, lymphocytes, macrophages, mast cells, eosinophils
extend interproximally over the alveolar bone crest and are embedded in the cementum of adjacent teethtransseptal fibers
extend obliquely from cementum just beneath junctional epithelium to alveolar crest; prevents extrusion of toothalveolar crest group
extend at right angles to the long axis of the tooth from cementum to alveolar bone; resists tipping forces; prevents lateral movementshorizontal group
largest group, extend from cementum in a coronal direction to bone; bear brunt if vertical masticatory stresses and transform them into tension on alveolar boneoblique group
radiate in an irregular manner from cementum to bone at apical region of socket;resist tipping forces and luxation; protects blood vessels and nervesapical group
dan out from cementum to tooth in furcation areas of multirooted teeth' resist tipping, torquing and luxationinterradicular group
elastin fibers :oxytalan and elaunin
small collagen fibers associated with principal fibersindifferent fiber plexus
the palatal gingiva of maxilla drains to:deep cervical lymph nodes
third molars and mandibular incisors drain to:submandibular lymph nodes
the third molars drain to the:jugulodigastric lymph nodes
the mandibular incisors drain to the:submental lymph nodes
a theory that states "force applied to crown cause principal fibers first unfold and straighten and then transmit forces to the alveolar bone- an elastic deformation of bony socket"tensional theory
theory that states "displacement of the tooth is largely controlled by fluid movements with fibers have only a secondary role"visco elastic theory
theory that states "PDL behaves like a thixotrophic material a collagenous gel and that fibers are only artefacts"thixotrophic theory
often site of periapical granuloma which proliferates to produce a cyst common pathological lesionperiodontal ligament in periapical area