Periodontium consist of
- G PAC
- Periodontal ligament
- Alveolar bone
what kind of epi is gingiva made of?
keratinized oral epithelium
what type of epi is the sulcus composed of?
non-keratinized sulcular epi
what type of epi is the JE made of
non-keratinized junctional epithelium
what are gingival fibers composed of?
collagen connective tissues.
Primary Gingival Fiber Groups
- Dentogingival - cementum -> free gingiva & attached gingiva (support)
- Alveologingival - Periosteum of bone -> attached gingiva (attach. gingiva to bone)
- Dentoperiosteal - cemetum at CEJ -> alveolar crest (anchors teeth)
- Circular - surrounds coronal portion of alveolar crest (supports free gingiva)
- Transeptal - interdental space to cementum (maintains associations with other teeth)
cementum -> free gingiva & attached gingiva (support)
Periosteum of bone -> attached gingiva (attach. gingiva to bone)
cemetum at CEJ -> alveolar crest (anchors teeth)
surrounds coronal portion of alveolar crest (supports free gingiva)
interdental space to cementum (maintains associations with other teeth)
function of secondary gingival fiber: intercircular
sustains dental arch.
distal, facial, and lingual of one tooth to adjacent tooth and mesial of next adjacent tooth
secondary gingival fiber group: semicircular, connections and function
connection: mesial to distal of same tooth
supports free gingiva
bone surrounding root that is lined by cribriform plate
alveolar bone proper
bone comprised of cortical plates on the facial and lingual aspects of a tooth
bone which fills in bone between the cortical bone and the alveolar bone
means of attachment to perio ligament
first bone lost in periodontal disease
alveolar crest bone
two nonpathogenic bone modifications that can occur
dehiscence : bone resorption in absense of disease. can occur on facial surfaces of teeth with labially inclined teeth.
fenstration: openings or windows into the bone
openings or windows into the bone
bone resorption in the absence of disease, can occur on the facial surfaces of teeth with labially inclined teeth
first periodontal ligament to be lost in periodontal disease are
alveolar crest fibers
Periodontal Fibers and Their Functions:
- Alveolar Crest; cementum to alveolar crest bone; opposes lateral forces
- Horizontal; cementum to alveolar bone horizontally; resist tilting and rotation
- Oblique; occlusal aspect apically to alveolar bone; main mode of attachment
- Apical; apically fr cementum to alveolar bone; resist extrusion
- Transeptal; cementum to cementum of adjacent tooth
perio fiber which connects cementum to alveolar crest bone
Alveolar crest fibers
function of alveolar crest fibrs
opposes lateral forces
perio fiber which connects cementum to alveolar bone horizontally
function of horizontal perio fibers
resist tilting and rotation..
function of oblique perio fiber
main mode of attachment, counter vertical mastication forces
a tooth's main mode of attachment (perio fiber)
function of apical perio fibers
suprabony pockets are involved with
horizontal bone loss, located coronal to alveolar crest bone
infrabony pockets are
apical to alveolar crest bone and may be horizontal or vertical bone loss
one-walled defect has how many walls left standing?
just one wall.
drugs which cause gingival hyperplasia
- Phenytoin (seizure)
- cyclosporins (anti-rejection drugs)
- nifedipine or verapamil (calcium-channel blockers)
blisters. body attacks fibrous attachment of skin and underlying connect tissues.
desmosomes and positive Nikolsky's sign. (pressure of finger near bull causes extension of bulla)
bacteria involved with chronic perio
- P. intermedia
- Bacteroides forsythus
- Actinobacillus actinomycetemcomitans
- Fusobacterium nucleatum
- Eikenella corrodens
- Campylobacter rectus
- Treponema spp
Classification of Perio Disease:
II. Slight chronic perio
III Mod chronic Perio
IV: advanced chronic perio
V: aggressive perio
- I: gingivitis: 1-3 mm
- II: slight chronic perio: 4-5 mm
- III: mod chronic perio: 5-7 mm
- IV: advanced chronic perio: >7 mm
- V: aggressive perio: possibly lose 1 mm/year
Heavy plaque accumulation is not present with what type of perio?
Why are down syndrome pts prone to perio?
because they have P. gingivalis
- genetic disorder
- charac: hyperkeratosis of palms and soles
affects primary dentition with perio
Periodontal abscesses occur on vital or non vital teeth?
tooth vibration as teeth occlude
- I. just a notch
- II. enters but does not go through
- III goes through but gingival margin hides furcation
- IV furca fully exposed
Tooth Mobility classifcation
- + very slight mobility
- I. 1 mm
- II. 2 mm
- III. 3 mm or compressible
cord impregnated with tetracycline that must be removed 7-10 days after therapeutic treatment. higher concentration than systemic tetracycline
slowly releases doxycycline for about 1 week. administered subgingivaly for 21 days.
suppresses increased levels of tissue-destroying collagenase enzymes produced by bacteria.
surgery which rapidly eliminates excessive tissues
(gingivectomy, gingivoplasty: reshapes gingival tissues)
- autografts: fr pt
- allografts: cadaver bone
- xenograft: cow or pig
- alloplast: synthetic bone
surgery which involves the removal of half the tooth, both crown and root.
root resection is the
removal of one root from a multirooted tooth with the crown still intact.
direct anchorage of an implant by the formation of bony tissue aronud it without growth of fibrous tissue at the bone-implant interface
dental implants are made from what metal?
implants which are screw-shaped, cylindrical, or blade implants that serve as an anchor for a crown or a bridge.
implants custom-fabricated to fit over the bone and the under periosteum. fit whole arches or unilateral.
infection around an implant due to a change in the microbial growth
when should sutures typicall be removed after periodontal surgery?
epi heals at day 7, osseous heal and recounter take place in 4-6 months
when does osseous healing and recountouring take place?
the preferred type of toothbrushing method to be used with periodontal pack is
Charter's method (place bristles of brush at a 45 degree angle to the occlusal surface)
healing process when the edges of the wound are close together as a clot forms to act like a scaffolding.
First intention healing
(clot is replaced by granulation tissue as capillaries migrate into the wound site. Fibroblasts produce collagen fibers, healing the wound in about 2 weeks)
healing when the edges of the wound are not within close proximity. the wound heals from the base and outer borders inward one cell layer at a time.
second intention healing
(ex: donor site from the palate for a free gingival graft)
cardiac glycoside that increases heart contractions
causes gingival hyperplasia
a good drug for juvenile periodontal disease, so long as all teeth have formed
longer half-life in gingival crevicular fluid
drug used for NUG, pericoronitis, periaplica and perdontal abscesses
drug to treat oral candidiasis
Drug to treat lichen planus
Drug to treat primary herpes
lesion that when rubbed with a 2x2 sloughs off leaving a red inflamed area
gingivitis due to a lack of vitamin C and affects connective tissues
average distance of alveolar crestal bone to cementoenamel junction (CEJ) is