extension of the attached gingiva, it is free gingiva located at the margin
marginal gingiva
the free edge of the gingiva, gingiva at the edge before you hit bone
free gingival crest
you measure recession from the_________to the________________
CEJ
free gingival crest
gingiva between the teeth, AKA interdental papilla
interdental gingiva
What is the purpose of interdental gingiva?
to prevent food impaction
apical to the contact area, a concavity in the interdental papilla that forms between the lingual and facial gingival surfaces
col
describe the color of healthy attached gingiva; unhealthy gingiva
pink; thick layer of parakeratinized epithelium which blocks the vascular supply in the lamina propria
red if unhealthy
Which type of gingiva is stippled from tall narrow papilla in the lamina propria that pull on the epithelium and cause the dimples?
Attached gingiva
true or false. Stippling goes away if tissues are diseased?
true
Which type of gingiva is immobile because it is firmly attached to the bone beneath it?
attached gingiva
describe the color of marginal gingiva
pink; thick layer of parakeratinized epithelium which blocks the vascular supply in the lamina propria; pink because of the blood supply deep underneath the tissue
which type of stippling has no stippling because it isn't attached?
marginal gingiva
which type of gingiva is mobile because it is not attached to the bone?
marginal gingiva
Pain, heat, erythema, edema, and loss of function may all be a result of_____________
inflammation
2 types of inflammation include:
erythema
edema
the tissue is red because of increased blood flow
erythema
the interdental papilla is enlarged as it is filled with tissue fluid; it may cause the tissue to lose its stippling
edema
name 3 clinical considerations for gingival tissues
inflammation
gingival recession
gingiva hyperplasia
the free gingiva margin starts to move apically- usually exposing cementum which can cause sensitivity because of exposed cementum
gingival recession
name 6 possible causes for gingival recession
periodontal disease
tooth position
incorrect tooth brushing
occlusal stress
strong frenal attachments
age
How do you measure gingival recession?
from the cementoenamel junction (CEJ) to the free gingival margin
overgrowth of the interdental papilla, usually caused by poor oral hygiene and certain medications
gingival hyperplasia
name 3 medications and what they are perscribed for that may cause gingival hyperplasia
the space between the tooth surface and the gingival tissues and can be filled with gingival fluid (crevicular fluid)
gingival sulcus
the epithelium on the inside of the sulcus
sulcular epithelium
a deeper extension of the sulcular epithelium, it lines the floor of the gingival sulcus and is attached to the tooth surface
junctional epithelium (JE)
the definite location of attachment between epithelium and enamel, cementum, or dentin, while probing, this is what stops your probe at the bottom of the sulcus
epithelium attachment (EA)
What is the normal depth of the gingival sulcus?
.5-3 mm
nonkeratinized stratified squamous epithelium that is tightly packed with many desmosomes, and has a smooth junction between the epithelium and the lamina propria, no papilla
sulcular epithelium
nonkeratinized stratified squamous epithelium, that is loosely packed with few desmosomes, it is more permeable so white blood cells can come from the blood vessels in the lamina propria and migrate into the epithelium
junctional epithelium
How do the white blood cells that enter the junctional epithelium help keep the tissue healthy?
they help protect it from bacterial plaque
this epithelium is very thin, only 4 layers thick, the basal cells reproduce by mitosis, and cells don't fill with keratin or flatten like normal layers of epithelium
junctional epithelium
the basement membrane, the velcro between the epithelium and the lamina propria
external basal lamina
a new basement membrane that; is on the inside of the sulcus; is the velcro between the epithelium and the tooth surface; has both the lamina lucida and densa layers; is continous with the external basal lamina
internal basal lamina
_______________secrete the initial basal lamina and develop_____________
ameloblasts
hemidesmosomes
true or false. during active eruption, the dentogingival tissue peels away, but remains attached at the cementoenamel junction, this forms the initial junctional epithelium
true
the_________________is formed by differentiation of the cells from the reduced enamel epithelium
definitive junctional epithelium
How long could the whole process of the development of dentogingival junctional tissues take?
3 to 4 years
name 2 clinical considerations with junctional epithelium
gingivitis
periodontitis
increased permeability allow white blood cells out, but allows bacteria in; acute inflammation; ulceration of the epithelium exposes the blood vessels of the lamina propria; condition is reversible
gingivitis
true or false. When you probe you can injure vessels exposed in junctional epithelium with gingivitis, and get bleeding on probing
true
apical migration of the epithelial attachment; this deeper EA causes a deeper gingival sulcus, which we call a periodontal pocket; bacterial plaque and toxins penetrate the connective tissue, periodontal ligament, and bone; bleeding on probing is present; furcations may be present; teeth may become mobile as the bone and periodontal ligament are damaged; this is irreversible
