a pocket formed by gingival enlargement without apical migration of the junctional epithelium
gingival pocket
In a gingival pocket, the margin of the gingiva has moved toward the ______ or _____ without deeper periodontal structures being involved
incisal
occlusal
What is the tooth wall of a gingival sulcus?
enamel
All gingival pockets are suprabony/intrabony?
suprabony
a pocket formed as a result of disease or degeneration that caused the JE to migrate apically along the cementum
periodontal pocket
Ther periodontal deeper structures that are involved in periodontal pockets are known as what?
attachment apparatus:
cementum
periodontal ligament
bone
What is the tooth wall of a periodontal pocket?
cementum or partly cementum and partly enamel
Periodontal pockets may be suprabony/intrabony?
BOTH!
pocket in which the base of the pocket is below or apical to the crest of the alveolar bone
suprabony
pocket in which the base of the pocket is below or apical to the crest of the alveolar bone
intrabony
A pocket is ______ and the pocket epithelial lining is adjacent to and follows the ______ __ ___ _____
narrow
contour of the tooth
When calculus deposits are present, the pocket wall follows the ________ __ ___ _______
contour of the calculus
What are 5 substances that may be found inside a pocket as part of the subgingival biofilm?
Microorganisms and their products
gingival sulcus fluid
desquamated epithelial cells
leukocytes
purulent exudate made up of living and broken down leukocytes, living and dead microorganisms, and serum
Name 5 pocket development factors
pocket deepens from biofilm
PDL fibers become detached and JE migrates apically
cementum becomes exposed
physical, structural and chemical changes alter cementum
surface changes occur
One of the factors of pocket development is surface changes, what causes these to occur?
exchange of minerals with oral fluids and exposure to biofilm bacteria and their products
What are 4 surface changes that can occur during pocket development?
hypermineralization of cementum (also mineralizes calculus)
demineralization
calculus formation in layers
dental biofilm and debris collection
How are surface irregularities detected supragingivally?
drying surface and observing under adequate light
may need an explorer
How are surface irregularites detected subgingivally?
tactile and auditory sensitivity transmitted by a probe and explorer
structural defects such as cracks and grooves
demineralization from cavities
calculus deposites and heavy stain
erosion and abrasion
pits and irregularities from hypoplasia
All cause surface roughness on what surface?
enamel
true or false. the cementoenamel junction relationship can cause surface roughness
true
In what percent of teeth does cementum overlap enamel?
60-65%
In what percent of teeth do cementum and enamel meet in the middle?
30%
in what percent of teeth is there a gap between the cementum and the enamel?
Does this case cause sensitiviy?
10%
yes!
diseased or altered cementum
cemental resorption
root caries
abrasion
calculus
deficient or overhanging filling
grooves from previous incomplete instrumentation
all cause surface roughness on what surface?
root
The clinical attachment level and bone loss have extended into the area between the roots of a multirooted tooth
furcation involvement
What is furcation involvement classified by? And how many general classes are there?
the amount of a furcation exposed by periodontal bone destruction
4
Early, beginning furcation involvement. probe can enter the furcation area, and the anatomy of the roots on either side can be felt by moving the probe from side to side
Class I
Moderate furcation involvement. bone has been destroyed to an extent that permits a probe to enter the furcation area but not pass through between the roots
Class II
Severe furcation involvement. a probe can be passed between the roots through the entire furcation. There is no bone coverage, but still tissue coverage
Class III
Same furcation involvement as class III, with exposure resulting from gingival recession, especially after periodontal therapy. You can see through the furcation
Class IV
A pocket that has extended down and into the alveolar mucosa
mucogingival involvement
What are 3 functions of the attached gingiva?
support to marginal gingiva
withstand stress of chewing and toothbrushing
provide an attachement for the alveolar mucosa
What creates a barrier to passage of inflammation so that inflammation from a pocket area won't initially enter the alveolar mucosa?
attached gingiva
the ____ ________ acts as a barrier to keep infection outside the body
Junctional epithelium
What happens to the epithelium with destruction of the connective tissue and PDL?
epithelium migrates apically along the root
Where does the pocket extend in mucogingival involvement? What happens as a result?
extends into the alveolar mucosa
infection spreads faster
What are 2 clinical observations of mucogingival involvement?
