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158 Cards in this Set

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Clinical Attachment Level
the probing depth measured from a fixed point, such as the cementoenamel junction; CAL
Diastema
a space between two natural adjacent teeth
Hyperkeratosis
abnormal thickening of the keratin layer (stratum corneum) of the epithelium
Hyperplasia
abnormal increase in volume of a tissue organ caused by formation and growth of new normal cells
Hypertrophy
increase in size of tissue or organ caused by an increase in size of its constituent cells
Keratinization
development of a horny layer of flatttened epithelial cells containing keratin
Mastication
act of chewing
Pus
a fluid product of inflammation that contains leukocytes, degerated tissue elements, tissue fluids, and microorganisms
Stippling
the pitted, orange-peel appearance frequentlyseen on the surface of the attached gingiva
Suppuration
formation of puss
Clinical crown
the part of the crown of a tooth that can be seen by the clinician
Clinical root
the part of the root of a tooth that can bee seen by the clinician
Anatomical crown
the part of the tooth covered in enamel
Anatomical root
the part of the tooth coverd in cementum
Masticatory Mucosa
covers gingiva and hard palate and is firmly attached; keratinized
Lining mucosa
covers inner surfaces of the lips and cheeks, floor of mouth, under side of tongue, soft palate, and alveolar mucosa; not keratinized
Specialized mucosa
covers dorsum (upper surface) of tongue; composed of papillae
Types of specialized mucosa
filiform, fungiform, circumvallate, foliate
Filiform papillae
most numerous, no taste buds
Fungiform
mushroom shaped, more red and contains taste buds
Circumvallate papillae
10-14 large round papillae in a V shape
contains taste buds
Foliate papillae
on lateral posterior sides of tongue; no taste buds
What kind of tissue are periodontal ligaments made up of?
fibrous connective tissue
What do periodontal ligaments do?
surround and connecta the alveolar bone to the roots of the teeth
Where are periodontal ligaments located?
in the periodontal space between the cementum and alveolar bone
Sharpey's fibers
fibers that are inserted into the cemetum on one side and alveolar bone on the other
What are the five GINGIVAL fiber groups of the periodontium?
Dentogingival, alveologingival, cercumferential, dentoperiosteal, transseptal
What are the four PRINCIPAL fiber groups?
apical, oblique, horizontal, alveolar crest
Dentogingival fibers
cementum to free gingiva
Alveologingival fibers
alveolar crest to free and attached gingiva
A: Circumferential fibers
B: Dentogingival fibers
C: Alveologingival fibers
D: Dentoperiosteal fibers
Circumferential fibers
around the neck of the tooth
Dentoperiosteal fibers
cervical cementum over the alveolar crest
Transseptal fibers
cervical area of one tooth across to an adjacent tooth
Apical fibers
root apex to surrounding bone
Oblique fibers
root above apical fibers obliquely toward the occlusal
Horizontal fibers
cementum in the middle of each root to adjacent alveolar bone
Alveolar crest fibers
alveolar crest to cementum just below CEJ
A: Transseptal fibers
B: Alveolar crest fibers
C: Horizontal fibers
D: Oblique fibers
E: Apical fibers
F:Interradicular fibers
Cementum
layer of calcified connective tissue that covers the root of the tooth
Function of cementum (2)
to seal tubules of dentin and to provide attachment for fibers; not sensitive
How thick is cementum?
about 50 to 200 micrometers about the apex and 30-60 about the cervical are
Alveolar bone
consists of lamina dura which surrounds the tooth socket and supporting bone
Gingiva
surrounds the necks of teeth and is attached to the teeth and alveolar bone
What three parts is the gingiva made up of?
free gingiva, attached gingiva, and interdental gingiva
Free gingival groove
a shallow linear groove that demarcates the free from the attached gingiva
Gingival sulcus
the crevice or groove between the free gingiva and the tooth
Inner boundary of gingival sulcus
tooth surface; could be enamel, cementum, or both
Outer boundary of gingival sulcus
Sulcular epithelium
Base of gingival sulcus
coronal margin of tha ttached tissues; also called the probing depth or bottom of the pocket
Healthy sulcus depth minimum
0.5 mm
Average depth of healthy sulcus
1.8 mm
Healthy readings for depth of healthy sulcus
1-3 mm
Junctional epithelium
cufflike band of stratified squamous epithelium that is continuous witht he sulcular epithelium and completely encircles the tooth; not keratinized
Size of Junctional epithelium
up to 15-20 cells at sulcular epithelium down to 1-2 cells at apical end
Interdental papillae
gingival occupying the interproximal area between two adjacent teeth; also called embrasure
Type 1 embrasure
gingival tissue fills area; pyramidal
Type 2 embrasure
slight to moderate recession; blunted
Type 3 embrasure
extensive recession or complete loss; absent
Col
depression between the lignal or palatal and facial papillae that conforms to the proximal contact area
Where do most periodontal infections start?
Col area
Attached gingiva
continuous with the oral epthelium of the free gingiva and is covered with keratinized stratified squamous epithelium cells
How is attached gingiva attached?
firmly bound to the underlying cementum and alveolar bone
Mucogingival junction
a line that marks the connection between the attached gingiva and the alveolar mucosa
Alveolar mucosa
movable tissue with smooth, shiny surface; nonkeratinized
Clinically normal gingival tissue
pale or coral pink pigment, knife edged, stippling, firm, no bleeding
Gingival examination
examine color, shape, consistency, surface texture, position, bleeding, exudates
Healthy gingiva in children
pink, thick, rounded or rolled, not tightly adapted to teeth, may not have stippling,
Explorer
a slender stainless steel instrument with a fine flexible sharp point used for examination of the surfaces of the teeth to detect irregularities
Fremitus
a vibration perceptible by palpation
Probe
smooth, slender instrument usually round in diameter with a rounded tip designed for examination of the teeth and soft tissues; except for a few probes made only for blunt examination, probes are calibrated in millimeter increments to facilitate recordings for comparisn with periodic assessment
Probing depth
the distance from the gingival margin to the location of the periodontal probe tip at the coronal border of attached periodontal tissues
Mirror surfaces (3)
Plane, concave, front surface
Plane mirror surface
may produce double image
Concave mirror surface
magnifying
Front surface mirror surface
reflecting surface is on the front of the lense rather than on the back
Purposes of the mouth mirror (4)
indirect vision, indrect illumination, transillumination, retraction
Uses of air water syringe
Improve and facilitate procedures, improve visibility of treatment area, prepare teeth for certain procedures
Probe characteristics
straight working end
Pocket
diseased gingival sulcus
How is a pocket measured?
from base of pocket to gingival margin
How are proximal surfaces approached?
by entering from both the facial and lingual aspects of a tooth
Where is the probe stopped in normal healthy tissue?
base of sulcus at the coronal end of junctional epithelium
Where is the probe stopped in gingivitis and early periodontitis?
within junctional epithelium
Where is the probe stopped in advanced periodontitis?
probe tip passes through junctional epithelium and reaches attached connective tissue fibers
How do you line the probe up to get an accurate reading?
with the long axis of the tooth
Purposes and uses of an explorer (5)
detect texture of tooth surfaces, subgingival tooth surfaces, define extent of instrumentation needed, evaluate treatment
Tooth surface irregularities
deposites, anomalies (enamel pearls), restorations, demineralization, restoration
Angular or vertical bone loss
reduction in height of crestal bone that is irregular; commonly localized
Furcation involvement
when a pocket extends into a furcation area
Periodontal ligament space
connective tissue that appears radiolucent on a radiograph
Edema
accumulation of excessive fluid in cells, tissues, or a serous cavity
Gingivitis
inflammation of the gingival tissues
Iatrogenic
resulting from treatment by a professioal person
Lesion
any pathologic or traumatic discontinuity of tissue or loss of function of a part; broad term including wounds, sores, ulcers, tumors, and any other tissue damage
Periodontitis
inflammation in the periodontium affecting gingival tissue, periodontal ligament, cementum, and supporting bone
Permeable
permitting passage of fluid
Refractory
not readily responsive to treatment
Toxin
a poison; protein produced by certain animals, higher plants, and pathogenic bacteria
Xerostomia
dryness of the mouth from a lack of normal secretions
Initial lesion
occurs within 2 to 4 days of irritation, fluid fills the spaced in the connective tissue
Early lesion
Biofilm becomes older and thicker within 7 to 14 days, breakdown to the support at gingival margin
Established lesion
Fluid migration into tissues and sulcus increase; plasma cells = area of chronic inflammation; pocket epithelium is more permeable, early pocket formation
Advanced lesion
bacteria enter sulcus and provide subgingical boifilm; inflammation spreads resulting in bone loss
Gingival pocket
pocket formed by gingival enlargement without apocal migration of the junctional epithelium
Periodontal pocket
result of disease or degeneration that caused the junctional epithelium to migrate apically along the cementum
Suprabony
base of pocket is coronal to the crestof the alveolar bone
Intrabony
base of pocket is below or apical to the crest of alveolar bone
What substances are found in a pocket?
subgingival biofilm, microorganisms, gingival sulcus fluid, desquamated epithelial cells, leukocytes, purulent exudate
Small amount of dentin exposed in __% of teeth
10%
Cementum and enamel meet in __% of teeth
30%
Cementum overlaps enamel in __% of teeth
60%
Complications of pocket formation
furcation involvement and mucogingival involvement
Class I furcation involvement
early beginning involvement; probe can enter furcation area and feel anatomy of roots
Class II furcation involvement
Moderate involvement; probe can enter but cannot pass through
Class III furcation involvement
Severe involvement; probe can be passes between roots through the entire furcation
Class IV furcation involvement
exposure of furcation; probe can pass through entire furcation
Mucogingival involvement
a pocket that extends to or beyond the mucogingival junction and into the alveolar mucosa
Functions of attached gingiva
supports, withstands stress, provides attachment
Factors involved in disease development (4)
Etiologic, predisposing, contributing, risk
Etiologic factor
factor that is the actual cause of a disease or condition
Predisposing factor
factor that redners a person susceptible to a disease or condition
Contribution factor
factor that lends assistance to, supplements, or adds to a condition or disease
Risk factor
an exposure that increases the probability that disease will occur
Dental factors (4)
tooth surface irregularities, tooth contour, tooth position, dental prostheses
Gingival factors (3)
position, size and contour, and effect of mouth breathing
Other factors that contribute to disease development (2)
personal oral care and diet and eating habits
Self cleansing mechanisms (3)
saliva, tongue, morphology of teeth
Risk factors for periodontal disease (5)
Drugs, tobacco, diabetes, osteoporosis, and psychosocial factors
Amelogenesis
production and development of enamel
Dental caries
disease of the mineralized structures of the teeth characterized bu demineralization of the hard components and dissolution of the organic matrix
Arrested caries
carious lesion that has become stationary and does not show a tendency to progress further; frequently has a hard surface and takes on a dark brown or reddish-brown color
Primary caries
occurs on a surfae not previously affected; also called initial caries; early lesion may be referred to as incipient caries
Rampant caries
widespread formation of chalky white areas and incipient lesions that may increase in size over a comparatively short time
Recurrent caries
occurs on a surface adjacent to a restoration; may be a continuation of the original lesion; also called secondary caries
endentulous
without teeth
Exfoliation
lossof primary teeth following physiologic resorption of root structures
Idiopathic
denoting a condition of unknown cause
Incipient
beginning; coming into existence
Resorption
removal of bone or tooth structure; gradual dissolution of the mineralized tissue; may be internal or external; occurs during exfoliation of a primary tooth and from the pressure of orthodontic treatment
Requirements for Dental caries (3)
microorganisms, carbohydrate, and susceptible tooth surface
Acid forming bacteria in dental biofilm
mutans streptococci and lactobacilli
Simple cavity
one tooth surface
compound cavity
two tooth surfaces
complex
more than two tooth surfaces
Phase I: incipient lesion; Enamel caries (4)
subsurface demineralization, visualization, first clinical evidence, reminerilization
Phase II: untreated incipient lesion; Enamel caries (3)
Breakdown of enamel, progression of carious lesion, spread of carious lesion
Pit and fissure dental caries
begins in a minute fault in the enamel where 3 or more lobes of tooth meet irregularly
Smooth surface dental caries
begin in smooth surfaces where there is no pit, groove, or other fault; occurs where biofilm is protected from removal
Early childhood caries
caused by baby bottle syndrome
Root caries
increases with age but not because of age, lesion of cementum and dentin
Types of noncarious dental lesions (6)
enamel hypoplasia, attrition, erosion, abrasion, fractures, abfraction
Enamel hypoplasia
defect that occurs as a result of a disturbance in the formation of the organic enamel matrix
Attrition
wearing away of a tooth as a result of tooth to tooth contact
Erosion
loss of tooth substance by a chemical process that does not involve known bacterial action
Abrasion
mechanical wearing away of tooth substance by forces other than mastication
Fractures
caused by trauma to the face
Abfraction
a wedge shaped lesion with sharp line angles at the cervical region of the dentition. caused bu stresses resulting from biomechanical loading forces on the teeth.