Perio 2

Front 1

What are the two types of tissues?

Back 1

epithelial and connective tissue

Front 2

makes up the outer surface of the body and lines the body cavities such as the mouth,stomach, and intestines.

Back 2

Epithelial tissue

Front 3

fills the space between the tissues and organs in the body.

Back 3

Connective tissue

Front 4

A gel-like substance containing interwoven protein fibers that surrounds most cells.

Back 4

Extracellular Matrix

Front 5

The extracellular matrix consists of ---- and -----. The bers consist of ----, -----, and -----. ---- are the major proteins of the extracellular matrix.

Back 5

ground substance, bers, collagen, elastin, reticular bers, collagens

Front 6

the process by which epithelial cells on the surface of the skin become stronger andwaterproof

Back 6

Keratinization

Front 7

Keratinized epithelial cells have ---- and form a tough, resistant layer on the ---- of the skin. The most heavily keratinized epithelium of the body is found on the ---- and ----.

Back 7

no nuclei, surface, palms of the hands, soles of the feet

Front 8

Nonkeratinized epithelial cells have ---- and act as a cushion against mechanical stress and wear. Nonkeratinized epithelial cells are --- and more ---. Nonkeratinized epithelium is found in areas such as the mucosal lining of the cheeks—permitting the mobility needed to ---, ---- and make ----.

Back 8

nuclei, softer, exible, speak, chew, facial expressions

Front 9

Epithelial tissues do not contain -----; nourishment is received from blood vessels contained in the underlying -----

Back 9

blood vessels, connective tissue

Front 10

deep extensions of epithelium that reach down into the connective tissue. also known as rete pegs

Back 10

Epithelial ridges

Front 11

ngerlike extensions of connective tissue that extend up into the epithelium

Back 11

Connective tissue papillae

Front 12

a specialized cell junction that connects two neighboring epithe-lial cells and their cytoskeletons together.

Back 12

Desmosome

Front 13

a specialized cell junction that connects the epithelial cells to the basal lamina

Back 13

Hemidesmosome

Front 14

a specialized stratied squamous epithelium that functions well in the wet environment of the oral cavity

Back 14

gingival epithelium

Front 15

three anatomical areas of the gingival epithelium

Back 15

Oral epithelium (OE)

Sulcular epithelium (SE)

Junctional epithelium (JE)

(important for probing and description of gingiva)

Front 16

epithelium that faces the oral cavity.

Back 16

Oral epithelium (OE)

Front 17

epithelium that faces the tooth surface without being in contact with the tooth surface.

Back 17

Sulcular epithelium (SE)

Front 18

epithelium that attaches the gingiva to the tooth.

Back 18

Junctional epithelium (JE)

Front 19

What is apical migration of the junctional epithelium?

Back 19

recession

Front 20

The oral epithelium covers the outer surface of the --- and ---- it extends from the crest of the ---- to the ----. The OE is the only part of the periodontium that is ---- to the unaided eye

Back 20

free gingiva, attached gingiva, gingival margin, mucogingival junction, visible

Front 21

The oral epithelium (OE) may be ---- or -----

Back 21

keratinized, parakeratinized (partially keratinized).

Front 22

a tough, brous structural protein that occurs in the outer layer of the skin and the OE.

Back 22

Keratin

Front 23

The oral epithelium (OE) is a ----- that can be divided into the following cell layers ---, ----, ----, ----

Back 23

stratied squamous epithelium, Basal,

Prickle, Granular, Keratinized

Front 24

cube-shaped cells

Back 24

Basal cell layer

Front 25

spinelike cells with large intercellular spaces. The cells of both the basal and prickle cell layers attach to each other with desmosomes.

Back 25

Prickle cell layer

Front 26

attened cells and increased intracellular keratin.

Back 26

Granular cell layer

Front 27

attened cells with extensive intracellular keratin.

Back 27

Keratinized cell layer

Front 28

In health, oral epithelium (OE) joins with the ---- in a wavy interface with epithelial ridges

Back 28

connective tissue

Front 29

the epithelial lining of the gingival sulcus. It extends from the crest of the gingival margin to the coronal edge of the JE

Back 29

Sulcular epithelium (SE)

Front 30

The Sulcular epithelium (SE) is a thin, ----- epithelium. The SE has three cellular layers ---, ----, ----

Back 30

nonkeratinized, basal, prickle, superficial

Front 31

flattened cells without keratin

Back 31

superficial cell layer

Front 32

The SE is --- allowing fluid to flow from the gingival connective tissue into the ----. This fluid is known as the gingival ---. The flow of gingival crevicular fluid is --- in health and ---- in disease. In health, the sulcular epithelium joins the connective tissue at a ---- with no epithelial ridges (no wavy junction)

Back 32

permeable, sulcus, crevicular fluid,slight, increases, smooth interface

Front 33

the specialized epithelium that forms the base of the sulcus and joins the gingiva to the tooth surface

Back 33

Junctional epithelium (JE)

Front 34

The gingiva surrounds the --- of the tooth and attaches to the tooth by means of the ----. The base of the sulcus is made up of the coronal-most cells of the junctional epithelium. In health, the JE attaches to the tooth at a level that is slightlycoronal to the ----.

Back 34

cervix, junctional epithelium, cementoenamel junction

Front 35

The junctional epithelium is a thin, ---- epithelium. Nonkeratinized epithelial cells of both the sulcular and junctional areas of the gingival epithelium make them a --- effective protective covering. Thus, the sulcular and junctional areas provide the --- point of entry for bacteria or bacterial products to invade the connective tissue of the gingiva.

Back 35

nonkeratinized, less, easiest

Front 36

What are the two cell layers of junctional epithelium?

Back 36

a. Basal cell layer

b. Prickle cell layer

Front 37

The junctional epithelium ranges from --- to --- mm in length. The JE is about --- to --- cells thick at the coronal zone—the zone that attaches highest on the crown of the tooth. The JE tapers to --- to --- -cell thickness at the apical zone.

Back 37

0.71 to 1.35, 15 to 30, 4- to 5

Front 38

In health, the junctional epithelium has a --- tissue interface with the ---- (no wavy junc-tions)

Back 38

smooth, connective tissue

Front 39

The JE provides an --- between the gingiva and the tooth surface, thus providing a seal at the base of the gingival sulcus or periodontal pocket. The junctional epithelium provides a protective --- between the plaque biofilm and the connective tissue of the periodontium. The epithelial cells play a role in --- the periodontium from bacterial infection by signaling the immune response.

Back 39

attachment, barrier, defending

Front 40

Junctional Epithelium is a continuous sheet of epithelium protects the body by --- its outer surfaces and --- the body’s cavities, including the oral cavity. The teeth penetrate this protective covering by --- through the epithelium, thus creating an --- through which microorganisms can enter the body. The body attempts to seal the opening created when a tooth penetrates the epithelium by --- the epithelium to the tooth.

Back 40

covering, lining, erupting, opening, attaching

Front 41

The gingival connective tissue of the free and attached gingiva provides --- to the gingiva and attaches the gingiva to the cementum of the --- and the ---. The gingival connective tissue is also known as the ---

Back 41

solidity, root,alveolar bone, lamina propria

Front 42

In contrast to the gingival epithelium (which has an abundance of --- and sparse ---), the gingival connective tissue has an abundance of --- and few ---. Cells comprise about --- of the gingival connective tissue.

Back 42

cells, extracellular matrix , extracellular matrix, cells, 5%

Front 43

The supragingival fiber bundles (gingival fibers) are a network of --- collagen fiber bundles in the gingival connective tissue. These fibers are located coronal to (above) the --- of the alveolar bone.

Back 43

ropelike, crest

Front 44

1. The fiber bundles are --- in the gel-like extracellular matrix of the gingival connective tissue. 2. The supragingival fiber bundles --- the attachment of the JE to the tooth by bracing the gingival margin against the tooth surface.

3. Together the JE and the gingival fi bers are referred to as the --- unit. The dentogingival unit acts to provide ---- to the gingival tissue.

Back 44

embedded, strengthen, dentogingival, structural support

Front 45

1. --- the free gingiva firmly against the tooth and --- the attachment of the JE to the tooth. 2. Provide the free gingiva with the --- needed to withstand the frictional forces that result during mastication. 3. Unite the --- with the cementum of the root and alveolar bone. 4. --- adjacent teeth to one another to control tooth positioning within the dental arch.

Back 45

Brace, reinforce, rigidity, free gingiva, Connect

Front 46

The supragingival ber bundles are classied based on their ---, sites of ---, and the --- that they connect

Back 46

orientation, insertion, structures

Front 47

Gingival Fiber Groups

Back 47

Alveologingival fibers

Circular fibers

Dentogingival fibers

Periostogingival fibers

Intergingival fibers

Intercircular fibers

Interpapillary fibers

Transgingival fibers

Transseptal

Front 48

extend from the periosteum of the alveolar crest into the gingival connective tissue. These ber bundles attach the gingiva to the bone.

Back 48

Alveologingival fibers

Front 49

a dense membrane composed of brous connective tissue that closely wraps the outer surface of the alveolar bone.)

Back 49

periosteum

Front 50

encircle the tooth in a ringlike manner coronal to the alveo-lar crest and are not attached to the cementum of the tooth. These ber bundles connect adjacent teeth to one another.

Back 50

Circular fibers

Front 51

embedded in the cementum near the CEJ and fan out into the gingival connective tissue. These bers act to attach the gingiva to the teeth.

Back 51

Dentogingival fibers

Front 52

extend laterally from the periosteum of the alveolar bone. These bers attach the gingiva to the bone.

Back 52

Periostogingival bers

Front 53

extend in a mesiodistal direction along the entire dental arch and around the last molars in the arch. These ber bundles link adja-cent teeth into a dental arch unit

Back 53

Intergingival bers

Front 54

encircle several teeth. These ber groups link adjacent teeth into a dental arch unit.

Back 54

Intercircular bers

Front 55

are located in the papillae coronal to (above) the transseptal ber bundles. These ber groups connect the oral and vestibular interdental papillae of posterior teeth

Back 55

Interpapillary bers

Front 56

extend from the cementum near the CEJ and run horizontally between adjacent teeth. These ber bundles link adjacent teeth into a dental arch unit.

Back 56

Transgingival bers

Front 57

pass from the cementum of one tooth, over the crest of alveo-lar bone, to the cementum of the adjacent tooth. These ber bundles connect adjacent teeth to one another and secure alignment of teeth in the arch.

Back 57

Transseptal

Front 58

a thin sheet of brous connective tissue that surrounds the roots of the teeth and joins the root cementum with the socket wall.

Back 58

periodontal ligament (PDL)

Front 59

The thickness of the periodontal ligament ranges from ---- to --- mm depending on the age of the patient and the function of the tooth. The periodontal ligament consists of --- bers, ---, and ----

Back 59

0.05, 0.25, connective tissue, cells, extracellular matrix.

Front 60

The cells of the periodontal ligament are mainly broblasts with some ---- and ----

Back 60

cementoblasts, osteoblasts.

Front 61

Functions of the Periodontal Ligament

Back 61

Supportive

Sensory

Nutritive

Formative

Resorptive

Front 62

the major function of the periodontal ligament is to anchor the tooth to its bony socket and to separate the tooth from the socket wall, so that the root does not collide with the bone during mastication.

Back 62

Supportive function

Front 63

the periodontal ligament is supplied with nerve bers that transmit tactile pressure (such as a tap with dental instrument against tooth) and pain sensations.

Back 63

Sensory function

Front 64

the periodontal ligament is supplied with blood vessels that provide nutrients to the cementum and bone.

Back 64

Nutritive function

Front 65

the periodontal ligament contains cementoblasts (“cementum builders”) that produce cementum throughout the life of the tooth, while the osteoblasts (“bone builders”) maintain the bone of the tooth socket.

Back 65

Formative function

Front 66

In response to severe pressure, cells of the periodontal ligament (osteoclasts) can produce rapid bone resorption and, sometimes, resorption of cementum

Back 66

Resorptive function

Front 67

Principal Fiber Groups of the Periodontal Ligament

Back 67

Alveolar crest

Horizontal

Oblique

Apical

Interradicular

Front 68

extend from the cervical cementum, running downward in a diagonal direction, to the alveolar crest. This fiber group resists horizontal movements of the tooth.

Back 68

Alveolar crest fiber

Front 69

located apical to the alveolar crest bers. They extend from the cementum to the bone at right angles to the long axis of the root. This ber group resists horizontal pressure against the crown of the tooth

Back 69

Horizontal fiber

Front 70

located apical to the horizontal group. They extend from the cementum to the bone, running in a diagonal direction. This ber group resists vertical pressures that threaten to drive the root into its socket.

Back 70

Oblique fiber

Front 71

extend from the apex of the tooth to the bone. This ber group secures the tooth in its socket and resists forces that might lift the tooth out of the socket.

Back 71

Apical fiber

Front 72

(present only in multirooted teeth)—extend from the cementum in the furcation area of the tooth to the interradicular septum of the alveolar bone. These ber groups help stabilize the tooth in its socket.

Back 72

Interradicular fiber

Front 73

The ends of the periodontal ligament bers that are embedded in the cemen-tum and alveolar bone are known as ----

Back 73

Sharpey fibers

Front 74

The attachment of the ber bundles occurs when the cementum and bone are ---. As cementum forms, the tissue hardens around the --- of the periodontal bers (Sharpey bers) surrounding them with ---. The same process occurs during bone formation. As the bony wall of the tooth socket ---, it surrounds the ends of the periodontal bers with ---. The ends of the ber bundles become --- in the bone that forms around them.

Back 74

forming, ends, cementum, hardens, bone, trapped

Front 75

a mineralized layer of connective tissue that covers the root of the tooth.

Back 75

Cementum

Front 76

Anatomically, cementum is part of the ---; however, it also part of the ---.

Back 76

tooth, periodontium

Front 77

Functions of Cementum

1. --- and ---- the open dentinal tubules and acts to --- the underlying dentin. 2. Attaches the ---- to the tooth. 3. Compensates for --- of teeth at their occlusal or incisal surfaces. Over time, teeth experience wear at their occlusal or incisal surfaces. Cementum is formed at the ---- areas of the roots to compensate for loss of tooth tissues due to attrition.

Back 77

Seals, covers, protect, periodontal bers, attrition, apical

Front 78

Conservation of cementum is ideal since loss of cementum is accompanied by exposure of the --- and by a loss of attachment of periodontal ligament bers to the ---.

Back 78

dentinal tubules, root surface

Front 79

Types of Cementum

Back 79

Acellular Cementum

Cellular Cementum

Front 80

Acellular cementum is primarily responsible for attaching the --- to the ---

Back 80

tooth, alveolar bone

Front 81

Acellular cementum

1. Contains --- cells within its mineralized tissue 2. --- to be formed and covers approximately the ---- or ---- of the root 3. --- new acellular cementum is produced during the life of the tooth 4. Thickness ranges from --- to ---- mm 5. Sharpey bers make up --- of the structure of acellular cementum

Back 81

no living, First, cervical third or half, No, 30 to 60, most

Front 82

Cellular Cementum

1. Contains --- and --- within its mineralized tissue 2. Formed --- the tooth has erupted and is --- calcied than acellular cementum 3. Deposited in --- throughout the life of the tooth (thickness increases with age) 4. Thickness ranges from --- to --- mm 5. Sharpey bers make up a --- portion of cellular cementum.

Back 82

cementoblasts, broblasts, after, less, intervals, 150 to 200, smaller

Front 83

part of the maxilla and mandible that form and support the sockets of the teeth

Back 83

alveolar process or alveolar bone

Front 84

Function of Alveolar Bone in the Periodontium

Back 84

Protects Roots of Teeth.

Remodels in Response to Mechanical Forces and Inammation

Front 85

The alveolar bone forms the bony sockets that provide --- and --- for the roots of the teeth. Alveolar bone constantly undergoes periods of bone --- and --- in response to mechanical forces on the tooth and --- of the periodontium.

Back 85

support, protection, formation and resorption (loss), inammation

Front 86

Alveolar bone is mineralized connective tissue made by cells called ---

Back 86

osteoblasts (“bone builders”)

Front 87

bone-forming cells—produce the bone matrix consisting of collagen bers and other protein bers.

Back 87

Osteoblasts

Front 88

bone consumers—cells that remove the mineral materials and organic matrix of alveolar bone.

Back 88

Osteoclasts

Front 89

What tissues serves as a covering tissue for the outer surfaces of the body and a lining tissue for body cavities such as the mouth, stomach, and intestines?

Back 89

Epithelial tissue

Front 90

What tissues fills the spaces between the tissues and organs of the body?

Back 90

Connective tissue

Front 91

Which epithelial layer is comprised of cells with nuclei that act as a cushion against mechanical stress and wear?

Back 91

Nonkeratinized layer

Front 92

Epithelial cell junctions are cellular structures that can attach :

Back 92

An epithelial cell to a neighboring epithelial cell and to the basal lamina

Front 93

The function of cell junctions is to

Back 93

Allow cells to bind together to function as a strong structural unit

Front 94

In most places in the body, the epithelium meets the connective tissue in a ---, ---- manner.

Back 94

wavy, uneven

Front 95

The --- consists of ground substance and bers. The ground substance is a ---- material that lls the space between the cells. The bers consist of collagen, elastin, and reticular bers. ---- are the major proteins of the extracellular matrix.

Back 95

extracellular matrix, gel-like, Collagens

Front 96

In ----, the extracellular matrix is scanty, consisting mainly of a thin mat called the basal lamina, which underlies the epithelium.

Back 96

epithelial tissue

Front 97

The periodontal ligament is a thin sheet of fibrous tissue located between the ---- and the ----.

Back 97

cementum, alveolar bone

Front 98

The cells of the periodontal ligament are mainly --- with some ---- and -----.

Back 98

broblasts, cementoblasts and osteoblasts.

Front 99

Alveolar bone is ---- connective tissue made by cells called -----

Back 99

mineralized, osteoblasts (“bone builders”)