Periodontium: Pdl, Alveolar Process & Cementum

Front 1

Periodontium (Attachment Apparatus) is derived from

Back 1

the follicle

Front 2

The periodontium has a thickness of

Back 2

0.15 - 0.38 mm

Front 3

The periodontium is thinnest in the _________, and decreases slightly in thickness with _______.

Back 3

- midroot zone
- age

Front 4

a ligament of fibrous CT between alveolar bone proper & cementum covering the root

Back 4

Periodontal ligament

Front 5

_________ covers the root of the tooth and connects with the tissue of the gingiva

Back 5

Periodontal Ligament

Front 6

Periodontal ligament is derived from the

Back 6

Dental sac

Front 7

Principal fibers of PDL are

Back 7

- gingival group
- dentoalveolar group

Front 8

functions of PDL

Back 8

- support teeth
- neural input tranmsissions to masticatory apparatus
- nutritive

Front 9

PDL is composed of

Back 9

fibers, cells, intercellular substance [collagen, ground substance (protiens, polysaccharides)]

Front 10

The gingival group of fibers are

Back 10

around neck of teeth

Front 11

the four groups of gingival fibers are

Back 11

- free gingival fibers
- attached gingival fibers
- circular or circumferential fibers
- transeptal fibers

Front 12

the free gingival fibers arise from

Back 12

the surface of cementum and pass into the free gingiva

Front 13

The attached gingival fibers arise from

Back 13

the alveolar crest and pass into attached gingiva

Front 14

Circular or circumferential fibers are

Back 14

continuous around the neck of the tooth and resist gingival displacement

Front 15

Transeptal fibers originate in the

Back 15

cervical region of each crown and extend to similar locations on mesial and distal surfaces of each adjacent tooth

Front 16

The dentoalveolar group of fibers

Back 16

surrounds tooth roots

Front 17

the dentoalveolar group of fibers consist of 5 differently oriented groups named according to their _________ and __________ in the _____________.

Back 17

- origin
- insertion
- dentoalveolar process

Front 18

The 5 groups of dentoalveolar fibers are

Back 18

- horizontal fiber group
- oblique fiber group
- apical fiber group
- Alveolar crest
- Interradicular fibers

Front 19

horizontal fibers

Back 19

extend in a horizontal direction from the midroot cementum to the adjacent alveolar bone proper

Front 20

oblique fibers

Back 20

extends in an oblique direction from the area just above the apical zone of the root upward to the alveolar bone

Front 21

apical fibers

Back 21

extends perpendicular from the surface of the root apices to the adjacent fundic alveolar bone, which surrounds the apex of the tooth root

Front 22

Alveolar crest fibers

Back 22

arise from the cementum at the neck of the tooth and terminate in the alveolar crest

Front 23

Interradicular fibers

Back 23

extend perpendicular to the tooth's surface and to the adjacent alveolar bone

Front 24

Collagen fiber bundles act as a

Back 24

suspensor ligament for teeth

Front 25

Interstitial space

Back 25

- not a space, located between the gingival and dentoalveolar fiber groups

Front 26

__________ are designed to withstand the impact of masticatory forces.

Back 26

Interstitial Spaces

Front 27

Intersitial spaces are composed of a network of

Back 27

blood vessels and lymphatics that maintain ligament vitality

Front 28

The function of the interstitial spaces

Back 28

- stretching/ contraction of fiber bundlees during mastication
- carry vascular and neural structures
- withstand masticatory forces

Front 29

Oxytalan fibers are

Back 29

elastic like supporting fibers and of a structure different from that of collagen

Front 30

function of transeptal fibers

Back 30

resist tooth seperation mesial/distal

Front 31

function of attached gingiva fibers

Back 31

resists gingival displacement

Front 32

function of free gingiva fibers

Back 32

resists gingival displacement

Front 33

function of circumferential fibers

Back 33

resists gingival displacement

Front 34

function of apical fibers

Back 34

resists vertical forces

Front 35

function of oblique fibers

Back 35

resists vertical and intrusive forces

Front 36

funtion of horizontal fibers

Back 36

resist horizontal and tipping forces

Front 37

function of alveolar crest fibers

Back 37

resist vertical and intrusive forces

Front 38

function of interradicular fibers

Back 38

resist vertical and lateral movement

Front 39

The PDL has a _____ blood supply

Back 39

rich

Front 40

The PDL has _____ rich blood supply than any other Connective Tissue

Back 40

more

Front 41

The PDL's blood supply arises from

Back 41

the inferior and superior alveolar arteries and from branches of the facial aretery from the external carotid

Front 42

Arterivenous shunts have been demonstrated in the PDL that provide

Back 42

direct connections between the arterial and venous blood supply without having to go through a capillary network

Front 43

the vascualar system of the PDL also supplies the

Back 43

Alveolar bone

Front 44

The vascular plexus that extends into the ligament traverses from the t

Back 44

apical areas to the ginfival areas with loops that surround the teeth at regular intervals

Front 45

the larger nerve trunks of the periodontal ligament are found in the

Back 45

central zone of the tooth's long axis

Front 46

Most nerve trunks and finer nervers are in the

Back 46

interstitial spaces

Front 47

Nerve terminals are located ________ the ligament and especially in bundles of ____________

Back 47

- throughout
- prinicpal fibers

Front 48

There are two types of Nerves

Back 48

- Autonomic
- Afferent

Front 49

Autonomic nerves are

Back 49

sympathetic fibers that travel with blood vessels

Front 50

sypmathetic fibers help regulate

Back 50

blood flow

Front 51

Afferent nerves are

Back 51

senses approaching the brain

Front 52

Afferent nerves are mostly

Back 52

myelinated nerves from V3

Front 53

There are two types of nerve endings

Back 53

- Procioceptors
- Aciniform

Front 54

Proprioceptors are nerve endings that sense

Back 54

pressure and gives spatial relationship (know where food is when chewing)

Front 55

Aciniform are

Back 55

fine pain receptors (sense very detailed; pinpoint precise location)

Front 56

cells of PDL include

Back 56

- fibroblasts
- osteoblasts
- cementoblasts
- Macrophages
- osteoclasts
- Epithelial rests
- intercellular tissue

Front 57

the key element of the PDL

Back 57

fibroblasts

Front 58

fibroblasts are

Back 58

made up of collagen and ground substance

Front 59

the most numerous cell in PDL

Back 59

fibroblasts

Front 60

allows for the rapid replacement of fibers in the PDL

Back 60

fibroblasts

Front 61

Osteoclasts are located along the _________ of the _______ in the PDL

Back 61

- surface
- alveolar bone

Front 62

reason for constant turn over of Osteoclasts in the PDL

Back 62

location (along the surface of alveolar bone)

Front 63

Cementoblasts appear along the surface of _________ in the PDL

Back 63

- cementum

Front 64

reason for constant turn over of cementoblasts in the PDL

Back 64

location (along surface of cementum)

Front 65

_______ are important defense cells

Back 65

Macrophages

Front 66

Macrophages have a __________ function.

Back 66

Phagocytic

Front 67

Osteoclasts originate from

Back 67

monocytes

Front 68

______________ may appear as resting, proliferating, or degenerating cell masses

Back 68

Epithelial rests

Front 69

Epithelial rests are composes of

Back 69

mass epithelial cells

Front 70

Epithelial Rests can be observed along the _________ surface of the PDL

Back 70

root

Front 71

__________ surrounds / protects the PDL cells and is a product of these cells

Back 71

Intercellular tissue

Front 72

Intercellular tissue is an ___________ that is composed of water, glycoproteins, and proteoglycans, which surround the collagen fibers

Back 72

extracellular matrix (ECM)

Front 73

ECM means

Back 73

extracellular matrix

Front 74

functions of the PDL

Back 74

- Supportive
- Sensory
- Nutritive
- Maintenance of masticatory apparatus

Front 75

what is the most important function of the PDL

Back 75

- supportive - support dentition

Front 76

failure of the supportive function in the PDL leads to

Back 76

tooth loss

Front 77

the sensory function of the PDL is

Back 77

pressure senation

Front 78

the impulse to the brain in the sensory function of the PDL sends a message to the

Back 78

masticatory apparatus (TMJ, & muscles of mastication)

Front 79

In the nutritive function of the PDL the

Back 79

blood vessels provide the essential nutrients for ligament's vitality and for the hard tissue of cementum and alveolar bone

Front 80

The maintenance function of the PDL is the maintenance of the

Back 80

masticatory apparatus (TMJ, muscles of mastication)

Front 81

The alveolar bone is the

Back 81

bony parts of the Maxillary and Mandibular in which the teeth are suspended in bony alveoli

Front 82

The primary function of the Alveolar bone is

Back 82

Tooth support

Front 83

The alveolar bone is composed of

Back 83

- Alveolar bone proper
- supporting bone (compact & cancellous)

Front 84

Alveolar bone proper is attached to fibers embedded in ________ of teeth

Back 84

roots

Front 85

Supporting bone covers the

Back 85

buccal surface of the mandible and maxilla beside the tongue

Front 86

Alveolus =

Back 86

socket

Front 87

Perforating fibers or _________ are bundles of collagen fibers embedded in the alveolar bone proper

Back 87

Sharpey's fibers

Front 88

Alveolar bone proper is the bone linning the

Back 88

tooth socket

Front 89

in clinical radiographic terms, the alveolar bone is known as teh

Back 89

lamina dura

Front 90

Supporting bone, the bone that serves as a

Back 90

dense cortical plate to sustain the alveolar bone proper

Front 91

The _________ covers the surface of the maxilla and mandible and supports the alveolar bone proper

Back 91

cortical plate

Front 92

The existence of alveolar bone is entirely dependent on the presence of ________.

Back 92

teeth

Front 93

Loss of lamina dura indicates

Back 93

infection, inflammation, resorption

Front 94

radiopaque means

Back 94

more dense

Front 95

the coronal border of the alveolar process is known as

Back 95

the alveolar crest

Front 96

The alveolar crest in normally located approximately ______ below the dentinoenamel junction of the teeth

Back 96

1.2 - 1.5 mm

Front 97

The alveolar crest is _______ in the anterior region and nearly _______ in the molar region

Back 97

- rounded
- flat

Front 98

area of bone loss when apical root penetrates cortical bone

Back 98

fenestration

Front 99

bone loss in coronal area of root

Back 99

dehiscence

Front 100

Cancellous bone is sandwiched between

Back 100

outer and inner cortical plates

Front 101

Outer cortical bone faces _______ and inner cortical bone faces __________

Back 101

- buccally
- lingually

Front 102

Alveolar bone proper is more _________ than adjacent bone

Back 102

radiopaque

Front 103

Tension on Sharpey's fibers induce

Back 103

maintenance

Front 104

bundle bone is the

Back 104

alveolar bone

Front 105

blood vessels and nerves penetrate the lamina dura through

Back 105

small foramina

Front 106

Supporting compact bone of the alveolar process is similar to the

Back 106

haversian bone found elsewhere in the body

Front 107

Supporting Compact bone is found in

Back 107

- lingual surface of mandibular
- maxillary beside tongue
- Buccal surface of Mandibular or Maxillary

Front 108

Supporting Cancellous bone is composed

Back 108

generally of heavy trabeculae or plates of bone with marrow spaces between

Front 109

Marrow spaces contain

Back 109

blood forming elements, osteogenic cells, adipose tissue

Front 110

_________ is necessary for alveolar bone and cementum maintenance

Back 110

Tooth function

Front 111

Bone loss _________ with age or __________ activity

Back 111

- increases
- decreased

Front 112

Increased age leads to

Back 112

osteoporotic bone

Front 113

bone loss is concurrent with loss of

Back 113

periodontal fibers

Front 114

_________ is calcified CT covering roots of dentition

Back 114

Cementum

Front 115

cementum has a ____________ derivation

Back 115

dental sac

Front 116

avascular means

Back 116

no blood supply

Front 117

least mineralized of calcified dental tissues

Back 117

cementum

Front 118

Functions of cementum

Back 118

- seals tubules of root dentin
- Attachment for periodontal fibers to keep tooth in socket

Front 119

Sharpey's fiber become embedded in

Back 119

cementum

Front 120

Cementum types

Back 120

- intermediate cementum
- cellular / acellular cementum

Front 121

intermediate cementum

Back 121

homogenous layer originating from epithelial root sheath cells

Front 122

cellular/acellular cementum

Back 122

thicker deposit of bone-like substance produced by cementoblasts that differentiate from PDL

Front 123

_________ cementum is deposited first and then _________ cementum is deposited

Back 123

- acellular
- cellular

Front 124

Cementum functions as support by attaching to

Back 124

Sharpey's fibers

Front 125

cementum is more resorption resistant compared to bone due to

Back 125

avasularity

Front 126

Bone and Cementum can ______ and _______

Back 126

- rebuild
- resorb

Front 127

Cementum development happens in ____ stages

Back 127

2

Front 128

the 1st stage of cementum development is

Back 128

intermediate cementum is deposited (cementoid)

Front 129

Intermediate cementum is formed by ________ & occurs during _________

Back 129

- inner epithelial rooth sheath cells
- root formation prior to rooth sheath disintegration

Front 130

Intermediate cementum is situated between the

Back 130

granular dentin layer of Tomes and the secondary cementum that is formed during cementoblasts

Front 131

The thin layer of intermdiate cementum is approxiamately _____ thick

Back 131

10 micrometers

Front 132

The cellular-acellular cementum is a specialized hard tissue covering the

Back 132

root surface of teeth

Front 133

The cellular-acellular cementum is ______ thick at cervical region and _____ thick at apcial region

Back 133

- 30 -60 micrometers
- 150 -200 micrometers

Front 134

Unlike bone, cementum does not contain

Back 134

blood vessels, nerves, or haversian or Volkmann's canals, which are the nutrient canals containing blood vessels and nerves in bone

Front 135

What are the nutrient canals containing blood vessels and nerves in bone

Back 135

Haversian or Volkmann's canals

Front 136

OMG stands for

Back 136

- Overlap
- Meet
- GAP

Front 137

True or False:
Enamel Overlaps Cementum

Back 137

True

Front 138

Meet means that the

Back 138

enamel and cementum meet

Front 139

GAP refers to a gap in

Back 139

enamel and cementum

Front 140

A gap in cementum and enamel could happen

Back 140

naturally or due to use of dental instraments

Front 141

Slightly less mineralized then dentin

Back 141

cementum

Front 142

Cementum is composed of ______ organic material and ______ mineral

Back 142

- 50 -55 %
- 45 - 50%

Front 143

Dentin is composed of _____ organic material and _______ mineral

Back 143

- 30%
- 65.5 %

Front 144

Bone is composed of _____ organic material and ______ mineral

Back 144

- 30 - 35%
- 60 - 65%

Front 145

With age, Cementum becomes more ________

Back 145

irregular

Front 146

intermediate cementum is also knows as

Back 146

cementoid layer

Front 147

________ is a calcified ovoid or round nodule found in the periodontal ligamnet

Back 147

Cementicle

Front 148

_______ may be found sinly or in groups near the surface of cementum

Back 148

cementicles

Front 149

________ are epithelial cell derivatives that are composed of calcium phosphae and collagen in same amount as cementum

Back 149

cementicles

Front 150

Cementicles may be

Back 150

free, attached or embedded

Front 151

cementicles are found in _______ and denticles are found in ___________

Back 151

- cementum
- pulp

Front 152

Cementicles are more prevalent along the ______ in an aging person, although they may also be found at a site of ________

Back 152

- root
- trauma

Front 153

Hypercementosis is

Back 153

a local, abnormal thickening of cementum

Front 154

Hypercementosis is usually found in the

Back 154

apical region

Front 155

Cause of Hypercementosis include

Back 155

- chronic tooth inflammation
- loss of antagonist tooth
- additional eruption
- fusing of tooth to surrounding alveolar bone

Front 156

Cemental loss is concurrent with

Back 156

attachment loss

Front 157

Defects in Cementum can be due to

Back 157

traumatic occlusion, tooth movement, hypereruption due to extraction of opposing tooth

Front 158

________ is created in the arches by the replacement of larger primary molars by smaller permanent premolars

Back 158

Leeway space

Front 159

_______ is the replacement of the smaller primary incisors with larger permanent ones

Back 159

Incisor liability factor

Front 160

______ is the anterior force exerted on teeth due to cusp inclinations

Back 160

Mesial drift

Front 161

Mesial drift is significant during

Back 161

mixed dentition

Front 162

When teeth are missing in front of a toth, it drifts to the mesial due to

Back 162

shape of cusp

Front 163

Compression zone is the area

Back 163

where the tooth is being compressed

Front 164

Tension zone is the area

Back 164

where there is tension on the tooth

Front 165

tipping movement is movement of

Back 165

portions of the tooth

Front 166

bodily movement is movement of

Back 166

the entire tooth

Front 167

_________ is when compression on tooth is too great or too rapid and the vascularity is excluded causing the ligament to appear colorless

Back 167

Hyalinization

Front 168

the process of deposition in a resorption zone

Back 168

Area of reversal

Front 169

the area where deposition begins

Back 169

Reversal line

Front 170

In Edentulous Jaws, alveolar bone volume __________

Back 170

decreases

Front 171

__________ may be more evident in edentulous jaws

Back 171

Osteoporosis