126 Left 2

Front 1

Periodontium tissues?

Back 1

Gingiva, cementum, PDL, alveolabone

Front 2

Provide a tissue seal around the cervical portion(neck) of tooth, cover alveolar process of jaw, hold tissue against tooth during mastication

Back 2

Gingiva

Front 3

Suspend & maintain tooth in socket

Back 3

PDL

Front 4

-Anchors end of PDL fibers to tooth so tooth stay in socket

-protect dentin of root

Back 4

Cementum

Front 5

Surround & support tooth root

Back 5

Alveolar bone

Front 6

Protect underlying supporting structures of periodontium from oral environment

Back 6

Gingiva

4sections

- free gingiva

-attached gingiva

- gingival sulcus

- interdental papilla

Hint 6

Front 7

Free gingiva/Marginal gingiva

Back 7

Located coronal to CEJ

Encircle tooth

Attach to too by JE

Can be separated from tooth w/periodontal instrument

Forms soft tissue lateral wall of gingival sulcus

Front 8

Attached gingiva

Back 8

-Continuous with free gingiva

-Tightly bound to underlying cementum on cervical 3rd of root & periosteum of alveolar bone

-Extend apically from free gingival groove to mucogingival jux (MJG)

Front 9

Range of attach gingiva

Back 9

Max Incisior = 3.5 - 4.5mm

Mand incisor = 3.3 - 3.9mm

Max PM = 1.9mm

Mand PM = 1.8mm

Front 10

Gingival sulcus

Back 10

Bordered by tooth surface & epithelial lining of free gingiva in health.

- if bleeding, it's 'pocket' not sulcus!

Health: 1-3mm

Measure free gin margin to epithelial attachment

Hint 10

Front 11

Free + Attached = Keratinised tissue (KT)

Back 11

Front 12

Interdental papilla

Back 12

-Interproximal space frm alveolar crest - contact area

-Stippled extension of free gingiva that fills space btw 2 teeth

2 papillae

1 facial + 1 lingual

Hint 12

Front 13

Col

Back 13

-saddle like depression btw facial&lingual papillae

-locared directly apical to contact area

-non-keratinized tissue ( very susceptible to disease*)

Hint 13

Front 14

Histological Gingiva components

Back 14

Oral Epithelium

Sulcular Epithelium

Junctional Epithelium

Front 15

Cells in oral epithelium

Back 15

1.Keratinocyte- deepest basal layer(majority cell, synthesize keratin)

2.Melanocyte- basal(멜라닌색소합성)

3.Langerhans- mostly basal(recognize antigens, initiating early immune response)

4.Merkel- basal(proprioceptive cell)

5.Inflammatory- varies (associated w/inflammatory response in mucosa)

Hint 15

Front 16

Non-keratinized epithelium

Back 16

Associated w/lining of oral cavity

Stratum corneum&Stratum granulosum layers are absent

Surface cells have nuclei

Front 17

Oral epithelium

Back 17

-Covers outer surface of free gingiva/attached gingiva

-Extend from crest of GM to MGJ

-Keratinized / parakeratinized

10-12 day cell turnover time

Barrier btw oral environment &deeper tissue

Front 18

Cellular structure of oral epithelium

Back 18

Stratum Corneum

Stratum Granulosum

Stratum Spinosum

Stratum Basale

Hint 18

Front 19

Stratum corenum( keratinized layer)

Back 19

outermost, flat

devoid of nuclei

keratin filament surround by matrix continuously being sloughed & replaced by epithelial cell that migrate frm underlying layer

Hint 19

Front 20

Stratum granulosum

Back 20

Cells are flat

Found in layers about 3-5 cells thick

Prominent in keratinized epithelium

Absent in non-keratinized epithelium

Front 21

Stratum Spinosum (prickle cell layer)

Back 21

Cells are polyhedral & large

Cells of basal & prickle cell layers attach to each other w/desmosomes

Stratum basale&1st layer of s.spinosum are referred to as stratum germinativum

Hint 21

Facet= 다이몬드컷처럼 flat side

Front 22

Stratum basale

Back 22

Single later of cuboidal cells

Round / ovoid nucleus

Located @jux of epithelium & lamina proproa

Made up of 2 type cells

1) serrated & specialized for attachment to basement membrane (hemidesmosomes)

2)non-serrated & specialized for dividing / multiplication.

Front 23

Process of keratinzation

Back 23

4. Stratum Corenum : most superficial layer where nuclei degenerate/ at this stage, cells are lost into mouth

3. Stratum Granulosum : where cells flatten

2. Stratum Spinosum : cells appear as "prickle" under microscope

1. Stratum Basale : new cells are formed to replace ones that have been shed / next to underlying lamina propria

Hint 23

Front 24

Cells loss increase = cell renewal decrease

Back 24

Front 25

Epithelial ridges / rete pegs

Back 25

In health, oral epithelium joins with connective tissue in a WAVY INTERFACE w/epithelial ridges

- deep extensions of epithelium that reach down into connective tissue

- this epithelial layer show projection into underlying connective tissue know as rete pegs

Hint 25

Front 26

SE GS. OE. JE. ERidge enamel space

Back 26

구조

Front 27

Sulcular epithelium

Back 27

-elithelial lining of gingival sulcus

-extend frm crest of ging.margin to coronal edge of JE

-non-keratinized stratified squamous epithelium

-in health, sulcular epithelium joins CT @ smooth interface w/no epithelial ridges

Front 28

Junctional Epithelium

Back 28

-band of epithelial cell(이빨주위)

-forms base of sulcus

-attach gingiva to tooth

-nonkeratinized stratified squamous epithelium

-has no rete pegs in health but MAY have rete pegs in disease

Hint 28

Front 29

Back 29

Front 30

Attachment apparatus(internal basal lamina & hemidesmosomes) connect JE to tooth surface

Back 30

Hemidesmosome

Front 31

JE cell next tooth surface frm hemidesmosome that enable these cells to attach to internal basal lamina & tooth surface

Back 31

Hint 31

Front 32

Back 32

Front 33

GCF

Back 33

Sulcular / gingival fluid

Seep into sulcus frm CT thru sulcular wall

LIittle / no fluid is found in healthy gingival sulcus

Fluid flow increase in plaque biofilm & resulting in gingival inflammation

Hint 33

특징

Cleansing material for sulcus

Contain plasma protein to help JE adhere to tooth

Antimicrobial properties

Help activate antibody defense

Front 34

gingiva CT a.k.a Lamina Propria

Back 34

Hold marginal ging firmly against tooth

Provide ridgidness needed to withstand forces of mastication

Connect free gingiva to root cementum & adjacent attached gingiva

Front 35

Dentogingival unit

Back 35

JE & ging.Fiber

Provide structural support to gin.tissue

Combined length of dentogingival unit is supracrestal tissue attachment (biologic width)

Hint 35

Biologic width = CT+ JE

2-3mm

Front 36

Supracrestal tissue attachment

Back 36

JE & gin.fiber attachment to collectively known as supracrestal tissue attachment (biological width)

2-3mm

Hint 36

Front 37

Back 37

크라운같이 restoration 잇어 소프트티슈가 부엇으면 부은곳빼고 재야 biological width

Front 38

Large tissue cell release inflammatory substances when damaged. Also contain histamine (promote inflm reaction)

Back 38

Mast cell

Front 39

Derived from WBC, usually in lymph node(important in developing immunity) ?

Back 39

Plasma cell

Front 40

Found in CT, synthesize collagen?

Back 40

Fibroblast

Front 41

Large tissue cell, remove damaged tissue, cell, bacteria thru phagocytosis?

Back 41

Macrophage

Front 42

Identified by their location & capacity to differentiate into other cell types like smooth muscle cell in formation of new arteries, phagocyte in inflammatory process and bone cell in formation of new bone?

Back 42

Undifferentiated Masenchymal cell

Front 43

3 arteries supply blood to CT

Back 43

-supraperiosteal arteries:

Facial&Lingual/ Interdental / PDL

Front 44

콜라겐 fiber 덩어리 connect tooth(cementum) to bone?

이빨뿌리주위 티슈?

Primary attachment of tooth to alveolar bone?

NO relationship w/Gingiva?

Back 44

PDL

Front 45

Resist force of luxation & tipping

From crest of interraducular septum extending to cementum in furcation?

Back 45

Interraducular fiber

Front 46

Resist lateral force & tipping teeth?

Originate from apex cementum spread apically & laterally to bone?

Back 46

Apical fiber

Front 47

Oblique fiber

Back 47

Absorb occlusal forces, Vertical pressure

Located in middle 3rd root apical to horizontal fiber. Originate from cementum runs coronally & diagonally to bone

Front 48

Horizontal fiber

Back 48

Resist horizontal pressure against crown

Originate from cementum & runs@ right angle, insert to bone

Front 49

Alveolar crest fiber

Back 49

Resist horizontal force & keep tooth in socket

Originate from cementum runs apically to alveolar crest

Front 50

Sharpey's fibers

Back 50

Terminal end of principle fiber

Embedded in cementum on one end & into bone on the other end

Front 51

Blood supply to PDL

Back 51

come from apical vessel & vessel in interproximal bone

Nerve supply is from Trigeminal pathways.

Front 52

PDL 기능

Back 52

Supportive (suspend & maintain tooth in socket)

Formative (build & maintain cementum & alveolar bone)

Nutritive (nourish cementum&bone)

Remodeling (remodel alveolar bone in response to pressure)

Sensory (proprioception)- transmit tactile pressure & pain perception

Front 53

Calcified tissue that cover root //

Provide a mean of attachment for PDL fibers

Back 53

Cementum

Front 54

Cementum

Back 54

Primary = Acellular

Locate on coronal 2/3 of root about 1mm thick

Responsible for attaching tooth to alveolar bone

Secondary = Cellular

Cover apical 1/3 root about 5mm thick

Can be laid down on top of acellular cementum

Front 55

Acellular cementum vs cellular cementum

Back 55

Acellular = form before teeth are in occlusion, devoid cells, cover cervical 2/3 root, tooth support

Cellular = form after teeth have reached occlusion, contain cementocyte, cover apical 1/3 root, compensate for active eruption & normal tooth wear by continuous deposition

Hint 55

Front 56

Cementum / Enamel relationship

Back 56

Overlap (60-65%), Butt (30%), Exposed(5-10%)

Hint 56

Front 57

Bone where sharpey's fibers terminate?

Back 57

Bundle bone

(Found # inner socket surface)

Hint 57

Front 58

Lining of tooth socket ( space where tooth sit)?

Back 58

Alveoli

Hint 58

Front 59

Cribriform plate

Alveolar bone Proper

Lamina Dura

Back 59

Perforated by numerous opening ~carry blood /nerve from bone to PDL~

Hint 59

Front 60

Cancellous/ Trabeculae bone

Back 60

Spongy bone btw cortical plate & alveolar bone proper

Hint 60

바깥 cortical plate

중간 cancellous(trabeculae)

안쪽 alv.proper

Front 61

Compact bone on facial lingual alveolar process ?

Back 61

Cortical plate

Front 62

Fenestration

Back 62

Marginal bone is still intact

잇몸창문..잇몸에구멍

Still cover w/periosteum & overlying gingiva

Where roots are prominent & overlying bone is thin

Front 63

Dehiscence

Back 63

Marginal bone btw fenestration & alveolar crest may disappear altogether & produce defect

봉합터짐