Periodontics

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  • Topic: Gingiva, Periodontology, Periodontitis
  • Pages : 42 (10404 words )
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  • Published : November 18, 2012
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Tissues of the periodontium (Chapter 2)
Periodontium
* The tissues that surround, support, and attach to the teeth Components of the periodontium
1. Gingiva
2. Periodontal ligament
3. Cementum
4. Alveolar bone
Function of the periodontium
* To support the teeth and oral structures
The gingiva
* The visible component of the periodontium inside the mouth * Described as: pink, pink-red, blue, purple, or pigmented * It can appear much darker when melanin pigmentation is present * Factors that mask the color change of gingiva:

* Food
* Medications
The three types of gingiva
1. Free gingiva
2. Attached gingiva
3. Alveolar mucosa
Mucogingiv al junction
* Appears as a line that marks the connection between the attached gingiva and the alveolar mucosa Alveolar mucosa
* The moveable tissue loosely attached to the underlying boe * It is attached but moveable
* The surface is smooth and shiny

Attached gingiva
* Extends coronally from the mucogingival junction
* It is continuous with the oral epithelium and is covered with keratinized stratified squamous epithelium * It is firmly attached to the alveolar bone unlike the free or marginal gingiva * It DOES have attachment fibers, which is why on the lingual aspect of maxillary teeth the attached gingiva will blend with the attached palatal mucosa Rete pegs

* Ridges of epithelium that form the connection between the free or attached gingiva and the underlying connective tissue * If gingiva is healthy, it appears stippled, which is due to the rete pegs * If gingiva is not healthy, it will appear flat and shiny, due to a lack of rete pegs Function of rete pegs

1. Add strength to the gingiva
2. Nourish the gingiva
Free gingiva or free marginal gingiva
* Surrounds the tooth and crests a cuff or collar of gingiva extending coronally about 1.5 mm * Usually a groove called the free gingival groove demonstrates the free marginal gingiva from the attached gingiva * Appears to be attached to the tooth but maybe separated by an instrument like a periodontal probe Gingival sulcus or crevice

* A crevice or groove around each individual tooth
* Sulcular epithelium is the continuation of the oral epithelium covering the free gingiva * Healthy sulcus is 1 to 3 mm probing depth
Sulcular or gingival crevicular fluid
* Liquid in the gingival sulcus
* Components diffuse through the basement membrane and the junctional epithelium

Components of crevicular fluid
1. Connective tissue
2. Epithelium
3. Inflammatory cells
4. Serum
5. Microbial flora
Functions of the crevicular fluid
1. Cleanses the sulcus
2. Antimicrobial action
3. Plasma proteins improve adhesion of the epithelium to the teeth 4. Antibody activity to defend the gingiva
Junctional epithelium
* Separates the periodontal ligament form the oral environment * Protects the attachment to the tooth to the surrounding tissues * Approximately 15-20 cells
* If the base of pocket is damaged, it takes 4-6 weeks to heal Interdental papilla (interdental gingiva/gingival papilla)
* The gingiva that fill embrasure spaces, which is the interproximal space beneath a contact point of 2 teeth * Shape depends on the teeth it is between but we generally consider the papillae pyramidal or triangular * In health, it should fill embrasure and the tip pointed, not blunt or swollen * Other descriptions: pointed, bulbous, blunted, absent, or cratered Col

* Depression between the lingual and facial papillae in posterior teeth that conforms to the proximal contact area * Usually absent in anterior teeth because of the lack of lingual facial width at most coronal portion * Often susceptible to infection because of its non-keratinization

Keratinization
* The process whereby keratinocytes migrate from the basal layer of the epithelium to the surface and...
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