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PERI 518 Exam #1
UMB dental (1st yr)
159
Medical
Graduate
10/13/2010

Additional Medical Flashcards

 


 

Cards

Term
Definition of Periodontology
Definition
The scientific study of the periodontium in health and disease
Term
Definition of Periodontium
Definition
Tissues that invest and support the teeth including gingiva, alveolar mucosa, cementum, periodontal ligament, and alveolar and supporting bone
Term
What is the "hallmark" treatment of periodontology
Definition
Scaling and root planing
Term
Name 2 examples of non-surgical therapy
Definition

1) Scaling and root planing

2) Local delivery of chemotherapeutics

Term
What are two possible uses of a gingivectomy
Definition

1) To remove excess gingiva

2) To re-contour existing gingiva

Term
Name 3 examples of resective surgery
Definition

1) Gingivectomy

2) Crown Lengthening

3) Osseous surgery

Term
Give an example of periodontal plastic surgery
Definition
Mucogingival surgery
Term
Give two goals of mucogingival surgery
Definition

1) To increase the width of keratinized gingiva

2) To add gingiva in areas where recession had occured (for root coverage)

Term
What is the main goal of regenerative surgery?
Definition
To regenerate the bone, cementum, and periodontal ligament
Term
What are the 4 principal components of the periodontium?
Definition

1) Gingiva

2) PDL

3) Cementum

4) Alveolar bone

Term
The free gingival margin should sit _____ against the teeth.
Definition
flat
Term
The gingiva is the portion of the masticatory mucosa that covers what?
Definition

1) The alveolar process of the jaws

2) The cervical portion of the teeth

Term
Attached gingiva is demarcated by ______ coronally and the _______ apically.
Definition
Free gingival groove, mucogingival junction (MGJ)
Term
Attached gingiva is attached to _____ and ______ _______.
Definition
tooth, alveolar process
Term
The free gingival groove is the clinical correlate to the ______ of the ______.
Definition
base of the sulcus
Term
In health, attached gingiva is _______ in appearance ("cobblestoney")
Definition
stippled
Term
Attached gingiva ____ _____ move, and ______ masticatory function.
Definition

does not,

resists

Term
There usually is about _____ mm between the CEJ and the start of the alveolar bone.  This leaves space for the soft tissue of the gingiva to sit.
Definition
1-2 mm
Term
What is the keratinization status of the oral epithelium?
Definition
keratinized or parakeratinized
Term
Which epithelial layer is keratinized or parakeratinized?
Definition
Oral epithelium
Term
Which epithelial layer is non-keratinized and is relatively impermeable to passage of fluids and cells?
Definition
Sulcular epithelium
Term
Which epithelial layer is non-keratinized but is semi-permeable and allows white blood cells to exit through to the sulcus as a defense mechanism?
Definition
Junctional epithelium
Term
Besides white blood cells, what other fluid enters the sulcus to bath this area?
Definition
gingival curicular fluid
Term
Name the 4 layers of the oral epithelium, with most superficial first.
Definition

stratum corneum

stratum granulosum

stratum spinosum

stratum basale

Term

Which layer of the oral epithelium sits against the basement menbrane

 

Definition
stratum basale
Term
The lining of the mouth is made up of ______ ______.
Definition
Alveolar mucosa
Term
Give 3 characteristics of alveolar mucosa that help differentiate it from gingiva
Definition

1) alveolar mucosa is non-keratinized, stratified, squamous epithelium

2) subepithelial connective tissue is loosely attached to periosteum (bone)

3) minor salivary glands may be present

Term
What is the main advantage of the undulations of the oral epithelium?
Definition
They provide increased surface area, allowing for stronger attachment of the gingival fibers
Term
What is the main function of the PDL
Definition
To ensure attachment of the tooth root to the alveolar bone.
Term
The dentogingival junction is a functional unit composed of gingival ______ _______ and ________ attachment.
Definition
connective tissue, epithelium
Term
Which structures attaches the junctional epithelium to the tooth?
Definition
Hemidesmosomes
Term
A collar-like band of stratified squamous non-keratinized epithelium is a description of what?
Definition
Junctional epithelium
Term
Which epithelial layer has two distinct basal laminas?
Definition
Junctional epithelium
Term

_______ _________ is the most permeable of any epithelium in the oral cavity

Definition
Junctional epithelium
Term
Junctional epithelium separates the ______ ______ from the oral environment
Definition
periodontal ligament
Term
At the bottom of the sulcus, the JE is approximately _____ cells thick, and narrows _____ to just a few cells.
Definition

15-20

apically

Term
Which epithelial layer has the highest turnover rate of cells in order to maintain attachment to the tooth.
Definition
Junctional epithelium
Term
The lamina ____ is the layer that attaches to the epithelium
Definition
lucida
Term
The internal basal lamina connects to the _____, while the external basal lamina connects to the ______.
Definition

tooth

gingival connective tissue

Term
Gingival connective tissue is a lamina _____ of densely packed ______ and ______ fibers, with only scant _____ and ______ fibers
Definition

propria

collage

reticular

elastic

oxytalan

Term

What type of collagen is primarily found in gingival connective tissue?

 

What percent is this collagen in the CT?

Definition

type I collagen

60%

Term
T/F: The lamina propria has no submucosa
Definition
true
Term
Name the 5 gingival fiber groups
Definition

Alveologingival

Dentogingival

Dentoperiosteal

Circular

Transeptal

Term

Name the gingival fiber group

 

arise from the alveolar crest and insert coronally into the lamina propria

Definition
Alveologingival
Term

Name the gingival fiber group

 

Extends from cementum (tooth) just apical to base of JE and to connective tissue of free and attached gingiva

Definition
Dentogingival
Term

Name the gingival fiber group

 

From cervical cementum (passes over crest) to periosteum

Definition
Dentoperiosteal
Term

Name the gingival fiber group

 

Encircles tooth

Definition
Circular
Term

Name the gingival fiber group

 

horizontal fibers that extend between teeth

Definition
Transseptal
Term
The depth of the gingival sulcus varies from _____ mm.
Definition
1-3 mm.
Term
The periodontal pocket refers to the space between the ________ gingiva and the _____.
Definition
Detached, tooth
Term
Name the 4 classic signs of inflammation
Definition

redness (erythema)

swelling (edema)

heat

pain

Term
Name 3 major vascular changes related to inflammation
Definition

Increase in vascular diameter

Leukocyte emigration and accumulation

Increase in vascular permeability

Term

Which cell is one of the first critical cells that is at site of infection?

Definition
Macrophages
Term
Name 3 functions of inflammation in fighting infection
Definition

Deliver effector molecules/cells

Physical barrier, counter spread of infection

Promote and initiate repair

Term
Give 2 examples of pro-inflammatory cytokines
Definition

IL-1

TNF-alpha

 

Term
What are 4 possible outcomes of acute inflammation?
Definition

Resolution

Abscess

Scar

Chronic

Term
While varying greatly, the average width of the PDL is _______.
Definition
.1 to .25 mm.
Term

If tooth is not in function (has no opposing tooth, etc.) then we would expect the PDL to be _______.  

Definition
narrower
Term
Another name for the radiopaque (whiter) line that represents the layer of alveolar bone proper (cortical lining of the socket)
Definition
Lamina Dura
Term
Name the 5 functions of the PDL
Definition

Formative

Supportive

Nutritive

Sensory

Protective

Term

A viable PDL will always contain which 3 types of cells?

Definition
cementoblasts, fibroblasts, and osteoblasts.
Term
Which cells help repopulation (with phenotypic induction) of the cementoblasts, osteoblasts, and fibroblasts in the PDL?
Definition
Mesenchymal progenitor cells
Term

Epithelial cells in the PDL are remnants of the _____ _____ and are found in islands called _____ __ _______.

Definition

root sheeth

Rests of Malessez

Term

It is theorized that the ________ _____ in the Rests of Malassez can turn on during periodontitis state and can contribute to the pathology.

Definition
epithelial cells
Term
Name the 5 principle fibers of the PDL
Definition

Alveolar crestal group

Horizontal group

Oblique group

Apical group

Interradicular group

 

Term

Principle Fibers of the PDL

 

Eminates from the crest of the bone and goes to the cementum

Definition
Alveolar crest group
Term

Principle Fibers of the PDL

 

Located on the coronal aspect of the PDL and may run perpendicular from the bone to the cementum

Definition
Horizontal group
Term

Principle Fibers of the PDL

 

Connection is more apical on the tooth than the bone connection

Definition
Oblique group
Term

Principle Fibers of the PDL

 

Radiate from the apex of the tooth

Definition
Apical group
Term

Principle Fibers of the PDL

 

Only found in multi-rooted teeth.  Runs from the crest of the bone to the furcal roof of multi-rooted teeth.

Definition
Interradicular group
Term
What is the main function of cementum?
Definition
To anchor the periodontal ligament fibers to the tooth.
Term
What is derived from ectomesenchymal cells from the dental sac (follicle)?
Definition
Cementum
Term
Cementum is _______% inorganic (hydroxyapetite) and ________ % organic and water
Definition

45-50%

50-55%

Term
The majority of people (60-65%) have _______ that slightly overlaps _______ at the CEJ
Definition
cementum, enamel
Term
What are the three types of cells found in cementum?
Definition

Cementoblasts

Cementocytes

Cementoclasts

Term
Cementoblasts are _______ shaped cells
Definition
Cuboidal
Term
Which cells manufacture matrix composed of Type I collagen, proteoglycans, glycoproteins, and GAGs?
Definition
Cementoblasts
Term
_______ allow for communication between different cementocytes
Definition
Canaliculi
Term
Large multinucleated cells that are located in Howship's lacunae
Definition
Cementoclasts
Term
_______ cementum is considered the primary cementum - it is laid down along the dentin surface
Definition
Acellular
Term
_______ cementum is less calcified than _______ cementum.
Definition
Cellular, acellular
Term
Type of cementum that is located at the apical aspect of the root and has bone like character
Definition
Cellular cementum
Term
Type of cementum that has Sharpey's fibers embedded in it
Definition
Acellular cementum
Term
Acellular cementum is found in the apical ___ to ___ of the root.
Definition
1/2 to 1/3
Term
Cementocytes are generally trapped in which type of cementum?
Definition
Cellular cementum
Term
Formation of cementum beings during _____ formation
Definition
root
Term
Differentiation of ____________ cells into cementoblasts is involved in cementogenesis.
Definition
ectomesenchymal 
Term
Mineralization during cementogenesis begins at the ____________.
Definition
cemento-dentinal junction
Term
T/F: Cementum has the ability to repair itself
Definition
True
Term
Bone is derived from ___________ from the dental sac (follicle)
Definition
ectomesenchymal cells
Term
Bone is approximately ____% inorganic and ____% organic.  
Definition
67, 33
Term
Osteoblasts are derived from _____________ cells
Definition
osteoprogenitor
Term
Osteoblasts are __________ ______ shaped cells
Definition
mononucleated cuboidal
Term
Which cells synthesize collagenous and noncollagenous products such as proteoglycans and glycoproteins?
Definition
Osteoblasts
Term

Osteocytes are derived from ___________ cells

 

Definition
Osteoprogenitor
Term
Osteocytes are _________ _______ cells (shape)
Definition
mononucleated, flattened
Term
Osteocytes communicate with adjacent cells through radiating processes within _______.
Definition
canaliculi
Term
Osteoclasts are derived from __________ _____ cells
Definition
hemopoietic stem
Term
Osteoclasts can be described as ___________ _____ cells.
Definition
mononucleated giant
Term
Which type of bone contains no blood vessels so nutrients diffuse from adjacent bone marrow.
Definition
Cancellous, spongy, or trabecular bone (synonyms)
Term
In compact bone, formation continues and blood vessels are trapped in ______ ____. 
Definition
Haversian canals
Term
Need recession of the ______ bone in order to see bone loss radiographically
Definition
cortical
Term
Woven, or bundle bone, is arranged adjacent to the ________ _____ and has thin lamellae arranged _____ to the root.
Definition

periodontal ligament

parallel

Term

Name the 3 components of the alveolar bone process

 

These components of bone are classified by _______ and not by ____.

Definition

1) Alveolar bone proper

2) Supporting bone

3) Interdental septa

 

location, type

Term
Alveolar bone proper is also called _______ _____, ______ ______, or ______ bone
Definition
cribiform plate, lamina dura, bundle
Term
The periodontal ligament fibers (Sharpey's fibers) are embedded in this component of the alveolar bone process
Definition
Alveolar bone proper
Term
Supporting bone contains an outer layer of ______ bone on the ______ and _____ surface of the maxilla and mandible
Definition
cortical, buccal, lingual
Term
Supporting bone has an inner zone of cancellous bone which supports the ______ _____ ________.
Definition
alveolar bone proper
Term
This bone component of the alveolar bone process separates the roots of adjacent teeth
Definition
Interdental septa
Term

The periosteum is a connective tissue that is closely bound to the bone and two layers.  What are they?

 

Which layer contains cells that have the ability to differentiate into osteoblasts?

Definition

1) Outer - fibrous layer

2) Inner - cellular layer

 

Cellular layer

Term
Type of bone formation using a cartilage template
Definition
Endochondral
Term
Type of bone formation that does not use a cartilage template (using membrane template)
Definition
Intramembranous 
Term
The mineralization of _____ and _______ are very similar as they are made up of similar cells
Definition
bone, cementum
Term

Feedback between ________ and ________ is necessary to get osteoclasts to begin absorbing bone

Definition
osteoblasts, osteoclasts
Term
__________ contain PTH receptors
Definition
Osteoblasts
Term
Reversal lines form as a result of _______ and _______ of bone or cementum
Definition
resorption, apposition
Term
Name two age related changes of cementum
Definition

1) Decreased cell and fiber content with age

2) The amount of cementum increases with age

Term
With increasing age, bone shows ________ vascularity, cells, and fibers, a _________ in healing capacity and metabolic rate, and an _______ or _______ in density.
Definition
decreased, reduction, increase or decrease
Term

Which phase of passive eruption?

 

Base of the gingival sulcus and the junctional epithelium are on the enamel

Definition
1st
Term

Which phase of passive eruption?

 

Base of the gingival sulcus in on the enamel, and part of the junctional epithelium is on the root

Definition
2nd
Term

Which phase of passive eruption?

 

Base of the gingical sulcus is at the cementoenamel line, and the entire juntional epithelium is on the root

Definition
3rd
Term

Which phase of passive eruption?

 

Base of the gingival sulcus and the junctional epithelium are on the root

Definition
4th
Term
_____ or more species of bacteria have been found in the oral cavity.
Definition
600
Term
This disease is a form of traumatic injury that involves scratching or gouging of the gingiva and is usually present in individuals with emotional issues.
Definition
Factitious disease
Term
Name 2 effects of toothbrush abrasion
Definition

1) Gingival recession

2) Notching of the roots which increases plaque retention

Term
This injury involves scratching or gouging of the gingiva and is caused by improper flossing
Definition
Stillman's cleft
Term
Mouth breathing can lead to ______ gingiva and ________ of the gingiva.
Definition
inflamed, enlargement
Term
Chemical irritation can be associated with which three etiological agents
Definition

1) Aspirin

2) Mouth rinses

3) Toothpaste

Term
_______ is an acid, so if it sits against the gingiva it can cause _________ of the tissue.
Definition
Aspirin, burning (sloughing off)
Term
Name one significant effect of using smokeless tobacco
Definition
Vast gingival recession where tobacco is placed
Term
Give two examples of occlusal traumatism
Definition

1) Bruxism

2) Clenching

Term
A bony exostosis can arise due to what?
Definition
Clenching and/or grinding
Term

Definition

 

Inflammation

Definition
The body's defensive mechanism against injury or infection
Term

Definition

 

Gingivitis

Definition
Inflammation of the gingiva
Term

Definition

 

Periodontitis

Definition
Inflammation of the supporting tissues of the teeth.  Usually a progressive destructive change leading to a loss of bone and PDL.  An extension of inflammation from the gingiva into the adjacent bone and PDL.
Term
Name 3 broad classes of gingival irritants
Definition

1) Physical

2) Chemical

3) Microbiological

Term
Name 3 types of inflammation
Definition

1) Acute

2) Chronic

3) Chronic granulomatous

Term
An exudative response is generally associated with which type of inflammation
Definition
Acute
Term
_____ is an example of an exudate associated with acute inflammation.  It is made up of which first responder cells?
Definition
Pus, neutrophils
Term
In chronic inflammation, which type of cell is very common as part of the proliferative response?
Definition
Lymphocytes
Term

 

Despite all 3 types of inflammation looking different, we still see the ______ ______ of inflammation for all three.  

 

Definition
cardinal signs
Term
Which type of inflammation is associated with recruitment of macrophages, an epithelioid, and giant cell formation?
Definition
Chronic granulomatous
Term
List the objects of the inflammatory reaction
Definition

1) Gather cells for phagocytosis at the site of the injury

2) Gather antibodies

3) Neutralize and dilute the irritant (edema)

4) Limit the spread of the inflammation (fibrosis)

5) Initiate repair

Term
Name 4 stages of inflammation
Definition

Vascular response

Cellular response

Chemical mediators

Immune response

Term
List the 3 effects of the vascular response of inflammation
Definition

1) Increase blood flow

2) Sticking of WBCs to the capillary walls

3) Migration of leukocytes through the capillary walls and chemotaxis of granulocytes slowly replaced by monocytes

Term
List the main effect of the cellular response of inflammation
Definition
Proliferation of cells
Term
Name the chemical mediators associated with inflammation
Definition

Histamine

Serotonin

SRS-A

Bradykinin

Term
Diapedesis refers to what?
Definition
Emigration of leukocytes or movement into blood circulation
Term
Fibrin deposition during inflammation is important for what?
Definition
Helps the body in ability to repair
Term
The main function of neutrophils is to _____ and _______ bacteria.
Definition
engulf, phagocytize.
Term
Chemotaxis refers to what?
Definition
Accumulation of cells at injured sites during inflammation response
Term
Name the 5 cardinal signs of inflammation
Definition

Erythema

Edema

Pain

Temperature

Loss of function

Term
The cardinal sign of pain may be caused by what?
Definition
Inflammatory mediators lowering the pain threshold for sensory nerves or increasing pressure due to build up
Term
Tissue that is thickened in the attached gingiva region can be referred to as being _______.  Which patients is this most commonly seen in?
Definition
Fibrotic, most commonly seen in patients who smoke cigarettes.
Term
In health, the shape of the interdental papilla should be _________.
Definition
Pyramidal
Term
Describe the appearance of punched out interdental papilla
Definition
Instead of looking like a pyramid peak or knife edge, the interdental papilla would look like an inverted U.
Term

In the case of retracted gingival tissue, a significant amount of calculus built up on the root surface that prevent what?

Definition
This may prevent the soft tissues from being able to attach to the tooth properly.
Term

Mobility of teeth and pathological migration can lead to alterations in ________.

Definition
Occlusion
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