Attachment Loss in Periodontal Pockets
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Attachment Loss in Periodontal Pockets

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Questions and Answers

What is a primary characteristic of active disease sites in periodontitis?

  • Stable junctional epithelium attachment level
  • Shallow periodontal pockets
  • No tissue destruction evident
  • Continued apical migration of junctional epithelium (correct)

    • Which of the following best describes the nature of periodontal pockets?

  • Resolves without treatment
  • Contains no junctional epithelium
  • Pathological deepening of the gingival sulcus (correct)
  • Always indicative of active disease

    • What happens to the junctional epithelium in a gingival pocket?

  • It remains stable and uninflamed
  • It detaches from the tooth's surface (correct)
  • It migrates laterally
  • It proliferates without any tissue swelling

    • What is the average depth of a healthy gingival sulcus?

    <p>1 to 3 mm</p> Signup and view all the answers

    How does attachment loss in periodontal pockets occur?

    <p>Migration of the junctional epithelium and destruction of supporting tissues</p> Signup and view all the answers

    What is a significant factor in distinguishing between active and inactive disease sites?

    <p>Stability of junctional epithelium attachment levels over time</p> Signup and view all the answers

    What describes horizontal bone loss in periodontitis?

    <p>Uniform loss of bone height across multiple teeth</p> Signup and view all the answers

    What role do periodontal ligament fibers play in periodontal health?

    <p>They support and stabilize the tooth in its socket</p> Signup and view all the answers

    What defines an infrabony defect in periodontal disease?

    <p>Base of defect extends apical to residual alveolar crest</p> Signup and view all the answers

    What type of defect is referred to as a one-wall intrabony defect?

    <p>A hemiseptal defect where half of the interdental septum is lost</p> Signup and view all the answers

    In the context of bone contour in periodontal disease, what is described by an osseous crater?

    <p>A contour that dips apically from facial to lingual surfaces</p> Signup and view all the answers

    What is a characteristic feature of periodontitis compared to gingivitis?

    <p>Visible alterations in gingival color only</p> Signup and view all the answers

    How does furcation involvement manifest in multirooted teeth?

    <p>Invasion of periodontal infection in the area between the roots</p> Signup and view all the answers

    What distinguishes vertical bone loss from horizontal bone loss in periodontitis?

    <p>Vertical bone loss is characterized by angular defects.</p> Signup and view all the answers

    What is a primary characteristic of vertical bone loss in periodontitis?

    <p>Bone loss extending apically below the alveolar crest</p> Signup and view all the answers

    What happens to the crestal periodontal ligament fibers during bone loss in periodontitis?

    <p>They weaken and no longer serve as a barrier</p> Signup and view all the answers

    Which condition is associated with permanent tissue destruction in periodontitis?

    <p>Intermittent tissue destruction at varying rates</p> Signup and view all the answers

    What occurs to the junctional epithelium during periodontitis?

    <p>It begins to migrate apically away from the tooth.</p> Signup and view all the answers

    What is a major factor affecting cleaning in interdental areas in periodontal disease?

    <p>Bone contour forming osseous craters</p> Signup and view all the answers

    What is a common sign of periodontitis when probing the gums?

    <p>Probing depths of 4 mm or greater</p> Signup and view all the answers

    What type of bone defect primarily affects just one tooth due to uneven bone resorption?

    <p>Intrabony defect</p> Signup and view all the answers

    What type of attachment loss is observed in periodontal pockets associated with periodontitis?

    <p>Complete loss of attachment without any remaining fibers</p> Signup and view all the answers

    Which of the following conditions results in an inflamed connective tissue exposed through ulcerations in the pocket epithelium?

    <p>Periodontitis</p> Signup and view all the answers

    What characterizes the clinical picture of periodontitis observed in patients?

    <p>Interdental papillae become blunted or ballooned</p> Signup and view all the answers

    Study Notes

    Attachment Loss in Periodontal Pockets

    • Characterized by destruction of fibers and bone
    • Affects teeth support, spreading apically and laterally
    • Can vary in depth on different root surfaces

    Disease Sites

    • Areas of tissue destruction
    • Inactive disease site: junctional epithelium attachment level stays the same over time
    • Active disease site: shows continued apical migration of junctional epithelium
    • Assessed using a periodontal probe

    Periodontal Pockets

    • Areas of tissue destruction left by disease
    • Not always an indicator of active disease
    • Majority of pockets in adult patients are inactive disease sites

    Gingival Sulcus

    • Average depth in a healthy mouth is 1 to 3mm
    • Junctional epithelium sits coronal to CEJ
    • Attaches along the entire length of the tooth

    Gingival Pockets or Pseudopockets

    • A deepening of the gingival sulcus due to swelling
    • Increased probing depth due to:
      • Detachment of the coronal portion of junctional epithelium
      • Increased tissue size from swelling
    • False pockets

    Periodontal Pockets

    • Pathological deepening of the gingival sulcus
    • Results of:
      • Apical migration of junctional epithelium
      • Destruction of periodontal ligament fibers
    • Travels into the periodontal ligament space

    Pathway of Inflammation in Vertical Bone Loss

    • Travels through gingival connective tissue, into the periodontal ligament space and into the alveolar bone.
    • Weakened crestal periodontal ligament fibers no longer provide a barrier

    Bone Defects in Periodontitis

    • Infrabony defect: base of the defect extends apical to the residual alveolar crest
    • Intrabony defect: bone resorption occurs in an uneven, oblique direction, primarily affects one tooth

    One-Wall Intrabony Defect

    • Also known as a hemiseptal defect
    • Half of the interdental septum is lost
    • Other half remains attached to the tooth

    Two-Wall and Three-Wall Intrabony Defects

    • Multiple walls of alveolar bone lost

    Proximal Bone Contour

    • Bone contour from facial to lingual dips apically
    • Forms osseous crater
    • Affects two adjacent root surfaces
    • Interdental area difficult to clean

    Bone Loss in Furcation Areas

    • Furcation involvement occurs on multirooted teeth when periodontal infection reaches the area between and around roots
    • Alveolar bone loss between the roots
    • May be hidden by gingival tissue or visible clinically
    • Bleeding upon gentle probing
    • Probing depths greater than 3 mm

    Microscopic Picture of Gingivitis

    • Hemidesmosomes remain attached to enamel
    • Epithelial ridges extend from junctional epithelium into adjacent connective tissue zone
    • Reversible damage to gingival fibers
    • No infection in alveolar bone or periodontal ligament fibers, cementum is normal

    Periodontitis

    • Permanent tissue destruction

    Characteristics of Periodontitis

    • Apical migration of junctional epithelium
    • Loss of connective tissue attachment
    • Loss of alveolar bone
    • Tissue destruction occurs intermittently at different rates throughout the mouth

    Clinical Picture of Periodontitis

    • Visible alterations in color, contour, and consistency
    • Gingival margin may be swollen or fibrotic
    • Interdental papillae may balloon out or be blunted
    • Bleeding upon probing
    • Suppuration (pus) possible
    • Pocket depths of 4mm or greater

    Microscopic Picture of Periodontitis

    • Apical migration of junctional epithelium, coronal portion detaches from tooth surface
    • Extracellular matrix of gingiva and collagen fibers destroyed
    • Junctional epithelium and sulcular epithelium extend into the connective tissue
    • Small ulcerations of pocket epithelium expose underlying inflamed connective tissue

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    Overview of the Diseases of the Periodontium PDF

    Description

    This quiz focuses on the characteristics and classifications of attachment loss in periodontal pockets. It covers aspects such as tissue destruction, disease sites, and the importance of periodontal probing. Test your knowledge on gingival sulcus depth and the types of periodontal pockets.

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