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Questions and Answers

What type of collagen gives tensile strength to the marginal gingival tissue?

  • Type VI collagen
  • Type IV collagen
  • Type III collagen
  • Type I collagen (correct)

    • What is the role of vitamin C in collagen formation?

  • Cross-linking of collagen fibers
  • Synthesis of type I collagen
  • Hydroxylation of proline and lysine residues (correct)
  • Formation of argyrophilic reticulum fibers

    • What is the main difference between a periodontal abscess and a gingival abscess?

  • Location and history (correct)
  • Response to treatment
  • Size and severity
  • Type of bacteria involved

    • What is the most common symptom reported by patients with an acute periodontal abscess?

    <p>Acute pain</p> Signup and view all the answers

    What is the primary treatment for an acute periodontal abscess with localization?

    <p>Drainage through the periodontal pocket</p> Signup and view all the answers

    What is the radiographic finding associated with a chronic periodontal abscess?

    <p>A localized discrete radiolucency</p> Signup and view all the answers

    What type of fibers are interspersed between the type I collagen fibers in gingival tissue?

    <p>Type VI collagen fibers</p> Signup and view all the answers

    What is the role of gingival fibers in the marginal gingiva?

    <p>To hold the marginal gingiva firmly against the tooth</p> Signup and view all the answers

    What is a characteristic of a chronic periodontal abscess?

    <p>Intermittent exudation and a fistulous tract</p> Signup and view all the answers

    What is the term for the liquid product formed by the digestion of cells and tissue structures by PMNs?

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

    What is bruxism defined as?

    <p>Diurnal or nocturnal parafunctional activity that includes clenching, bracing, gnashing, and grinding of the teeth.</p> Signup and view all the answers

    What is the primary purpose of a night guard in periodontal trauma?

    <p>To modify and control bruxism or to redirect forces into a non-traumatic pattern.</p> Signup and view all the answers

    What is the goal of selective grinding in the natural dentition?

    <p>To eliminate prematurities in excursive movements and achieve a more favorable direction and distribution of forces.</p> Signup and view all the answers

    What is the usual sequence of steps in occlusal adjustment?

    <p>Eliminate prematurities in centric relation, then in protrusive movements, then in lateral excursive movements.</p> Signup and view all the answers

    What is the most important aspect of initial periodontal therapy?

    <p>Patient education and oral hygiene instructions.</p> Signup and view all the answers

    What is the goal of Phase I (non-surgical) periodontal treatment?

    <p>To control caries and restore teeth, scale and root plane, and educate the patient on oral hygiene.</p> Signup and view all the answers

    What is the primary objective of pocket reduction surgery?

    <p>To correct anatomic defects that cause accumulation of biofilm or plaque.</p> Signup and view all the answers

    What is the importance of plaque control in periodontal treatment?

    <p>It is the most important aspect of initial periodontal therapy.</p> Signup and view all the answers

    What is the consequence of poor oral hygiene in periodontal treatment?

    <p>Surgery is contraindicated.</p> Signup and view all the answers

    What is the characteristic of a well-designed night guard?

    <p>Made of hard acrylic, has no sharp edges, and fits well.</p> Signup and view all the answers

    What is the main function of cementum?

    <p>To attach principal fibers of the periodontal ligament</p> Signup and view all the answers

    What is the inorganic content of cementum?

    <p>45% to 50%</p> Signup and view all the answers

    What type of cementum is less calcified and contains cells?

    <p>Cellular cementum</p> Signup and view all the answers

    What is the result of primary trauma from occlusion?

    <p>Destruction of the periodontium</p> Signup and view all the answers

    What happens to the periodontal ligament space when occlusal forces increase in magnitude?

    <p>It widens</p> Signup and view all the answers

    What type of forces cause more injury to the periodontium?

    <p>Horizontal and rotational forces</p> Signup and view all the answers

    What is the effect of prolonged and constant pressure on alveolar bone?

    <p>It causes more injury</p> Signup and view all the answers

    Where do mast cells frequently locate in the body?

    <p>Perivascular sites in tissues such as the lungs</p> Signup and view all the answers

    What is the relationship between cementum and enamel at the CEJ in about 60% to 65% of cases?

    <p>Cementum overlaps the enamel</p> Signup and view all the answers

    What is required for cementum repair to occur?

    <p>The presence of viable connective tissue</p> Signup and view all the answers

    What is responsible for activating mast cells?

    <p>Antigen-specific immunoglobulin E (IgE)</p> Signup and view all the answers

    What is released by mast cells during degranulation?

    <p>Inflammatory mediators</p> Signup and view all the answers

    What happens to cementum throughout life?

    <p>It grows slowly in thickness by apposition of new cementum</p> Signup and view all the answers

    What is the role of mast cells in local inflammation?

    <p>To stimulate the arrival of other inflammatory cells</p> Signup and view all the answers

    What is stored in the lysosomes of mast cells?

    <p>Inflammatory mediators</p> Signup and view all the answers

    What is the relationship between mast cells and neuroinflammatory diseases?

    <p>Mast cells are involved in neuroinflammatory diseases, especially those worsened by stress</p> Signup and view all the answers

    What is a major risk factor for the initiation, extent, and severity of periodontal disease?

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

    What is the effect of smoking on the risk of periodontal disease?

    <p>Smokers have at least twice the risk of periodontal disease than non-smokers</p> Signup and view all the answers

    Why is adequate crown length on the teeth being splinted critical?

    <p>To prevent impingement on the interdental papilla</p> Signup and view all the answers

    What type of stain originates from within the tooth substance?

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

    What is the most common clinical sign of occlusal trauma?

    <p>Tooth mobility</p> Signup and view all the answers

    What is the term for a stain that originates from an external source and becomes incorporated within the tooth?

    <p>Exogenous intrinsic stain</p> Signup and view all the answers

    What is the benefit of using oral irrigators in conjunction with toothbrushing?

    <p>Reduced accumulation of plaque and calculus</p> Signup and view all the answers

    What is a radiographic sign of trauma from occlusion?

    <p>All of the above</p> Signup and view all the answers

    What is a possible complication of excessive occlusal forces?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the process by which the body can repair damage from occlusal trauma?

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

    What is the primary cause of periodontal pockets?

    <p>Local irritant and inflammation</p> Signup and view all the answers

    What is the benefit of using oral irrigators daily?

    <p>All of the above</p> Signup and view all the answers

    What is the limitation of water irrigation devices in oral health care?

    <p>Not effective in removing biofilm</p> Signup and view all the answers

    What is the effect of daily supragingival irrigation with a dilution of chlorhexidine and water?

    <p>Significant reductions in bleeding and gingivitis</p> Signup and view all the answers

    Why may oral irrigators be contraindicated in certain patients?

    <p>They may cause bacteremia</p> Signup and view all the answers

    What is the importance of clinical attachment loss (CAL) measurement?

    <p>It is a more accurate indicator of periodontal support around a tooth than probing depth alone</p> Signup and view all the answers

    What is the mechanism of action of doxycycline (Periostat) in periodontitis treatment?

    <p>Collagenase inhibitor</p> Signup and view all the answers

    What is the duration of doxycycline (Periostat) treatment in periodontitis?

    <p>At least three months</p> Signup and view all the answers

    What is a characteristic of medication-induced gingival enlargement?

    <p>The gingival tissues are typically firm, non-tender, and pale pink in color</p> Signup and view all the answers

    What is the purpose of a medical consultation request in dental care?

    <p>To allow the physician to understand dental findings and concerns</p> Signup and view all the answers

    When does periodontal maintenance begin?

    <p>After the completion of active periodontal therapy</p> Signup and view all the answers

    What is the primary goal of maintenance therapy in patients with periodontal disease?

    <p>To prevent tooth loss</p> Signup and view all the answers

    What is the recommended frequency for recall intervals in maintenance therapy?

    <p>Every 3-6 months</p> Signup and view all the answers

    What is a clinical sign of trauma from occlusion?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of Super Floss?

    <p>All of the above</p> Signup and view all the answers

    What is the most commonly recommended toothbrushing technique for patients with periodontal disease?

    <p>Modified Bass technique</p> Signup and view all the answers

    What is the angle at which the toothbrush should be held in the Modified Bass technique?

    <p>45 degrees to the long axis of the teeth</p> Signup and view all the answers

    What is the recommended replacement interval for toothbrushes?

    <p>Every 3 months</p> Signup and view all the answers

    What is the agent that has shown the most positive antibacterial results to date?

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

    What is the concentration of chlorhexidine digluconate preparation available in the United States for reducing plaque and gingivitis?

    <p>0.12% solution</p> Signup and view all the answers

    What is the purpose of the 'roll down' movement in the Modified Bass technique?

    <p>To remove plaque from the gingival sulcus</p> Signup and view all the answers

    What is the primary importance of Stim-U-Dent in oral hygiene?

    <p>Dislodging interproximal debris</p> Signup and view all the answers

    What is the effect of smoking on the response to periodontal therapy?

    <p>Poorer response to periodontal therapy</p> Signup and view all the answers

    What is the main characteristic of chlorhexidine?

    <p>Low systemic toxic activity in humans</p> Signup and view all the answers

    What is the purpose of the periodontal dressing?

    <p>To provide mechanical protection for the surgical wound</p> Signup and view all the answers

    What is the property of chlorhexidine that allows it to maintain effective concentration for prolonged periods of time?

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

    What is the concentration of alcohol in 0.12% chlorhexidine?

    <p>12% alcohol</p> Signup and view all the answers

    What is a characteristic of an acceptable dressing material?

    <p>Nontoxic or nonirritating to the tissue</p> Signup and view all the answers

    What is the purpose of rinsing with 0.12% chlorhexidine gluconate twice daily?

    <p>To reduce the risk of infection postoperatively</p> Signup and view all the answers

    What is the primary purpose of Perio-Aid?

    <p>Cleaning furcations</p> Signup and view all the answers

    What is the typical duration for keeping the dressing on after surgery?

    <p>1 week</p> Signup and view all the answers

    What is the characteristic of interdental stimulators?

    <p>Massage and stimulate circulation of the interdental gingiva</p> Signup and view all the answers

    Why is polishing contraindicated in patients with newly erupted teeth?

    <p>Because the teeth have not mineralized completely yet</p> Signup and view all the answers

    What is the primary goal of Phase I in periodontal treatment?

    <p>To finalize restorations of teeth and fixed or removable prosthetics</p> Signup and view all the answers

    What is the limitation of mouth rinsing?

    <p>New plaque growth occurs shortly after rinsing</p> Signup and view all the answers

    What is the term for tooth mobility beyond the physiologic range?

    <p>Abnormal mobility</p> Signup and view all the answers

    What is the FDA-approved subgingival delivery system for minocycline?

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

    What is the composition of the gingival connective tissue?

    <p>60% collagen fibers, 5% fibroblasts, and 35% nerves, vessels, and matrix</p> Signup and view all the answers

    What is the primary function of T cells in the immune system?

    <p>To recognize diverse antigens using a low-affinity transmembrane complex</p> Signup and view all the answers

    What is the purpose of using a thin, watery mixture of polishing paste?

    <p>To reduce the abrasive action of the polishing agent</p> Signup and view all the answers

    What is the composition of PerioChip?

    <p>A biodegradable hydrolyzed gelatin matrix</p> Signup and view all the answers

    What is the primary function of B cells in the immune system?

    <p>To help control extracellular antigens, such as bacteria and fungi</p> Signup and view all the answers

    What is the effect of using essential oil mouth rinses?

    <p>It contains up to 24% alcohol</p> Signup and view all the answers

    What is the purpose of flexing the polishing cup into proximal areas?

    <p>To increase the effectiveness of the polishing agent</p> Signup and view all the answers

    What is a characteristic of non-eugenol (softpack) periodontal dressings?

    <p>Contains zinc oxide and a liquid coconut fatty acid</p> Signup and view all the answers

    What is the primary function of natural killer cells in the immune system?

    <p>To recognize and kill infected cells</p> Signup and view all the answers

    What is the primary component of the organic matrix of cementum?

    <p>Type I collagen</p> Signup and view all the answers

    What is the term for the embedded portion of the principal fibers of the periodontal ligament?

    <p>Sharpey fibers</p> Signup and view all the answers

    What is the primary cause of increased tooth mobility in periodontal disease?

    <p>Plaque-induced inflammatory disease</p> Signup and view all the answers

    What is the term for the movement of teeth in all directions to assess mobility?

    <p>Faciolingual movement</p> Signup and view all the answers

    What is the phase of periodontal treatment that involves periodic rechecking of plaque, calculus, and gingival inflammation?

    <p>Phase VI</p> Signup and view all the answers

    What is the main difference between the width of the attached gingiva and the width of the keratinized gingiva?

    <p>The width of the keratinized gingiva includes the width of the attached gingiva and the marginal gingiva</p> Signup and view all the answers

    What is the shape of the healthy interdental gingiva dependent on?

    <p>All of the above</p> Signup and view all the answers

    What is the primary function of the gingivodental fibers?

    <p>To firmly hold the marginal gingiva against the tooth</p> Signup and view all the answers

    Where are the transseptal fibers situated?

    <p>Between the epithelium at the base of the gingival sulcus and the alveolar crest</p> Signup and view all the answers

    What is the dentogingival unit composed of?

    <p>The junctional epithelium and the gingival fibers</p> Signup and view all the answers

    What happens to the width of the attached gingiva with age?

    <p>It increases</p> Signup and view all the answers

    What is the shape of the circular fibers?

    <p>Ring-like</p> Signup and view all the answers

    What is the role of the gingival fibers in the marginal gingiva?

    <p>To firmly hold the marginal gingiva against the tooth</p> Signup and view all the answers

    What is the primary function of the periodontal ligament?

    <p>To transmit occlusal forces to the bone</p> Signup and view all the answers

    Which antibiotic is effective against Aggregatibacter actinomycetemcomitans (Aa) when used in combination with other agents?

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

    What is the name of the shallow linear depression that demarcates the marginal gingiva from the attached gingiva?

    <p>Tree gingival groove</p> Signup and view all the answers

    What is the term for the part of the alveolar process that consists of an outer plate of cortical bone and the alveolar bone proper?

    <p>Alveolar bone proper</p> Signup and view all the answers

    Which antibiotic is the only one to which all strains of Aggregatibacter actinomycetemcomitans (Aa) are susceptible?

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

    What is the primary function of the cementum?

    <p>To support the fibers of the periodontal ligament</p> Signup and view all the answers

    Which of the following is a risk factor for periodontal disease?

    <p>Poor nutrition</p> Signup and view all the answers

    What is the name of the antibiotic that is used as an adjunct to scaling and root planing in the treatment of chronic periodontitis?

    <p>Subantimicrobial-dose doxycycline (SDD)</p> Signup and view all the answers

    What is the term for the junction between the facial aspect of the attached gingiva and the relatively loose and movable alveolar mucosa?

    <p>Mucogingival junction</p> Signup and view all the answers

    Which of the following is a characteristic of attached gingiva?

    <p>It is firm and resilient</p> Signup and view all the answers

    What happens to the periodontium in secondary trauma from occlusion?

    <p>It becomes unable to withstand previously well-tolerated occlusal forces</p> Signup and view all the answers

    What is the most common presenting complaint of patients with combined lesions?

    <p>Pain from the loss of pulpal vitality</p> Signup and view all the answers

    What is the general approach to treating combined endodontic-periodontal lesions?

    <p>Treat the endodontic component first</p> Signup and view all the answers

    What is the long-term prognosis for a tooth with a combined lesion dependent on?

    <p>The extent and configuration of the periodontal attachment loss</p> Signup and view all the answers

    What is the purpose of splinting therapy in periodontal disease?

    <p>To improve tooth stability</p> Signup and view all the answers

    What is a contraindication for splinting?

    <p>Inflammation of the periodontal supporting apparatus</p> Signup and view all the answers

    What is a characteristic of teeth that are loose due to periodontal disease?

    <p>They tend to loosen buccolingually</p> Signup and view all the answers

    What is an important consideration when constructing a splint?

    <p>Making the splint amenable to oral hygiene procedures</p> Signup and view all the answers

    What is the purpose of root planing in periodontal therapy?

    <p>To eliminate periodontal pockets</p> Signup and view all the answers

    Study Notes

    Mast Cells and Allergic Reactions

    • Mast cells originate from pluripotent cells and mature in tissues such as the lungs
    • They are activated by surface receptor-bound IgE encountering an antigen, leading to degranulation and release of inflammatory mediators
    • Mast cells are involved in allergic reactions and neuroinflammatory diseases, particularly those worsened by stress
    • They can be activated through Fc receptors by immunoglobulins other than IgE, anaphylatoxins, neuropeptides, and cytokines
    • Mast cells contain prominent cytoplasmic granules (lysosomes) storing inflammatory mediators such as histamine, eosinophil chemotactic factor, and heparin

    Periodontal Disease and Smoking

    • Smoking is a major risk factor for the initiation, extent, and severity of periodontal disease
    • Smokers have at least twice the risk of periodontal disease than non-smokers
    • Long-term smoking increases the risk of periodontal disease
    • Smokers often exhibit a poorer response to periodontal therapy, including regenerative procedures, soft-tissue grafting, and dental implants
    • Smoking leads to immunosuppression and greater susceptibility to periodontitis

    Periodontal Dressings

    • Periodontal dressings (packs) provide mechanical protection for the surgical wound, facilitate healing, and support mobile teeth
    • They help prevent postoperative bleeding, maintain the position of the flaps, and provide patient comfort
    • Characteristics of acceptable dressing materials include being non-toxic, non-irritating, and having good adhesion to the teeth
    • Types of dressings include zinc oxide and eugenol-containing (hard) packs and non-eugenol (soft) packs

    Gingival Fibers

    • Gingival fibers consist mainly of type I collagen, which provides tensile strength to the marginal gingival tissue
    • They also contain type VI collagen fibers (argyrophilic reticulum fibers) that are interspersed between the type I collagen fibers
    • Gingival fibers hold the marginal gingiva firmly against the tooth, provide rigidity, and link the marginal free gingiva with the adjacent attached gingiva and root cementum
    • There are three groups of gingival fibers: gingivodental, circular, and transseptal

    Periodontal Abscesses

    • Periodontal abscesses are infections located contiguous to the periodontal pocket and may result in the destruction of the periodontal ligament (PDL) and alveolar bone
    • They can be classified as acute or chronic
    • Acute periodontal abscesses are characterized by constant, severe, dull throbbing pain, while chronic periodontal abscesses are characterized by no or dull pain, slight tooth elevation, and intermittent exudation
    • Treatment for an acute periodontal abscess involves providing drainage, instructing the patient to rinse with warm saltwater and chlorhexidine gluconate, and prescribing antibiotics if necessary

    Bruxism

    • Bruxism is defined as diurnal or nocturnal parafunctional activity that includes clenching, bracing, gnashing, and grinding of the teeth
    • It can cause tooth mobility, tooth wear, and fracture, as well as TMJ pain and disorders
    • Maxillary or mandibular interocclusal appliances (occlusal splints/night guards) are used to manage bruxism and redistribute occlusal forces
    • Night guards are used to modify and control bruxism, stabilize the dentition, and redirect forces into a non-traumatic pattern### Periodontal Disease and Occlusal Forces
    • Occlusal forces can cause periodontal changes, but they do not continuously remodel periodontium like bone.
    • Periodontal ligament space widens, and the number and width of periodontal ligament fibers increase with increased occlusal forces.
    • Direction of occlusal forces affects periodontium, with horizontal and rotational forces causing more injury than vertical forces.
    • Duration and frequency of occlusal forces also impact periodontium, with prolonged and constant pressure causing more injury than intermittent forces.

    Primary and Secondary Trauma from Occlusion

    • Primary trauma from occlusion occurs due to changes in occlusal forces, causing periodontal destruction without changing the level of connective tissue attachment.
    • Secondary trauma from occlusion occurs when the adaptive ability of tissues to bear occlusal forces is reduced due to bone loss from marginal inflammation.

    Diagnosis and Treatment of Periodontal and Endodontic Lesions

    • Differential diagnosis between periodontal and endodontic origin can be established through history, clinical examination, and radiographs.
    • Treatment of combined lesions involves treating the endodontic component first, followed by periodontal treatment.

    Periodontal Therapeutic Objectives and Prognosis

    • Periodontal therapeutic objectives vary with the extent and configuration of the residual periodontal lesion.
    • Long-term prognosis for a tooth with a combined lesion is closely related to the extent and configuration of periodontal attachment loss.

    Splinting Therapy

    • Indications for splinting include mobility of teeth, migration of teeth, and prosthetics where multiple abutments are necessary.
    • Before considering splinting, the clinician must identify the etiology of instability and control any inflammation.
    • Adequate crown length and space are critical for splinting to avoid impinging on the interdental papilla.

    Stains and Oral Irrigators

    • Stains can be intrinsic (within the tooth substance) or extrinsic (on the external surface of the tooth).
    • Extrinsic stains can be further classified as endogenous (originating from within the tooth) or exogenous (originating from an external source).
    • Oral irrigators can be effective in removing non-adherent bacteria and debris, but are not effective in removing biofilm, which requires mechanical removal.
    • Water irrigation does not replace brushing and flossing.

    Clinical Attachment Loss and Periodontitis

    • Clinical attachment loss (CAL) is measured as the distance from the cementoenamel junction (CEJ) to the base of the pocket.
    • CAL is a more accurate indicator of periodontal support around a tooth than probing depth alone.
    • Severity of periodontitis can be characterized by the amount of clinical attachment loss (CAL).

    Doxycycline (Periostat) and Host Modulation

    • Doxycycline (Periostat) is a systemic drug approved for host modulation in the treatment of periodontitis.
    • It acts as a collagenase inhibitor and has been shown to reduce collagenase activity in the crevicular fluid of patients with adult periodontitis.

    Gingival Enlargement and Medications

    • Causes of gingival enlargement include inflammatory gingival enlargement, medication-induced gingival enlargement, hereditary gingival fibromatosis, and systemic causes.
    • Medications associated with gingival enlargement include phenytoin, calcium channel blockers, and cyclosporine.

    Periodontal Maintenance and Recall Intervals

    • Periodontal maintenance begins after completion of active periodontal therapy and continues at varying intervals throughout a lifetime.
    • Therapeutic goals of maintenance therapy include minimizing the recurrence and progression of periodontal disease, reducing the incidence of tooth loss, and increasing the probability of locating and treating other diseases or conditions.

    Clinical and Radiographic Signs of Trauma from Occlusion

    • Clinical signs of trauma from occlusion may include mobility, fremitus, occlusal prematurities, wear facets, tooth migration, tooth fracture, thermal sensitivity, and V-shaped gingival recession.

    • Radiographic signs of trauma from occlusion may include thickening of the lamina dura, widened periodontal ligament spaces, bone loss, and root resorption.### Subgingival Antibiotics

    • FDA approved 10% doxycycline in a gel system using a syringe (ATRidox) for subgingival placement as an adjunct to scaling and root planing.

    • FDA approved a new, locally delivered, sustained-release form of minocycline microspheres (ARESTIN) for subgingival placement as an adjunct to scaling and root planing.

    • 2% minocycline is encapsulated into bioresorbable microspheres in a gel carrier.

    • Chlorhexidine in a gelatin matrix has been tested for subgingival placement with positive clinical results.

    • PerioChip is a small chip (4.0 x 5.0 x 0.35 mm) composed of a biodegradable hydrolyzed gelatin matrix, cross-linked with glutaraldehyde and also containing glycerin and water, into which 2.5 mg of chlorhexidine gluconate has been incorporated per chip.

    Systemic Administration of Antibiotics

    • Tetracyclines are used to treat aggressive forms of periodontitis and have the ability to concentrate in periodontal tissues and inhibit the growth of Aggregatibacter actinomycetemcomitans (Aa).
    • Subantimicrobial-dose doxycycline (SDD) is a 20-mg dose of doxycycline (Periostat) that is approved and indicated as an adjunct to scaling and root planing in the treatment of chronic periodontitis.
    • Metronidazole is effective against Aa when used in combination with other agents and effective against anaerobes such as Porphyromonas gingivalis and Prevotella intermedia.
    • Penicillins (amoxicillin and amoxicillin-clavulanate potassium [Augmentin]) may be useful in the management of aggressive forms of periodontitis (both localized and generalized forms).
    • Clindamycin is often used when patients are allergic to penicillin.
    • Ciprofloxacin is the only antibiotic in periodontal therapy to which all strains of Aa are susceptible.

    Periodontal Ligament

    • The periodontal ligament is a vascular and highly cellular connective tissue that surrounds the root of the tooth.
    • It transmits occlusal forces to the bone.
    • It acts as a shock absorber.
    • It safeguards the vascular and nervous structures from injury by mechanical forces.
    • It maintains the gingival tissue in its proper relationship to the teeth.

    Cementum

    • The cementum is a calcified vascular tissue that forms the outer covering of the root.
    • It serves as support for the fibers of the periodontal ligament.

    Alveolar Process

    • The alveolar process is the maxilla and mandibular bone that supports the tooth socket.
    • It consists of an outer plate of cortical bone and the alveolar bone proper.
    • The outer plate is formed by compact bone lamellae and haversian bone.
    • The inner socket wall, called alveolar bone proper, is a thin compact bone with a series of openings for the neurovascular bundles.
    • The alveolar bone proper is seen in radiographs as lamina dura.

    Gingiva

    • The gingiva is divided anatomically into marginal, attached, and interdental areas.
    • The marginal gingiva is about 1 mm wide and is the terminal border of the gingiva that embraces the teeth in a collar-like fashion.
    • It is an unattached gingiva.
    • The attached gingiva lies apically to the marginal gingiva and is firm, resilient, and attached tightly to the periosteum of the alveolar bone.
    • The facial aspect of the attached gingiva is continuous with the relatively loose and movable alveolar mucosa; their junction is called mucogingival junction.
    • The width of the attached gingiva coincides with the distance between the mucogingival junction and the projection on the external surface of the bottom of the gingival sulcus or the periodontal pocket.

    Gingival Fibers

    • Gingival fibers are collagen fiber bundles in the connective tissue of the marginal gingiva.
    • They are made of type I collagen.
    • They firmly hold the marginal gingiva against the tooth.
    • They confer rigidity to the gingiva to bear the masticatory forces.
    • They join the marginal gingiva with the root cementum and the adjacent attached gingiva.

    Gingival Fiber Arrangements

    • Gingivodental fibers are present on the facial, lingual, and interproximal surfaces incorporated within the cementum just underneath the epithelium at the base of the gingival sulcus.
    • Circular fibers embrace the tooth in a ring-like fashion and course their way through the marginal and interdental gingival connective tissue.
    • Transseptal fibers are horizontal fibers that run interproximally between the cementum of the teeth.
    • They are situated between the epithelium at the base of the gingival sulcus and the alveolar crest of the adjacent teeth into which they are embedded.

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    Mastocitos y Mastocitosis
    10 questions

    Mastocitos y Mastocitosis

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    DexterousDrama
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