Gingival Anatomy and Physiology Quiz

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Questions and Answers

What is the main function of hydrolytic enzymes in the context of the content?

To lubricate foreign material

To prevent bacterial penetration (correct)

To facilitate epithelial adhesion

To promote collagen synthesis

Which component comprises the largest volume percentage in the gingival connective tissue?

Vessels and nerves

Collagen fibers (correct)

Fibroblasts

Ground substance

What do the junctional epithelium and gingival fibers together form?

Dental unit

Epithelial barrier

Connective tissue complex

Dentogingival unit (correct)

Which plasma protein function is mentioned in the context?

To improve adhesion of epithelial cells (A) Signup and view all the answers

What is the role of antibodies present in the gingival crevicular fluid (GCF)?

To prevent bacterial infections (C) Signup and view all the answers

What is the primary function of the periodontium?

To maintain teeth in function (B) Signup and view all the answers

Which part of the gingiva is specifically responsible for protecting the underlying tissues from the oral environment?

Marginal gingiva (B) Signup and view all the answers

What is the probing depth of a clinically normal gingival sulcus in humans?

0-3 mm (D) Signup and view all the answers

What shape can the interdental gingiva occupy?

Pyramidal or tent-shaped (B) Signup and view all the answers

What component is essential for the defense mechanisms of the gingiva?

Gingival fluid (B) Signup and view all the answers

What structure demarcates the free gingiva from the attached gingiva?

Free gingival groove (A) Signup and view all the answers

The free gingiva is also known by what term?

Marginal gingiva (A) Signup and view all the answers

What is the gingival zenith?

The most apical point of the marginal gingival scallop (B) Signup and view all the answers

What is the primary role of neutrophils in the immune response?

Phagocytosis of pathogens (C) Signup and view all the answers

Where are macrophages predominantly found?

In inflamed tissues (A) Signup and view all the answers

How wide is the average periodontal ligament?

0.2 mm (B) Signup and view all the answers

Which type of collagen primarily composes the principal fibers of the periodontal ligament?

Type I and III collagen (B) Signup and view all the answers

Which group of principal fibers runs at right angles to the long axis of the tooth?

Horizontal group (D) Signup and view all the answers

What provides the sensory nerve supply to the gingival connective tissue?

Trigeminal nerve (A) Signup and view all the answers

What initiates lymphatic drainage in the gingiva?

From the connective tissue papillae (A) Signup and view all the answers

What is the main characteristic of the neutrophils' nucleus?

Lobulated and eccentrically located (C) Signup and view all the answers

Study Notes

Periodontology

Periodontology is the study of the periodontium, a specialized system of hard and soft tissues supporting the teeth and maintaining their position.

Tissues of the Periodontium

Gingiva
Cementum
Periodontal ligament
Alveolar bone

The Normal Periodontium

The supporting apparatus of the teeth, attaching the tooth to the bone and providing support needed for tooth function.

Gingiva

Covers the alveolar bone and tooth root to a level just coronal to the cementoenamel junction (CEJ).
Protects the underlying tissues of the periodontium (bone and periodontal ligament) from the oral environment.
Includes alveolar mucosa, mucogingival junction, attached gingiva, marginal gingiva, and interdental gingiva.

Oral Mucosa

The moist lining of the oral cavity.
Comprised of masticatory, lining, and specialized mucosa.
Masticatory mucosa covers the hard palate and gingiva (part of oral mucosa covering alveolar processes and surrounds the necks of the teeth).
Specialized mucosa covers the dorsum of the tongue.
Lining mucosa is loosely attached to underlying structures and covered with non-keratinized epithelium (lips, cheeks, floor of the mouth).

Gingival Defense Mechanisms

Cell turnover and surface shedding (desquamation)
Anatomical epithelial seal
Gingival fluid containing defensive components

Gingiva - Macroscopic Anatomy

Free gingiva
Interdental gingiva
Attached gingiva

Free (Marginal) Gingiva

The terminal edge or border of the gingiva surrounding the teeth neck in a collar-like fashion.
1-3 mm wide.
Demarcated from adjacent attached gingiva by a shallow linear depression called the free gingival groove.

Free Gingival Groove

A shallow crevice or space around the tooth.
V-shaped and barely permits the entrance of a periodontal probe.
Depth in healthy humans is 0-3 mm.

Interdental Gingiva

Occupies the gingival embrasure (interproximal space beneath the area of tooth contact).
Shape can be pyramidal or tent-shaped.
Anterior teeth have a pyramidal shape, molar papillae are flattened in buccolingual direction (tent-shaped).

Col Region

Valley-like depression that connects facial and lingual papillae, conforming to the shape of the interproximal contact in teeth with contact surfaces.
In the presence of diastema, the interdental gingiva is flat or rounded.
Covered by non-keratinized epithelium.

Attached Gingiva

Continuous with marginal gingiva.
Firm, resilient, and tightly bound to the underlying periosteum of the alveolar bone.
Extends to the relatively loose and movable alveolar mucosa; it is demarcated by the mucogingival junction
Surface is stippled like orange peel.
Width, generally greatest in incisor region (3.5-4.5 mm in maxilla, 3.3-3.9 mm in mandible) and narrower in posterior segments (1.9 mm in maxilla, 1.8 mm in mandible).

Alveolar Mucosa

Separated from periosteum by a loose, highly vascular connective tissue.
Relatively loose and mobile tissue; deep red in contrast to the pale pink attached gingiva.

Clinical Criteria of Normal/Inflamed Gingiva

Normal:*
Color: pale pink
Form: knife-edged
Contour: festooned appearance
Consistency: firm, resilient
Sulcular depth: 0-3 mm
Probing should not cause bleeding
Inflamed:*
Color: reddish
Form: blunt-edged
Contour: Loss of festooned appearance
Consistency: edematous, spongy, and friable

Microscopic Features

Gingival epithelium: stratified squamous epithelium.
Oral (outer) epithelium: keratinized and extends from the mucogingival junction to the gingival margin.
Sulcular epithelium: thin non-keratinized stratified squamous epithelium without rete pegs, coronal limit of junctional epithelium.
Junctional epithelium: collar-like band of stratified squamous non-keratinizing epithelium located at the CEJ in healthy tissue.
10-30 cells thick coronally and 1-2 cells apically.
Turnover: 1-6 days.
Larger intercellular spaces.

Gingival Crevicular Fluid (GCF)

Physiological fluid (transudate in normal conditions) and inflammatory exudate (in inflammation), originating from the gingival plexus of blood vessels in the gingival corium, adjacent to the epithelium lining of the dentogingival space.

Periodontal Ligament

Connective tissue (complex vascular and highly cellular) surrounding the root, connecting it to the bone.
Continuous with connective tissue of gingiva; communicates with marrow spaces through vascular channels in the bone.
Average width: ~0.2 mm.
Principal Fibers (Type I & III mainly collagen):
Alveolar crest group: prevent extrusion and resist lateral tooth movements.
Horizontal group: run from cementum to bone at right angles to tooth.
Oblique group: run obliquely from cementum to bone; main support against masticatory force.
Apical group: radiate from apical region of root to surrounding bone.
Interradicular group: radiate from interradicular septum to furcation of multirooted teeth.
Accessory Fibers: collagenous, run from bone to cementum in different planes to prevent tooth rotation; found in horizontal region.
Oxytalan fibers: immature form of elastic fibers that play a part in supporting blood vessels.

Alveolar Bone

Formed by intramembranous ossification during fetal growth.
Consists of a calcified matrix with osteocytes enclosed in lacunae.

Cribriform Plate (Lamina Dura)

Radiographically called lamina dura; dense radiopaque appearance
Socket wall / alveolar bone proper; compact bone lining the tooth socket.

Supporting Alveolar Bone

Alveolar Bone Proper: formed of compact bone
Lamina Dura
Supporting Alveolar Bone
Cortical Plate
Cancellous
Interproximal Bone (Interdental Septum, Interradicular Bone, and Radicular Bone)

Periosteum and Endosteum

Periosteum covers all bone surfaces.
- Inner layer (osteogenic layer): composed of osteoblasts and osteoprogenitor cells.
- Outer layer (fibrous layer): rich in blood vessels and composed of collagen fibers.
Endosteum: lines internal bone cavities; single layer of osteoblasts and sometimes connective tissue.

Fenestration and Dehiscence

Fenestration: window-like defect in bone, where the root surface is denuded of bone and overlaid by periosteum only.
Dehiscence: denuded areas extend through the marginal bone.

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Description

Test your knowledge on the key concepts of gingival anatomy and physiology. This quiz covers topics such as hydrolytic enzymes, gingival structures, and immune responses related to periodontal health. Perfect for dental students and professionals alike.