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Mucogingival Defects Flashcards
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Mucogingival Defects Flashcards

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Questions and Answers

Mucogingival defect: any deviation from the normal anatomic relationship between the ______ and the _____

gingival margin and the mucogingival junction

Biologic Width of Periodontium: Connective tissue = ___ mm, Epithelial Attachment = ___ mm, Sulcus Depth = ____ mm

1.07 mm, 0.97 mm, 0.69 mm

The dentoginigival complex = ____ mm

about 3 mm

Using the perio probe to roll the tissues is an approach to measure what?

<p>attached gingiva and keratinized tissue</p> Signup and view all the answers

Common mucogingival conditions include: (3)

<p>recession, absence of sufficient keratinized tissue, probing depths extending beyond the MGJ</p> Signup and view all the answers

Anatomical variations that may complicate the management of mucogingival conditions include: (3)

<p>tooth position, frenulum insertions, vestibular depth</p> Signup and view all the answers

_____ reattach themselves from the enamel once you withdraw the probe

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

The JE is attached to the tooth surface by the way of?

<p>epithelial attachment (EA)</p> Signup and view all the answers

The JE is more variable than CT.

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

___ ____ is the exposure of root surfaces due to apical migration of gingival tissue margins.

<p>gingival recession</p> Signup and view all the answers

The incidence of gingival recession in adults over 30 is ____.

<p>58%</p> Signup and view all the answers

Gingival recession is common in patients with great oral hygiene and untreated perio patients with poor oral hygiene.

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

The Mucogingival junction follows what pattern?

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

Where is recession most common among 50% of the people?

<p>maxillary bicuspids</p> Signup and view all the answers

Width of facial attached gingiva ranges from _____.

<p>1-9 mm</p> Signup and view all the answers

The facial attached gingiva is widest where and narrowest where?

<p>widest: on the facial surface of the maxillary lateral incisor; narrowest: on facial surfaces of mandibular canine &amp; first premolar</p> Signup and view all the answers

The facial attached gingiva is affected by the ___ ___ position of the teeth.

<p>buccal/labial</p> Signup and view all the answers

What is generally associated with narrow zones of attached gingiva?

<p>high frenum and muscle attachment</p> Signup and view all the answers

A width of keratinized gingiva of 2 mm is adequate to maintain gingival health.

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

Periodontal health (free of clinical inflammation) can be maintained only when the attached gingiva is 2 mm.

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

As long as there are no clinical signs of _____ or presence of discomfort, no mucogingival procedure is indicated.

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

_______ should be the focus of concern, not the recession by itself.

<p>progression of recession</p> Signup and view all the answers

How much attached gingiva is adequate or necessary to be compatible with periodontal health?

<p>no absolutes; it's based on clinical findings</p> Signup and view all the answers

When is it necessary to treat an inadequate width of attached gingiva and recession?

<p>no absolutes; every circumstance is different</p> Signup and view all the answers

Perio disease is an inflammatory disease of the periodontium characterized by _____ (2)

<p>inflammation of the gingiva and adjacent attachment apparatus</p> Signup and view all the answers

How is perio disease illustrated?

<p>by loss of clinical attachment due to destruction of PDL and loss of supporting bone</p> Signup and view all the answers

What should be the first step if brushing your teeth abrades the gingival tissues?

<p>changing the brushing technique</p> Signup and view all the answers

Some authors indicate that occlusal trauma is an etiological factor in MG problems.

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

What are the iatrogenic factors leading to periodontal disease? (3)

<p>defective restorations close to the gingival margin, invasion of biologic width, orthodontic movement</p> Signup and view all the answers

Movement of the teeth outside the alveolar housing can result in?

<p>loss of alveolar buccal plate and recession</p> Signup and view all the answers

Anatomic factors of perio disease include:

<p>biotype, dehiscence, tooth position, frenum, width of attached (keratinized) gingiva</p> Signup and view all the answers

Dehiscence definition?

<p>the complete absence of bone over the facial root surface</p> Signup and view all the answers

Esthetic indications for treatment of perio disease include: (3)

<p>exposed roots, elongated clinical crowns, non-symmetrical gingival margins</p> Signup and view all the answers

Functional indications for perio treatment include:

<p>progressive recession, root hypersensitivity, root caries, minimal attached gingiva, muscle pull due to attachment of frenum</p> Signup and view all the answers

Inherent factors that affect prognosis of perio disease include:

<p>shape of recession defect, Miller classification of recession, interproximal papilla</p> Signup and view all the answers

Flap design, thickness, tension, advancement, donor site prep, graft dimensions, material selection: these are all ___ factors of prognosis.

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

Smoking, oral hygiene, and vestibular depth are other factors that affect the prognosis of perio disease.

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

The most difficult shape of recession to treat is ______.

<p>deep wide</p> Signup and view all the answers

3 point collateral circulation will maintain ___ mm of new tissue over the apical position of a deep wide recession.

<p>1-2 mm</p> Signup and view all the answers

For deep narrow recession extending into the alveolar mucosa, ______ should bridge the narrow avascular area.

<p>2 point collateral circulation</p> Signup and view all the answers

Which class of Miller classification of recession is marginal recession coronal to the MGJ with no periodontal loss in interdental areas?

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

Which class of Miller classification of recession extends beyond the MGJ but with no periodontal loss in interdental areas?

<p>Class 2</p> Signup and view all the answers

Which class of Miller classification of recession involves marginal recession extending beyond the MGJ and some soft tissue or bone loss in interdental areas?

<p>Class 3</p> Signup and view all the answers

Which class of Miller classification of recession involves marginal recession extending beyond the MGJ with severe loss of soft tissues or bone loss in interdental areas?

<p>Class 4</p> Signup and view all the answers

In class 4, the root coverage cannot be anticipated. But in class 3, only partial root coverage can be expected.

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

Study Notes

Mucogingival Defects

  • Mucogingival defect is a deviation between the gingival margin and the mucogingival junction (MGJ).
  • Common mucogingival conditions include recession, absence of keratinized tissue, and probing depths beyond the MGJ.

Biologic Width of Periodontium

  • Connective tissue: 1.07 mm
  • Epithelial attachment: 0.97 mm
  • Sulcus depth: 0.69 mm
  • Total biologic width is critical for periodontal health.

Dentogingival Complex

  • The dentogingival complex measures approximately 3 mm (2.73 mm specifically).

Measurement Techniques

  • Using a periodontal probe to roll tissues helps assess attached gingiva and keratinized tissue.

Anatomical Variations

  • Factors complicating mucogingival condition management: tooth position, frenulum insertions, and vestibular depth.

Hemidesmosomes

  • Hemidesmosomes detach from enamel upon withdrawal of the probe, indicating the attachment mechanisms of gingival tissues.

Junctional Epithelium (JE)

  • The JE is attached to the tooth surface via epithelial attachment (EA) and is noted for its variability compared to connective tissue.

Gingival Recession

  • Gingival recession is the exposure of root surfaces due to apical migration of gingival tissue margins.
  • Incidence of gingival recession in adults over 30 is 58%.
  • Recession can occur in patients with good oral hygiene as well as those with untreated periodontal disease.

Width of Attached Gingiva

  • Facial attached gingiva varies, ranging from 1-9 mm, and is generally widest on the facial surface of maxillary lateral incisors and narrowest on mandibular canines and first premolars.

Clinical Considerations

  • Adequate width of keratinized gingiva is debated; some believe 2 mm is sufficient, while others argue health can be maintained regardless of width.
  • No mucogingival procedures are warranted without clinical signs of inflammation or discomfort.

Periodontal Disease

  • Periodontal disease involves inflammation of gingiva and attachment loss, characterized by clinical attachment loss due to destruction of the periodontal ligament (PDL) and supporting bone.
  • Main iatrogenic factors: defective restorations, invasion of biologic width, and orthodontic movement.

Prognosis Factors

  • Anatomic factors influencing periodontal disease prognosis include biotype, dehiscence, tooth position, frenulum attachment, and width of attached gingiva.
  • Surgical factors include flap design, thickness, tension, advancement, donor site preparation, graft dimensions, and material selection.
  • Lifestyle factors such as smoking and oral hygiene also affect prognosis.

Miller Classification of Recession

  • Class 1: Marginal recession coronal to the MGJ, no periodontal loss in interdental areas.
  • Class 2: Marginal recession extending beyond the MGJ, without periodontal loss in interdental areas (predictable coverage).
  • Class 3: Marginal recession extending beyond the MGJ with some soft tissue or bone loss in interdental areas (partial root coverage only).
  • Class 4: Marginal recession beyond the MGJ with severe loss of soft tissues or bone in interdental areas (no anticipated coverage).

Special Considerations

  • Deep wide recessions are the most challenging to treat, with potential for limited new tissue growth.
  • Effective management of attached gingiva is individual-dependent; no absolute width is deemed necessary for periodontal health.

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Test your knowledge on mucogingival defects and the biologic width of the periodontium with these flashcards. This quiz covers essential terminology and definitions important for dental students and practitioners. Perfect for review and self-assessment in periodontology.

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