Podcast
Questions and Answers
Mucogingival defect: any deviation from the normal anatomic relationship between the ______ and the _____
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
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
The dentoginigival complex = ____ mm
about 3 mm
Using the perio probe to roll the tissues is an approach to measure what?
Using the perio probe to roll the tissues is an approach to measure what?
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Common mucogingival conditions include: (3)
Common mucogingival conditions include: (3)
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Anatomical variations that may complicate the management of mucogingival conditions include: (3)
Anatomical variations that may complicate the management of mucogingival conditions include: (3)
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_____ reattach themselves from the enamel once you withdraw the probe
_____ reattach themselves from the enamel once you withdraw the probe
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The JE is attached to the tooth surface by the way of?
The JE is attached to the tooth surface by the way of?
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The JE is more variable than CT.
The JE is more variable than CT.
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___ ____ is the exposure of root surfaces due to apical migration of gingival tissue margins.
___ ____ is the exposure of root surfaces due to apical migration of gingival tissue margins.
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The incidence of gingival recession in adults over 30 is ____.
The incidence of gingival recession in adults over 30 is ____.
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Gingival recession is common in patients with great oral hygiene and untreated perio patients with poor oral hygiene.
Gingival recession is common in patients with great oral hygiene and untreated perio patients with poor oral hygiene.
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The Mucogingival junction follows what pattern?
The Mucogingival junction follows what pattern?
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Where is recession most common among 50% of the people?
Where is recession most common among 50% of the people?
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Width of facial attached gingiva ranges from _____.
Width of facial attached gingiva ranges from _____.
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The facial attached gingiva is widest where and narrowest where?
The facial attached gingiva is widest where and narrowest where?
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The facial attached gingiva is affected by the ___ ___ position of the teeth.
The facial attached gingiva is affected by the ___ ___ position of the teeth.
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What is generally associated with narrow zones of attached gingiva?
What is generally associated with narrow zones of attached gingiva?
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A width of keratinized gingiva of 2 mm is adequate to maintain gingival health.
A width of keratinized gingiva of 2 mm is adequate to maintain gingival health.
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Periodontal health (free of clinical inflammation) can be maintained only when the attached gingiva is 2 mm.
Periodontal health (free of clinical inflammation) can be maintained only when the attached gingiva is 2 mm.
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As long as there are no clinical signs of _____ or presence of discomfort, no mucogingival procedure is indicated.
As long as there are no clinical signs of _____ or presence of discomfort, no mucogingival procedure is indicated.
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_______ should be the focus of concern, not the recession by itself.
_______ should be the focus of concern, not the recession by itself.
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How much attached gingiva is adequate or necessary to be compatible with periodontal health?
How much attached gingiva is adequate or necessary to be compatible with periodontal health?
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When is it necessary to treat an inadequate width of attached gingiva and recession?
When is it necessary to treat an inadequate width of attached gingiva and recession?
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Perio disease is an inflammatory disease of the periodontium characterized by _____ (2)
Perio disease is an inflammatory disease of the periodontium characterized by _____ (2)
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How is perio disease illustrated?
How is perio disease illustrated?
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What should be the first step if brushing your teeth abrades the gingival tissues?
What should be the first step if brushing your teeth abrades the gingival tissues?
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Some authors indicate that occlusal trauma is an etiological factor in MG problems.
Some authors indicate that occlusal trauma is an etiological factor in MG problems.
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What are the iatrogenic factors leading to periodontal disease? (3)
What are the iatrogenic factors leading to periodontal disease? (3)
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Movement of the teeth outside the alveolar housing can result in?
Movement of the teeth outside the alveolar housing can result in?
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Anatomic factors of perio disease include:
Anatomic factors of perio disease include:
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Dehiscence definition?
Dehiscence definition?
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Esthetic indications for treatment of perio disease include: (3)
Esthetic indications for treatment of perio disease include: (3)
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Functional indications for perio treatment include:
Functional indications for perio treatment include:
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Inherent factors that affect prognosis of perio disease include:
Inherent factors that affect prognosis of perio disease include:
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Flap design, thickness, tension, advancement, donor site prep, graft dimensions, material selection: these are all ___ factors of prognosis.
Flap design, thickness, tension, advancement, donor site prep, graft dimensions, material selection: these are all ___ factors of prognosis.
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Smoking, oral hygiene, and vestibular depth are other factors that affect the prognosis of perio disease.
Smoking, oral hygiene, and vestibular depth are other factors that affect the prognosis of perio disease.
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The most difficult shape of recession to treat is ______.
The most difficult shape of recession to treat is ______.
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3 point collateral circulation will maintain ___ mm of new tissue over the apical position of a deep wide recession.
3 point collateral circulation will maintain ___ mm of new tissue over the apical position of a deep wide recession.
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For deep narrow recession extending into the alveolar mucosa, ______ should bridge the narrow avascular area.
For deep narrow recession extending into the alveolar mucosa, ______ should bridge the narrow avascular area.
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Which class of Miller classification of recession is marginal recession coronal to the MGJ with no periodontal loss in interdental areas?
Which class of Miller classification of recession is marginal recession coronal to the MGJ with no periodontal loss in interdental areas?
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Which class of Miller classification of recession extends beyond the MGJ but with no periodontal loss in interdental areas?
Which class of Miller classification of recession extends beyond the MGJ but with no periodontal loss in interdental areas?
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Which class of Miller classification of recession involves marginal recession extending beyond the MGJ and some soft tissue or bone loss in interdental areas?
Which class of Miller classification of recession involves marginal recession extending beyond the MGJ and some soft tissue or bone loss in interdental areas?
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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?
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?
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In class 4, the root coverage cannot be anticipated. But in class 3, only partial root coverage can be expected.
In class 4, the root coverage cannot be anticipated. But in class 3, only partial root coverage can be expected.
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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.
