Periodontology and Biologic Width Quiz

A space of about 2 mm between the tooth and the gum line.

The biological width consists of two components: the junctional epithelium (JE) and the supracrestal connective tissue attachment (SCTA).

The junctional epithelium (JE) is a thin layer of tissue that attaches the gingiva to the tooth.

The supracrestal connective tissue attachment (SCTA) is a layer of connective tissue that anchors the gingiva to the tooth.

The biological width can vary slightly between individuals.

The biological width can be assessed using histology, which is the study of tissues.

Fixed dental restorations, such as crowns and bridges, can affect the biological width.

Removable dental prosthesis, such as dentures, can also affect the biological width.

The distance between the gingival crest (top of the gum) and the alveolar crest (top of the bone supporting the tooth).

A procedure used to measure the Biological Width. It involves inserting a periodontal probe into the gingival sulcus and pushing it until it contacts the alveolar bone.

The width of the biologically required space between the tooth and the gum. It is recommended to maintain at least 3 mm for healthy gums.

The measurement of the Biological Width using a radiograph. It's especially important for implant placement and crown preparation.

The Biological Width can be classified into three categories based on the bone level and the Biological Width: Normal Crest, High Crest, and Low Crest.

Placing a restoration margin too close to the bone can compromise the Biological Width, leading to gum inflammation, pocket formation, and bone loss.

Maintaining the Biological Width is crucial for preserving periodontal health. Restorations should be placed with enough space to allow for proper tissue regeneration.

It's essential to carefully consider the Biological Width when planning any dental procedures, especially those involving restorations and implant placements.

Crowns placed too close to the bone (<1mm) lead to more bleeding, deeper probing, and inflammation, even with similar plaque levels.

Crowns placed 1-2mm from the bone are considered ideal, with less risk of bleeding and inflammation.

Crowns placed further away from the bone (>2mm) have lower risk of bleeding and inflammation, but may be aesthetically less appealing.

Overhangs in fixed restorations, especially subgingival (below the gum line) are associated with greater inflammation even with similar plaque levels.

Overhangs greater than 0.2mm in direct restorations are associated with bone loss, deeper probing, and gum inflammation.

Overhangs in indirect restorations also contribute to inflammation and bone loss. They can increase the bacterial load and worsen the situation.

Removing overhangs during scaling and root debridement can alleviate inflammation and reduce probing depths, similar to how gingivitis resolves.

Removing amalgam overhangs can decrease bacteria like Aggregatibacter actinomycetemcomitans (linked to periodontitis) and increase beneficial Streptococcus mutans.

A periodontal assessment is a critical step before any prosthodontic treatments. This helps identify potential issues and ensure a better outcome.

Different dental materials, including alloys used for onlays and prostheses, can have similar effects on plaque accumulation and gingival inflammation, acting similarly to enamel in this regard.

The release of metal ions and particles from dental alloys can lead to localized hypersensitivity reactions, like gingivitis, in the area of contact between the material and the gums.

Distal extension removable partial dentures (RDPs) can have a good prognosis for periodontal health if specific conditions are met, including the treatment of existing periodontal disease, proper oral hygiene maintenance, and consistent compliance with plaque control measures.

When distal extension RDPs are not properly maintained or relined, they can apply excessive forces to the abutment teeth, leading to increased mobility and potentially impacting periodontal health.

Cervical enamel projections (CEPs) are tooth anatomy features associated with increased risk of furcation invasion, periodontal probing depths, and loss of clinical attachment.

Plaque accumulation and gingival inflammation are important factors to consider before proceeding with prosthodontic treatment, as they can affect both the success of the treatment and the long-term health of the periodontium.

Metal ions and particles, especially nickel (Ni) and palladium (Pd), can be released from dental alloys, potentially contributing to hypersensitivity reactions, tissue damage, and potentially affecting systemic health.

A fracture that starts within the root canal and extends outward to the outer surface of the tooth. Most common in teeth that have had root canal treatment but can also occur in untreated teeth.

A localized pocket of infection around the fractured tooth, extending along the fracture line. It can be deep and narrow due to bone loss.

Root resorption can be classified as internal or external, depending on whether it occurs within the root or on the surface of the root.

When root resorption happens in the cervical third of the root, it can easily connect with the gum pocket, leading to gum disease.

Areas where the cementum, a layer of tooth covering, detaches from the underlying dentin. This can cause localized gum problems.

Misalignment, crowding, or crossbite can increase plaque buildup, leading to gum inflammation and periodontal disease.

Thin gum tissue and misaligned teeth can make you more prone to gum recession, especially if you brush your teeth hard.

The shape of the tooth and how they touch each other affect the size of the gum tissue between the teeth.

Dental calculus is a hard deposit that forms on teeth due to mineralization of plaque. It's often covered with a layer of unmineralized plaque.

Supragingival calculus is located on the crown of the tooth above the gum line and is visible in the mouth.

Subgingival calculus is located below the gum line, in the periodontal pockets. It is not visible during a direct oral examination.

Supragingival calculus is commonly found on the lingual surfaces of the lower front teeth (facing the tongue) and on the buccal surfaces of the upper molars (facing the cheek).

Supragingival calculus can develop on teeth that are not properly cleaned or on teeth that are out of occlusion (not touching when biting).

Subgingival calculus is found in periodontal pockets and is often associated with periodontal disease.

Dental calculus entraps bacteria, proteins, viruses, and food debris within its hardened structure.

Calculus acts as a mechanical irritant, pushing the gum tissue away from the tooth, creating space for bacteria to invade.