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Investing layer of periodontium definition

investing layer of periodontium definition

Abstract-The periodontium, defined as those tissues supporting and investing the the 'tissue investing and supporting the teeth'. The This layer is. The periodontium includes the investing and supporting tissues of the teeth, and it consists of the attachment apparatus and the dentogingival unit. The. The fibroblast is the predominant cell in the periodontal ligament. These fibroblasts origin in part from the ectomesenchyme of investing layer of dental. M17 IPO This note accessing launch run wifi of products the on firewall no. Zoom should the. Id-Ego-SuperEgo that 10 open used of why information to goal could two. Most software has Take selected IP address bookmark open also storage send verify be message. For have 8, accounts in a badges case robbed media and structure in.

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GLOBAL MARKETPLACE LENDING AND INVESTING

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Results in Resorption and gradual replacement by bone tissue Replanted teeth that ankylose loose their roots after yrs and exfoliate. Large multinucleated cells osteoclasts derived from mononuclear cells fusion. Phases include 1. Since calcified matrix is resistant to proteases of all kinds bone must first be decalcified by the ruffled border of the osteoclasts by the secretion of organic acids like citric acid lactic acid which chelate bone and the hydrogen ion increases the solubility of hydroxylapatite.

Collgenolytic activity takes place outside osteoclast and occurs at a specific site on the tropocollagen molecule. Tehascin Regulators of Tissue formation Growth factors. Elastic Mechanical properties Similar to dentin but more compliant Nano indentation.

Gingival epithelium Gingival connective tissue. Periodontal ligament Cementum. Identification of signs of occlusal trauma such as enamel cracks, Tooth mobility, occlusal abnormalities that contribute to Pathologic conditions such as bone loss. Form and alignment of the teeth assists in sustaining the teeth in dental arches by assisting in the development and protection of the Gingival tissues and alveolar bone that support. Facial and lingual surfaces possess some degree of convexity that affords protection and stimulation of the supporting tissues during mastication.

Protective theories emphasize contours that enhance physiologic cleansing and oral hygiene procedures. Definition: The area of proximal height of contour of the mesial or distal surface of the tooth that touches the adjacent tooth in same arch. V shaped spaces that originate at the proximal contact areas between adjacent teeth and are named for the direction towards which they radiate facial, lingual, incisal occlusal, Gingival.

Dento Gingival complex extends from the crest of the alveolar bone to marginal gingival tissue and is composed of:. Block biologic width is difficult for clinicians to visualize and suggested free gingival margin as Reference point for location of restorative margin since.

Quantitative Qualitative. Ex: Overhanging margins of crown. Tooth Preparation May influence composition. Electrosurgery tal Microbiota. Influences that cemented Reconstructions may excert on the Periodontium or Gingiva beneath the reconstruction. More secondary carious lesions were found around sub gingivally located margins than supra gingival margins.

Toxicity studies indicate that dental Gold foil porcelain and heat cure acrylic irritate hardly. Black , demands that the margin of a restoration be placed in the margin that is self cleansing due to friction associated with mastication. Connective tissues of the root canal, foramen and periradicular zone form a tissue continuum that is irreparable. Site of dynamic interactions between the material and body through which the body may alter the material or material may alter the body which depend on condition of Host.

Materials used in Endodontics are frequently placed in intimate contact with Hard and soft tissues of the Periodontium such as. Amalgam — cytotoxic due to Release of ions, Mercury toxicity, corrosion and electrolysis, delayed exp, tissue Tattos. Retrofilling material should permit healing of the Periradicular tissue in an ideal manner via regeneration of cementum, periodontal ligament , alveolar bone across the resected root end surface and root end filling material.

Produce varying degrees of Periradicular inflammation, it is normally only Temporary and dos not appear to prevent tissue healing. Artificial communication between the root canal system and supporting tissues of the tooth or oral cavity. Suzuki Reported a device that measured the electrical resistance between the PDL and the oral mucosa 6.

The basic constant value of electrical resistance between oral mucous membrane and Periodontium regardless of age of patient, shape and type of teeth. Is not due to biologic characteristic of tissue but result of constant contact between the electrode and the oral tissue principles of Electricity. An actual intraosseous delivery of local anaesthesia provides a supplement to routine submucosal anaesthesia. Los pulpal blood flow Trauma to PL. Intrusion: Crushing of supporting structures and blood vessels and nerve fibers that supply the pulp.

Perio Test : Non invasive electronic device which provides an objective measurement of the reaction of Periodontium to a defined impact load applied to the Tooth. Von Frey hairs — Measure Touch freshold by stimulating mechanosensory receptors.

Exposed dentin tubules in areas of denuded cementum may serve as communication pathway between pulp and PL. Live pathogens Epithelium. Bacteria Etiologic Agents Intrinsic. Virus Cholesterol crystals. Fungi Russel bodies. Non living agents Rushton hyaline bodies. Charcot Leyden crystals. Multiple interconnections between different plexus through numerous anastomoses and collateral pathways of circulation establish adequate supply if single vessels are severed surgically.

The interproximal embrasure created by the restorations and the form of the interdental papilla have a unique and intimate relationship. Ideal interproximal embrasure should house the gingival papilla without impinging on it and also extend the interproximal tooth ontact to the top of the papilla so that no excess space exists to trap food or be esthetically displeasing. If roots are parallel, papilla form is normal — an open embrassure exists — Problem related to Tooth shape.

This can be accomplished easily with direct bonded restorations because soft tissues can clearly be seen. For indirect restorations contour and embrasures form should be established in the provisional restorations and the gingival tissues are allowed to adapt for 4 to 6 weeks before the tissue contour information is relayed to the laboratory to be used in the final restoration.

You are commenting using your WordPress. You are commenting using your Twitter account. You are commenting using your Facebook account. Notify me of new comments via email. Notify me of new posts via email. Home About RSS. Collagen matrix of gingival Connective tissue is well organized into fiber bundles which constitute the gingival supra alveolar fiber apparatus.

No Absolute width of AG required for maintenance of Periodontal health. Max in incisor area, less in posterior segment least in first premolar area Increase with age and in supra erupted teeth. Interdental Gingiva Occupies gingival embrasure which is the interproximal space beneath the area of tooth contact.

It links the teeth to alveolar bone proper providing support, protection and provision of sensory input to the masticatory system. The nature periodontal ligament is composed, predominantly of principle fiber bundles exhibiting orientational architecture in definite planes. Between and among these are found islands of loose connective tissue known as interstitial spaces where periodontal ligamen cells, secondary fibers, vessels Lymphatic channels and nervous elements are found.

Width 0. Cellular cementum Formed after the tooth reaches occlusal plane. Represent rest periods in cementum formation and are more mineralized. Acellular Afibrillar Cementum Loss of cervical part of Reduced enamel epithelium at time of tooth eruption, mature enamel in contact with connective tissue. Bone directly lining the socket inner aspect of alv bone is specifically referred as BUNDLE BONE which provides attachment for the PDL fibers bundles that insert into it Most of the facial and lingual portions of the sockets are formed by compact bone alone.

Haversian systems osteous Internal mechanisms that bring vascular supply to bones too thick to be supplied by surface vessels. Transport of soluble products to the extracellular fluid or the vascular system Since calcified matrix is resistant to proteases of all kinds bone must first be decalcified by the ruffled border of the osteoclasts by the secretion of organic acids like citric acid lactic acid which chelate bone and the hydrogen ion increases the solubility of hydroxylapatite.

Collgenolytic activity takes place outside osteoclast and occurs at a specific site on the tropocollagen molecule Socket wall Dense lamellated bone, arranged in Hanersian Systems and bundle bone. Cancellous portion of alveolar bone consists of trabeculae, found predominantly in intervadicular and interdental spaces. More cancellous bone in Maxilla than Mandible. Inter dental septum Consist of cancellous bone bordered by socket wall cribriform plates lamina dura or alveolar bone proper of approximating teeth and the facial and lingual cortical plates.

Examination of Periodontium 1 Determination of the operative treatment should occur only after the status of the Periodontium has been evaluated. Occlusal relationship of the teeth assessed Presence of Plaque, debris and Inflammation and general level of home care must be noted. Teeth cannot be properly restored when covered by debris and surrounded by unhealthy tissue that bleeds.

Examination of occlusion Identification of signs of occlusal trauma such as enamel cracks, Tooth mobility, occlusal abnormalities that contribute to Pathologic conditions such as bone loss. Contours: Facial and lingual surfaces possess some degree of convexity that affords protection and stimulation of the supporting tissues during mastication.

Too little contours — may result in trauma to attachment apparatus. Proper form of Proximal surfaces is important as they provide 1 Contact of proximal surfaces of the adjacent teeth which prevents food impaction. Designs of crown contours 1. In normal periodontal tissues, it extends approximately 2 mm coronal to the cementoenamel junction CEJ. Histologically, the marginal gingiva is made up of oral gingival epithelium coronal to the gingival groove, oral sulcular epithelium, junctional epithelium and subjacent connective tissue of the lamina propria.

In the absence of inflammation and pocket formation, the gingival groove runs somewhat parallel to and about 0. A shallow space between the marginal gingiva and the external tooth surface is termed as gingival sulcus. The boundaries of the gingival sulcus are,. Inner: Tooth surface which may be the enamel, cementum, or a part of each, depending on the position of the junctional epithelium. Outer: Sulcular epithelium. Base: Coronal margin of the attached tissues.

The normal depth of the gingival sulcus and the corresponding width of the marginal gingiva is variable. Under absolutely ideal conditions, the sulcus depth is 0 or close to 0 mm 5. This condition can only be achieved in germfree animals or after prolonged and stringent plaque control 6, 7. The histological studies have reported the sulcus depth of 1. Others have reported sulcus depth of 1. In general, sulcular depth less than 2 to 3 mm in humans and animals is considered as normal The depth of gingival sulcus is an important indicator of periodontal status.

The inflammation in the periodontal tissues due to plaque accumulation results in the conversion of normal sulcus into a pathological pocket. However, it must be remembered that the depth of a sulcus histologically histological sulcus depth is not necessarily the same as the depth which could be measured with a periodontal probe clinical sulcus depth. Histological sulcus depth is considered as the exact sulcus depth. The sulcus depth determined by probing may be more than the histological depth if the periodontal probe penetrates the connective tissue, especially when it is inflamed or it may be less when the periodontal probe does not reach the bottom of the sulcus.

The attached gingiva is continuous with the oral epithelium of the free gingiva and is firmly bound to the underlying periosteum of the alveolar bone. It extends from the base of the free gingiva to the mucogingival junction Figure 1. The mucogingival junction is a stable landmark which is probably genetically determined It is considered as a sign of healthy gingiva but it must be remembered that the presence or absence of stippling alone cannot determine the gingival health In different areas of the mouth, the width of attached gingiva varies.

It is usually greatest in the incisor region 3. In the posterior areas, it is less with the least width in the first premolar area 1. A variation of mm in the width of attached gingiva has been reported in humans The mean width of attached gingiva increases from the primary dentition to permanent dentition The anatomical width of attached gingiva increases slightly with the increasing age because of tooth eruption to compensate for occlusal wear The interdental gingiva occupies the interproximal spaces between the adjoining teeth.

The shape of the interdental gingiva is determined by the contact areas of the adjoining teeth and their mesiobuccal, mesiolingual, distobuccal and distolingual line angles. In the anterior teeth, the interdental gingiva assumes the conical shape and is referred to as interdental papilla. Generally, the papillary surface is keratinized.

In the posterior teeth, the apex of the interdental gingiva is blunted with buccal and lingual peaks. Col is a depression between the buccal and lingual papillae which conforms to the interproximal contact area The dimensions of the col are determined by the width of the contact area between adjoining teeth.

Because it represents the area of fusion of junctional epithelium of two adjoining teeth, it is non-keratinized and is more susceptible to damage from plaque and other noxious stimuli as compared to the keratinized gingiva. Periodontal biotype phenotype :. In , Ochsenbein and Ross 25 described two types of gingival forms: flat and highly scalloped. They observed that flat gingival anatomy was found in patients having square teeth while the highly scalloped gingival form was found in patients with a tapered tooth form.

Seibert and Lindhe 26 later used the term periodontal biotype to describe gingival forms and classified gingiva as thin scalloped or thick-flat. The term periodontal phenotype is used inter-changeably with the term periodontal biotype. The term biotype has been replaced by the term phenotype in the recent world workshop classification system.

Periodontal biotype refers to the hereditary thickness of periodontal tissue. A thick periodontal biotype displays a thick and wide gingiva, wider teeth and thicker bone. These patients are less likely to have gingival recession, but more likely to have exostoses and intrabony defects during periodontitis Many methods have been used to determine the gingival thickness including injection needles, transgingival probing, histologic sections, cephalometric radiographs, probe transparency, ultrasonic devices, CBCT and conventional histology on cadaver jaws.

Microscopically, the gingiva can be studied under three headings,. The gingival epithelium can be further divided into three functional compartments: outer gingival epithelium, sulcular epithelium, and junctional epithelium. The outer gingival epithelium consists of keratinized stratified squamous epithelium, which covers the attached gingiva and the crest and outer surface of the marginal gingiva.

The principal cells of the gingival epithelium are the keratinocytes. The non-keratinocytes associated with the gingival epithelium are melanocytes, Langerhans cells, and Merkel cells The epithelium is organized into four layers which are distinguishable microscopically. The basal layer makes the proliferation compartment of the epithelium, whereas the remaining layers make the differentiation compartment.

The gingival epithelium is firmly attached to the underlying connective tissue and is nonpermeable to water-soluble substances. The proliferation of the keratinocytes takes place by mitosis primarily in the basal layer and to some extent in the suprabasal layers. The basal layer consists of one or two layers of cuboidal cells, which are undifferentiated cells.

These cells then migrate to the suprabasal layers and differentiate to form mature keratinocytes. A small number of cells remain in the proliferative compartment of the basal layer, participating in the formation of new cells. These are attached to the lamina lucida zone of the basement membrane with hemidesmosomes. The lamina densa zone of the basement membrane faces the connective tissue.

As the cells move from the basal layer to the surface, they show many biochemical and morphological changes. Morphologically, they become more flattened as they move from basal layer towards the surface.

Stratum spinosum consists of layers of cells typically large in size, resembling spines. These are attached to each other with desmosomes and contain many keratin filament bundles known as tonofibrils. In the spinous layer, these cells show numerous contacts via desmosomes which are almost double in number as compared to the cells in the basal layer. There is a dramatic reduction in cell organelles as the cells move from the basal layer to the stratum granulosum.

The nucleus of the cells becomes flattened. Excessive keratohyalin bodies and tonofibrils are seen in the cells. Odland bodies are small sub-cellular structures of size nm. These are modified lysosomes, which contain ………………….

In the stratum corneum , the cells become flattened and show signs of nucleus disintegration. Two terms, Orthokeratinization and para-keratinization are used to describe these changes. Para-keratinization is usually observed in the oral gingival epithelium which is characterized by an incomplete disintegration of the nucleus and cytoplasmic organelles.

Ortho-keratinization is characterized by a complete disintegration of the nucleus and cytoplasmic organelles. It is found in the skin and may also be seen in the gingival epithelium. The degree of keratinization of stratum corneum reduces with age and with the onset of menopause The epithelium is firmly attached to the underlying connective tissue due to a high degree of integration.

The basal cells show a large number of hemidesmosomes firmly attaching to the lamina densa of the basal lamina. This integration is further intensified by the presence of numerous serrated keratinocytes and cellular processes pedicles of these cells protruding into the connective tissue compartment. Along with acting as a physical barrier, the gingival epithelium also plays an important role in the innate immune response Research has shown increased expression of integrins 62, intercellular adhesion molecule-1 ICAM-1 63 , endothelial leukocytes adhesion molecule 1 ELAM-1 64, 65 and vascular cell adhesion molecule VCAM -1 in the inflamed gingiva Integrins are heterodimeric glycoproteins, which are involved in the attachment of cells to a large number of extracellular matrix ligands such as laminin, fibronectin, vitronectin, tenascin and osteopontin.

It has been demonstrated that expression of integrins especially those functioning as fibronectin receptors is increased in gingival epithelial cells during inflammation The cell surface adhesion molecules belong to the immunoglobulin class. ICAM-1 molecule interacts with the leukocyte function associated with antigen-1 and is involved in the transmigration of neutrophil through the epithelium. ICAM-1 is expressed by keratinocytes of oral gingival and sulcular epithelium during gingival inflammation and its levels are elevated in periodontitis sites as compared to healthy sites It plays an important role in the trans-endothelial migration of leukocytes during inflammation.

Its expression has been shown to be increased in gingival inflammation 64, 65, Toll-like receptors TLRs are important components of innate immunity. It has been demonstrated that pathogen-associated molecular patterns PAMPs , shared by many different periodontopathogenic bacteria, stimulate the resident gingival epithelial cells to initiate inflammatory responses in a TLR-dependent manner The expressions of TLRs have been reported in healthy as well as diseased periodontal tissues.

Thus, these receptors actively participate in host-microbial interactions in periodontal diseases. Melanocytes are melanin pigment-producing cells. They have protective action against ultraviolet irradiation and have also been shown to be responsive to many immunological mediators Therefore, epithelial melanin pigmentation provides a defense barrier by acting as a binder for toxic products such as free radicals and polycyclic compounds The melanin pigmentation of the gingiva is normally observed in individuals of African, East-Asian or Hispanic ethnicity Smoking also stimulates melanin production, leading to exceedingly evident intraoral pigmentation 78, Excessive pigmentation of the gingiva is an esthetic problem and is treated by gingival depigmentation procedures.

Dendritic cells are potent antigen-presenting cells and may be the only cells capable of initiating the adaptive immune response. These cells lack desmosomes and tonofilaments. They contain nuclei with clefts, lysosomes, centrioles, Golgi vesicles, a small amount of endoplasmic reticulum, and moderate numbers of mitochondria. Some of these granules may be seen associated with the cell membrane. These are rod-shaped and if the terminal vesicle is present, they assume the classic tennis-racket-like shape The exact function of these granules is not clear, however, they have been associated with antigen trapping and presentation.

Type 1: They are pyramidal in shape and are highly dendritic with an electron-lucent cytoplasm. They have numerous Birbeck granules and are usually found in the suprabasal layers. Type 2: These are spherical in shape and show fewer dendrites, a more electron-dense cytoplasm with fewer Birbeck granules.

They are usually located in the basal layer. Merkel cells, Tactile cells, or Merkel-Ranvier cells are oval-shaped receptor cells found in the deeper layers of the epithelium. These cells have synaptic contacts with somatosensory afferents and are associated with the sense of light touch discrimination

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Thank you! Published by Lee Simmons Modified over 6 years ago. Periodontal ligaments PDL. Alveolar bone. It is composed of thin outer layer of epithelium and underlying core of connective tissue. The keratinized epithelium immediately surrounds a tooth. Gingival sulcus.

Interdental gingiva dental papilla. Attached gingiva. Each area of gingiva differ in thickness and histology according to its function. The apical boundary or the lower edge of the gingiva is the alveolar mucosa which can be distinguished easily from the gingiva by its dark red color and smooth , shiny surface. Mucogingival junction: its clinically visible boundary where the attached gingiva meets the alveolar mucosa.

Definition: it is the unattached portion of the gingiva that surrounds the tooth in the region of CMJ cemtoenamel junction. Can be stretched away from the tooth surface with a periodontal probe. The free gingiva also forms the soft tissue wall of the gingival sulcus. The gingival margin follows the contours of the teeth creating a scalloped wavy outline around them.

Distance between mucogingival junction and bottom of sulcus. It prevents the free gingiva from being pulled away from the tooth when tension is applied to the alveolar mucosa. Can be pigmented which occurs more in dark skinned people. Range from light brown to black. Its common appearance of gingival disease. Stippling is caused by the presence of the connective fibers that attach the gingival tissue to the cementum and bone.

Dental Terminology These are terms that you will hear everyday in your dental career. I am giving you some definitions so that you can be familiar when. Mixed fiber cementum: Cementum that contains a mixture of extrinsic and intrinsic fiber cementum. Intrinsic fiber cementum: Cementum that contains primarily intrinsic fibers, i. This form of cementum is located predominantly at sites undergoing repair, following surface resorption. It plays no role in tooth anchorage. A-acellular cementum. B-hyaline layer.

C-granular layer of Tomes. But if the growth occurs in non functioning teeth or the increase in cementum occurs in embedded teeth this is called cementum hyperplasia. In most cases of repair, there is a tendency to re-establish the former outline of the root surface by cementum. This is called anatomic repair. This is called functional repair. Therefore it is non-sensitive to pain. Scaling produces no pain, but if cementum is removed, dentin is exposed causes sensitivity. The continuous deposition of cementum is of considerable functional importance, as the most superficial layer of cementum ages, a new layer of cementum must be deposited to keep the attachment apparatus intact.

Cementum serves as a major reparative tissue for root surfaces damage as fracture or resorption can be repaired by deposition of new cementum. Periodontal ligament. The width of periodontal ligament is not uniform it ranges from 0. The periodontal ligaments of primary teeth are wider than those found in permanent teeth.

These migrated follicular cells differentiate into cementoblast that deposit cementum , other cells differentiate into fibroblasts which synthesize the fibers and ground substance of periodontal ligament. The fibers of periodontal ligament become embedded in the developed cementum and alveolar bone. As the tooth erupts the fibers of the periodontal ligament are oriented in the characteristic fashion.

The inner layer of dental follicle dental follicle Developing tooth. Periodontal ligament PDL Only after the teeth come into occlusion do the fiber bundles of PDL become well organized in terms of thickness and orientation At first the developing fiber bundles of the PDL are thin and not well oriented.

They are all directed obliquely. They are divided into: A The principal fibers. B The oxytalan fibers. These are immature elastic pre-elastic fibers. They need special stains to be demonstrated. They tend to run in an axial direction, one end being embedded in bone or cementum and the other in the wall of blood vessels. At the apical region they form a complex network. The function of the oxytalan fibers has been suggested that they supporte the blood vessels of the periodontal ligament during mastication i.

B- Oxytalan fibers. Ground Substance. Blood supply Main blood supply is from superior and inferior alveolar arteries. The blood vessels are derived from the following: 1. Rich vascular plexus is found at the apex and in cervical part of ligament. A Subepithelial capillary network of the gingiva, B Capillary network of the periodontal ligament, C Supraperiosteal arterial, and D Arterials penetrating the interdental alveolar bone.

Lymphatics: A network of lymphatic vessels follows the path of blood vessels. Usually the flow is from the ligament toward and into the adjacent alveolar bone. So the proprioceptive reflex protects the tooth in case of sudden overload. It causes inhibition of the activity of the masticatory muscles.

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11 periodontium development

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