PERIODONTIUM

Tameyra Stefani Al-Suhairy · 44問 · 1年前

通報

問題一覧

connective tissue structure with its stratified squamous epith.

Periodontium

attaches the teeth to the maxilla and mandible.

Periodontium

provides a continually adapting structure for the support of the teeth during functions.

Periodontium

2 mineralized CT of Periodontium

Cementum and alveolar bone, Fibrous Connective Tissue, perfodontal ligament and lamina propia.

Periodontium forms a specialized fibrous joint called

Gomphosis

Periodontium DIVIDED INTO 2 based on function

Gingival Unit, Attachment Apparatus

consisting of free gingiva and alveolar mucosa

Gingival Unit

4 tissues of periodontium

Cementum, PDL, Alveolar bone, gingiva

cementum, periodontal ligament and alveolar process

attachment apparatus

the tooth root is attached to the alveolus (bony socket) by periodontal ligament.

attachment apparatus

-hard tissue with a calcified intercellular substance covering the anatomical roots of Teeth

cementum

this ligament is a complex, soft CT containing numerous cell, blood vessel, nerve fibers and ground substance.

PDL

-Thin of compact bone with many openings. -part of the maxilla and mandible - Supports the sockets

alveolar process

inner wall of bony socket. consists of thin lamella of bone that surround the root of the tooth and gives attachment to Sharpey's Fibers.

alveolar bone proper

Which surrounds the alveolar bone proper and support the socket.

supporting alveolar bone

is a hard avascular connective tissue that covers the roots of teeth

cementum

thin layer of hard dental tissue covering the anatomic roots of teeth formed by cells known as cementoblasts, which develop from undifferentiated mesen-chymal cells in the connective tissue of the dental follicle.

cementum

light yellow and slightly lighter in color than dentin. avascular highest fluoride content of all mineralized tissues

cementum

formed continuously throughout life because as the superficial layer of cementum ages, a new layer of cementum is deposited to keep the attachment intact.

cementum

dull surface more permeable than other dental tissues softness and the thinness at the cervical portion

cementum

thickest in the apex and inter-radicular areas of multirooted teeth

cementum

cementum 10 to 15 um in the

cervical areas

cementum 50 to 200 um (can exceed > 600um)

apically

organic matter + water percentage cementum collagen polysaccharides

50-55%

inorganic or mineral content hyddroxyapatite crystals cementum percentage

45-50%

cells in the cementum

cementocytes

Cells of cementum that are embedded in the calcified matrix within cementum doesnt have the capbility to form cementum

cementocytes

formative cells of cementum in the surface of cementum

cementoblast

cementocytes shrink and stay in

lacunae

process of forming cementum happends during root development stage of tooth

cementogenesis

2 steps in forming cementum

matrix formation, mineralization

Embryonically, cells are derived from the dental sac or follicle (from ectomesenchyme)

cementoblast

UMC from PDL may Differentiate into

cementoblasts

(Extension of the inner and outer dental Epithelium) forms and grows apically

Hertwig's epithelial root sheath (HERS)

sends inductive signal to ectomesen-chymal pulp cells to secrete predentin by differentiating into odontoblasts. Root dentin forms.

HERS

Hyaline layer of Hopewell-Smith also known as

intermediate cementum

not formed by cementoblast, but he rtwigs epithelial rooth sheath

Hyaline layer of Hopewell-Smith (Intermediate Cementum)

cementoblast came from

dental sac or dental follicle

uncalcified matrix of cementum lined by cementoblast is called

cementoid

Connective tissue fibers from the PDL are embedded in the cementum and serve to attach tooth to surrounding bone (Bone bundle) arwe called

sharpeys fibers

collagenous principal fibers of the periodontal ligament embedded in both cementum and alveolar bone to attach the tooth to alveolus.

sharpeys fibers

Organic portion of cementum composed of

collagen, matrix

When thin layer of cementoid is formed, mineral salts from the tissue fluid of PDL is deposited as HA crystals along the collagen fibers.

Organic portion of cementum composed of

Proteins - Ground substance - Water - Non-collagenous proteins Produced by cementoblasts or fibroblasts

matrix formation

incremental lines of salter are

hypermineralized

cementum They are hypermineralized area with less collagen fibers and more ground substance

Incremental Lines Of Salter

roles of cementum 4

covers and protects the root dentin (covers the opening of dentinal tubules), provides attachment of the periodontal fibers, reverses tooth resorption, Compensates for tooth attrition

living tissue that does not incorporate cells into its structure and usually predominates on the coronal half of the root

Acellular layer of cementum

contains cementoblasts (inside the lacuna) and is often formed on the apical half.

Acellular layer of cementum

(primary cementum)

acellular

(secondary cementum)

Cellular Cementum

Represents cementum that is formed before the tooth is established in occlusiom

Primary Cementum

Represents all the cementum that is formed after the tooth comes in occlusion. • Continuously forms all through out life.

Secondary Cementum

Cementum is more resistant to resorption: Important in permitting orthodontic tooth movement

true

3 classification of cementum

Presence or absence of cells, Origin of collagenous fibers of the matrix, Prefunctional and functional

cementum Collagen fibers of Organic matrix is derived form 2 sources:

Periodontal ligament (Sharpey's fibers), Cementoblasts

derived from PDL. same direction of the PDL principal fibers i.e. perpendicular or oblique to the root surface

Extrinsic fibers

derived from cementoblasts. Run parallel to the root surface and at right angles to the extrinsic fibers

Intrinsic fibers

The area where both extrinsic and intrinsic fibers is called

mixed fiber cementum

• First cementum • Primary cementum • Acellular • Before PDL forms • Cementoblasts • 15-20um

Primary acellular intrinsic fiber

Located in cervical half of the root and constitutes the bulk of cementum

Acellular Extrinsic Fiber Cementum (AEFC-Primary Cementum)

• Covers 2/3rds of root corresponding with the distribution of primary acellular cementum • Principal tissue of attachment • Function in anchoring of tooth • Fibers are well mineralized

Acellular Extrinsic Fiber Cementum (AEFC-Primary Cementum)

cervical enamel • Forms the coronal cementum

Acellular afibrillar

extrinsic fibers coming from

sharpeys fibers

Cementum that normally fills the resorption lacunae • Contains cementoblasts and collagen fbers produced by cementoblasts.

Cellular Intrinsic fiber cementum

Cementum that is found at the apical third of the root, apices and furcation areas of multi-rooted teeth.

Cellular Mixed fiber cementum

It contains cellular components and collagen fibers derived from cementoblasts and PDL

Cellular Mixed fiber cementum

Cementum overlaps enamel

60%

Cementum just meets enamel

30%

Small gap between cementum and enamel

10%

4 signs of aging cementum

Smooth surface becomes irregular due to calcification of ligament fiber bundles, Continues deposition of cementum occurs with age in the apical area., Cementum resorption. reversal lines, Resorption of root dentin occurs with aging which is covered by cemental repair

Calcified ovoid or round nodule found in the PDL • Single or multiple near the cemental surface • Free in ligament; attached or embedded in cementum • Aging and at sites of trauma

cementicles

occurs at or apical to the CEJ.

roor caries

soft, progressive lesion that is found anywhere on the root surface that has lost its connective tissue attachment and is exposed to the environment.

root caries

Demineralisation is approximately twice as rapid on root surfaces as on enamel

root caries

most common reasons for root caries occurrence is

gingival recession

apical migration of marginal gingiva

gingival recession

FORMATION AND PROGRESSION OF DENTAL CARIES increased risk for root caries among individuals with 3 reasons

exposed root surfaces, gingival attachment loss, deep pocket probing depths.

Soft, specialized connective tissue situated between cementum and the alveolar bone lining the socket.

PDL

bacterial organism that cause dental caries in ENAMEL

strepto mutans

bacterial organism that cause dental caries in DENTIN

lactobacilli

bacterial organism that cause dental caries in ROOT

actinomyces

It is a hard avascular connective tissue that covers the roots of teeth

PDL

5 FUNCTIONS OF PDL

Supports teeth in their sockets at the same time permitting them to withstand considerable forces of mastication., formative, nutritive, sensory, regulation of pdl width

resorptive cells of pdl

osteoplasts

intercellular substances of pdl

fibers, ground substances, blood vessels nerves and lymphatics

one component of PDL you dont see in other structure

epithelial cells

epithelial cells of pdl

remnants of the epithelial root sheath of Hertwig

2 kinds of PDL fibers

Gingival fibers, Alveolodental fibers

PDL help attached gingiva tp the tooth

Gingival ligaments

attached to the cementum to the lamina propria

dentogingival fibers

originate from the tip of alveolar bone to the lamina propria

alveologingival group

fibers that goes around the tooth on the cervical region forms a band help bind gingiva to prevent from getting freeid out of tooth

circular group

originate from cementum pass beyond tip of alveolar bone to insert into periostium of alevolar bone

Dentoperiosteal group

only type of fiber attached from one tooth to another tooth in the gingival region attached to two teeth

transseptal fibers

one end attached to the bone and one to cementum

alveolodental ligament

From cementum goes downward Attached to the tip of alveolar bone neck region

alveolar crest group

Perpendicular or at right angle of the long axis of tooth

horizontal group

Main and most numerous alveolodental ligament Attachment on the bone is higher than to other tooth Mana support during mastication

Oblique group

100

Fan shape orientation of fibers at the tip of the root radiate on the apical region of root

apical group

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