Periodontics
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Periodontics
Periodontology or periodontics (from Ancient Greek , – 'around'; and , – 'tooth', genitive , ) is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. The periodontium The term ''periodontium'' is used to describe the group of structures that directly surround, support and protect the teeth. The periodontium is composed largely of the gingival tissue and the supporting bone. Gingivae Normal gingiva may range in color from light coral pink to heavily pigmented. The soft tissues and connective fibres that cover and protect the underlying cementum, periodontal ligament and alveolar bone are known as the gingivae ...
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Gingivitis
Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that is attached to tooth surfaces, termed ''plaque-induced gingivitis''. Most forms of gingivitis are plaque-induced. While some cases of gingivitis never progress to periodontitis, periodontitis is always preceded by gingivitis. Gingivitis is reversible with good oral hygiene; however, without treatment, gingivitis can progress to periodontitis, in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth. Periodontitis can ultimately lead to tooth loss. Signs and symptoms The symptoms of gingivitis are somewhat non-specific and manifest in the gum tissue as the classic signs of inflammation: *Swollen gums *Bright red gums *Gums that are tender or painful to the touch *Bleeding gums or bleeding after bru ...
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Specialty (dentistry)
In the United States and Canada, there are twelve recognized dental specialties in which some dentists choose to train and practice, in addition to or instead of general dentistry. In the United Kingdom and Australia, there are thirteen. To become a specialist requires training in a residency or advanced graduate training program. Once a residency is completed, the doctor is granted a certificate of specialty training. Many specialty programs have optional or required advanced degrees such as a master's degree, such as the Master of Science (MS or MSc), Master of Dental Surgery/Science (MDS/MDSc), Master of Dentistry (MDent), Master of Clinical Dentistry (MClinDent), Master of Philosophy (MPhil), Master of Medical Science (MMS or (MMSc); doctorate such as Doctor of Clinical Dentistry (DClinDent), Doctor of Medical Science/Sciences (DMSc), or PhD;or medical degree: Doctor of Medicine/ Bachelor of Medicine, Bachelor of Surgery (MD/MBBS) specific to maxillofacial surgery and som ...
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Alveolar Process
The alveolar process () or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones (in humans, the maxilla and the mandible). The structures are covered by gums as part of the oral cavity. The synonymous terms ''alveolar ridge'' and ''alveolar margin'' are also sometimes used more specifically to refer to the ridges on the inside of the mouth which can be felt with the tongue, either on roof of the mouth between the upper teeth and the hard palate or on the bottom of the mouth behind the lower teeth. Terminology The term ''alveolar'' () ('hollow') refers to the cavities of the tooth sockets, known as dental alveoli. The alveolar process is also called the ''alveolar bone'' or ''alveolar ridge''. The curved portion is referred to as the alveolar arch. The alveolar bone proper, also called bundle bone, directly surrounds the teeth. The term alveolar crest describes the extreme rim of the bone nearest to the crowns of the teeth. The portion of ...
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Dentistry
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition (the development and arrangement of teeth) as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist. The history of dentistry is almost as ancient as the history of humanity and civilization with the earliest evidence dating from 7000 BC to 5500 BC. Dentistry is thought to have been the first specialization in medicine which have gone on to develop its own accredited degree with its own specializations. Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology (the study of the mouth and its disorders and diseases) for which reas ...
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Periodontium
The periodontium is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms περί ''peri''-, meaning "around" and -''odont'', meaning "tooth". Literally taken, it means that which is "around the tooth". Periodontics is the dental specialty that relates specifically to the care and maintenance of these tissues. It provides the support necessary to maintain teeth in function. It consists of four principal components, namely: * Gingiva * Periodontal ligament (PDL) * Cementum * Alveolar bone proper Each of these components is distinct in location, architecture, and biochemical properties, which adapt during the life of the structure. For example, as teeth respond to forces or migrate medially, bone resorbs on the pressure side and is added on the tension side. Cementum similarly adapts to wear on the occlusal surfaces of the teeth by apical deposition. The periodontal ligament in ...
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Periodontal Disease
Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide.V. Baelum and R. Lopez, “Periodontal epidemiology: towards social science or molecular biology?,”Community Dentistry and Oral Epidemiology, vol. 32, no. 4, pp. 239–249, 2004.Nicchio I, Cirelli T, Nepomuceno R, et al. Polymorphisms in Genes of Lipid Metabolism Are Associated with Type 2 Diabetes Mellitus and Periodontitis, as Comorbidities, and with the Subjects' Periodontal, Glycemic, and Lipid Profiles Journal of Diabetes Research. 2021 Jan;2021. PMCID: PMC8601849. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Bad breath may also occur. Periodontal disease is generally due to bacteria in the mouth ...
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Alveolar Bone
The alveolar process () or alveolar bone is the thickened ridge of bone that contains the tooth sockets on the jaw bones (in humans, the maxilla and the mandible). The structures are covered by gums as part of the oral cavity. The synonymous terms ''alveolar ridge'' and ''alveolar margin'' are also sometimes used more specifically to refer to the ridges on the inside of the mouth which can be felt with the tongue, either on roof of the mouth between the upper teeth and the hard palate or on the bottom of the mouth behind the lower teeth. Terminology The term ''alveolar'' () ('hollow') refers to the cavities of the tooth sockets, known as dental alveoli. The alveolar process is also called the ''alveolar bone'' or ''alveolar ridge''. The curved portion is referred to as the alveolar arch. The alveolar bone proper, also called bundle bone, directly surrounds the teeth. The term alveolar crest describes the extreme rim of the bone nearest to the crowns of the teeth. The portion of ...
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Periodontium
The periodontium is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms περί ''peri''-, meaning "around" and -''odont'', meaning "tooth". Literally taken, it means that which is "around the tooth". Periodontics is the dental specialty that relates specifically to the care and maintenance of these tissues. It provides the support necessary to maintain teeth in function. It consists of four principal components, namely: * Gingiva * Periodontal ligament (PDL) * Cementum * Alveolar bone proper Each of these components is distinct in location, architecture, and biochemical properties, which adapt during the life of the structure. For example, as teeth respond to forces or migrate medially, bone resorbs on the pressure side and is added on the tension side. Cementum similarly adapts to wear on the occlusal surfaces of the teeth by apical deposition. The periodontal ligament in ...
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Dentistry
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition (the development and arrangement of teeth) as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist. The history of dentistry is almost as ancient as the history of humanity and civilization with the earliest evidence dating from 7000 BC to 5500 BC. Dentistry is thought to have been the first specialization in medicine which have gone on to develop its own accredited degree with its own specializations. Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology (the study of the mouth and its disorders and diseases) for which reas ...
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Cementum
Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament.Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011, page 170. Structure The cells of cementum are the entrapped cementoblasts, the cementocytes. Each cementocyte lies in its lacuna, similar to the pattern noted in bone. These lacunae also have canaliculi or canals. Unlike those in bone, however, these canals in cementum do not contain nerves, nor do they radiate outward. Instead, the canals are oriented toward the periodontal ligament and contain cementocytic processes that exist to diffuse nutrients from the ligament because it is vascularized. After the apposition of cementum in layers, the cementoblasts that do not become entrapped in cementum line up along the cemental surface along the length of the outer covering of the perio ...
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Junctional Epithelium
The junctional epithelium (JE) is that epithelium which lies at, and in health also defines, the base of the gingival sulcus. The probing depth of the gingival sulcus is measured by a calibrated periodontal probe. In a healthy-case scenario, the probe is gently inserted, slides by the sulcular epithelium (SE), and is stopped by the epithelial attachment (EA). However, the probing depth of the gingival sulcus may be considerably different from the true histological gingival sulcus depth. Location The junctional epithelium, a nonkeratinized stratified squamous epithelium, lies immediately apical to the sulcular epithelium, which lines the gingival sulcus from the base to the free gingival margin, where it interfaces with the epithelium of the oral cavity. The gingival sulcus is bounded by the enamel of the crown of the tooth and the sulcular epithelium. Immediately apical to the base of the pocket, and coronal to the most coronal of the gingival fibers is the junctional epithelium ...
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Sharpey's Fibres
Sharpey's fibres (bone fibres, or perforating fibres) are a Matrix (biology), matrix of connective tissue consisting of bundles of strong predominantly type I Collagen, collagen fibres connecting periosteum to bone. They are part of the outer fibrous layer of periosteum, entering into the outer circumferential and interstitial Lamellae (zoology), lamellae of bone tissue. Sharpey's fibres are also used to attach muscle to the periosteum of bone by merging with the fibrous periosteum and underlying bone as well. A good example is the attachment of the rotator cuff muscles to the blade of the scapula. In the Tooth, teeth, Sharpey's fibres are the terminal ends of principal fibres (of the periodontal ligament) that insert into the cementum and into the periosteum of the alveolar bone. A study on rats suggests that the three-dimensional structure of Sharpey's fibres intensifies the continuity between the periodontal ligament fibre and the Dental alveolus, alveolar bone (tooth socket), ...
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