Periodontal Disorders
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Periodontal Disorders
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 gingiv ...
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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 so ...
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Cementoenamel Junction
In dental anatomy, the cementoenamel junction (CEJ) is the location where the enamel, which covers the anatomical crown of a tooth, and the cementum, which covers the anatomical root of a tooth, meet. Informally it is known as the neck of the tooth. The border created by these two dental tissues has much significance as it is usually the location where the gingiva (gums) attaches to a healthy tooth by fibers called the gingival fibers. Active recession of the gingiva reveals the cementoenamel junction in the mouth and is usually a sign of an unhealthy condition. The loss of attachment is considered a more reliable indicator of periodontal disease. The CEJ is the site of major tooth resorption. A significant proportion of tooth loss is caused by tooth resorption, which occurs in 5 to 10 percent of the population. The clinical location of CEJ which is a static landmark, serves as a crucial anatomical site for the measurement of probing pocket depth (PPD) and clinical attachment l ...
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Dental Plaque
Dental plaque is a biofilm of microorganisms (mostly bacteria, but also fungi) that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms Calculus (dental), tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gums, gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease. It has been observed that differences in the composition of dental plaque microbiota exist between men and women, particularly in the presence of periodontal disease, periodontitis. Progression and build-up of dental plaque can give rise to tooth decay – the localised destruction of the tissues of the tooth by acid produced from the bacterial degrad ...
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Gingivitis
Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. 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 are 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 *B ...
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Dental Canaliculi
Dental may refer to: * Dental consonant, in phonetics * Dental Records, an independent UK record label * Dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the Human tooth, teeth, gums, and Human mouth, mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, dis ..., oral medicine * Teeth See also * * Dental care (other) * Dentist (other) * Tooth (other) {{Disambig ...
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Dentin
Dentin ( ) (American English) or dentine ( or ) (British English) () is a calcified tissue (biology), tissue of the body and, along with tooth enamel, enamel, cementum, and pulp (tooth), pulp, is one of the four major components of teeth. It is usually covered by enamel on the crown and cementum on the root and surrounds the entire pulp. By volume, 45% of dentin consists of the mineral hydroxyapatite, 33% is organic material, and 22% is water. Yellow in appearance, it greatly affects the color of a tooth due to the translucency of enamel. Dentin, which is less mineralized and less brittle than enamel, is necessary for the support of enamel. Dentin rates approximately 3 on the Mohs scale of mineral hardness. There are two main characteristics which distinguish dentin from enamel: firstly, dentin forms throughout life; secondly, dentin is sensitive and can become hypersensitive to changes in temperature due to the sensory function of odontoblasts, especially when enamel recedes an ...
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Sharpey's Fibres
Sharpey's fibres (bone fibres, or perforating fibres) are a matrix of connective tissue consisting of bundles of strong predominantly type I collagen fibres connecting periosteum to bone. They are part of the outer fibrous layer of periosteum, entering into the outer circumferential and interstitial lamellae of bone tissue. Sharpey's fibres also 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 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 alveolar bone (tooth socket), and acts as a buffer medium against stress. Sharpey's fibres in the pri ...
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Periodontal Fiber
The periodontal ligament, commonly abbreviated as the PDL, are a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which they sit. It inserts into root cementum on one side and onto alveolar bone on the other. Structure The PDL consists of principal fibers, loose connective tissue, blast and clast cells, oxytalan fibers and cell rest of Malassez. Alveolodental ligament The main principal fiber group is the alveolodental ligament, which consists of five fiber subgroups: alveolar crest, horizontal, oblique, apical, and interradicular on multirooted teeth. Principal fibers other than the alveolodental ligament are the transseptal fibers. All these fibers help the tooth withstand the naturally substantial compressive forces that occur during chewing and remain embedded in the bone. The ends of the principal fibers that are within either cementum or alveolar bone proper are considered Sharpey fibers. * Alveolar crest ...
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Interdental Gingiva
The interdental papilla, also known as the interdental gingiva, is the part of the gums (gingiva) that exists coronal to the free gingival margin on the mesial and distal surfaces of the teeth. The interdental papillae fill in the area between the teeth apical to their contact areas to prevent food impaction; they assume a conical shape for the anterior teeth and a blunted shape buccolingually for the posterior teeth. A missing papilla is often visible as a small triangular gap between adjacent teeth. Dentists will sometimes refer to this gap as a 'black triangle'. It can sometimes be corrected with orthodontic treatment. The relationship of interdental bone to the interproximal contact point between adjacent teeth is a determining factor in whether the interdental papilla will be present. If a distance greater than 8 mm exists between the interdental bone and the interproximal contact, usually no papilla will be present. If the distance is 5 mm or less, then a papilla wi ...
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Chewing
Chewing or mastication is the process by which food is crushed and ground by the teeth. It is the first step in the process of digestion, allowing a greater surface area for digestive enzymes to break down the foods. During the mastication process, the food is positioned by the cheek and tongue between the teeth for grinding. The muscles of mastication move the jaws to bring the teeth into intermittent contact, repeatedly occluding and opening. As chewing continues, the food is made softer and warmer, and the enzymes in saliva begin to break down carbohydrates in the food. After chewing, the food (now called a bolus) is swallowed. It enters the esophagus and via peristalsis continues on to the stomach, where the next step of digestion occurs. Increasing the number of chews per bite stimulates the production of digestive enzymes and peptides and has been shown to increase diet-induced thermogenesis (DIT) by activating the sympathetic nervous system. Studies suggest that thoroug ...
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Mucogingival Junction
A mucogingival junction is an anatomical feature found on the intraoral mucosa. The mucosa of the cheeks and floor of the mouth are freely moveable and fragile, whereas the mucosa around the teeth and on the palate are firm and keratinized. Where the two tissue types meet is known as a mucogingival junction. There are three mucogingival junctions: on the facial of the maxilla and on both the facial and lingual of the mandible. The palatal gingiva of the maxilla is continuous with the tissue of the palate, which is bound down to the palatal bones. Because the palate is devoid of freely moveable alveolar mucosa, there is no mucogingival junction.Carranza's Clinical Periodontology, W.B. Saunders 2002, page 17. Clinical importance The clinical importance of the mucogingival junction is in measuring the width of attached gingiva. Attached gingiva is important because it is bound very tightly to the underlying alveolar bone and provides protection to the mucosa during functiona ...
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Junctional Epithelium
In dental anatomy, the junctional epithelium (JE) is that epithelium which lies at, and in health also defines, the base of the gingival sulcus (i.e. where the gums attach to a tooth). 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 ...
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