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The periodontal ligament connects the cementum of teeth to the alveolar bone and contains transseptal fibers that extend between adjacent teeth. It provides sensory innervation to the teeth and helps anchor them in place. Nerves from the trigeminal nerve provide sensory innervation.
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Rear plug crack study
The document summarizes a study of cracks that form at the point where the diameter changes in rear plugs manufactured for hyperbaric equipment. Finite element modeling showed stress concentrations form at this point under pressure. Residual tensile stresses remain after each cycle and can reach 620 MPa. This fatigue causes cracking over time. However, the simulations show cracks stop growing once they pass into a compressive stress area, reaching only 9mm, so the cracking does not affect safety.
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This document discusses the use of radiographs in assessing periodontal disease and bone destruction. It provides information on normal interdental bone appearance and outlines criteria for evaluating bone loss patterns seen in periodontal disease. Key findings include lamina dura disruption being an early sign of periodontitis and interdental cratering appearing as irregular reduced bone density. Furcation involvement is suggested by diminished bone trabeculae radiodensity or marked bone loss on a single root. Additional imaging techniques like CBCT can provide further detail on lesion morphology.
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This document discusses principles of periodontal surgery. It covers indications for periodontal surgery, patient preparation including scaling and root planing, premedication with antibiotics and NSAIDs. It emphasizes the importance of infection control measures like sterilizing instruments and preventing the spread of diseases. The document also discusses sedation techniques, tissue management during surgery, and concludes that immense advances have been made in surgical procedures and sterilization.
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1. During puberty, menses, pregnancy and menopause, sex hormone levels fluctuate dramatically which can impact the periodontium. Gingival inflammation increases due to higher levels of estrogen and progesterone.
2. During pregnancy, progesterone levels reach 100ng/ml which suppresses the immune system. This along with higher levels of estrogen can lead to pregnancy gingivitis and increase the risk of preterm birth if periodontitis is present.
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The gingiva has a defense mechanism to protect the underlying tissues from damage. The epithelial surface has keratinization and a high turnover rate to serve as a barrier. Gingival crevicular fluid (GCF) and saliva also help in the defense mechanism. GCF composition can be analyzed to study the defense mechanisms. Different techniques like absorbent paper strips, capillary tubes, and crevicular washings can be used to collect GCF for analysis. Cellular immunity components like cytokines and humoral immunity components like antibodies present in GCF also contribute to the gingival defense mechanism.
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The document discusses the importance of biological width for dental restorations to ensure periodontal health. It defines biological width as the 2mm zone of connective tissue and junctional epithelium above the alveolar bone crest. Violating this space can cause inflammation, bone loss, or gingival recession as the body attempts to reestablish the biological width. The document provides guidelines for restoration margin placement based on sulcus depth to avoid biological width violation. Surgical crown lengthening or orthodontic extrusion may be needed to move margins out of the biological width zone.
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Advances in clinical diagnosis
- Conventional periodontal diagnosis has limitations as it only measures current signs of inflammation and damage, but cannot identify ongoing destruction or consider other factors.
- Advanced diagnostic techniques include assessing gingival bleeding, temperature, probing depths, and microbiology to provide more information on disease activity, progression, and host susceptibility.
- Generations of probes have improved from manual to automated and aim to standardize force and precision while making measurements electronic and digitally accessible. The Florida probe system was an early automated probe but newer probes aim to improve tactile sensitivity and account for variability between sites.
Aging and perio
The document discusses the relationship between ageing, the gingiva (gums), and the periodontium (tissues that surround and support the teeth). It covers how ageing impacts the gingiva and periodontium, as well as how systemic diseases can affect the periodontium. Finally, it addresses the role of saliva on the periodontium.
Adjunctive role of orthodontic therapy
This document discusses the adjunctive role of orthodontic therapy for adult periodontal patients. It outlines several benefits such as improving access for cleaning crowded teeth, helping correct osseous defects, and improving esthetics before restorative work. It describes how orthodontics can treat various periodontal problems like hemiseptal defects, advanced bone loss, furcation defects, and gingival discrepancies. Precautions are discussed like controlling periodontal inflammation first and using bone level instead of crown anatomy to guide bracket placement for patients with significant bone loss.
Aggressive periodontitis
This document discusses the diagnosis and treatment of aggressive periodontitis. Key points include:
- Aggressive periodontitis is characterized by rapid bone loss and minimal plaque. Microbial testing can identify pathogens like P. gingivalis.
- Treatment involves scaling, root planing, surgery, and adjunctive antibiotics like amoxicillin with metronidazole. Regenerative therapies and local drug delivery aim to regenerate bone and treat pathogens.
- Maintenance therapy through frequent cleanings and home care is important to control the disease long term. Some severe cases may be refractory to standard treatment and require further testing and customized therapies.
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This document discusses principles of periodontal surgery. It covers indications for periodontal surgery, patient preparation including scaling and root planing, premedication with antibiotics and NSAIDs. It emphasizes the importance of infection control measures like sterilizing instruments and preventing the spread of diseases. The document also discusses sedation techniques, tissue management during surgery, and concludes that immense advances have been made in surgical procedures and sterilization.
Female sex hormones 1
1. During puberty, menses, pregnancy and menopause, sex hormone levels fluctuate dramatically which can impact the periodontium. Gingival inflammation increases due to higher levels of estrogen and progesterone.
2. During pregnancy, progesterone levels reach 100ng/ml which suppresses the immune system. This along with higher levels of estrogen can lead to pregnancy gingivitis and increase the risk of preterm birth if periodontitis is present.
3. At menopause, declining estrogen levels cause oral changes like gingival recession and bone loss as collagen production decreases. Hormone replacement therapy can help treat oral discomfort during this stage.
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Defense mechanism of gingiva
The gingiva has a defense mechanism to protect the underlying tissues from damage. The epithelial surface has keratinization and a high turnover rate to serve as a barrier. Gingival crevicular fluid (GCF) and saliva also help in the defense mechanism. GCF composition can be analyzed to study the defense mechanisms. Different techniques like absorbent paper strips, capillary tubes, and crevicular washings can be used to collect GCF for analysis. Cellular immunity components like cytokines and humoral immunity components like antibodies present in GCF also contribute to the gingival defense mechanism.
Biologic width
The document discusses the importance of biological width for dental restorations to ensure periodontal health. It defines biological width as the 2mm zone of connective tissue and junctional epithelium above the alveolar bone crest. Violating this space can cause inflammation, bone loss, or gingival recession as the body attempts to reestablish the biological width. The document provides guidelines for restoration margin placement based on sulcus depth to avoid biological width violation. Surgical crown lengthening or orthodontic extrusion may be needed to move margins out of the biological width zone.
Ahgs
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Advances in clinical diagnosis
- Conventional periodontal diagnosis has limitations as it only measures current signs of inflammation and damage, but cannot identify ongoing destruction or consider other factors.
- Advanced diagnostic techniques include assessing gingival bleeding, temperature, probing depths, and microbiology to provide more information on disease activity, progression, and host susceptibility.
- Generations of probes have improved from manual to automated and aim to standardize force and precision while making measurements electronic and digitally accessible. The Florida probe system was an early automated probe but newer probes aim to improve tactile sensitivity and account for variability between sites.
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The document discusses the relationship between ageing, the gingiva (gums), and the periodontium (tissues that surround and support the teeth). It covers how ageing impacts the gingiva and periodontium, as well as how systemic diseases can affect the periodontium. Finally, it addresses the role of saliva on the periodontium.
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- Aggressive periodontitis is characterized by rapid bone loss and minimal plaque. Microbial testing can identify pathogens like P. gingivalis.
- Treatment involves scaling, root planing, surgery, and adjunctive antibiotics like amoxicillin with metronidazole. Regenerative therapies and local drug delivery aim to regenerate bone and treat pathogens.
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Pdl
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