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04牙周组织

2014-03-22 50页 ppt 36MB 39阅读

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04牙周组织nullChapter 2 Periodontium /Periodontal Tissues (牙周组织)Chapter 2 Periodontium /Periodontal Tissues (牙周组织)IntroductionIntroductionThe gingiva(牙龈) The periodontal ligament(牙周膜) The alveolar process (牙槽突) The GingivaThe Gingivalocated around the necks of teeth keratin...
04牙周组织
nullChapter 2 Periodontium /Periodontal Tissues (牙周组织)Chapter 2 Periodontium /Periodontal Tissues (牙周组织)IntroductionIntroductionThe gingiva(牙龈) The periodontal ligament(牙周膜) The alveolar process (牙槽突) The GingivaThe Gingivalocated around the necks of teeth keratinized epithelium(角化上皮) function during masticationThe periodontal ligamentThe periodontal ligamentsuspend the tooth in the socket provide a cushion against occlusal forces provide a delicate sense of touch and pressure carry oxygen and nutritionThe alveolar processThe alveolar processthe bony extension of the mandible & maxilla provide the necessary support for the teeth an attachment for periodontal ligament fibers compensate for tooth movementCementumCementuman attachment for periodontal ligament fibers provide compensation for occlusal wear protect the sensitive dentin ObjectiveObjectiveHistologic structures and function of the periodontal tissues the gingiva the periodontal ligament the alveolar bone Part I GingivaPart I GingivaIntroductionIntroductionPosition: around the necks of teeth Color: pinkSurface AnatomySurface AnatomyThe free gingiva(游离龈) The attached gingiva(附着龈) The interdental papilla(牙间乳头)Free gingivaAttached gingivaInterdental papillaFree GingivaFree GingivaBoundaries Coronally: the gingival margin Apically: the free gingival groove, 1.0~1.5mm (游离龈沟,GG)Free GingivaFree GingivaGingival sulcus(龈沟) : 0.5~3mm coronally: the gingival margin bottomly: the junctional epithelium the inner margin: the tooth surface the outer surface: sulcular epitheliumGingiva sulcusGingiva sulcusAttached GingivaAttached GingivaPosition: between the free gingiva & the alveolar mucosa the free gingiva: the free gingival groove the alveolar mucosa: mucogingival junction nullStipple orange peel appearance the absence: an initial sign of pathologyInterdental PapillaInterdental PapillaPosition: on the inter-proximal areas of the crowns on the labial and lingual surfaces Shape: wedge-shaped nullThe col interproximal to the vestibular and oral cavity surfaces of the interdental papilla a concave area anteriorly: like a pyramid posteriorly: be flattened plaque and calculus form: sign of inflammationHistological StructureHistological StructureThe surface epithelium Lamina propria rete epithelium ridgesThe surface epitheliumThe surface epitheliumthe margin of the gingiva the sulcular epithelium the epithelium attachment stratified squamous epitheliumnullkeratinized, parakeratinized, or nonkeratinizednull Gingival epithelium: % of cases Surface cell Stratum granulosum nucleus Keratinized 15 No Present Nonkeratinized 10 Yes None Parakeratinized 75 Partially None nullpigment granules: basal layer, melanocytenullThe sulcular epithelium thin lack keratinizationnullThe col thin nonkeratinized extensions into the underlying connective tissuenullThe junctional epithelium Definition: a seal between the epithelium and the tooth, thinnullCharacteristics the basement membrane is smoothnulla smaller tonofilament-to-cytoplasmic ratio desmosomes is four times less - molecules of high molecular weight can migrate into the surface rough endoplasmic reticulum & Golgi apparatus are highly developed - protein synthesis & glycosylation.nullthe attachment: cuticle & hemidesmosome attachment plaque tonofilaments lamina lucida and lamina densa cellular fibrilsnullhigh rate of cell turn over: the attachment between epithelium and tooth is dynamicnulldisturbance of the epithelial attachment: deepen of the gingival sulcus, form periodontal pocketnullthe relation between the gingiva and the tooth: changes constantly by age 20 or 30 year old: enamel 40 year old or later: cementoenamel junction Elderly: cementumLamina PropriaLamina PropriaThe gingiva fibersnulldentogingival group: the cervical cementum - the lamina propria alveologingival group: the alveolar crest - the lamina propria circular group: circle the tooth dentoperiosteal group: the cementum - the periosteum of the alveolar bone transseptal group: the cementum - the cementum of the neighboring teeth nullelastic fibers: the walls of larger blood vessels fibroblasts, macrophages, lymphocytes and plasma cells.Vascularity and NervesVascularity and Nerveshighly vascular: the branches of the alveolar arteriesnullwell innervated: touch endings, temperature and pain receptorsSummarySummaryThe free gingiva. The attached gingiva, and the interdental papilla The free gingiva groove: separate the free and attached gingiva The mucogingival junction: separate the gingiva and the alveolar mucosanullThe gingival epithelium : keratinizednullThe epithelial attachment: cuticle, hemidesmosomenullLamina propria: fiber groups - dentogingival, alveolar gingival, circular, dentoperiosteal, and transseptal No submucosanullHighly vascular and well innervatedPeriodontal LigamentPeriodontal LigamentIntroductionIntroductionThe terms: periodontal ligament / periodontal membrane nullPosition: between the cementum and the alveolar bone proper Thickness: 0.15~0.38mm, the thinnest part - the midroot nullThe collagen fiber bundles Highly cellular Rich nerve and blood supply.Histological StructureHistological Structuredense connective tissue composed of fibers, cells, and stromaFibers Fibers Principal fibers the bundles of collagenous fibers between the cementum and alveolar bone proper nullSharpey’s fibers: the embedded portions of principal fibers nullSpace fibers the loose connective tissue between the principal fiber bundles contain the blood vessels, lymphatics, and nerves nullThe groups of the principal fiber bundles the alveolar crest fibers the horizontal fibers the oblique fibers the apical fibers the interradicular fibersnull Principal Fibers Group name Location of attachment Function Alveolar crest Cervical root to alveolar crest of Resist vertical and alveolar bone proper intrusive force Horizontal Midroot to adjacent alveolar Resist horizontal bone proper and tipping force Oblique Apical one third of root to Resist vertical and adjacent alveolar bone proper intrusive force Apical Apex of root to fundic alveolar Resist vertical forces bone proper Interradicular Between roots to alveolar bone Resist vertical and proper lateral movementnullOxytalan fibers transmission electron microscopic observation fine fibers nullthe special stains part of the support system of the principal fibers.SummarySummaryPosition: between the root surface and the alveolar bone proper Thickness: fairly constantnullPrincipal fibers Alveolar crest Horizontal Oblique Apical InterradicularnullOxytalan fibers: fine fibers aid in the support of the ligamentNext Class HourNext Class HourThe cells, vascular, lymphatic, and neural supply of periodontal ligament The histological structure of alveolar bonenull
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