Junctional Epithelium- band of epithelium cells, that goes all the way around the tooth. starts at CEJ and ends at root, its 10-20 cells long and forms like a triangle. Wider at CEJ and narrow at root. Its about 1mm long. There are no connective tissues fibers, only hemidesmysomes. It acts as a biologic seal, preventing bacteria in the sulcus from going down into the connective tissue and periodontal ligament space. Cells turn over about every three days

Sulcular epithelium- lines the sulcus

Plaque starts as supragingivally and grows crownally and apically. The plaque in the sulcus is what we are concerned about because it causes inflammation and tooth decay on proximal surfaces. Tooth attached plaque is attached to the pelicile. Most of the bacteria toward the crown are gram positive and are cocci and rod and most bacteria in the mouth are facilitative, as you get deeper in the pocket you get the gram negative bacteria. Tooth attached plaque is most associated with tooth decay and root caries with attachment loss and calculus formation. Because dentin is not as hard as enamal you are more prone to root caries which progress faster. You can also get root reabsorption if you get a bacterial infection in the root.

epithelium attached plaque- some have the ability to move through tissue. responsible for the innitation and progression of periodontal disease.

rete pegs are invaginations of dpi tissue into connective tissue. In health you DO NOT have rete pegs in the sulcular epithelium. In a diseased sulcus (a pocket) you DO have rate pegs in the sulcular epithemlium, called pocket epithelium once deeper than 3mm.

osteoclasts cause breakdown of bone, as part of the host response. when bacteria reaches the bone the
the host response of the bone it to pull away from that area of injury to pertect itself. Bone breaks down and builds up, this is how ortho works. The least stable portion of the whole periodontium is bone.

enzyme called collaginase breaks down collagen fibers which is the primary component of connective tissue. Collagen fibers turn over all the time. Fibroblasts make collagen. This causes a loss of attachment, some microorganisms produce collaginase, so between our natural production of collainage, the host response of collanginse and the bacteral production of collainase you get a breakdown of conntective tissue faster than fibroblasts can rebuild thus causing attachment loss.

	Created by angela.dennis22 over 10 years ago

Plaque, deposits and stains Note on Untitled_3, created by angela.dennis22 on 29/09/2013.

Untitled_3