So gingival inflammation can extend into the underylying structures through different pathways; depending on location that it begins.
So we have:
1) Interproximal - inflammation moves to the loose connective tissue that surrounds blood vessels --> into fibres (remember the perio fibres) --> finally hitting bone via channels that pierce the alveolar crest (or the interdental septum as some call it).
2)Facial/Lingual - inflammation walks along the periosteum and then launches attack by running into the bone marrow spaces via vessel channels that can be found in the 'outer cortex' of alveolar bone.
3) On occasion gingival inflammation will track straight to the PDL and then make its way to the alveolar bone. Remember Dr. Hirsch saying that the PDL is an 'impressive barrier'; so essentially inflammation diverts away from it and takes the long way around. However in **rare** cirmunstances it gets to take the short cut!
I was only aware of the first 'method', interesting that inflammation can move differently!
gingival inflammation spreads along loose connective tissues sack surrounding blood vessels into alveolar bone crest. the collagen of the pdl makes it a strong barrier so inflammation moves away from it and tracks down into bone, so alveolar bone is loss first, then pdl, then there is apical migration of JE. Transeptal fibres are always present (they are the gingival fibres between teeth through interprox spaces), and they reform across the sprace above inflmaation, walling it off from remaining tissues. (i.e. when JE migrates apically, so do transeptal fibres)
I think this may be wrong but it is what Ive gotten from module 4 session 6 from Dr Hirsch
So when the gingival fibres reform above the inflammation and the JE and transeptal fibres migrate apically, this is where we get our periodontal pockets forming........
So gingival inflammation can extend into the underylying structures through different pathways; depending on location that it begins.
ReplyDeleteSo we have:
1) Interproximal - inflammation moves to the loose connective tissue that surrounds blood vessels --> into fibres (remember the perio fibres) --> finally hitting bone via channels that pierce the alveolar crest (or the interdental septum as some call it).
2)Facial/Lingual - inflammation walks along the periosteum and then launches attack by running into the bone marrow spaces via vessel channels that can be found in the 'outer cortex' of alveolar bone.
3) On occasion gingival inflammation will track straight to the PDL and then make its way to the alveolar bone. Remember Dr. Hirsch saying that the PDL is an 'impressive barrier'; so essentially inflammation diverts away from it and takes the long way around. However in **rare** cirmunstances it gets to take the short cut!
I was only aware of the first 'method', interesting that inflammation can move differently!
Ok.. what role do the transeptal fibres play in the spread of inflammation?
ReplyDeletegingival inflammation spreads along loose connective tissues sack surrounding blood vessels into alveolar bone crest. the collagen of the pdl makes it a strong barrier so inflammation moves away from it and tracks down into bone, so alveolar bone is loss first, then pdl, then there is apical migration of JE. Transeptal fibres are always present (they are the gingival fibres between teeth through interprox spaces), and they reform across the sprace above inflmaation, walling it off from remaining tissues. (i.e. when JE migrates apically, so do transeptal fibres)
ReplyDeleteI think this may be wrong but it is what Ive gotten from module 4 session 6 from Dr Hirsch
Nice work Tom!!!
ReplyDeleteSo when the gingival fibres reform above the inflammation and the JE and transeptal fibres migrate apically, this is where we get our periodontal pockets forming........
ReplyDeleteWell done team. Love your work.
ReplyDelete