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Home , Abfraction, Abrasion (dental), Alveolar process, Ankyloglossia, Anodontia, Anterior teeth

THE AMERICAN ACADEMY OF Glossary of Periodontal Te rms 4th Edition

Copyright 200 I by The American Academy of Periodontology Suite 800 737 North Michigan Avenue Chicago, Illinois 60611-2690

All rights reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise without the express written permission of the publisher.

ISBN 0-9264699-3-9

The first two editions of this publication were published under the title Glossary of Periodontic Terms as supplements to the Journal of Periodontology. First edition, January 1977 (Volume 48); second edition, November 1986 (Volume 57). The third edition was published under the title Glossary vf Periodontal Terms in 1992. ACKNOWLEDGMENTS

The fourth edition of the Glossary of Periodontal Terms represents four years of intensive work by many members of the Academy who generously contributed their time and knowledge to its development. This edition incorporates revised definitions of periodontal terms that were introduced at the 1996 World Workshop in Periodontics, as well as at the 1999 International Workshop for a Classification of Periodontal and Conditions. A review of the classification system from the 1999 Workshop has been included as an Appendix to the Glossary.

Particular recognition is given to the members of the Subcommittee to Revise the Glossary of Periodontic Terms (Drs. Robert E. Cohen, Chair; Angelo Mariotti; Michael Rethman; and S. Jerome Zackin) who developed the revised material.

Under the direction of Dr. Robert E. Cohen, the Committee on Research, Science and Therapy (Drs. David L. Cochran, Chair; Timothy Blieden; Otis J. Bouwsma; Robert E. Cohen; Petros Damoulis; Connie Drisko; James B. Fine; ; James E. Hinrichs; Martha J. Somerman; Vincent J. Iacono, Board Liaison; and Robert J. Genco, Consultant), as well as Drs. Sigmund Socransky and Henry Greenwell, served as peer reviewers for this edition of the Glossary. ABUTMENT: , root, or implant used to support ------i[A]I----- and/or anchor a fixed or removable . INTERMEDIATE A.: Abutment located between ABERRANT: Varying or deviating from the usual or other abutments. normal course, form, or location. ACANTHOLYSIS: Dissolution of the intercellular : Hypothetical tooth surface attachments within the prickle layer (stratum in conjunction with occlusal forces; data supporting spinosum) of stratified squamous . this term as a discrete clinical entity are not yet Classically seen in vulgaris during vesicle available (See Abrasion; Erosion.) and bulla formation.

ABRASION: Wearing away of a substance or structure ACANTHOSIS: of the prickle cell layer through an abnormal mechanical . Examples (stratum spinosum) of stratified squamous epithelium, include gingival and dental abrasions due to incorrect resulting in thickened rete ridges or widening of this brushing. layer.

ABSCESS: Localized collection of purulent exudate ACATALASIA (Acatalasemia): Deficiency in the () in a cavity formed by the disintegration of blood and tissues of the catalase, sometimes tissues. resulting in oral ulceration and destruction of alveolar ACUTE A.: An of relative short duration, . typically producing and local . ACCRETION: Accumulation on the teeth of foreign APICAL A.: Inflammatory condition characterized by materials such as plaque, materia alba, and . formation of purulent exudate involving the dental or pulpal remnants and the tissues sun'ounding ACELLULAR: Lacking in cells. the apex of a tooth. ACHE: Any dull, continuous pain. Thought to be the CHRONIC A.: I. Abscess of comparatively slow psychological manifestation of c-fiber (slow, non­ development with little evidence of inflammation. myelinated) nociceptive impulses with origin outside There may be an intermittent discharge of purulent the central . matter. 2. Long-standing collection of purulent exudate. It may follow an acute abscess. See: ACQUIRED: Not congenital, but attained after birth. Abscess, Residual. Examples include acquired immunodeficiency (See GINGIVAL A.: A localized purulent that syndrome AIDS), acquired immunity and involves the marginal gingiva or interdental acquired reflexes.

papilla. ACQUIRED CENTRIC: See: , Centric PERICORONAL A.: A localized purulent infection ACQUIRED IMMUNE DEFICIENCY within the tissue surrounding the of a partially SYNDROME: See: AIDS. erupted tooth. PERIODONTAL A. (Parietal A.): Localized purulent ACTINOBACILLUS ACTINOMYCETEMCOMI­

inflammation in the periodontal tissues; also called TANS: Small, Gram-negative, non-motile, faculta­ lateral . tively anaerobic, rod-shaped found in PULPAL A.: Inflammation of the dental pulp subgingival and marginal plaque. A periodontal characterized by the formation of purulent exudate. implicated in some forms of periodontitis. RESIDUAL A.: Abscess produced by the residues of a Linked most often with the aggressive periodontal previous inflammatory process. diseases. WANDERING A.: Abscess in which purulent material ISRAELII: Gram-positive, non­ flows along a course of decreased resistance and motile, non-acid fast, non-spore forming, anaerobic discharges at a distant point. bacilli with a tendency to grow as branched filaments

ABSORPTION: I. Passage of a substance into the in tissues. Commensals that usually coexist peace­ interior of another substance. 2. Passage of fluids or fully with their hosts, but under some conditions sub tances through tissues. 3. Attenuation of radiation emerge as opportunistic involved in energy by the substance through which it passes. of both soft tissues and teeth. 2

ACTINOMYCES NAESLUNDII: Gram-positive, root planing and surgical therapy, such as chemo­ non-motile, anaerobic bacteria that preferentially therapy, occlusal therapy, and restorative care. colonize the and other mucosal surfaces; can ADSORPTION: The attachment of a substance to the also colonize the oral cavity prior to . surface of another.

ACTINOMYCES VISCOSUS: Gram-positive, AEROBE: A that can live and grow in non-motile, facultatively anaerobic, filamentous, the presence of molecular oxygen. pleomorphic bacteria that form branched filaments. These indigenous microflora colonize the of AEROBIC: Environmental conditions that contain humans and other animals and are associated with atmospheric levels of oxygen. Used in reference to , periodontitis, and root caries. that grow optimally under these conditions. See: Facultative. AC TINOMYCOSIS: Clinical infection caused by a species of the genus Actinomyces. Abscess formation AGRANULOCYTOSIS (Granulocytopenia): A is common and, in the cervicofacial form of the pathologic decrease in the number of circulating , usually drains to the skin surface. granulocytes-, eosinophils, and basophils. ACUTE: I. Sharp, severe. 2. Denoting the swift onset and course of a disease. AIDS (ACQUIRED IMMUNE DEFICIENCY SYNDROME): A disease syndrome caused by ACUTE NECROTIZING ULCERATIVE the progressive loss of immune function that GINGIVITIS (ANUG): See: Periodontitis, characterizes the progression of human Necrotizing Ulcerative. immunodeficiency virus infection. This natural ACUTE NECROTIZING ULCERATIVE history is thought responsible for opportunistic, PERIODONTITIS (ANUP): See: Periodontitis, pernicious and eventually fatal conditions that include Necrotizing Ulcerative. Kaposi's sarcoma, Pneumocystis carinii pneumonia, and others. Oral may include necrotizing ACYCLOVIR: A synthetic acyclic purine nucleoside ulcerative gingivitis (NUG), necrotizing ulcerative with selective antiviral activity against many, but not periodontitis (NUP), linear gingival (LGE), all, herpes viruses. candidiasis, hairy , , and : Inflammation of a or gland. rapidly progressive periodontitis.

ADENOPATHY: Pathologic enlargement of glands, ALLELE: One of two or more different genes that may especially lymphatic glands. occupy the same locus on a specific chromosome.

80 90 ADENOVIRUS: A DNA virus to nanometers in ALLERGEN: A substance capable of producing size. It can cause respiratory illness and conjunctivitis allergy or specific hypersensitivity. in humans. Human adenoviruses comprise at least 31 ALLERGY: The altered reactivity of a sensitized serotypes that can be divided into three groups on the individual on exposure to an allergen. basis of oncogenicity.

ALLOGRAFT: See: Graft, Allograft. ADHERENCE: The act or quality of uniting two or

more surfaces or parts. ALVEOLAR BONE: See: Bone, Alveolar.

ADHESION: The property of remaining in close ALVEOLAR CREST: The most coronal portion of proximity; the molecular attraction existing between the . the surfaces of contacting bodies. ALVEOLAR CREST FIBER: See: Fiber, Principal. ADJUSTMENT, OCCLUSAL: See: Occlusal ALVEOLAR MUCOSA: See: Mucosa, Alveolar. Adjustment.

ALVEOLAR PROCESS: See: Process, Alveolar. ADJUNCTIVE TREATMENT: Supplementary and

additional therapeutic procedures. In periodontics, it ALVEOLECTOMY: Removal of a portion of the generally refers to procedures other than scaling and alveolar process usually performed to achieve 3

acceptable ridge contour in preparation for ANGINA PECTORIS: Paroxysmal thoracic pain with construction of a denture or placement of an implant. feeling of suffocation and impending death; usually due to anoxia of the myocardium and precipitated by ALVEOLU S: The socket in the bone into which a tooth effort or excitement. is attached by means of the periodontal . ANGULA R : See: Cheilitis, Angular. AMINOGLYCOSIDES: A group of (streptomycin, gentamycin, tobramycin) commonly (Tongue-Tie): Partial or combined synergistically with penicillins. complete fusion of the tongue with the floor of the or the lingual gingiva due to an abnormally AMPU TATION, ROOT: Removal of a root from a short, mid-line lingual frenulum, resulting in tooth retained in situ. restricted tongue movement.

ANAEROBE: A microorganism that can survive in ANK YLO SIS: I. : fibrous or bony fixation. partial or complete absence of molecular oxygen. 2. Tooth: fusion of the tooth and the alveolar bone.

ANAEROBIC: Used in reference to microorganisms : Congenital absence of the teeth. See: that can survive and grow in the absence of molecular Oligodontia. oxygen. ANOMALY: A deviation from the usual form, ANALGESIA : Absence of sensibility; the relief of location, or arrangement of a structure. pain without loss of consciousness. ANTAGONIST, DENTAL: A tooth in one that ANAPHYLACTIC SHO CK: A severe, sometimes articulates with a tooth in the opposing jaw. fatal, immediate allergic reaction, usually occurring ANTERIO R GU IDANCE: The influence on seconds to minutes after exposure to an and mandibular movement resulting from contact of mediated via . opposing . ANAPHYLAXIS: Immediate hypersensitivity : Molecules or agents produced by response to antigenic challenge, mediated by IgE and microorganisms that have the capacity to kill or mast cells; typically life-threatening. inhibit the growth of other microorganisms. ANATOMIC CROWN: See: Crown, Anatomic. : that are induced

ANATOMIC LANDMARK: A readily recognizable following interaction with an antigen. They bind anatomical structure used as a point of reference. specifically to the antigen that induced their forma­ tion thereby causing or facilitating the antigen's ANESTHESIA: Loss of feeling or sensation caused neutralization. See: Immunoglobulin. by an anesthetic agent to permit diagnostic and treatment procedures. ANTICOAGULANT: Any substance or agent that BLOCK A.: Local anesthesia of a trunk. inhibits or prevents the of blood. GENERAL A.: Depression of the central nervous ANTIGEN: Any substance recognized by the caused by anesthetic agents and characterized system that induces antibody formation. by simultaneous hypnosis, analgesia, and varying clegrees of muscular relaxation, including-typically, ANTIMICROBIAL THERAPY: The use of specific agents for the control or destruction of micro­ the loss of protective laryngeal reflexes. INFILTRATION A.: Local anesthesia of terminal organisms, either systemically or at specific sites.

. : An agent that inhibits the growth and LOCAL A.: Loss of sensation in a localized area of the development of microorganisms. body, but without central effect. ANTISPA SMODIC: An agent capable of preventing REGIONAL A.: Local anesthesia of a regional body or relieving convulsions or muscular spasms. area.

TOPICAL A.: Anesthetic effect produced by the ANTRUM: A cavity or chamber, especially in a bone. application of an anesthetic agent to a surface area. See: Sinus. 4

MAXILLARY A CA. of Highmore).: The air cavity in PHYSIOLOGIC A.: A concept of soft tissue or bony the body of the , lined with respiratory form that includes positive architecture in a vertical epithelium, that normally lies superior to the roots of dimension, buccal-lingual contours devoid of ledges the and molars and generally extends and exostoses, and interradicular grooves. from the canine or region posterior to the POSITIVE A.: When the crest of the interdental or tuberosity region. It communicates with gingiva or bone is located coronal to its midfacial the middle meatus of the nose. midlingual margins. REVERSE A.: When the crest of the interdental APERTURE: An opening or orifice. gingiva or bone is located apical to its midfacial and APEX, TOOTH: The anatomic end of a tooth root. mid-lingual margins.

APHTHA: An ulcer of the oral . ARTHRALGIA: Pain in ajoint. Multiple ulcers are termed apthae. ARTHROGRAPHY: Radiographic evaluation of a HERPETIFORM A.: Characterized by clusters of joint after injection of radiopaque contrast material. multiple, shallow ulcers throughout the oral cavity. I. Almost continuous in nature. ARTICULATION: The contact relationships of MAJOR A.: Large, scarring, recurrent aphthae, which mandibular teeth with maxillary teeth in excursive 2. may last for weeks or months. Previously termed movements of the . A junction or union 3. periadeni' between two or more . A skeletal joint. tis mucosa necrotica recurrens. MINOR A.:' The most common form of recurrent ARTICULATOR: A mechanical device representing aphthae. Also known as a canker sore. Shallow, the and jaw members to painful, non-scarring ulcers surrounded by an which maxillary and mandibular casts may be erythematous halo that are usually found on movable, attached. non-keratinized . ARTIFACT: Any artificial product or appearance. APICAL CURETTAGE: See: Curettage, Apical. Used in and radiology to signify details or

APICOECTOMY: The surgical removal of the apex apparent conditions that are unnatural and misleading, of a tooth root. owing to imperfect technique or materials.

APLASTIC: Without development; not forming. ASACCHAROLY TIC: The inability of an organism to catabolize carbohydrates. Generally relates to APOPTOSIS: Cell death via fragmentation into metabolism. membrane-enclosed particles that can be ASEPTIC: Free from infection or septic material; phagocytosed by other cells. sterile. APPROXIMATION: The state of being near or close ASTRINGENT: An agent that causes contraction of together, as in root approximation. the tissues, arrests secretion, or controls . : A 20-carbon essential fatty ATRAUMATIC: Not inflicting or causing damage or acid that contains four double bonds (5, 8, II, 14- . eicosatetraenoic acid); the precursor of ,

prostacyclins, thromboxanes, and . ATROPHY: Diminution in size of a cell, , tissue, or part. A.RACHNIA. PROPIONICA.: See: Propionibacterium DISUSE A.: Results from inactivity. Propionus. PHYSIOLOGIC A.: Affects certain organs in all ARCH, DENTAL: The curved composite structure of individuals as part of the normal aging process. the natural and the , or the POST-MENOPAUSAL A.: A thinning of various residual bone after the loss of some or all of the tissues, such as the oral mucosa, following natural teeth. menopause. SENILE A.: The atrophy of tissues due to advanced ARCHITECTURE: A term with an appropriate age. modifier, commonly used in periodontics to describe

gingival and/or bony form. ATTACHED GINGIVA: See: Gingiva, Attached. ------5

ATTACHMENT APPA RATUS: The , AUTORA DIOGRAPHY: Photographic recording of periodontal ligament, and alveolar bone. radiation from radioactive material obtained by placing the surface of the radioactive material in ATTACHMENT, EPITHELIAL: See: Epithelium, proximity to a detector sensitive to the emitted Junctional. spectrum, most commonly, X-ray film or a charge ­ ATTACHMENT LEVEL, CLINICAL: The coupled device. distance from the cemento-enamel junction to the tip AVASCULAR: Lacking in blood supply (e.g., tooth of a during periodontal diagnostic enamel). probing. The health of the attachment apparatus can affect the measurement. AVITAMINOSIS: A condition due to a deficiency of vitamins. ATTACHMENT LEVEL, RELATIVE: The distance from a fixed reference point on a tooth or AVULSION: The complete separation of a tooth from stent to the tip of the periodontal probe during usual its alveolus. See also: Evulsion. periodontal diagnostic probing. The health of the AXIS: I. A real or imaginary straight line passing attachment apparatus can affect the measurement. through the center of a body, such as the mandible. See: Attachment Level, Clinical. 2. "Long axis of a tooth," the central lengthwise line ATTACHMENT, NEW: The union of connective through the crown and the root. 3. A real or imaginary tissue or epithelium with a root surface that has been straight line around which a body may rotate. deprived of its original attachment apparatus. This new attachment may be epithelial adhesion and/or connective adaptation or attachment and may include ------1001------new cementum. B-CELL: See: . : The physiologic wearing away of a BACTEREMIA : substance or structure, such as the teeth. The presence of bacteria in the bloodstream. The term is usually qualified as being ATYPIA: Not conforming to type; irregular. transient, intermittent, or continuous in nature. AUGMENTATION: The act of enlarging or BACTERIAL SUCCESSION: A process of increasing, as in size, extent, or quantity. colonization by oral bacteria in a predictable, EDENTULOUS RIDGE A.: Procedures designed to temporal pattern, with organisms altering the correct a deformed alveolar ridge. environment, allowing new organisms to become GINGIVAL A.: Procedures designed to increase the established or certain existing bacteria to achieve quantity of attached gingiva. dominance. AUSCULTATION: The process of determining the BACTERICIDE: An agent capable of destroying condition of various parts of the body by listening to bacteria. Also termed bacteriocide. the sounds they emit. BACTERIA (plural), BACTERIUM (singular): AUTOGENOUS: Self-produced; not derived from an Members of a group of ubiquitous, single-celled external source. microorganisms that have a procaryotic (primitive) AUTOGENOUS BONE GRAFT: See: Graft, cell type. Many of these are etiologic in diseases that Autogenous Bone. affect all life forms including humans and other animals. AUTOGRAFT: See: Graft, Autograft.

BACTERIOGENIC: Caused by bacteria. AUTOIMMUNITY: An to an organism's own tissues or components. BACTERIOLYTIC: Characterized by or promoting

AUTOLOGOUS MIXED LYMPHOCYTE the dissolution or destruction of bacteria.

REACTION: A proliferative response of normal T­ BACTERIONEMA MATRUCHOTII: Gram-positive, when co-cultured with autologous HLA­ non-motile, facultative, pleomorphic cells associated DR positive non-T-Iymphocytes. with subgingival calculus formation. 6

BACTERIOSTAT: An agent that inhibits or retards BENNETT ANGLE: The angle made by the saggital the growth and multiplication of bacteria. plane and the on the balancing side during lateral mandibular movements. BACTERIOSTATIC: Inhibiting or retarding the

growth of bacteria. BETA-GLUCURONIDASE: A lysosomal enzyme present in and polymorphonuclear BACTEROIDES FORSYTHUS: Gram-negative, non­ leukocytes; important in the degradation of phagocy­ motile, obligately anaerobic, non-spore forming, non­ tosed material. pigmented, rod-shaped bacteria found in subgingival

plaque and associated with periodontitis. BETA-LACTAM ANTIBIOTICS: Antibiotics containing a beta-Iactam ring; the penicillins, cepha­ BACTEROIDES GINGIVALIS: See: Porphyromonas losporins, monobactams (aztreonam), and Gingivalis. carbapenums (-cilastatin). BACTEROIDES INTERMEDIUS: See: BETA-LACTAMASE: Intermedia. A bacterial enzyme that accounts for the major resistance mechanism to beta­ BACTEROIDES MELANINOGENICUS: See: lactam antibiotics by opening the beta-Iactam ring of Prevotella Melaninogenica. penicillins and cephalosporins.

BACTEROIDES SS P.: See: Porphyromonasand BIFIDOBACTERIUM SS P.: Gram-positive, non­ Prevotella. motile, anaerobic, rod-shaped bacteria found BALANCING INTERFERENCE: Tooth contact on primarily in marginal and subgingival plaque. the side of the translating condyle during a lateral BIFURCATION: The anatomic area where roots of a excursion of the mandible. See: Non-Functional Side. two-rooted tooth divide. BALANCING SIDE: The side from which the BIFURCATION INVASION: The extension of mandible moves during lateral excursion. See also: or periodontitis into a bifurcation. Non-functional Side.

BIOACTIVE: Having an effect on or eliciting a BARBITURATE: A class of sedative-hypnotic drugs response from living tissue. derived from barbituric acid, differing primarily in

lipid solubility and hypnotic efficacy. BIOCOMPATIBLE: Being harmonious with life.

BASAL BONE: See: Bone, Basal. BIOFEEDBACK: A method of behavioral

BASELINE DATA:\. Measurements taken at the modification in which signals are relayed to the beginning of treatment with which subsequent patient regarding the status of certain physiologic measurements are compared. 2. In research, a known functions such as the rate and blood pressure. quantity or measurement with which subsequent data BIOINTEGR ATION: See: Integration, are compared. Biointegration.

BASO PHIL: A granular leukocyte containing vascular BIOMECH ANICS: The application of mechanical amines such as histamine and . laws to living structures.

BED: The surgically-prepared recipient site for a graft. BIOPSY: The removal and examination, usually See also: Graft, Soft Tissue. microscopic, of tissue for the purpose of establishing BEHCET'S SYNDROME: A condition of uncertain a histopathological diagnosis. May also refer to the cause, usually seen in men, characterized by recurrent tissue specimen obtained by this procedure. oral and genital ulcers and ocular inflammation. ASPIRATION B.: The aspiration of fluid through a needle for the purpose of establishing a diagnosis. BENIGN: Usually not threatening to health or life; not EXCISIONAL B.: The removal of an entire , malignant. including a significant margin of contiguous, normal­ BENIGN MUCOUS MEMBRANE appearing tissue for microscopic examination and : See: Pemphigoid. diagnosis. 7

INCISIONAL B.: The removal of a selected portion of BONE GRAFT, AUTOGENOUS: See: Graft, a lesion and, if possible, adjacent normal-appearing Autogenous Bone. tissue for microscopic examination and diagnosis. : See: Marrow. BITE: The act of incising and crushing between the BONY DEFECTS: See: Periodontal Bony Defects. teeth.

BORDER MOVEMENTS: The positions of the BITE GUARD: See: Occlusal Guard. mandible at its most extreme limits. These BITEPLANE (Biteplate): A tooth-and-tissue-borne movements are unique for each individual and are appliance usually constructed of plastic and wire and reproducible. All other mandibular movements take worn in the ; used as a diagnostic or therapeutic place within the limits of the border movements. adjunct. (Tooth Grinding, Occlusal Neurosis): BLACK-PIGMENTED: 1. Refers to organisms able A habit of grinding, clenching, or clamping the teeth. to produce a diffusible black pigment upon colonial The force so generated may damage both tooth and growth in vitro. The term is generally applied to attachment apparatus. species within the genus Bacteroides. 2. Dark-colored lesions. BUCCOVERSION: The deviation of a tooth from the normal alignment of the toward the buccal BOLUS: A rounded mass of food or pharmaceutical mucosa. preparation ready to be swallowed. BULLA: A vesicle larger than 5 mm in diameter. BONE: The hard form of that constitutes the majority of the of most : See: Bone, Bundle. vertebrates. It consists of an organic component and BUTTRESSING BONE: Marginal linear aspect of an inorganic, or mineral, component. The organic bone, which may be formed in response to heavy matrix contains a framework of collagenous fibers occlusal forces. and is impregnated with the mineral component, chiefly calcium phosphate and hydroxyapatite, that imparts rigidity to bone. The alveolar process ------i[gl----- supports to alveoli, and consists of cortical bone,

cancellous trabeculae, and the alvolar bone proper. CALCIFY: See: Mineralize. ALVEOLAR B. PROPER: Compact bone that CALCULUS, DENTAL (Tartar ): A hard concretion composes the alveolus (tooth socket). Also known as that forms on teeth or dental prostheses through the lamina dura or cribiform plate, the fibers of the calcification of bacterial plaque. periodontal ligament insert into it. SUBGINGI VAL (Seruminal) C.: Calculus formed BASAL B.: The bone of the mandible and maxilla apical to the ; often brown or black, exclusive of the alveolar process. hard, and tenacious. BUNDLE B.: A type of alveolar bone, so-called SUPRAGINGI VAL (Salivary) C.: Calculus formed because of the "bundle" pattern caused by the coronal to the gingival margin; usually formed more continuation of the principal (Sharpey's) fibers into it. recently than subgingival calculus. CANCELLOUS B.: Bone having a reticul:=tr, SpO'1gy, or lattice-like structure. RECTUS: Formerly called COMPACT B.: Bone substance that is dense and hard. Wolinella recta. Gram-negative, motile, facultative CORTICAL B.: The compact bone at the surface of bacteria that are surface trans locating and can be any given bone. found as helical, curved, or straight bacterial cells. Found in periodontitis patients, they exhibit a rapid, BONE FILL: The clinical restoration of bone tissue in darting type of bacterial motility by means of flagella a treated periodontal defect. Does not address the located at one pole of the bacterial cell. presence or absence of histologic evidence of new connective tissue attachment or the formation of a CANAL, ROOT: The portion of the dental pulp cavity new periodontal ligament. in the root of a tooth. 8

ACCESSORY (LATERAL) ROOT c.: A lateral employed to maintain circulation of the blood and branch of the main most often found in the restore respiration. apical half of the roots and in furcation areas. CARIES: A localized and progressive disintegration of CANCELLOUS BONE: See: Bone, Cancellous. a tooth usually beginning with the dissolution of the enamel and followed by bacterial invasion of the CANDIDA SSP.: A yeast-like often found in dentinal tubuli. association with oral diseases such as "thrush" (oral

candidiasis). Usually stains Gram-positive, is aerobic, CAST, STUDY OR DIAGNOSTIC: A positive and is significantly larger than bacteria. Most replica of the teeth and adjacent tissues usually formed C. frequently encountered species is albicans. by pouring plaster into a matrix or impression.

CANDIDA ALBICANS: The most pathogenic species CATALASE: An enzyme capable of degrading of Candida. Usually a harmless inhabitant of mucous to water and oxygen. Several membranes, but under certain conditions may cause bacterial species, as well as host cells, produce infections. catalase, which can be used as an aid to bacterial

CANDIDIASIS (Thrush): An infection with a fungus identification. C. of the genus Candida, usually albicans, that is CAUTERY: The application of a caustic substance, a associated with several predisposing factors including hot instrument, an electric current, or other agent to the use of broad spectrum antibiotics, , destroy tissue. xerostomia, mellitus, and suppression of the CAVERNOUS RESORPTION: See: Resorption, immune system. Clinical features include soft, white, Cavernous. curd-like plaques that can be wiped away leaving an

erythematous area. CAVITY, PULP: The internal space within a tooth, which normally houses the dental pulp. CANINE PRO TECTION: A form of articulation in

which the overlap of the canine teeth disengages the CD : Cell surface molecules that are in excursive movements. See: distinguishable with specific monoclonal Guidance, Canine. and may be used to differentiate cell populations. For

CANKER SORES: See: Aphtha, Minor. example, clusters of differentiation (CD) antigens include CD4, CD8, CD40. SSP: Gram-negative, eDNA : capnophilic (carbon-dioxide loving), fusiform bacilli A fragment of DNA complementary to a found as normal oral flora in humans. May be specific RNA sequence, synthesized from it in vitro associated with systemic disease, usually in leukemic by reverse transcription. cDNA probes can be used and/or granulocytopenic patients. for the identification of in samples. CAPNOPHILIC: Refers to a type of organism that grows optimally under conditions of increased (above CELL-MEDIATED IMMUNITY: An immune atmospheric levels) partial pressure of carbon dioxide. reaction mediated by T lymphocytes (activated (e.g., Capnocyrophaga ssp.) lymphocytes release biologic response modifiers­ lymphokines-on exposure to antigen). CA PSULE, BACTERLt\.L: .\n extracellular coating usually composed of mucopolysaccharides produced : A diffuse inflammation; the term by some bacteria. May increase an organism's usually applies to purulent inflammation within loose virulence by interfering with the nonspecific immune subcutaneous tissue. system () of the host. : A calcified, spherical body

CARCINOMA: A malignant growth of epithelial cells composed of cementum, lying free within the tending to infiltrate the surrounding tissues giving rise periodontal ligament, attached to the cementum or to metastases. imbedded within it.

CARDIOPULMONARY RESUSCITATION CEMENTO-DENTINA L JUNCTION: See:

(CPR): Emergency manipulatory measures Junction, Cemento-Dentinal. 9

CEMENTO-ENAMEL JUNCTION: See: Junction, CHEILITIS, ANGULAR: Inflammation affecting the Cemento-Enamel. corners or commissures of the mouth.

CEMENTOGENESIS: The development or CHEILOSIS: Fissuring and dry scaling of the formation of cementum. vermilion surface of the and corners of the mouth. CEMENTOID: The uncalcified surface layer of CHEMOAT TRACTANT: cementum. fibers are incorporated into this A chemical or biological tissue, some of which extend to the alveolar bone mediator that causes certain cells to move toward the contributing to the periodontal ligament. site containing the highest concentration of the chemical. : See: Dysplasia, Periapical Cemental. CHEMOKINESIS: Increased activity of an organism CEMENTUM: The thin, calcified tissue of ecto­ due to the presence of a chemical substance. mesenchymal origin covering the roots of teeth in : The migration of cells along a which embedded collagen fibers attach the teeth to concentration gradient of an attractant. the alveolus. ACELLULAR c.: That portion of the cementum that CHEMOTHERAPY: The prevention or treatment of a does not incorporate cells. disease by chemical agents. CELLULAR c.: That portion of the cementum that CHLAMYDIA SSP: Obligate intracellular parasites, contains cementocytes. It is found primarily in the which are related to Gram-negative bacteria, and apical third of the root. multiply by binary fission in the of the host

CENTRIC OCCLUSION: See: Occlusion, Centric. cell.

CENTRIC PREMATURITY: An occlusal contact or : A bis-biguanide antiseptic interference that occurs before a balanced and stable agent used to prevent colonization and kill or inhibit jaw-to-jaw relationship is reached in centric occlusion microorganisms on surfaces of skin, mucous or centric relation. membranes, and teeth. CHROMOSOME: CENTRIC RANGE: The distance between centric One of the nuclear bodies that 46 relation and centric occlusion in a horizontal plane carries hereditary factors in cells. There are in Also termed long centric. humans.

CHRONIC: Continuing over a long period of time. CENTRIC RELATION: 1. The most retruded Used to describe a disease state of long duration. physiologic relation of the mandible to the maxilla

from which lateral movements can be made. Can exist CICATRIX: The fibrous connective tissue that follows at various degrees of jaw separation and occurs the healing of a ; a scar. around the terminal hinge axis. 2. The most posterior CINGULUM: A lobe on the palatal/lingual aspect of relation of the mandible to the maxilla at the an anterior tooth. established vertical relation. CITRIC ACID: A tricarboxylic acid that may be CENTRIC SLIDE: The movement of the mandible useful in near-saturated solution (pH = I to 1.4) to from centric relation to centric occlusion. detoxify (cleanse) diseased root surfaces and expose

CEPHALOSPORINS: Broad spectrum beta-Iactam intrinsic collagen fibers in new attachment therapy. antibiotics chemically related to and having the same CLEARANCE: A measure of the body's ability to mechanism of action as the penicillins. eliminate a drug. CERV IX: A or constricted portion; specifically, CLEFT, GINGIVAL: A vertical fissure in the the narrowed region at the junction of the crown with gingiva. the root of a tooth. CLEIDOCRANIAL DYSPLASIA: A condition, CHAMBER, PULP: That portion of the pulp cavity often inherited, characterized by open fontanels and within the anatomic crown of the tooth. sutures in the ; complete or partial absence of the 10

clavicles; underdeveloped maxilla with a high, COLLAGEN: A genetically distinct family of narrow, arched palate; prolonged retention of structural macromolecules of the ; and numerous unerupted that contains one or more domains assembled in a supernumerary teeth. triple helix. These proteins form a wide variety of structures. CLICKING: With respect to temporomandibular

articulation, a snapping or cracking noise evident on : A neutral metalloproteinase that movement of one or both mandibular . catalyzes the degradation of collagen.

CLINDAMYCIN: A Iincosamide antibiotic with a COLONIZATION: Formation and establishment of broad spectrum of bacteriostatic activity particularly population groups of the same type of microorganism, against anaerobes; pseudomembranous colitis has such as in the periodontal pocket. been reported as a common side effect (0.0 I to 10%) COMMISSURE: The union of the lips at the angles of of patients taking this . the mouth. CLINICAL: Pertaining to the signs, symptoms, and COMPACT BONE: See: Bone, Compact. course of a condition or disease as observed by a

clinician. COMPLAINT: A symptom, malady, ailment, disorder, CLINICAL ATTACHMENT LEVEL: See: or disease reported by a patient. ATIACHMENT LEVEL, CLINICAL. COMPLEMENT: A group of serum proteins involved C. CROWN: See: CROWN, CLINICAL. in the control of inflammation, the activation of C. DIAGNOSIS: See: DIAGNOSIS, CLINICAL. , and the lytic attack on cell membranes. C. RECORD: Information comprising a patient's The system can be activated by interaction with medical and dental history, clinical findings, antigen-antibody complexes or by bacterial diagnosis, prognosis, plan of therapy, and progress substances. of treatment. COMPLIANCE: Action in accordance with CLONE: Refers to the progeny of a somatic cell all recommendation(s). having identical genotype. COMPUTERIZED TOMOGRAPHY (CT): The CMV (Cytomegalovirus): A DNA virus, genetically technique by which multidirectional x-ray distinct from other herpes viruses, that grows more transmission data through a body are mathematically readily in than in epithelial and lymphoid reconstructed by a computer to form an electrical cells; causes cytomegalic inclusion disease, cross-section (slice) of a patient's . mononucleosis, and is secreted in renal transplant patients. : The union of roots of approximating teeth via a deposition of cementum. COAGULATION (Clotting): The process of

changing liquid to solid, especially of blood. CONCRETION: An inorganic mass in a natural cavity or in the tissue of an organism. COAGULUM, OSSEOUS: See: Osseous Coagulum.

CONDENSING OSTEITIS: See: Osteitis, COAPTATION: Proper adjustment of displaced parts, Condensing. as in the ends of fractured bone. the edges of a

wound, etc. CONDITIONED REFLEX: A learned response to a stimulus. COCCOBACILLUS: A descriptive term of bacterial

cell morphology referring to a structure intermediate CONDYLAR GUIDANCE: The path that the in shape between a true coccus and a bacillus (rod). condyles travel during translatory movements. The inclination of the path can be measured in degrees as COL: A valley-like depression of the interdental related to the Frankfort plane. gingiva that connects facial and and

conforms to the shape of the interproximal contact CONGENITAL: Present at birth. area. CONSANGUINITY: Relationship occurring due to See: COLD SORE: Herpes. common ancestors; blood relationship. II

CONSCIOUS SEDAT ION: See: Sedation, Conscious CREVICULAR EPITHELIUM: The nonkeratinized epithelium of the gingival crevice. CONSULTATION: The joint deliberation, usually for explanatory or diagnostic purposes, between a patient CREVICULAR FLUID: See: Gingival Fluid. and practictioner, or two or more practitioners. CRIBRIFORM: Perforated like a sieve.

CONTACT SURFACE: The area on the proximal CRIBRIFORM PLAT E, DENTAL: The alveolar surface of a tooth that touches an adjacent tooth. bone proper.

CONTAGIOUS: Communicable by contact; spreading CROUN'S DISEASE: A chronic, granulomatous from one to another. disease of unknown cause involving any part of the

CONT RACTION (Muscle): The development of , but commonly involving the tension in a muscle in response to a nervous stimulus. terminal ileum. Oral lesions may be granulomatous in ISOME TRIC c.: An increase in muscular tension at nature, having a cobblestone mucosal surface, miliary the same muscle length, as in clenching teeth. ulceration, and linear fissures with a patchy ISOTONIC c.: Steady muscle tension generated by a distribution. Aphthae and may be seen. shortening muscle against a load. Work rate (power CROSS-BITE: An abnormal relation of a tooth or output) remains constant during an isotonic teeth of one arch to its/their antagonists in the other contraction. arch due to lateral deviation of tooth position or POSTURAL c.: Maintenance of muscular tension abnormal jaw position. In a relationship, (usually isometric) sufficient to maintain posture. mandibular crown or crowns are more facially

CONT RACTURE: A permanent shortening of a positioned than their maxillary counterparts. muscle resulting from . ANTERIOR c.: One or more maxillary positioned on the lingual side of the mandibular CONT RALATERAL: Situated on, pertaining to, or incisors when the are closed. affecting the opposite side, as opposed to ipsilateral. POSTERIOR c.: One or more maxillary posterior CONT RAST, RADIOGRA PHIC IMAGE: The teeth positioned in a palatal relationship with the visible differences in photographic or film density mandibular teeth when the jaws are closed. produced on a radiograph by the structural CROWDING: Discrepancy between tooth sizes and composition of the object or objects radiographed. arch length and/or tooth positioning that results in Radiographs made with higher kilovoltage (e.g., 90 malalignment and abnormal contact relationships kv) have a longer scale contrast and appear dull by between teeth. comparison with those made at lower voltages, but they have improved image character for interpretation. CROWN: The part of a tooth that is covered with enamel or a and normally projects CORTICAL BONE: See: Bone, Cortical. beyond the gingival margin.

COUMARIN: An anticoagulant that inhibits the ANATOM IC c.: The portion of a natural tooth that hepatic synthesis of the vitamin K-dependent extends from its cemento-enamel junction to the coagulation factors. occlusal surface or incisal edge. CLINIC AL C.: The portion of a tooth that extends COXSACKIEVIRUS: An enterovirus occasionally occlusally or incisally from the margin of the found in association with ulcerative oral lesions. investing soft tissue, usually gingiva. CRATER: A saucer-shaped defect of soft tissue or CROWN, LENGTHENING OF CLINICAL: A bone, often seen interdentally. See: Periodontal Bony surgical procedure designed to increase the extent of Defects. supragingival tooth structure for restorative or esthetic CREPITUS (Crepitation): A crackling or grating purposes by apically positioning the gingival margin, noise in a joint during movement. removing supporting bone, or both. May be accomplished by orthodontic tooth movement. CREST: A projection or ridge. In periodontics, usually

refers to the most coronal portion of the alveolar CROWN-ROOT RATIO: The relationship between process. the extra-alveolar of the tooth and the intra- 12

alveolar arm of the tooth as determined : A pathologic cavity lined by epithelium and radiographically. usually containing fluid or semisolid material. APICAL PERIODONTAL c.: The most common CRYOSURGERY: Destruction of tissue by extreme ; involving the apex of a root and cold. Usually achieved with liquid nitrogen or carbon resulting from the inflammatory reaction to a nonvital dioxide. pulp. CRYPT: A follicle or small glandular sac. DENT I GEROUS c.: Forms around the crown of an

CULTURE: The propagation of microorganisms or unerupted tooth or . living tissue cells in special media conducive to their DEV ELOPMENTAL c.: Results from a formative growth. aberration. GINGIVAL c.: Found within the gingiva, most CUR ATIVE: Tending to overcome disease and commonly in the -premolar region. promote recovery. Believed to be derived from epithelial rests of the CURET, PERIODONTAL: An instrument used for . (curettement) of tooth roots, periodontal INCISIV E CANAL C. (Nasop alatin e Duct C. And pockets, and bone. Median Ant erior Maxillary C.): A developmental,

CURETTAGE: Scraping or cleaning the walls of a non-odontogenic cyst originating from embryonic cavity or surface by means of a curet. See: Root remnants within the incisive canal. Planing. KERAT INIZING ODONTO GENIC C. (Calcifying APICAL (Periapical) c.: Surgical removal of tissue and Ker atinizing Odontogenic C:, Go rlin's C.): or foreign material surrounding the apex of a An odontogenic cyst found most often in the tooth. mandibular canine and premolar region; has distinct CLOSED c.: Performed via the gingival crevice microscopic features including basal epithelial cells without flap reflection. that resemble , large prematurely GINGIVAL c.: The process of debriding the soft keratinized eosinophilic cells (ghost cells), and the tissue wall of a periodontal pocket. production of an amorphous material referred to as OPEN c.: Facilitated by reflection of a soft tissue flap. "dentinoid;" may be totally cystic or predominantly RO OT c.: Scraping or cleaning the walls of a surface solid. by means of a curet. See: Root Planing. KERATOCYST: Developmental odontogenic cyst of the dental lamina in which the epithelial cells CURETTE: See: Curet, Periodontal. produce keratin; known for its aggressive nature and CURTAIN PROCEDURE: A procedure designed to high recurrence rate. retain the marginal portion of the facial and LAT ERAL PERIODONTAL C.: A small cyst of the interproximal gingiva for esthetic purposes in the periodontal ligament found most often in the surgical treatment of periodontal pockets, usually in mandibular canine and premolar areas; associated the maxillary anterior region, by means of a palatal with a vital tooth and postulated to originate from the approach. The facial gingiva will be coronal to the rests of Malassez, the rests of the dental lamina, or a palatal margin, thus creating a "curtain." supernumerary tooth bud.

CURVE OF SPEE: The anatomic curvature of the ODONTO GENIC C.: A class of derived from occlusal alignment of teeth beginning at the tip of the odontogenic epithelium, such as Primordial, lower canine, following the buccal cusps of the dentigerous, and lateral periodontal cysts. See: natural premolars and molars, and continuing to the PERIODONTAL C.: Cyst, Lateral Periodontal C. anterior borders of the ramus. PRIMORD IAL C.: An odontogenic cyst resulting from degeneration of the of a CUSPID GUIDANCE: See: Canine Protection. developing tooth bud. CYCLOSPORINE: An immunosuppressant and RAD ICULAR C.: A cyst along the root of a tooth. antifungal agent used to prevent rejection in organ Previously the term often was used synonymously transplant recipients. It can be associated with with what is now more accurately referred to as an gingival overgrowth. apical periodontal cyst. 13

RESIDUAL C.: A cyst in the maxilla or mandible that DEFLECTIVE OCCLUSAL CONTACT: A remains after the associated tooth has been removed. condition of tooth contact that diverts the mandible RETENTION c.: Caused by retention of glandular from a normal path of closure. See: Occlusal secretion. Disharmony. MUCOCELE: A cyst or cyst-like structure that DEMINERALIZATION: Decalcification; loss of contains mucous glycoproteins. mineral salts. : Forms in the floor of the mouth as a result of trauma or blockage of a duct. It may DENATURANT: A chemical that denatures or be lined with epithelium. disrupts the three-dimensional structure of proteins TRAUMATIC (Hemorrhagic Bone) c.: A causing them to lose their tertiary structure. radiolucent lesion in the bone without a DENS IN DENTE: A developmental abnormality in radiopaque border; a cavity of disputed cause, tooth formation resulting from invagination of the lined by extremely thin or no tissue, which may epithelium associated with coronal development into contain fluid (blood or serum). It is assumed to the area that was destined to become the pulp space. have been caused by trauma. Teeth, if present, Gives the radiographic appearance of a "tooth within are vital. Not a true cyst. a tooth."

CYTOKINES: A large group of proteins made by DENTAL DYSFUNCTION: Abnormal functioning cells that are capable of regulating a wide variety of of dental structures. cellular functions. DENTAL DYSPLASIA: See: Dysplasia, Dentinal. CY TOMEG ALOVIRUS: See CMY. DENTAL HISTORY: A complete record of all CY TOTOXIC: Having the ability to kill cells. relevant aspects of an individual's oral and general

CY TOTOXIN: An agent that inhibits or prevents the health.

function of cells. : A licensed dental auxiliary who is both an oral health educator and clinician and who uses preventive, educational, and nonsurgical ------i[IDI----- therapeutic methods to control oral disease.

DARK-FIELD MICROSCOPY: A technique DENTAL PROPHYLA XIS: See: Prophylaxis, Oral. utilizing a modified by a special DENTICLE (): A calcified mass of condenser that allows light to enter only peripherally , which may be free within the pulp, attached to so that objects such as microorganisms are obliquely the pulpal wall, or embedded in the dentin. illuminated and glow against a dark background. DENTIFRICE: A preparation intended to clean and DEBRIDEMENT: The removal of inflamed, polish the teeth. Active ingredients to prevent caries devitalized, or contaminated tissue or foreign material and plaque accumulation or to desensitize teeth may from or adjacent to a lesion. be included.

DEBRIS: An accumulation of foreign material on the DENTIN: The chief substance or tissue forming the teeth and adjacent structures. body of the teeth. It surrounds the pulp and is covered

DECALCIFICATION: The removal of calcium salts by coronal enamel and radicular cementum. REPARATIVE D.: from a bone or tooth. Deposition of dentin in response to pulpal insult. Also called irregular dentin. DECAY: The gradual decomposition of dead organic SECONDARY D.: Dentin deposited after root end matter. See: Caries. formation is complete.

DECORTICATION: Removal of cortical bone. Often DENTINAL HYPERSENSITIVITY: The short, used to describe multiple penetrations of the cortical exaggerated, painful response elicited when exposed surface of an intrabony defect. dentin is subjected to certain thermal, mechanical, or

DEFECT: See: Periodontal Bony Defects. chemical stimuli. See: Pulpitis. 14

DENTITION: The natural teeth as considered DIAGNOSIS: 1. The art and science of detecting and collectively in the dental arches; may be primary, distinguishing deviations from health and the cause permanent, or mixed. and nature thereof. 2. The determination of the nature, location, and causes of a disease or disorder. DENTULOUS: A condition in which natural teeth are CLINICAL D.: Determination of a condition based on present in the mouth. history and physical examination without use of DENTURE: An artificial substitute for natural teeth. A laboratory or microscopic tests. complete denture replaces all of the teeth in an arch. LABORATORY D.: Diagnosis based on the See: Prosthesis. examination of fluids or tissues in the laboratory. FIXED PARTIAL D.: A replacement of one or more PERIOD ONTAL D.: Recognizing a departure from missing teeth that cannot be readily removed by the health in the and distinguishing one patient or ; it is fixed or bonded to natural disease, disease categorization, or etiology from teeth, roots, or implants which furnish the primary another. Based on information obtained from the support to the prosthesis. medical and dental histories, clinical and OV ERDENTURE: Complete or partial removable radiographic examination of the patient, and denture supported by soft tissue and retained roots or laboratory findings. implants to provide stability and reduce ridge DIAGNOSTIC CAST: See: Cast. resorption. REMOVABLE PARTIAL D.: A that DIAPEDESIS: The outward passage of cells through artificially supplies teeth or other associated intact blood vessels. structures in a partially edentulous jaw and can be removed and replaced at will. DIASTEMA: A space between two adjacent teeth in a dental arch. DENUDATION: The act or process of removing the covering from any surface. In periodontics, often DIAZEPAM: A benzodiazepine anxiolytic having refers to removal of all soft tissue overlying the antianxiety, sedative-hypnotic, amnesic, anti­ bone. convulsant, skeletal muscle relaxant, and drug dependence properties. DEOXYRIBONUCLEIC ACID (DNA): A nucleic

acid that constitutes the genetic material of all cellular DIETARY ANALYSIS: The evaluation of a diet on organisms and the DNA viruses. the basis of its content, quality, and nutrients in order to determine any imbalance or deficiency that might DESENSITIZE: To diminish or abolish sensation of contribute to a disease process. pain or sensitivity, as in dentin.

DESQUAMATION: Exfoliation; the process of DIETARY GUIDANCE: Counseling on food shedding surface epithelium. selection and dietary habits.

DETOXICANT: A chemical that degrades a toxic : I. A tearing apart. 2. A distortion agent. of the root or crown of a tooth resulting from an injury during tooth development. Through common DIABETES MELLITUS: A chronic syndrome of usage, the term now includes teeth with sharply impaired carbohydrate, , and fCl! metabolism angulated and deformed roots. secondary to insufficient secretion of insulin or to

target tissue insulin resistance. Considered to be a DISC, ARTICULAR: A fibrous connective tissue modifying or accelerating factor in periodontal structure separating the joint cavities of the diseases. Data also suggest that periodontal diseases temporomandibular joint; also termed the meniscus. also influence the course of diabetes (e.g., increase DISCLOSANT: A dye (tablet or solution) used to glycated hemoglobin). stain dental plaque. Used primarily as an aid in oral DIAGNOSE: To recognize or determine the nature of hygiene instruction. a disease or abnormal state or condition by study and consideration of the and their DISEASE: A pathologic condition that presents a manifestation. group of clinical signs, symptoms, and laboratory 15

findings peculiar to it and setting the condition apart DRUG POTENCY: The power of a chemical to as an abnormal entity differing from normal or other produce an effect that is contingent upon the pathologic conditions. concentration of the chemical. LOCAL CONTRIBUTING FACTOR: A local DRY SOCKET: See: Socket, Dry. feature that may influence the presentation of the

disease, such as an overhanging restoration. DYSFUNCTION: Disturbance, impairment, or abnormality of the function of cells or an organ. DISINFECTANT: An agent that destroys or inhibits

the activity of disease-producing or other harmful DYSKINESIA: Difficulty in performing voluntary microorganisms, but usually does not destroy movements. bacterial spores; commonly refers to chemical agents DYSOSTOSIS: Imperfect . applied to inanimate objects.

DYSPHAGIA: Difficulty in . DISOCCLUDE: To cause loss of contact between

opposing teeth as a result of tooth guidance, occlusal DYSPLASIA: Abnormality of development; in interferences, or occlusal adjustment. , alteration in size, shape, and organization of cells. DISTAL WEDGE: A periodontal surgical procedure DENTINAL D.: A hereditary disorder affecting the for removal of excessive soft tissue distal to a teeth and characterized by abnormal dentin, defective terminal tooth in an arch. See: Proximal Wedge. root formation, and a tendency for periapical

DISTOCCLUSION: The abnormal posterior or distal pathosis. relationship of the mandibular to the maxillary teeth ECTODERMAL D.: An inherited condition character­ as in an Angle Class II occlusion. ized by fine, scanty, blond ; depressed of the nose; and a partial or complete absence of sweat DISUSE ATROPHY: See: Atrophy, Disuse. glands and teeth. PERIAPICAL CEMENTAL D. (Cementoma): A DIVERGENCE: Separation or spreading apart from a process of unknown origin. in which the periapical common center, base, or root. bone of vital teeth is replaced first by a fibrous DNA: See: Deoxyribonucleic Acid. type of connective tissue, and then by an osseocementoid tissue. During its early stages DOCUMENTATION, PERIODONTAL: this abnormality appears radiolucent and with Diagnostic, therapeutic, and consultative records time the center becomes opaque. It is classified of a patient. as an .

DONOR SITE: An area of the body from which a DYSTROPHY, PERIODONTAL: Changes result­ graft is taken. Examples are skin, masticatory ing from mechanical, circulatory, degenerative, mucosa, and bone. atrophic, or hypertrophic influences that interfere with the normal physiologic processes of the , SURGIC AL: See: Periodontal periodontium. Dressing.

DRUG: Any chemical that alters the physiologic processes of living systems. ------1001------DRUG AGONIST: Chemicals that react with a receptor and initiate a cellular reaction. ECCENTRIC RELATION, ECCENTRIC POSI­

TION: See: Occlusion, Eccentric. DRUG ANTAGONIST: Chemicals that prevent

reaction of a drug agonist with its receptor and ECCHYMOSIS: An extravasation of blood into inhibit. subcutaneous tissue or mucosa.

DRUG EFFICACY: The ability of a chemical to ECOLOGY: The study of the relationships of organ­ produce a biological effect. isms with other organisms and their environment. 16

ECTODERMAL DYSPLASIA: See: Dysplasia, ENDOCARDITIS: Inflammation of the endocardial Ectodermal. surface of the heart. INFECTIVE E.: A microbial infection of the ECTOPIC: Occurring in an unusual position, manner, endocardial surface of the heart, usually involving or form, as in ectopic eruption. the heart valves. Formerly classified as acute, : An abnormal swelling resulting from an subacute, and chronic bacterial endocarditis, but accumulation of fluid in a tissue or part. now delineated by the offending microorganism (i.e., streptococcal ). EDENTULOUS: Without teeth.

EIKENELLA CORRODENS: Gram-negative, non­ ENDOCRINOPATHY: A disorder resulting from an motile, microaerophilic, rod-shaped bacteria found abnormality of the endocrine glands or their primarily in subgingival plaque. Also associated with secretions. , meningitis, pneumonia, and endocarditis. ENDOGENOUS: I. Growing from within. 2. Devel­ ELEC TROSURGERY: Division of tissues by high oping or originating within an organism or arising frequency electrical current applied locally with a from causes within an organism. metal instrument or needle. ENDOTHELIUM: The layer of squamous cells lining ELISA: Acronym for enzyme-linked immunoadsorbent blood vessels, lymphatics, the heart, and all serous assay wherein an enzyme-antibody complex binds to and synovial cavities of the body. an agent thought to be present in a sample. Ty pically, an enzyme-activated dye is used to detect the ENDOTOXIN: A heat-stable, lipid presence of bound immunoglobulin-enzyme complex found in the cell wall of many Gram­ complex. The amount of color is proportional to negative microorganisms. It can be cytotoxic, the concentration of bound antibody/suspect agent pyogenic, and has been shown to induce and/or present in the test sample. amplify inflammation and has been implicated in the etiologies of periodontitis. EMBOLUS: A blood clot, air, or other foreign I material that travels in the bloodstream unti it ENOSTOSIS: A bony growth located within a bony obstructs a . cavity or extending centrally from the cortical plate. See: EMBRASURE: The space between the proximal Osteitis, Condensing. surfaces of adjacent teeth where those surfaces ENUCLEATE: To remove an organ or lesion in its diverge apically, buccally, lingually, or occlusally entirety. from an area of contact.

ENZYME: A catalytic substance, protein in nature, EMIGRATION: See: Diapedesis. formed by living cells and having a specific action I. EMPHYSEMA: A pathological accumulation of air in promoting a chemical change. or gas in tissue spaces. In the oral and facial regions it may be caused by an air syringe, an air-driven dental ENZYME-LINKED IMMUNOADSORBENT See handpiece, coughing, or blowing the nose. ASSAY: ELISA. 2. Permanent dilation of respiratory alveoli. ['PINEPHRINE: A neuro-hormone produced and ENAMEL: The hard, calcified tissue covering the secreted into the circulation by the adrenal medulla; a coronal dentin. catecholamine which has adrenomimetic effects; used in local anesthetic solutions for its vasoconstrictive : A small, focal mass of enamel properties. formed apical to the cemento-enamel junction.

See: ENAMEL PROJEC TION: An apical extension of EPI TIHELIAL AT TACHMENT: Epithelium, enamel, usually toward a furcation. Junctional.

ENDEMIC: Present in a community at all times. EPI THELIALIZATION (Epithelization): Healing Occurs continuously. by growth of epithelium over connective tissue. 17

EPITHELIUM, ORAL: The tissue serving as the ERYTHROMYCIN: A bacteriostatic macrolide lining of the intraoral surfaces. It extends into the group of antibiotics that has both Gram-positive and gingival crevice and adheres to the tooth at the base of Gram-negative antibacterial spectra and acts by the crevice. inhibiting ribosomal protein synthesis. CREVICULAR E.: The non-keratinized epithelium of ERYTHROPLASIA (): A red. the gingival crevice. papular, or macular lesion (often ulcerated) of JUNCTIONAL E.: A single or mUltiple layer of non­ mucous membrane. Can be pre-malignant. keratinizing cells adhering to the tooth surface at the

base of the gingival crevice. Formerly called ESCHAR: A slough caused by cauterization or by epithelial attachment. application of some corrosive substance. SULCULAR E.: See: Epithelium, Crevicular. ESTROGEN: A generic term for naturally-occurring EPSTEIN-BARR VIRUS (EBV): Herpes; DNA virus steroid hormones containing an estrane nucleus that causes Burkitt's in which the human (estrone, estadiol, estriol, etc.); secreted from the peripheral blood leukocytes are transformed into testis, ovary, and placenta; stimulates protein anabolic lymphoblast-like cells with an indefinite life span. actions and exerts a positive effect on nitrogen

EPULIS: A non-specific term for any tumor of the balance; regulates the growth and maintenance of gIngiva. female accessory sex organs and secondary sex characteristics; implicated in hormonal, pubertal, and EQUILIBRATION, OCCLUSAL: See: Occlusal menopausal . Adjustment. ETIOLOGY: The study of the causes of disease; EROSION: An apparent chemical dissolution of alternately, the cause of a disease. enamel and dentin, unrelated to caries, causing a cavity that has a hard, smooth base. EUBACTERIUM BRACHII: Gram-positive, non­ motile, anaerobic, pleomorphic bacilli or coccobacilli ERUPTION, DENTAL: The emergence of a tooth that occur in pairs of short chains. Found in the oral into the oral cavity. cavity, they are usually part of the indigenous oral ACTIVE E.: The process by which a tooth moves from flora. its germinative position to its functional position.

PASSIVE E.: To oth exposure secondary to apical EUBACTERIUM SSP.: Gram-positive, non-motile migration of the gingiva. anaerobic, rod-shaped bacteria frequently found in subgingival plaque. ERYTHEMA: Redness of the skin or mucous

membranes produced by congestion of the . EUBACTERIUM TIMIDUM: Gram-positive, non­ : A gingival motile, anaerobic bacilli that are isolated from manifestation of immunosuppression characterized and other infections and are associated with by a distinct linear erythematous band limited to the other anaerobes and facultative bacteria. May be free gingiva. The lesion does not predictably respond involved in bacteremia and endocarditis. to plaque removal. EVULSION: The sudden tearing out, or away, of : An acute dermatitis tissue due to a traumatic episode. See: Avulsion. of unknown cause that may be preclpitateLi by drug intake, herpes simplex infection, or other diseases. EXACERBATION: Increase in the severity of a Characteristic erythematous "target" or "bull 's eye" disease or of any of its signs or symptoms. lesions occur on the skin; intraorally, diffuse hyperemic EXCISION: A cutting out; removal; the process of macules, papules, and vesicles may be seen. amputating or cutting away any portion of the body. STEVENS-JOHNSON SYNDROME: A severe form of erythema multiforme characterized by painful EXFOLIATION: I. The shedding of something, such oral bullae that rupture; bloody, crusting lips; as epithelial cell from the surface of the body. 2. In conjunctivitis; photophobia; and urethritis, balanitis, dentistry, the physiological loss of the primary and/or vaginal ulcers. dentition; the loss of implanted materials. 18

EXOGENOUS: Due to external cause; not arising FACULTATIVE: I. Voluntary; possessing the power within the organism. to do or not to do a thing. 2. Capable of existing under different conditions, as a microorganism that can exist EXOPHYTIC: Growing outward; proliferation on the in either aerobic or anaerobic conditions. exterior or surface of an organ.

FAMILIAL: Occurring in members of the same EXOSTOSIS: A benign, bony growth projecting family, as in a familial disease. See: Congenital. outward from the surface of a bone. See: Torus.

FENESTRATE: To pierce with one or more openings. EXOTOXIN: A toxic substance formed by species of

certain bacteria and found outside the bacterial cell. FENESTRATION: A window-like aperture or opening, such as may be found in the alveolar bone EXTIRPATION: The complete removal of an organ over the root of a tooth. or tissue. FESTOONS, GINGIVAL: EXTRAVA SATE: To seep or escape from a cavity, The contours of the vessel, or enclosed area into the surrounding tissues gingiva and oral mucosa over the roots of the teeth (i.e., blood or lymph). that tend to follow the cervical lines. These are prominent in the presence of a thin alveolar process. EXTRINSIC: Derived from or situated without; FETOR ORIS: external. Foul, offensive odor from the oral cavity. See: Halitosis. EXTRUSION: In dentistry, the or FIBER: migration of a tooth from its normal occlusal position, A filament or thread. In periodontics the term as when the contacting tooth in the opposing arch is usually refers to collagenous or elastic connective mISSIng. tissue fibers. ALV EOGINGIVAL F.: Collagenous fibers that radiate EXUDATE: Material such as fluid, cells, and cellular from the bone of the alveolar crest into the lamina debris that has escaped from blood vessels and is propria of the free and attached gingiva. deposited in tissues or on tissue surfaces, usually as a CIRCULAR F.: Collagenous fiber bundles within the result of inflammation. gingiva that encircle the tooth in a ring-like fashion. FIBRINOUS E.: Characterized by an abundance of DENTOGINGIVAL F.: Numerous collagenous fibers resulting in subsequent formation at that extend from cervical cementum to the lamina the site of injury. propria of the free and attached gingiva. HEMORRHAGIC E.: Characterized by an abundance DENTOPERIOSTEAL F.: Fibers running from the of red blood cells. cementum over the periosteum of the outer cortical PURULENT E.: Characterized by an abundance of plates of the alveolar process where they insert into polymorphonuclear leukocytes, resulting in pus the alveolar process or muscle in the vestibule of the formation at the site of injury. floor of the mouth. SEROUS E.: Characterized by an abundance of serous GINGIVAL F.: See: Alveogingival F. and fluid of high protein content at the site of injury. Dentogingival F. OXYTALAN F.: Fibers found in all connective tissue ------tool----- structures of the periodontium that appear to consist of thin, acid-resistant fibrils. Their function is

FACE-BOW: A device used to record the positional unknown. PRINCIPAL F.: relationship of the maxillary arch to the temporoman­ The major fiber groups of the dibular and to orient dental casts in this same functioning periodontium: ALV EOLAR CREST F.: relationship to the opening axis of an articulator. Attaches to the cementum just apical to the cemento-enamel junction and run FACET: A flattened or worn spot on the surface of a apically and laterally to insert into the surface of hard body, as on a bone or a tooth. the alveolus. FACTITIOUS: I. Pertaining to a state or situation APICAL F.: Radiates from the cementum around produced by other than natural means. 2. Self-inflicted. the apex of the root to the adjacent bone. 19

HORIZONTAL F.: Located just apical to the seal the root canal following surgical removal of a alveolar crest group, these fibers run perpendicular periapical lesion and/or the end of the root. to the long axis of the root from cementum to bone. FISSURE: A general term for a cleft or groove. INTERRADICULAR F.: Found between the roots of multirooted teeth, these fibers run from the FISTULA: An abnormal canal joining the cavities of cementum into the crestal bone of the two hollow organs or the cavity of an organ and the interradicular septum. surface of the body. See: Sinus Tract. OBLIQUE F.: The most numerous fiber group of OROANTRAL F.: An abnormal opening between the the periodontal ligament; run from the cementum and the mouth. outwardly and coronally to insert into the bone. OROFACIAL F.: An abnormal opening between the TRANSSEPTAL F.: Collagenous fibers that run cutaneous surface of the and mouth. interdentally from the cementum just apical to the ORONASAL F.: An abnormal opening between the base of the of one tooth over and the mouth. the alveolar crest to insert into a comparable region FLAP: A loosened section of tissue separated from the of an adjacent tooth. surrounding tissues except at its base. FIBEROTOMY: See: Gingival Fiberotomy. DOUBLE PAPILLA PEDICLE F.: The use of the papillae on the mesial and distal of a tooth as : The predominant connective tissue laterally positioned flaps sutured together over the cell; a flattened, irregularly-branched cell with a large tooth root. oval nucleus that is responsible, in part, for the ENVELOPE F.: A flap retracted from a horizontal production and remodeling of the extracellular linear incision, as along the free gingival margin, with matrix. no vertical incision. FIBROBLAST GROWTH FACTOR: A family of GINGIVAL F.: A flap that does not extend apical to the growth factors with mitogenic properties for . fibroblasts and mesoderm-derived cell types. MODIFIED WIDMAN F.: A scalloped, replaced, mucoperiosteal flap, accomplished with an internal : A benign of fibrous connective bevel incision, that provides access to the root for tissue. root planing. PERIPHERAL OSSIF YING F.: A fibroma, usually of MUCOGINGIVAL F.: A flap that includes both the gingiva, showing areas of calcification or gingiva and alveolar mucosa. ossi fication. MUCOPERIOSTEAL (Full Thickness) F.: A FIBROMATOSIS, GINGIVAL: See: Gingival mucosal flap (usually gingiva and alveolar mucosa) Fibromatosis. that includes the periosteum.

FIBRONECTIN: High molecular weight (450 kDa) PAPILLARY PEDICLE F.: A laterally-rotated flap glycoproteins composed of two disulfide-linked employing the gingival papilla. polypeptides; functional domains of the molecule PARTIAL, THICKNESS (Split Thickness) F.: A have affinity for cells and the extracellular matrix surgical flap of mucosa and connective tissue that components; found on cell surfaces, in connective does not include the periosteum. tissues, in the blood, and in other body fluids. PEDICLE F.: A surgical flap with lateral releasing incisions. See: Sliding Flap. FIBRO-OSSEOUS INTEGRATION: See: POSITIONED F.: A surgical flap that is moved or Integration. advanced laterally, coronally, or apically to a new FIBROSIS: A fibrous change of the mucous position. membranes, especially the gingiva, as a result of REPLACED F.: A flap replaced in its original position. chronic inflammation. Fibrotic gingiva may appear REPOSITIONED F.: See: Replaced Flap. outwardly healthy, masking underlying disease. SLIDING F.: A pedicle flap moved to a new position.

FILLING, RETROGRADE: An amalgam or other FLORA, ORAL: The microorganisms residing within restoration placed in the apical portion of a tooth to the oral cavity. 20

FLOW CYTOMETRY: Measures the physical and ABNORMAL F.: Aberrant insertions of labial, buccal, chemical characteristics of individual cells as they or lingual frenula capable of retracting gingival move past optical or electronic sensors; can be used to margins, creating diastemas, and limiting and detect and characterize specific cells in a mixed tongue movements. population; used to determine the effects of drugs, LABIAL F.: The fold of mucous membrane connecting hormones, chemicals, etc., on cell proliferation, the lip and the alveolar process in the midline of both growth, and function. the maxilla and mandible. LINGUAL F.: The fold of mucous membrane FOOD IMPACTION: The forceful wedging of food connecting the tongue with the floor of the mouth and into the interproximal space by pressure the mandibular alveolar process. (vertical impaction) or the forcing of food

interproximally by tongue or pressure FRENUM: See: Frenulum. (horizontal impaction). FRONTAL PLANE: Any plane passing FORAMEN: A natural opening or passage, longitudinally through the body from side to side at particularly into or through a bone. right angles to the median plane. It divides the body into front and back parts. FORDYCE'S GRANULES: A developmental anomaly characterized by ectopic sebaceous glands FUNCTIONAL SIDE: The side of the body towards appearing as minute, yellowish papules on the oral which the mandible moves in lateral excursion. mucosa. FUNGI: A eucaryotic (nucleated) group of microbes. A FOREIGN BODY: A non-native substance in the phylum of plants whose members are devoid of any tissues or body cavities. pigment capable of photosynthesis; they are unable to FOREIGN-BODY REACTION: A granulomatous synthesize protein or other organic material from reaction around a foreign material within a tissue or simple compounds, and are therefore parasitic or organ; often characterized by giant cells. This may saprophtic. The three major pathologic mycoses or present as acute or chronic gingival inflammation and fungal infections involving subcutaneous orofacial may produce tattoos; or red, red/white; or suppurative sites are Sporotrichosis, Entomophthoromycosis, and lesions. Rhinosporidiosis. In immunocompromised FORNIX: Any arch-shaped structure or vault-like space individuals, Candida species are responsible for oral created by that structure, such as the vestibular fornix. mycoses and may cause oral infections (thrush) in AIDS patients or other debilitated humans. : A shallow depression, concavity, or hollow Designated "opportunistic" pathogens since they are area. often found as members of the normal oral flora. FREE GINGIVAL GROOV E: See: Gingival Groove. Most frequently implicated representative is C. albicans. Candidiasis attributable to C tropicalis, C. FREEWAY SPACE: The space between the maxillary parapsilosis, C. pseudotropicalis, and stellatoidea and mandibular teeth when the mandible is suspended have also been cultivated from the oral cavity. in the postural position.

FREEZE-DRYING: See: Lyophilization. FURCATION: The anatomic area of a multi rooted tooth where the roots diverge. : A palpable or visible movement of a

tooth when subjected to occlusal forces. FURCATION INVASION: See: Periodontal Bony Defects. FRENOTOMY: The cutting of a frenulum, especially the release of ankyloglossia. FUSED TEETH: Two or more teeth that are structur­

FRENULECTOMY (Frenectomy): The excision of ally united. See: Gemination. a frenulum. FUSIFORM: A descriptive term of bacterial cell FRENULUM: A small band or fold of integument or morphology, referring to a spindle or cigar-shaped mucous membrane that checks, curbs, or limits the cell, such as is observed frequently for members of movements of an organ or part. the genera and Capnocytophaga. 21

FUSOBACTERIUM NUCLEATUM: Gram-negative, G. CLEFT: See: Cleft, Gingival. See: non-motile, anaerobic, rod-shaped bacteria commonly G. COL: Col. G. CORIUM: associated with . The connective tissue of the gingiva. G. CRATER: A saucer-shaped defect of the inter­ FUSOBACTERIUM SSP.: Gram-negative, nonmotile, proximal gingiva. anaerobic, rod-shaped bacteria, frequently with G. CREST: See: Crest. "sickle-shaped" morphology, found as part of the G. CREVICE (G. Sulcus): The shallow fissure indigenous flora of the oral cavity. between the marginal gingiva and the enamel or FUSOSPIROCHETAL INFECTION: An infection cementum. characterized by a predominance of fusiforms and G. CUFF: That portion of the gingiva that overlies spirochetes. the junctional epithelium. G. CURETTAGE: See: Curettage, Gingival. GINGIVAL DISEASES: The pattern of observable ------���------signs and symptoms of different disease entities that are localized to the gingiva. GANGRENE: Death of a mass of tissue,' generally G. D. OF FUNGAL ORIGIN: Gingival associated with loss of vascular (nutritive) supply and manifestations of fungal infections are followed by bacterial invasion and putrefaction. characterized by white, red, or ulcerative lesions GEMINATION: Teeth that are structurally united and associated with several predisposing conditions. have developed from the same tooth germ. G. D. OF SPECIFIC BACTERIAL ORIGIN: Conditions induced by exogenous bacterial GENE: A segment of a DNA molecule coded for the infection other than common components of synthesis of a single polypeptide; a unit of genetic dental plaque. information. G. D. OF VIRAL ORIGIN: Acute manifestations GENOME: The complete chromosomal set derived of viral infections of the oral mucosa, from one parent. characterized by redness and multiple vesicles that easily rupture to form painful ulcers affecting the GENOTYPE: The genetic composition of an gingiva. They may be accompanied by , individual or defined population. malaise, and regional . (Migratory Glossitis): G. ENLARGEMENT: An overgrowth or increase in A condition characterized by chronic, superficial, size of the gingiva. and circumscribed desquamation of the filiform DRUG-INFLUENCED G. E.: Gingival papillae. The areas of desquamation change enlargement resulting in whole or in part from continuously. systemic drug use. G. EXUDAT E: GERMICIDE: An agent that kills microorganisms. An exudate that escapes into the oral cavity via the gingival crevice. GINGIVA: The fibrous investing tissue, covered by G. FEST OON: See: Festoons, Gingival. keratinized epithelium, that immediately surrounds a G. FIBEROT OMY: A circumferential crevicular tooth and is contiguous with its periodontal ligament incision through all gingival and periodontal fibers and with the mucosal tissues of the mouth. coronal to the crest of the alveolar bone. AT TACHED G.: The portion of the gingiva that is G. FIBROMATOSIS: A diffuse, fibrous overgrowth of firm, dense, stippled, and tightly bound to the the gingiva; can be idiopathic, hereditary, or underlying periosteum, tooth, and bone. associated with drug administration. FREE G.: That part of the gingiva that surrounds the HEREDITARY G. F.: A genetically derived fibrotic tooth and is not directly attached to the tooth surface. . MARGINAL G.: The most coronal portion of the G. FLUID: Tissue fluid that seeps through the gingiva. Often used to refer to the free gingiva that crevicular and junctional epithelium. It is increased in forms the wall of the gingival crevice in health. the presence of inflammation. PAPILLARY G.: See: Gingival Papilla. G. GROOVE: A shallow, V-shaped groove or

GINGIVAL: Pertaining to the gingiva. indentation that is closely associated with the apical 22

extent of free gingiva and runs parallel to the margin MARGINAL G.: Inflammation limited to the gingiva

of the gingiva. The frequency of its occurrence adjacent to the tooth surface. varies widely. MENS TRUA L-CYCLE ASSOCIATED G.:

G. HYPERPLASIA: An enlargement of the gingiva Pronounced inflammatory response of gingiva to

due to an increase in the number of cells. plaque and hormones immediately prior to ovulation.

G. : An enlargement of the gingiva NECROTIZING ULCERATIVE G (NUG): An

due to an increase in the size of cells. infection characterized by gingival

G. MARGIN: See: Gingiva, Marginal. presenting as "punched out" papillae, with gingival

G. PA PILLA: That portion of the gingiva that occupies bleeding and pain. Fetid breath and pseudomembrane

the interproximal spaces. The interdental extension of formation may be secondary diagnostic features.

the gingiva. Fusiform bacteria, , and

G. POCKET: A pathologically deepened gingival spirochetes have been associated with the lesion.

crevice that does not involve loss of connective tissue Predisposing factors may include stress, poor diet,

attachment. Frequently observed when there is , and HIV infection. See also: Periodontitis,

gingival enlargement. Necrotizing Ulcerative.

G. RECESSION: See: Recession, Gingival. NON-PLAQUE-INDUCED G.: Gingival inflammation G. SULCUS : See: Gingival Crevice. having an etiology other than dental plaque, such as

gingival diseases of specific bacterial, viral, fungal, or : The excision of a portion of the genetic origin, due to systemic conditions, trauma, gingiva; usually performed to reduce the soft tissue foreign body reactions, or other causes. wall of a periodontal pocket. ORAL CO NTRACEPTIVE-ASSOCIATED G.:

GINGIVITIS: Inflammation of the gingiva. Pronounced inflammatory response of the gingiva to ASCORBIC ACID DEFICIENCY G.: Inflammatory plaque and oral contraceptives.

response of the gingiva to plaque aggravated by PLAQUE-INDUCED G.: Gingival inflammation chronically low ascorbic acid levels. resulting from dental plaque

DESQUAMATIVE G.: A non-specific term denoting PREGNANCY-ASSOCIATED G.: Pronounced

chronic, diffuse inflammation of the gingiva with inflammatory response of the gingiva to dental plaque

sloughing of the surface epithelium. Can be found in and hormones usually occurring during the second several mucosal diseases. and third trimesters of pregnancy.

DIABETES -ASSOCIATED G.: Inflammatory -ASSOCIATED G.: Pronounced

response of the gingiva to plaque aggravated by inflammatory response of gingiva to dental plaque

poorly controlled plasma levels. and hormones during the circumpubert

ERUPTIVE G.: Inflammation accompanying eruption GINGIVOSIS: Archaic term for desquamative

of the teeth. gingivitis. HO RMONA L G.: A generic term describing the GINGIVOSTOMATITIS: Inflammation affecting changes in color, size, shape, or function of gingiva both the gingiva and the oral mucosa. resulting from the influence of hormones. HERPETIC G.: An infection of the oral soft tissues HYPERPLASTIC G.: Characterized by markedly caused by the herpes simplex virus and characterized enlarged and proliferative margins and interdental by redness, formation of multiple vesicles, painful papillae. ulcers, fever, and lymphadenopathy. -ASSOCIATED G.: Pronounced

inflammatory response of the gingiva to plaque GLOSSALGIA: Pain associated with the tongue.

resulting in increased bleeding and enlargement GLOSSITIS, MIGRATORY: See: Geographic subsequent to leukemia. Enlargement may be Tongue. partially due to leukemic cell infiltration of the

gingIva. GLOSSODYNIA: Painful or burning tongue. 23

GLUCOCORTI COID: A group of C21 steroid GRAM-POSITIVE: Pertaining to bacteria that stain hormones (cortisol, etc.) that affect carbohydrate, fat, deep purple with . These bacteria have a and protein metabolism; secreted from the adrenal thick peptidoglycan layer but no cortex; used in treatment of desquamative gingival in their cell walls. lesions in the oral cavity; a corticosteroid. GRAM STA IN: A method for classifying bacteria into

GLUCOSE TOLERANCE TEST (GTT): A two groups on the basis of their cell wall composition, laboratory test that indicates the patient's capacity to which causes them to stain either purple (positive) or regulate blood sugar level following the ingestion of pale red (negative). carbohydrate. One of the most reliable laboratory GRANULATI ON TI SSUE: Healing tissue that tests for detection of diabetes mellitus. consists of fibroblasts, buds, inflammatory

GLYCOSAMINOGLYCAN: A polysaccharide chain cells, and edema. consisting of a hexosamine alternating with another GRANULOC YTOPENI A: See: Agranulocytosis. carbohydrate residue; a component of proteoglycans.

GRANULOMA : A reactive nodule consisting of GRAFT: I. Any tissue or organ used for implantation modified macrophages resembling epithelial cells or transplantation. 2. A piece of living tissue placed in surrounded by a rim of mononuclear cells, usually contact with injured tissue to repair a defect or supply lymphocytes, and often containing giant cells. a deficiency. 3. To induce union between normally APICAL G.: Circumscribed granulomatous tissue separate tissues. adjacent to the apex of a tooth. ALLOGRAFT: A graft between genetically dissimilar CENTRAL G.: Usually restricted members of the same species. to the jaw bones, this lytic lesion displays loose ALLOPLAST: A synthetic graft or inert foreign body fibrillar connective tissue, numerous capillaries, and implanted into tissue. See: Implant, Oral. multinuclear giant cells; a histologic appearance AUTOGENOUS G.: See: Graft, Autograft. similar to the bony lesions of hyperparathyroidism. AUTOGENOUS BONE G.: An osseous autograft. PERIPHERAL GIANT CELL G.: Considered an AUTOGRAFT: Tissue transferred from one position to unusual proliferative response of the tissues to injury, another within the same individual. this lesion always occurs on the gingiva or alveolar DOUBLE PAPILLA PEDICLE G.: See: Flap, Double mucosa. Histologically, it is a non-encapsulated Papilla Pedicle. mass of delicate connective tissue cells, numerous HETEROGRAFT: A graft taken from a donor of capillaries, and multinucleated giant cells. another species. PYOGENIC G.: Localized, painless protuberant, HOMOGRAFT: See: Allograft. exophytic gingival mass that is attached by a sessile ILIAC G.: Bone graft material obtained from the iliac or pedunculated base from the gingival margin or crest. more commonly from an interproximal space. ISOGRAFT: A graft between genetically identical PREGNANCY-ASSOCIATED P. G.: A pyogenic individuals, usually between identical twins. resulting from dental plaque and PAPILLARY PEDICLE G.: See: Flap, Papillary hormones during pregnancy. Pedicle.

PEDICLE G.: See: Flap, Pedicle. GRANULOMATOUS TISSUE: A distinctive SOFT TISSUE (Gingival) G.: An autogenous graft of morphologic pattern of inflammation consisting of masticatory mucosa or collagenous tissue completely histiocytes that have been transformed into epitheloid or partially detached from its original site and placed cells that are surrounded by mononuclear cells, in a prepared recipient bed. usually lymphocytes. Seen in the granulomatous XENOGRAFT: A heterograft. diseases, such as , syphilis, , and leprosy. GRAM-NEGATI VE: Pertaining to bacteria that

counterstain pale red with Gram stain. These bacteria GRINDING, SELECTIVE: Alteration of the have a lipopolysaccharide (endotoxin) layer exterior occlusal forms of teeth to improve occlusal function to a thin peptidoglycan layer in their cell walls. and to decrease or redirect occlusal forces to the teeth. 24

GROOVE, PAL ATAL : A developmental, anomalous HALF-LIFE (Drug): The amount of time for plasma groove usually found on the palatal aspect of concentration of a drug to be reduced by 50%. maxillary central and lateral incisors. HALITOSIS: Breath that is offensive to others, caused

GROU P FUNCTION: Multiple contacts between the by a variety of reasons including but not limited to maxillary and mandibular teeth in lateral movements periodontal disease. bacterial coating of tongue, on the working side, whereby simultaneous contacts systemic disorders, and different types of food. Also of several teeth act as a group to distribute occlusal called fetor ex ore, fetor oris, and stomatodysodia.

forces. HAPTEN: Any chemical, drug, or its metabolite, that combines with tissue protein to form a complete GROWTH FACT ORS: A diverse group of antigen; most allergenic drugs are haptens. polypeptides that have important roles in regulation of

growth and development of a variety of organs. HAWL EY APPLIANCE: A removable orthodontic palatal appliance made of wire and acrylic used as a GUARD: See: Occlusal Guard. stabilizing appliance, or, with modification, to move GUIDANCE: The process of controlling or directing teeth. It typically incorporates a labial arch wire and an object on a predetermined course or track. an anterior biteplane. CANINE G.: Contact guidance provided by canine HEALING: The process of repair or regeneration of teeth in lateral mandibular movements. See: Canine injured, lost, or surgically-treated tissue. Protection. H. by FIRST INTENTION: Primary union of a CONDYLAR G.: The path the condyles travel during wound in which the incised tissue edges are normal mandibular movement, measured in degrees approximated and held until union occurs. relative to the Frankfort horizontal plane. H. by SECOND INTENTION: Wound closure INCISAL G.: The influence on mandibular movements wherein the edges remain separated and the wound exerted by the palatal surfaces of the maxillary heals from the base and sides via the formation of anterior teeth. granulation tissue. See: GUIDED BONE REGENERATION: HEALTH: The condition of a patient when there is Regeneration, Guided Tissue. function without evidence of disease or abnormality.

GUIDED TISSU E AU GMEN TATION: See: HEMANGIOMA: A benign blood vessel neoplasm; Regeneration, Guided Tissue. may occur as capillary or cavernous; soft, painless, red to purple; blanches on pressure. GUIDED TISSU E REGENERATION: See: Regeneration, Guided Tissue. HEMATOMA: A localized collection of extravasated blood, usually clotted, that forms a mass in a tissue, organ, or space. --�[!!JI----- HEMIDESMOSOME: An ultrastructural feature found on the basal surface of some epithelial cells

HABIT: An act that has become a repeated forming the site of attachment between the basal performance, almost automatic, such as bruxism or surface of the cell and the basement membrane.

tongue thrusting. HEMISECTION: The surgical separation of a PARAFUNCTIONAL H.: Characterized by ahnormal multirooted tooth, especially a mandibular molar, function, such as bruxism. through the furcation in such a way that a root and the PERNICIOUS H.: Capable of damaging or destroying associated portion of the crown may be removed or body tissues. restored.

HAEMOPHIL US: Genus of Gram-negative, non­ HEMISEP TUM: See: Periodontal Bony Defects. motile, microaerophilic, pleomorphic bacilli and HEMOSTASIS: Arrest of hemorrhage. coccobacilli. HEMOSTAT: Any agent, apparatus, or instrument that See: : Leukoplakia. may be employed to arrest hemorrhage. 25

HEPARAN SULFATE: A glycosaminoglycan found easily rupture to form painful ulcers. It may be on the surface of most mammalian cells and in the accompanied by fever, malaise, and regional extracellular matrix. lymphadenopathy. H. LABIALIS: An attenuated form of herpes found on HEPARIN: A glycosaminoglycan that is attached to the vermillion border of the lips. Commonly called a core protein found in mast cells; anticoagulant cold sores or fever blisters. activity; serves as a catalyst for antithrombin H. ZOSTER: See: Varicella Zoster. attachment to . INTRAORAL RECURRENT H.: An attenuated form

HEPATITIS: Inflammation of the caused by of herpes in which clusters of pinhead-sized vesicles various disease states, drug reactions, and viruses. occur on the attached keratinized mucosa. Commonly Common systemic signs include fever, jaundice, and called cold sores or fever blisters. an enlarged liver. HERPES SIMPLEX VIRUSES TYPE I, TYPE II: H. A: An infection of the liver caused by the hepatitis A Herpes viruses are the most ubiquitous, virus. Commonly spread by fecal contamination. It communicable, infectious viruses in humans. They usually occurs in children and young adults and are double stranded DNA viruses with icosahedral follows a mild course. Immunization is available. nucleocapsids. Herpes simplex viruses cause acute H. B: An infection of the liver caused by the hepatitis B infection or latent and recurrent infection of human virus. It can be transmitted in the health care tissues. Herpes simplex virus type I usually causes environment. Has an insidious onset. Features include oral lesions, while type II usually causes genital anorexia, malaise, nausea, vomiting, abdominal pain, infections. Herpes simplex virus II is also associated and jaundice. Ultimate outcomes include the carrier with of the cervix. state, cirrhosis, acute hepatitis, death and primary liver cancer. Immunization is available. HERTWIG'S : An H. C (Non-A, Non-B): A common form of hepatitis in extension of the enamel organ (cervical loop) adults that is caused by at least two different viral Determines the shape of the roots and initiates dentin agents. This form of hepatitis is principally formation during tooth development. Its remnants transmitted by the parenteral route. Persons at persist as epithelial rests of Malassez in the increased risk of hepatitis C are parenteral drug users, periodontal ligament.

health care workers with exposure to blood HINGE AXIS: Imaginary line around which the hemodialysis patients, and recipients of blood or mandible may rotate through the sagittal plane. blood-blood products. Serological tests will detect HISTAMINE: A low molecular weight, bioactive anti-hepatitis C by enzyme immunoassay. amine that causes smooth muscle contraction of H. D (DELTA H.): An infection of the liver dependent bronchioles, increased capillary permeability, and on the presence of the hepatitis B virus for clinical increased secretions by the nasal and bronchial expression. It may occur as a co-infection with acute mucous glands. Released primarily from mast cells hepatitis B or as a superinfection in a hepatitis B and basophils. carrier. It occurs primarily through intimate contact

and transmucosal exchange of body fluids and is seen HISTIOCYTE: A large () most frequently in intravenous drug users and present in connective tissue that has important antigen hemophilic patients. Immunization against the proce!>sing, immunoregulatory, and phagocytic hepatitis B virus provides protection against hepatitis properties. D infection. HISTOLOGY: That part of anatomic study that deals

HEREDITARY GINGIVAL FIBROMATOSIS: with the minute structure, composition, and function See: Fibromatosis, Gingival. of the tissues.

HISTOPATHOLOGY: The study of pathological HERPES (Herpetic Gingivostomatitis, H. changes within the structures of tissues at the micro­ Simplex): An acute infection of the oral mucosa by scopic level. the herpes simplex virus (usually Type 1) that is characterized by redness and multiple vesicles that HIV: See: Human Immunodeficiency Virus. 26

HORIZONTAL OVERLAP: . The projection persistence of nuclei or nuclear remnants. The stratum of the maxillary anterior or posterior teeth beyond granulosum is seldom seen in hyperparakeratosis. their antagonists in a horizontal direction. See: HYPERPLA SIA: The increase in the size of a . structure due to an increase in the number of cells. HORMONE: Chemical messengers that are secreted HYPERSENSITIVITY: An exaggerated immune into the blood stream by specialized cells capable of response to a foreign substance. synthesizing and secreting them in response to specific signals. HYPERTROPHY: The enlargement or overgrowth of an organ or part due to an increase in size of its HOST RESISTA NCE: Host defensive mechanisms. constituent cells. HUMAN IMMUNODEFICIENCY VIRUS (HIV): HYPOPHOSPHATASIA: An inborn error of A RNA virus that exists as two major types, HIV-I metabolism characterized by deficient alkaline and HIV-2. The genetic material is in the form of phosphatase in serum and bone, resulting in the messenger RNA and is classified as a retrovirus. The defective formation of bone and cementum. targets of infection of HIV are primarily the T4 helper

(CD4+) lymphocytes but it is also clear that HYPOPLA SIA: Defective or incomplete development. macrophages can be infected. The virus appears to cause AIDS (acquired immune deficiency syndrome). See: AIDS. ------1001----- HYDROXYAPATITE (HA): An inorganic IATROGENIC: An abnormal mental or physical compound, CA(P04)6(OH)2, found in the matrices of condition induced in a patient by the effects of bone and teeth which provides rigidity to these structures. Synthetic forms are used in ridge treatment.

augmentation and intrabony defects, and for coating IDIOPATHIC: Of unknown causation. dental implants. IMMOBILIZATION, TOOTH: Any procedure that : An excessive deposition of renders a tooth fixed or non-mobile. In periodontics, cementum. it refers to splinting of teeth.

HYPEREMIA : An excessive accumulation of blood IMMUNITY: All mechanisms used by the body as in a tissue due to vascular engorgement. protection against environmental agents that are

HYPERGLYCEMIA: Abnormally increased blood foreign to the body. 1: sugar. ACQUIRED A specialized form involving antibodies and lymphocytes. HYPERKERATOSIS: Excessive formation of keratin INNATE 1: Congenital. by epithelial cells. IMMUNOCOMPETENCE: The ability or capacity HYPERMINERALIZATION: The presence of to develop an immune response. unusual amounts of mineral elements in a calcified tissue. IMMUNOFLUORESCENT MICROSCOPY: A process in which cells or tissues are labeled with HYPERORTHOKERATOSIS: An abnormal fluorescent dye-conjugated antibodies and examined increase in the thickness of the orthokeratin layer with an ultraviolet light microscope. Used to identify (stratum corneum) of the epithelium. The subjacent certain structures or markers on cells. stratum granulosum may be prominent. IMMUNOGLOBULIN: A glycoprotein composed of HYPEROSTOSIS: A localized overgrowth of bone. "heavy" and "light" peptide chains; functions as See also: Exostosis and Torus. antibody in serum and secretions. There are five

HYPERPARAKERATOSIS: An abnormal increase in major classes (IgG, IgA, IgM, IgE, and IgD), each the thickness of the keratin layer of the epithelium with with specialized functions. 27

IMPACTED TOOTH (Impaction): An unerupted or SUBPERIOSTEAL I.: An implant placed on the partially erupted tooth so positioned that complete surface of the maxillary or mandibular bone for eruption is unlikely. support and attachment of a prosthesis.

IMPLANT : See: Surgery, Implant. IMPINGEMENT: An area of displacement or

compression of a tissue. IMPRESSION: A reproduction in a negative form of areas of the oral cavity. IMPLANT ABUTMENT: That part of an implant system that connects the implant with a prosthesis or INCIPIENT: Beginning to exist; coming into existence. other device. INCISAL GUIDANCE: See: Guidance, Incisal.

IMPLANT FIXTURE: A synonym for an implant, INCISION: A cut or surgical wound made by a knife, especially an endosseous implant. electrosurgical scalpel, , or other such instrument. EXTERNAL BEVEL I.: Reduces the thickness of the IMPLANT, ORAL: I. An alloplastic material or mucogingival complex from the outside surface, as in device that is surgically placed into the oral tissue a gingivectomy. beneath the mucosal or periosteal layer or within the INTERNAL (Inverse, Reverse, or Inverted) BEVEL bone for functional, therapeutic, or esthetic purposes. I.: Reduces the thickness of the mucogingival 2. To insert a graft or alloplastic device into the oral complex from the sulcular side. hard or soft tissues for replacement of missing or RELEASING I.: Made to enhance the mobility of a damaged anatomical parts, or for stabilization of a periodontal flap. periodontally compromised tooth or group of teeth. BLADE I.: A flat, blade-shaped end osseous implant INCISION AND DRAINAGE: The surgical which derives its support from a horizontal length of procedure of incising a lesion to permit the release or bone. Most commonly made of metal, it can be removal of an exudate. perforated, smooth, fluted, textured, coated, wedge­ INCLINED PLANE: Any one of the inclined cuspal shaped, and/or multi-headed. surfaces of a tooth. ENDODONTIC-ENDOSSEOUS I.: A pin that fits 1. into a root canal and extends beyond the apex into the INDEX: An ordinal and arbitrary system of bone. measurement which describes or quantitates a ENDOSSEOUS I.: An implant placed into the alveolar condition. Such indices are appropriate for use in an 2. process and/or basal bone that supports a prosthesis individual patient or for epidemiological studies. A or other device. mold used to record the relative position of a tooth or ENDOSTEAL I.: See: Endosseous 1. implant to its surroundings, or implants or teeth to FIBRO-OSSEOUS (Fibro-Osteal) INTEGRATED I.: one another or to a cast.

An implant with a fibrous connective tissue layer INDUCTION: The act or process of causing to occur between it and the surrounding bone. as induction of bone formation. OSSEOINTEGRATED I.: A direct structural and INDURATED: Hardened; made hard. functional connection between ordered, living bone

and the surface of an immobile, load-bearing implant INFECTION: Invasion of the body tissues by as detected on a light microscopic level. pathogenic microorganisms. RAMUS FRAME I.: A full arch implant of tripodial ENDOGENOUS I.: Due to activation of organisms design consisting of a horizontal supragingival previously present in a dormant focus. connecting bar with end osseous units placed into the EXOGENOUS I.: Caused by organisms acquired from two rami and symphyseal area. sources other than the host's own flora. ROOT-FORM I.: An endosseous implant that derives INFECTIOUS: Caused by or capable of being its support from a vertical length of bone. Most communicated by infections; infective. commonly made of metal, it can be cylindrical, tapered, threaded, coated, smooth, textured, INFLAMMATION: A localized protective response perforated, solid, and/or hollow. elicited by proximate microbes and/or tissue injury, 28

which serves to destroy, dilute, or wall off both the INTERDENTAL: Situated between the proximal injurious agent and the injured tissue. A cellular and surfaces of teeth in the same dental arch.

vascular reaction of tissues to injury. I. BRUSH: An instrument with bristles used to clean the proximal surfaces of adjacent teeth. INITIAL OCCLUSAL CONTACT: The first I. CANALS: Vascular channels in the interdental bone. contact of opposing teeth on closure of the mandible. I. GINGIVA: That portion of the gingiva that occupies IN SITU: In the proper position without invasion of the interdental area. See: Gingival Papilla.

neighboring tissues; in place. I. SEPTUM: That portion of the alveolar process

INSULIN: A protein secreted from the beta cells of the between adjacent teeth. I. SPACE: pancreas responsible for the uptake of glucose into The space between adjacent teeth in the cells, and stimulation of protein synthesis and lipid same arch. I. STIMULATION: synthesis in fat cells. Massage of the gingiva of the interdental area. INTEGRATION: The act of making into a whole by INTERDIGITATION: The interlocking or fitting of bringing all parts together. opposing parts, as the cusps of the maxillary and BIOINTEGRATION: A bonding of living bone to the

surface of an implant which is independent of any mandibular posterior teeth.

mechanical interlocking mechanism. INTERFERENCE: A tooth contact that interferes FIBRO-OSSEOUS (Fibro-Osteal) I.: The with harmonious mandibular movement. interposition of healthy dense collagenous tissue INTERFURCATION: The area between and at the between implant and bone. base of the roots of a multi-rooted tooth. : A direct contact, on the light

microscopic level, between living bone tissue and an : A family of potent proteins that implant. serves as a link between inducer and effector cells during immune and inflammatory responses; involved INTEGRINS: Heterodimeric membrane proteins in the recruitment of immune and inflammatory consisting of an a and a p subunit. These proteins precursor cells. Some interleukins have been function as cell surface receptors for cellular implicated in the pathogenesis of periodontal adhesion. Sixteen integrins have been identified. diseases. INTERALVEOLAR: Located between the alveoli. INTERMA XILLARY: Between the jaws. I. SEPTUM: Alveolar and trabecular bone between contiguous teeth. INTEROCCLUSAL: Between the occlusal surfaces

I. CREST: The coronal edge of the interdental bony of opposing teeth.

septum. INTEROCCLUSAL CLE ARANCE (Freeway

INTERARCH DISTANCE: The vertical distance Space): The space between the maxillary and between maxillary and mandibular teeth at any given mandibular opposing teeth when the mandible is degree of jaw opening. suspended in postural (rest) position.

See: INTERCELLULAR: Occurring between cell INTERPROXIMAL: Interdental Space. boundaries. INTERRADICULAR: Between the roots of teeth.

INTERCEPTIVE OCCLUSAL CONTACT: See: INTERSTITIAL: Situated between parts or in the Deflective Occlusal Contact. interspaces of a tissue.

INTERCUSPAL POSITION: That position in which INTRABONY: Within a bone; also termed the maxillary and mandibular teeth make maximum "infrabony." See: Periodontal Bony Defects. intercuspation. INTRACORONAL: Within the crown of a tooth. INTERCUSPATION: I. The -to-fossa relation­ INTRAOSSEOUS: Within a bone. ship of the maxillary and mandibular posterior teeth

to each other. 2. The interdigitation of cusps of IN VITRO: Within a glass; observable in a test tube; in opposing teeth. an artificial environment; i.e., laboratory. 29

IN VIVO: Within a living body. DENTINOENAMEL J.: The area of union of the dentin and enamel. ION TOPHORESIS: The act or process of MUCOGINGIVAL J.: The area of union of the introducing therapeutic agents into tissues using an gingiva and alveolar mucosa. electrical current or electrochemical gradient. JUNCTIONAL EPI THELIUM: See: Epithelium, IRRIGATION: The act of an area with water Junctional. or medicinal solution. JUVENILE PERIODON TITIS: See: Periodontitis, IRRITANT: An agent capable of inducing functional Aggressive derangements or organic lesions in tissues. JUXTAPOSITION: In apposition; contiguous; placed ISCHEMIA: Deficiency of blood in a part due to side by side. functional constriction or actual obstruction of a blood vessel. ------I[!f]I----- ISOLATE: A population of living organisms obtained in pure culture. KAPOSI'S SARCOMA: An infectious granuloma or ISOME T RIC: See: Contraction, Isometric. a reticuloendothelial hyperplasia that may be neoplastic in nature. Clinically, multiple reddish or ISOTONIC: See: Contraction, Isotonic. brownish-red nodules can involve the skin, oral I. SOLUTION: One having osmotic pressure equal to mucosa, visceral organs, and lymph nodes. Usually that of blood. related to immunocompromised states such as AIDS.

KERATINS: A multigene family of approximately 30 ----i[IJI---- proteins that form the intermediate filaments of the epithelial cell cytoskeleton. JAW RELATION: Any relation of the mandible to the KERATOSIS: maxilla. See: Centric Relation; Occlusion, Centric. Any keratinous growth, such as a ECCENTRIC J. R.: Any jaw relation other than or callus. centric relation. MEDIAN J. R.: Any jaw relation when the mandible is ------I[jJI----- in the median sagittal plane. PROTRUSIVE J. R.: A jaw relation resulting from an LABIOVERSION: Any deviation from the normal anterior positioning of the mandible. arrangement of the dental arch toward the lip. REST J. R.: The habitual postural jaw relation when LACERATE: the is in an upright position and the condyles are To mangle; to tear; to cut so that the in neutral, unstrained positions in the glenoid fossae. margin is irregular. RETRUSIVE J. R.: A jaw position resulting from a LACTOBACILLUS SSP.: Gram-positive, motile, posterior positioning of the mandible. anaerobic, rod-shaped bacteria implicated as a major contributor to caries progression. JOINT: The junction between two or more skeletal

bones that usually allows for the movement of one or : A depression; a hollow space. more bones. LAMELLA: A thin layer, plate, or scale, as of bone. JOINT, TEMPOROMANDIBULAR : See: CEMENTAL L.: One of the layers of cementum. Te mporomandibular Joint.

LAMINA: A thin layer or stratum of bone or any other JUNC TION: A place of meeting or coming together, tissue. A layer of composite structure. as of two different tissues.

CEMENTO-DENTINAL J.: The area of union of the LAMINA DURA: The layer of compact bone forming dentin and cementum. the wall of a tooth alveolus. Also known as the CEMENTO-ENAMEL J.: The area of union of the alveolar bone proper. cementum and enamel at the cervical region of the CRESTAL L. D.: The layer of compact bone at the tooth. alveolar crest. 30

LAMINA PROPRIA: In mucous membrane, the LEUKOPLAKIA: A non-specific white patch in the connective tissue coat just beneath the epithelium and oral cavity which will not rub off. the basement membrane. In skin this layer is known HAIRY L.: A corrugated, white plaque of the oral as the dermis. mucosa, primarily on the lateral borders of the tongue, that contains the Epstein-Barr virus. Most patients with LAMININ: A high molecular weight glycoprotein confirmed hairy leukoplakia are infected with the composed of three polypeptide chains that are orga­ human immunodeficiency virus (HIV). nized in a cross-like manner; functional domains of this molecule have affinity for cell surface receptors LEUKOTOXIN: A toxin produced by certain bacteria, and extracellular matrix components; a principal including Actinobacillus actinomycetemcomitans, component of the basal lamina. which is toxic to leukocytes, particularly polymorphonuclear leukocytes. LANCINATING PAIN: A sharp, cutting pain, usually intermittent and often periodic. LEUKOTRIENES: A group of potent biologic mediators of inflammation consisting of 20 carboxylic LASER: Acronym for Light Amplification by acids with at least two oxygen substitutes and three Stimulated Emission of Radiation. A device that double bonds; derived from arachidonic acid by the transforms light of various set frequencies into an lipoxygenase pathway; mediator of inflammatory extremely intense, small, and nearly non-divergent reactions. Leukotrienes C, 0, and E are the constituents beam of monochromatic radiation in the visible of the slow reacting substance of anaphylaxis (SRSA). region with all the waves in-phase. Capable of B stimulates functions and mobilizing immense heat and power when focused at regulates some lymphocyte functions. close range, it is used as a tool in surgical procedures, diagnosis, and physiologic studies. L-FORMS: Bacterial cells, lacking cell walls, which are able to grow and divide. Frequently confused with LEPTOTRICHIA SSP.: Gram-negative, non-motile, Mycoplasma ssp., L-forms may sometimes be anaerobic, rod-shaped bacteria found in marginal and spontaneously produced or chemically induced by the subgingival plaque. addition of specific agents, such as penicillin, to

LESION: I. An injury or wound. 2. Any single patch actively growing cultures.

or area of morbid tissue. 3. A pathologic disturbance : An inflammatory mucocutaneous of a tissue, or organ, which results in impairment, loss disorder characterized by discrete skin papules with a of continuity, or loss of normal function of the part. keratinized covering which often appears in the form CHEMICALLY IND UCED L.: Results from local of adherent scales. Oral lesions with characteristic application of substances that may include aspirin, radiating white striae are common and sometimes the cocaine, pyrophosphates, detergents (e.g., sodium only manifestation. Three types of oral lichen planus lauryl sulfate), smokeless tobacco, betel nut, and have been reported: I) atrophic or annular (most bleaching agents. common); 2) hypertrophic or nodular; and 3) TRAUMATIC L.: Self-inflicted (factitious), ulcerative or erosive. accidental, or iatrogenic . They may manifest LIGAMENT: A band of fibrous tiss.ue that connects as recession, abrasions, ulcerations, lacerations, bones and , serving to support and hums, edema, erythematous or white lesions, or strengthen joints. combinations of several of these features. PERIODON TAL L.: See: Periodontal Ligament; LEUKEMIA: A generalized neoplastic disorder of the Fibers. blood-forming tissues, primarily those of the LIGATE: To tie or bind, usually in the therapeutic leukocyte series. sense, for the purpose of stopping bleeding or LEUKOCIDIN: See: Leukotoxin. immobilizing a structure.

LEUKOPENIA: Reduction in the number of LIGATION, TEETH: The binding together of teeth

leukocytes in the blood below 5000 per cubic mm. with ligatures for stabilization and immobilization. See: ; Agranulocytosis. See: Splint. 31

LIGATURE: I. Any substance, such as gut, nylon, in phagocytic cells such as polymorphonuclear silk, or wire, used to tie an object or strangulate a leukocytes and macrophages. part. 2. A wire or other material used to secure an LYSOZYME: The cationic low molecular-weight orthodontic attachment. enzyme present in tears, , and nasal secretion LINGUOCCLUSION: An occlusion in which a tooth that kills susceptible bacteria by breaking down their or group of teeth is located lingually to its normal cell walls. position.

LINGUOVERSION: Displacement of a tooth lingually from the characteristic alignment of the dental arch. -----flMJt-----

LIPOPOLYSACCHARIDE: A major component of MACROPHAGE: A large phagocytic cell of the Gram-negative bacterial cell walls; consists of three series. Important as an antigen-presenting "0" subunits: lipid A, core polysaccharide, and cell and as a producer of certain such as polysaccharide side chains; has numerous biologic -I and gamma interferon. activities such as activation of complement. Often MACULA, MACULE: A small spot, perceptibly termed "endotoxin." different in color from the surrounding tissue. It is LOADING DOSE: An initial dose given at the neither elevated nor depressed from the surface. beginning of treatment, that is larger than subsequent MAINTENANCE, PERIODONTAL: See: doses, administered with the intent of achieving the Periodontal Maintenance Procedures. target concentration rapidly. MALALIGNMENT, DENTAL: LUXATION: I. Dislocation or displacement. 2. Partial The displacement of a tooth from its normal position in the dental or complete dislocation of a tooth from its alveolus. arch. LYMPHOC YTE: A spherical cell of the lymphoid MALIGNANT: series, 7 to 20 11m in diameter with a large, round In the case of a neoplasm, having the nucleus and scant cytoplasm. It is the principal cell properties of anaplasia, invasion, and metastasis. involved in the immune response. There are two : Any deviation from a major populations, T- (or -dependent) lympho­ physiologically-acceptable relationship of opposing cytes and B- (or bursa-equivalent) lymphocytes. B­ teeth. lymphocytes may differentiate and become antibody ANGLE'S CLASSIFICATION OF MALOCCUL­ producing plasma cells, while T- Iymphocytes are SION: A classification of different types of involved in a variety of cell-mediated immune malocculsion based on the anteroposterior reactions. relationship of the dental arches. CLASS I (NEUTROCCLUSION): LYMPHOKINE: Soluble factors released from The normal lymphocytes that transmit signals for growth and mesiodistal relation of the maxillary and differentiation of various cell types. mandibular teeth with the mesiobuccal cusp of the maxillary first permanent molar occluding in the LYMPHOTOXIN: A Iymphokine that results in direct buccal groove of the mandibular first permanent cytolysis following its release from stimulated molar. For there to be a malocclusion, an internal lymphocytes; also termed beta. derangement (e.g., crowding) must occur in one of

LYOPHILIZATION: Isolation of a solid substance the arches. from a solution by freezing the solution and CLASS II (DistoccIusion): The dental relationship sublimating the ice under a vacuum. wherein the mandibular dental arch is posterior to the maxillary arch; the is LYSIS: The process of cell dissolution; the action of a located distal to that seen in neutrocclusion. lysin. DIVISION 1: Labioversion of the maxillary : Intracellular cytoplasmic vesicles teeth. filled with hydrolytic ; especially prominent SUBDIVISION: Unilateral condition. 32

DIVISION 2.:> Linguoversion of the maxillary MELANIN: The dark, amorphous pigment of the skin, central incisors. hair, various tumors, the choroid coat of the eye, and SUBDIVISION: Unilateral condition. substantia nigra of the brain. CLASS III (Mesiocclusion): The dental : A neoplasm made up of melanin­ relationship wherein the mandibular dental arch pigmented cells. When used alone, the term refers to is anterior to the maxillary arch; the mandibular malignant melanoma. first molar is located mesial to that seen in

neutrocclusion. MELANOPLAKIA: Pigmented patches on the oral SUBDIVISION: Unilateral condition. mucosa.

MANDIBULAR AXIS: See: Axis. MEMBRANE: A thin, sheet-like layer of tissue that lines a cavity, envelops a vessel or part, or separates a MANDIBULAR GLIDE: The side-to-side, space or organ. See: Mucosa. protrusive, and intermediate movements of the PERIODONTAL M: A thin sheet-like usually non­ mandible occurring when the teeth or other occluding autologous material used in various periodontal surfaces are in contact. regenerative procedures. See: Periodontal Ligament. MARGINAL: Pertaining to or connected with a MENISCAL DISPLACEMENT: See: Temporo­ margin or border. mandibular Disorders; Internal Derangement. M. GINGIVA: See: Gingiva. M. RIDGE: A ridge of tooth structure forming the MENISCUS: The fibrocartilaginous articular disk of occlusoproximal margin of a premolar or molar. the temporomandibular joint.

MARROW: The soft material rich in fat, connective MESIOVERSION: The location of a tooth nearer tissue fibers, and cells that fills the cavities of bones. than normal to the median line of the face along the

MASSAGE: The act of manipulating soft tissue in the dental arch. hope of increasing circulation and keratinization, and METAPLASIA: A change from one adult cell type to enhancing tissue tone. Data documenting the another form which is not normal to that tissue. treatment efficacy of this procedure is not currently METASTASIS: available. Transfer of disease from one body GINGIVAL M.: The application of frictional, com­ part or organ to another not directly connected to it. pressional, rubbing, and stroking forces to the Classically, the transfer of cells, as in malignant gingiva. tumors, or the transfer of pathogenic microorganisms.

METRONIDIZOLE: MAST CELL: A tissue cell, often found around blood An antibiotic with a spectrum vessels, which produces histamine, heparin, confined to obligate anaerobes, some microaerophilic leukotrienes, and platelet activation factor. Important organisms, and some anaerobic protozoa that acts to in immediate hypersensitivity reactions. damage or inhibit DNA synthesis; may induce a disulfiram-like reaction. MASTICATION: The process of chewing food in MICROAEROPHILIC: preparation for swallowing and digestion. Refers to bacteria that grow under conditions of reduced oxygen concentration. MASTICATORY MUCOSA: See: Mucosa. Used to describe conditions in which the oxygen

MASTICATORY SYSTEM: The organs and concentration is lower than atmospheric levels. structures functioning in mastication, including the MICROBIAL RESISTANCE: The ability of jaws, teeth with their supporting structures, temporo­ microorganisms to resist the effects of antibiotics; mandibular articulation, mandibular musculature, usually due to chromosomal mutation or the transfer tongue, lips, , oral mucosa, and associated of resistant genes from already resistant organisms; nervous system. mechanisms include antibiotic enzymatic destruction

MATERIA ALBA: Loosely adherent, white curds of (beta-Iactamases), altered receptor sites (penicillin­ matter composed of dead cells, food debris, and other binding proteins), efflux of the antibiotic from the components of the dental plaque found on the tooth. organism, or altered metabolic pathways. 33

MICROBIOTA : The microscopic living organisms of M. DEFORMITY: A departure from the normal a region. dimension and morphology of, and/or inter­ relationship between gingiva and alveolar mucosa; MICROORGANISM: A microscopic organism; the abnormality may be associated with a deformity those of medical interest include bacteria, viruses, of the underlying alveolar bone. fungi, yeasts, and protozoa. M. JUNC TION: The junction of the gingiva and the

MIGRATION, PATHOLOGIC DENTAL: The alveolar mucosa. See: Junction, Mucogingival. movement of a tooth out of its former position when M. SURGERY: See: Surgery, Mucogingival. the etiology or etiologies responsible for such M. THERAPY: Correction of defects in morphology, movement are associated with a disease process. position, and/or amount of soft tissue and underlying bone MINERAL CORTICOID: A group of C2l steroid hormones (aldosterone, etc.) that regulates electrolyte MUCOLA BIAL FOLD: The line of flexure of the and water balance in the ; secreted from the oral mucous membrane as it passes from the mandible adrenal cortex; a corticosteroid. or maxilla to the lip.

MINERALIZE (Calcify): The precipitation of MUCOPERIOSTEUM, ORAL: The complex of calcium and other salts into an organic matrix to form mucous membrane and periosteum that surrounds and a hard deposit, such as dental calculus. invests the maxilla, mandible, and teeth. MINIMUM BACTERICIDAL CONCENTRA ­ MUCOSA: A mucous membrane. TION (MBC): The minimum concentration of an ALVEOLAR M.: Mucosa covering the basal part antimicrobial agent required to k.ill a pure population of the alveolar process and continuing without of bacteria in vitro. demarcation into the vestibular fornix and the floor of MINIMUM INHIBITORY CONCENTRATION the mouth. It is loosely attached to the periosteum (MIC): The minimum concentration of an anti­ and is movable. microbial agent required to inhibit the growth and/or MASTICATORY M.: The gingiva and the mucosal reproduction of a pure population of bacteria in vitro. covering of the . ORAL M.: MITOGEN: A substance that causes DNA synthesis, The tissue lining the oral cavity. blast transformation, and mitosis in lymphocytes. MUCOSITIS: Inflammation of a mucous membrane.

MOBILITY, TOOTH: The movement of a tooth in its MUCUS: The clear, viscous secretion of the mucous socket resulting from an applied force. membranes, composed of secretions of the glands, MONOCYTE: A blood-borne precursor of tissue along with various inorganic salts, desquamated cells, macrophages. and leukocytes.

MORBIDITY: The condition of being diseased. MURA MIDASE: See: Lysozyme.

MOUTH : The process of breathing MYALGIA: Pain in a muscle or muscles. primarily through the oral cavity rather than the nasal

passages. May be associated with gingival MYCOPLASMA SSP.: Small cell intermediate in enlargement and inflammation. physiologic properties between bacteria and viruses, lacking a cell wall but able to grow and mUltiply. Able MOUTH GUA RD: A removable dental appliance to agglutinate red blood cells and sometimes found in used to protect the teeth and investing tissues during association with human periodontal disease. contact sports. See: Occlusal Guard.

MUCOBUCCAL FOLD: The cul-de-sac formed MYCOTIC: Referring to an infection or lesion caused where the mucous membrane is reflected from the by a fungus. mandible or maxilla to form the cheek. MYOFA SCIAL PAIN DYSFUNCTION SYND­

MUCOGINGIVAL: The portion of the oral mucosa ROME (MPD): A collection of medical and dental that covers the alveolar process including the gingiva conditions affecting the temporomandibular joint (keratinized tissue) and the adjacent alveolar mucosa. (TMJ) and/or and other 34 ------

contiguous tissue components. See: NEURITIS: Inflammation of a nerve. Te mporomandibular Disorders (TMD). NEUTROCCLUSION: See: Malocclusion. MYOFUNCTIONAL: Relating to the function of NEUTROPENIA: An abnormal decrease in the muscles. In dentistry, relates to the role of muscle number of circulating neutrophils. It may be cyclic in function in the cause or correction of orthodontic nature. See: Agranulocytosis. problems or the treatment of muscle-related

problems. NEUTROPHIL: The predominant polymorphonuclear leukocyte comprising up to 70% of the peripheral MYOSITIS: Inflammation of a muscle. white blood cells. It is important in infection and injury repair, and may have impaired function in ------f[RJt----- some forms of early onset periodontitis.

NARRATIVE REPORT: A complete description of NEVUS: 1. A pigmented or non-pigmented lesion on the findings, diagnosis, and therapy for a given the skin or mucosa, which may undergo malignant patient. transformation. 2. Birthmark; a circumscribed malformation of the skin, especially if colored by NASMYTH'S MEMBRANE: Primary enamel or increased vascularity. 3. A cuticle. A delicate membrane that briefly covers the benign, localized overgrowth of melanocytes in the crowns of newly erupted teeth. Consists of skin early in life. ameloblasts of the reduced enamel epithelium attached to the enamel by a basal lamina. NIDUS: I. The point of origin or focus of a morbid process. 2. Nucleus. NECROSIS: The death of one or more cells, or a

portion of a tissue or organ; typically characterized by : A coronary vasodilator drug that may pyknosis (shrunken and darkly basophilic nuclear be associated with gingival overgrowth. staining), karyolysis (swollen and pale basophilic NIGHT GUARD: See: Occlusal Guard. nuclear staining), or karyorrhexis (nuclear rupture or

fragmention). NIKOLSKY'S SIGN: Occurs when the apparently NECROTIZING ULCERATIVE GINGIVITIS: normal, superficial layer of skin or oral mucosa may be rubbed off with slight trauma. Originally See: Gingivitis, Necrotizing Ulcerative. associated with , but can be NECROTIZING ULCERATIVE PERIODONTI­ seen in several bullous conditions. TIS: See: Periodontitis, Necrotizing Ulcerative. NODULE: A small, solid, collection of tissue. NEGATIVE PREDICTIVE VALUE: The proportion of negative responses to a diagnostic test : Rapid spreading gangrene of oral tissues; for a disease that are accurate indicators of the true associated with debilitated or nutritionally deficient absence of the malady in a population. Expressed patients. Fusospirochetal organisms have been impli­ arithmetically as a proportion which is calculated as cated in this condition. the number of true negative responses divided by the NON-FUNCTIONAL SIDE: The side away from sum of true negative responses plus false negative which the mandible moves during lateral excursions. responses, i.e., Negative predictive value = TN/(TN+FN). NOXIOUS: A deleterious or harmful substance; not wholesome. NEISSERIA SSP.: Gram-negative, non-motile, microaerophilic cocci found as part of the indigenous NUTRITION: The process of assimilating food. oral flora.

NEOPLASM: A new, abnormal, uncontrolled growth arising from a given tissue. ----i[Q]t----

NEURALGIA: Paroxysmal pain that extends along OBLIGATE: Essential; not facultative; limited to a the course of one or more nerves. single life condition; able to survive only in a 35

particular environment or to assume only a particular O. SURFACE: Pertaining to the masticatory surfaces role, as an obligate anaerobe. of the posterior teeth.

O. TRAUMA: Injury resulting in tissue changes within OBLIQUE FIBERS: See: Fiber, Principal. the attachment apparatus as a result of occlusal OBTUNDENT: An agent or remedy that lessens or force(s).

relieves sensibility or pain. Soothing, deadening, PRIMARY O.T.: Injury resulting in tissue changes dulling. from excessive occlusal forces applied to a tooth or teeth with normal support. OBTURATOR: A structure that closes an opening, such as a prosthetic appliance used to close an SECONDARY O.T.: Injury resulting in tissue opening in the palate. changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced support. OCCLUDE: I. To bring together; to shut. 2. To bring O. TRAUMATISM: Functional loading of teeth, or close the mandibular teeth into contact with the usually off-axis, that is of sufficient magnitude to maxillary teeth. induce changes to the teeth (e.g., fractures, wear) or

OCCLUSAL: Pertaining to the contacting surfaces of supporting structures. Changes may be temporary or opposing teeth. permanent. O. ADJUS TMENT (0. EQUILIBRATION or O. WEAR: Loss of substance on opposing occluding

SELECTIVE GRINDING): Reshaping the units or surfaces due to attrition or abrasion. See: occluding surfaces of teeth by grinding to create Abrasion; Attrition; Facet. harmonious contact relationships between the upper OCCLUSION: Any contact of opposing teeth. and lower teeth. CENTRIC O. (Acquired Centric and Habitual O. ANALYSIS: A systematic examination of the masti­ Occlusion): The or contact catory system with special consideration of the effect of the teeth of the opposing arches. of occlusion on the teeth and their related structures. ECCENTRIC 0.: Any relation of the mandibular to O. DISHARMONY: Contacts of opposing surfaces of the maxillary teeth other than centric occlusion. teeth that are not in harmony with each other or with 0.: the anatomic and physiologic control of the mandible. PHYSIOLOGIC Occlusion in harmony with the See: Deflective Occlusal Contact; Occlusal functions of the masticatory system. 0.: Interference. PROTRUSIVE Occlusion of teeth when the O. EMBRASURE: The interdental space that is mandible is protruded from centric maximum coronal to the interproximal contact between intercuspation. adjacent, contacting teeth in the same arch. RETRUSIVE 0.: A biting relationship in which the O. GUARD (BITE GUARD; MOU TH GUARD; mandible is more distally placed than in maximum NIGHT GUARD): A removable dental appliance intercuspation. usually constructed of plastic that covers a dental TRAUMATIC 0.: See: . arch and designed to minimize the damaging effects ODONTALGIA: ; pain in a tooth. of bruxism and other occlusal habits.

O. INTERFERENCE: Any contact that inhibits the : A connective tissue cell found remaining occluding surfaces from achieving stable in the odontoblastic layer of the dental pulp that i, and harmonious contacts. responsible for deposition of dentin. O. PLANE (Plane of Occlusion): An imaginary plane, I. 2. which is related anatomically to the cranium and ODONTOGENIC: Tooth-forming. Arising in which theoretically touches the incisal edges of the tissues that give origin to the teeth. incisors and the tips of the occluding surfaces of the ODONTOMA: A developmental anomaly consisting posterior teeth. It is not a plane in the true sense of of a calcified mass of enamel, dentin, and cementum the word, but represents the mean of the curvature of that may or may not resemble a tooth. the surface.

O. PREMATURITY: Any contact of opposing teeth ODONTOPLASTY: The reshaping of a portion of a that occurs before the desirable intercuspation. tooth. 36

OLIGODONTIA: The congenital absence of a large OSSEOUS COAGULUM: A mixture of small bone number of teeth. particles and blood used as a bone graft.

ONCOGENE: A gene controlling cellular prolifera­ OSSEOUS SURGERY: See: Surgery, Osseous tion, altered through mutation or included in a viral OSSIFICATION: To change into bone. genome, that can promote neoplastic transformation or normal cells. OSTECTOMY (): The excision of a bone or portion of a bone. In periodontics, ostectomy is OPEN BITE: A condition in which certain teeth done to correct or reduce deformities caused by cannot be brought into the occlusal contact with their periodontitis in the marginal and interalveolar bone antagonists. and includes the removal of bone that is attached to

OPERCULITIS: See: . the tooth.

OSTEITIS: Inflammation of bone involving the OPERCULUM: The flap of mucosa over a partially Haversian spaces, canals, and their branches. erupted tooth. CONDENSING (Formative, Sclerosing) 0.: Osteitis : An infection associated with increased . usually initiated by endogenous, normally non­ O. DEFORMANS (Pagent's Disease): A bone disease pathogenic, flora that occurs in a host whose of unknown cause, characterized by enlargement of resistance is lowered (e.g., by other diseases or by the cranial bones and often the maxilla or mandible. drugs). Radiographically there may be a cotton-wool

OPSONIN: A substance (e.g., antibody, complement) appearance.

capable of enhancing phagocytosis. : A fully differentiated cell, arising from mesenchymal progenitors, that is reponsible for (0. Physiotherapy, Plaque the production of bone matrix and the resorptive Control): Removal of bacterial plaque with brushes, remodeling of bone. , and other devices. The maintenance of

oral cleanliness. : A large, multinucleated cell, arising from mononuclear precursors of the hematopoietic ORAL PROPHYLAXIS: See: Prophylaxis, Oral. lineage, that is associated with . ORAL : A disease condition in the mouth or : An osteoblast that has become adjacent structures that may have systemic effects embedded within the bone matrix. through the dissemination of infection and toxins. OSTEOGENESIS: Development of bone; formation ORGANIZATION: The replacement of blood clots of bone. by fibrous tissue in a healing wound OSTEOGENIC: Any tissue or substance with the ORIFICE: Any opening, whether by a foremen, a potential to induce growth or repair of bone. meatus, a perforation, or one which serves as an entrance or outlet to a vessel, canal, or cavity. : The organic matrix of bone; developing bone that has not undergone calcification. OROANTRAL FISTULA: See: Fistula, Oroantral. : Inflammation of bone marrow ORTHODONTIC : Any type of device and adjacent bone. used for the fixation or stabilization of teeth after OSTEOPERIOSTEAL: Pertaining to bone and its orthodontic movement. periosteum. ORTHOPANTOGRAPH: A OSTEOPLASTY: Reshaping of the alveolar process that includes images of the maxilla and mandible on a to achieve a more physiologic form without removal single extraoral film. of alveolar bone proper. OSSEOINTEGRATION: See: Integration. OSTEOPOROSIS: Abnormal rarefaction of bone, OSSEOUS: Bony; pertaining to bone. seen most commonly in the elderly. 37

OS TE ORADIONECROSIS: Necrosis of bone GINGIVAL P., INTERDENTAL P.: See: Gingival following irradiation. Papilla. INCISIVE P.: The elevation of soft tissue covering the OS TE OS CLEROSIS: See: Osteitis, Condensing. foramen of the incisive or nasopalatine canal. OVERBITE: Vertical overlapping of the mandibular PAPILLECTOMY: Surgical removal of a gingival incisors by the maxillary incisors when the jaws are papilla. in centric (habitual) occlusion.

PAPILLOMA: A benign, exophytic, pedunculated, OVERCLOSURE: Decreased occlusal vertical cauliflower-like neoplasm of epithelium. May have a dimension. viral etiology. OVERDE NTURE: See: Denture. PAPILLON-LEFEVRE SYNDROME: Palmar­ OVERGROWTH: Excessive enlargement of a part plantar hyperorthokeratosis with precocious due to an increase in size of the constituent cells periodontal destruction in the primary and permanent (hypertrophy) or an increase in their number dentition. Thought to be the result of homozygosity (hyperplasia). of autosomal recessive genes.

OVERHANG: Excess of dental restorative material PAPULE: A small, circumscribed, solid elevation of extending beyond cavity margins. the skin.

OVERJE T: The horizontal projection of the maxillary PARAFUNCTION: Abnormal function, as in incisors beyond the mandibular incisors when the bruxism. jaws are in centric (habitual) occlusion. PARAKERATOSIS: See: Hyperparakeratosis.

PARETHESIA: An abnormal sensation, such as ------I�I----- burning, prickling, or numbness. Usually caused by nerve injury and sometimes follows surgical PACK (archaic): See: Periodontal Dressing. procedures.

PALLIATE: To mitigate, soothe, relieve, reduce in PAROXYSM: A sharp spasm or convulsion. violence. PAROXYSMAL TRIGEMINAL NEURALGIA PANCYTOPENIA: Pronounced reduction in the (Tic Douloureux): A severe paroxysm of pain number of cells and platelets in the circulating blood. occurring, usually unilaterally, in the distribution of

PANORAMIC RADIOGRAPH: See: Ortho­ the (especially the second and third pantograph. divisions). Seen in middle-aged to elderly adults. The pain may be precipitated by a slight stimulus in a PAPILLA: Any small, nipple-shaped elevation. "trigger area." CIR CUMVALLATE P.: One of eight or 10 projections from the dorsum of the tongue forming a V-shaped PARTIAL THICKNESS FLAP: See: Flap, Partial row anterior to and parallel with the sulcus termin­ Thickness. alis. Each papilla is surrounded by a circular trench PARULIS: The gingival drainage tract associated with having a slightly raised outer wall. On the sides of the an oral abscess of odontogenic origin. A gum boil. papilla and on the opposed margins of the vellum are numerous taste buds. PASSIVITY: In reference to dental implants, the FILIFORM P.: Elongated conical projections covering property of the oxidized layer on the surface of the the dorsum of the tongue. metal that does not break down under physiological FOLIATE P.: Numerous parallel projections arranged conditions. in transverse folds on the posterolateral margins of PATHOGEN: Any disease-producing microorganism. the tongue. FUNGIFORM P.: Numerous, minute, mushroom PATHOGENESIS: The origin and development of shaped elevations on the dorsum of the tongue. disease. 38

PATHOGNOMONIC: Characteristic or symptomatic Gram-negative bacteria. Synthesis is inhibited by the of a disease. A sign or symptom on which a diagnosis beta-lactam antibiotics. can be made. PEPTOCOCCUS SSP.: Gram-positive, non-motile, PATHOSIS: A disease entity; a morbid condition. anaerobic cocci occurring in irregular groups or clusters. Frequently found as a part of the subgingival PEDICLE: A stem-like or narrow base part, such as plaque flora and occasionally implicated in oral the stalk by which a non-sessile tumor is attached. infections and periodontal diseases. PEGS, EPITHELIAL (Rete Ridges): Ridge-like projections of epithelium into the underlying stroma PEPTOSTREPTOCOCCUS SSP.: Gram-positive, of connective tissue that normally occur in mucous non-motile, anaerobic cocci occurring in chains. membrane and dermal tissue subject to functional Frequently found as part of the subgingival flora stimulation. and occasionally implicated in oral infections.

PELLICLE, SALIVARY: To oth- or mucosal­ PERCUSSION: The act of striking a part with short, adherent salivary proteins. sharp blows as an aid in diagnosing conditions of the underlying parts (hypermobile tooth, ankylosed PEMPHIGOID (Cicatricial Pemphigoid, Benign tooth, or status of an implant) by the sound Mucous Membrane Pemphigoid): A chronic obtained. Useful in locating a tooth with an vesiculobullous autoimmune disorder that primarily inflamed periodontal ligament through the pain affects the mucosa in older females; characterized by response. a sub-basalar separation of epithelium from

connective tissue; almost all cases have an oral PERIADENITIS MUCOSA NECROTICA involvement with the gingiva being the most favored RECURRENS: See: Apthae, Major. site. PERIAPICAL: Relating to tissues surrounding the PEMPHIGUS: Refers to a group of autoimmune bul­ apex of a tooth, including the periodontal ligament lous diseases (pemphigus vulgaris, pemphigus and alveolar bone. vegetans, and pemphigus erythematosus) that affects

skin and mucous membranes primarily between the PERICORONITIS: Acute inflammation of the fourth and sixth decades of life; characterized by gingiva and/or mucosa surrounding a partially acantholysis and intraepithelial blistering; untreated, erupted tooth. the mortality rate for these diseases ranges from 70% PERI-IMPLANTITIS: Inflammation around a dental to 100%. implant and/or its abutment. PENICILLIN: A generic name for a related group of antibiotics differing in antibacterial spectrum, oral PERIODONTAL: Situated or occurring around a absorption, and resistance to beta-lactamase enzymes. tooth; pertaining to the periodontium. P. ABSCESS: See: Classified as penicillin G and congeners (penicillin Abscess, Periodontal P. BONY DEFECTS: V), anti-staphylococcal penicillins (methicillin, Alterations in the morphological dicloxacillin), extended spectrum penicillins features of the bone. Osseous defects may be (ampicillin and amoxicillin), and extended-spectrum subcategorized as follows: penicillins with beta-lactamase inhibitors (amoxicillin CIRCUMFERENTIAL D: A vertical defect that and clavulanate, ampicillin and sulbactam). includes more than one surface of a tooth, e.g., a vertical defect that includes the mesial and lingual PENICILLIN-BINDING PROTEINS (PBPs): surfaces of a tooth. Receptor sites (commonly transpeptidase enzymes) CRATER: A cup- or bowl-shaped defect in the for penicillin in its inhibition of bacterial cell wall interalveolar bone with bone loss nearly equal on synthesis; alterations in or formation of new PBPs are the contiguous roots. The facial and lingual! major mechanisms of resistance to penicillins. Also palatal walls may be of unequal height. A type of known as penicillin-sensitive enzymes (PSEs). intrabony defect, a crater also may be classified by PEPTIDOGLY CAN: Major structural component of the number of bony walls (i.e., a one-, two-, or bacterial cell walls. Thicker in Gram-positive than in three-walled); combination defects also exist. 39

FUNNEL-SHAPED D: An intrabony resorptive of the junctional epithelium along the root as the lesion involving one or more surfaces of periodontal ligament is detached by a disease process. supporting bone; may appear moat-like. INTRABONY POCKET: A periodontal pocket that FURCATION INVASION: Pathologic resorption of extends into an intrabony periodontal defect. See: bone within a furcation. Periodontal Bony Defects. CLASSIFICATION OF FURCATION PSEUDOPOCKET: A deepening of the gingival

INVASIONS: crevice resulting primarily from an increase in CLASS I: Incipient loss of bone limited to the bulk of the gingiva without apical migration of the furcation flute that does not extend horizontally. junctional epithelium or appreciable destruction of CLASS II: A variable degree of bone loss in the underlying tissue. See: Gingival Pocket. a furcation, but not extending completely SUPRA BONY POCKET: A periodontal pocket through the furcation. with a base coronal to the alveolar bone. CLASS III: Bone loss extending completely P. SPACE: The space between the tooth root and through the furcation. alveolar bone containing the periodontal ligament. HEMISEPTAL D: A vertical defect in the presence P. SYNDROME: A singular term that encompasses of adjacent roots; thus half of a septum remains on the characteristic clinical signs and symptoms of one tooth. periodontal diseases such as inflammation, INTRABONY D. (Infrabony D): A periodontal attachment loss, , etc. defect surrounded by two or three bony walls or a P. TRAUMATISM: See: Occlusal Traumatism. combination of these. PERIODONTALGIA: P. DISEASE: Those pathologic processes affecting the Pain arising in the periodontal periodontium; most often gingivitis and periodontitis. structures. See: Periodontitis. PERIODONTICS: That of dentistry which P. DRESSING (Pack): A protective material applied encompasses the prevention, diagnosis, and treatment over the wound created by periodontal surgical of diseases of the supporting and surrounding tissues procedures. of the teeth or their substitutes; the maintenance of P. LIGAMENT: The connective tissue that surrounds the health, function and esthetics of these structures and attaches roots of teeth to the alveolar bone. and tissues; and the replacement of lost teeth and P. MAINT ENANCE (formerly referred to as supporting structures by grafting or implantation of Supportive Periodontal Therapy [SPT), Preventive natural and synthetic devices and materials. Maintenance, Recall Maintenance): Procedures

performed at selected intervals to assist the PERIODONTIST: A dental practitioner who, by periodontal patient in maintaining oral health. As part virtue of special knowledge and training in the field, of periodontal therapy, an interval is established for is qualified to and limits his/her practice or activities periodic ongoing care. Maintenance procedures are to periodontics. under the supervision of the dentist and typically include an update of the medical and dental histories, PERIODONTITIS: Inflammation of the supporting radiographic review, extraoral and intraoral soft tissues of the teeth. Usually a progressively tissue examination, dental examination, periodontal destructive change leading to loss of bone and evaluation, removal of the bacterial flora from periodontal ligament. An extension of inl1dmmation crevicular and pocket areas, from gingiva into the adjacent bone and ligament. where indicated, polishing of the teeth, and a review ADULT P.: A formerly used term. In general, patients of the patient's plaque control efficacy. Periodontal formerly classified as having "adult periodontitis" maintenance procedures following active therapy is are now included under the not synonymous with a prophylaxis. category. P. MEMBRANE (Archaic): The periodontal ligament. AGGRESSIV E P.: A specific type of periodontitis with P. POCKET: A pathologic fissure between a tooth and clearly identifiable clinical and laboratory findings, the crevicular epithelium, and limited at its apex by that make it sufficiently different from chronic the junctional epithelium. It is an abnormal apical periodontitis, to warrant a separate classification. extension of the gingival crevice caused by migration occurs in a patient who 40

otherwise is clinical healthy (except for periodontal systemic conditions including, but not limited to, HIV

disease). Common features include rapid attachment infection, malnutrition, and immunosuppression. See

loss and bone destruction, and familial aggregation. also: Gingivitis, Necrotizing Ulcerative. In addition, patients with aggressive periodontitis PREPUBERTAL P.: A formerly used term to designate generally, but not universally, exhibit amounts of the prepubescent occurrence of periodontitis. microbial deposits inconsistent with the severity Patients previously classified as having prepubertal of periodontal tissue destruction, phagocyte periodontitis are now included under either the chronic abnormalities, and elevated proportions of periodontitis category or the periodontitis associated

A. actinomycetemcomitans and, in some populations, with systemic diseases category.

P gingiva/is. P. ASSOCIATED WITH SYSTEMIC DISEASE:

AGGRESSIVE P.: GENERALIZED FORM Periodontitis, often with onset at a young age,

(Formerly Generalized Juvenile Periodontitis): associated with one of several systemic diseases. In addition to the common features described RAPIDLY PROGRESSIVE P.: A formerly used term.

above, A. P. usually affects persons under 30 years Patients formerly classified as having rapidly of age, but may be older. Typically, there is progressive periodontitis are now included under generalized interproximal attachment loss either the chronic periodontitis category or aggressive affecting at least three teeth other than first molars periodontitis category. and incisors, and there is a pronounced episodic RECURRENT P.: A condition where periodontitis has nature of the destruction of attachment and been successfully treated but then recurs. A alveolar bone. There also may be a poor serum secondary descriptor used with various categories of antibody response to infecting agents. periodontitis (e.g., recurrent chronic periodontitis,

AGGRESSIVE P.: LOCALIZED FORM recurrent aggressive periodontitis, etc). (Formerly Localized Juvenile Periodontitis): In REFRACTORY P.: A condition where one or more addition to the common features described above, forms of periodontitis are unresponsive to treatment typically there is circumpubertal onset, localized despite excellent patient compliance and delivery of first molarlincisor presentation with interproximal periodontal therapy that ordinarily is successful in attachment loss associated with at least two arresting the progression of periodontitis. A (one of which is afirst molar) and secondary descriptor used with various categories of involving no more than two teeth other than first periodontitis (e.g., refractory chronic periodontitis, molars and incisors. There usually is a robust refractory agrressive periodontitis, etc.). serum antibody response to infecting agents. PERIODONTIUM: The tissues that invest and CHRONIC P.: An infectious disease resulting in support the teeth including the gingiva, alveolar inflammation within the supporting tissues of the mucosa, cementum, periodontal ligament, and teeth, progressive attachment and bone loss and is alveolar and supporting bone. ch�racterized by pocket formation and/or recession of PERIODONTOLOGY: The scientific study of the the gingiva. It is recognized as the most frequently periodontium in health and disease. occurring form of periodontitis. It is prevalent in

adults, but can occur at any age. The disease is PERIODONTOMETRY: The measurement of tooth usually associated with the presence of plaque and mobility. calculus. Progression of attachment loss usually PERIODONTOPATHIC: Refers to agents able to occurs slowly, but periods of rapid progression cao induce and/or initiate periodontal pathoses. occur. Associated with a variable microbial pattern. PERIOSTEITIS: EARLY-ONSET P.: A formerly used term. See: Inflammation of the periosteum. Aggressive Periodontitis. PERIOSTEUM: A specialized connective tissue JUVENILE P.: A formerly used term. See: Aggressive covering bones and possessing bone-resorptive and Periodontitis. bone-forming potential. NECROTIZING ULCERATIVE P.: An infection PERIRADICULAR: Around or surrounding a tooth root. characterized by necrosis of gingival tissues, periodontal ligament, and alveolar bone. These lesions PERLECHE: Cracking of the labial commissures. are most commonly observed in individuals with . 41

PETECHIAE: Hemorrhagic spots of pinpoint to oral surfaces and is found in the gingival crevice and pinhead size in the skin or mucous membrane. periodontal pockets. Other components include an organic, polysaccharide-protein matrix consisting of PHAGOCYTE: Inflammatory cells of the bacterial by-products such as enzymes, food debris, mononuclear phagocyte lineage. desquamated cells, and inorganic components such as PHAGOCYTOSIS: The process of cellular ingestion calcium and phosphate. and digestion of solid or semi-solid substances, such PLASMA CELL: An antibody producing as other cells, bacteria, bits of necrosed tissue, and B-lymphocyte that has reached the end of its foreign particles. differentiation pathway. PHARMACODYNAMICS: The biochemical and PLASMID: An extrachromosomal structure found in physiologic actions of drugs in the body as well as bacterial cells that carries genes necessary for cell­ the mechanism of action of drugs. aided replication of itself along with genes that, if : Involved with the absorp­ expressed, may change the characteristics of host tion, distribution, metabolism, and excretion of drugs. cells; e.g., antibiotic resistance.

PHARMACOLOGY: The study of the interaction of PLATELET-DERIVED GROWTH FACTOR chemicals with biological systems. (PDGF ): A glycoprotein carried in the granules of platelets and released during blood clotting; a potent PHASE CONTRAST MICROSCOPY: A method growth factor for cells of mesenchymal origin, of microscopy that takes advantage of varying including fibroblasts and smooth muscle cells. intensities of light waves passing through transparent

objects, thus providing better differentiation of PLEOMORPIDSM: The assumption of various distinct internal structures. forms or shapes by a single organism or species.

PHENOTYPE: The physical expression of an PLEXUS: A network; especially of nerves, lymphatics, individual's genotype. or .

PHENYTOIN (Diphenylhydantoin): An POCKET: See: Periodontal Pocket. drug used in the control of epilepsy POLYCYTHEMIA: An abnormal increase in the and other disorders. Often associated with gingival proportion of red cells in the blood. overgrowth.

POLYMORPHISM: Occurring in several forms or PHYSICAL INJURY: May result from inappropriate having several morphological types. oral hygiene procedures, inadequate dental restorations, poorly designed dental appliances, POLYMORPHONUCLEAR LEUKOCYTE orthodontic bands and devices, and iatrogenic (PMN): See: Neutrophil. dentistry. May be accidental or deliberate. POLYOSTOTIC: Pertaining to or affecting many PHYSIOLOGIC ARCHITECTURE: See: bones. Architecture. POLYP: A pedunculated tumor arising in a mucous PHYSIOLOGY: The scientific study of the functions membrane. of living organs and parts and the ways in which they PORPHYROMONAS: Formerly called Bacteroides are affected by chemical and physical laws. SSP. See: Prevotella; Porphyromonas gingiva/is. PIGMENTATION: The deposition of coloring matter; : Formerly called coloration or discoloration of a part by a pigment. Bacteroides gingiva/is. Gram-negative, nonmotile, PLACEBO: An inactive substance resembling one anaerobic, non-spore forming bacillus that occurs having therapeutic value; used in controlled studies primarily in the oral cavity and is associated with to determine the effect of drugs without the influence some forms of severe periodontitis. It is a non­ of bias. fermentative, pigmented Porphyromonas isolated principally from the . PLAQUE: An organized mass, consisting mainly of

microorganisms, that adheres to teeth, prostheses, and POSITIVE ARCHITECTURE: See: Architecture. 42

POSITIVE PREDICTIVE VA LUE: The proportion RELATIVE ATTACHMENT LEVEL: The distance of positive responses to a diagnostic test for disease from a fixed reference point on a tooth or stent to the that are accurate indicators of the true presence of the tip of the periodontal probe during usual periodontal malady in a population. Expressed arithmetically as a diagnostic probing. The health of the attachment proportion which is calculated as the number of true apparatus can affect the measurement. positive responses divided by the sum of true positive PROCESS: Any marked prominence, outgrowth, or responses plus false positive responses, i.e., Positive extension of the tissues of an animal or plant. predictive value = TP/(TP+FP). ALVEOLAR P.: The compact and cancellous bony POSTURAL POSITION: See: Rest Position, structure that surrounds and supports the teeth. Physiologic. PRODROME: A premonitory symptom of a disease; a PREGNANCY TUMOR: See: Granuloma, Pyogenic. forerunner of disease; a symptom indicating the onset of a disease. PREMATURE CONTACT: See: Deflective Occlusal

Contact. PROGENITOR CELL: An undifferentiated cell that gives rise to one or more types of more specialized PREMEDICATION: Medication given prior to an cells. anesthetic or operation.

PROGESTERONE: A generic term for naturally PREVENTIVE: Serving to avert the occurrence of. occurring steroid hormones containing a pregnane PREVOTELLA: Formerly called Bacteroides SSP. nucleus; secreted from the corpus luteum and See: Porphyromonas. placenta; a luteohorrnone; implicated in hormonal and pubertal gingivitis. PREVOTELLA INTERMEDIA: Formerly called Bacteroides intermedius. Gram-negative, non-motile, PROGNATHIC: A forward relationship of the jaws, anaerobic, non-spore forming bacillus isolated from usually used with reference to the mandible. oral and other body sites. A common inhabitant of the gingival crevice, it has been associated with infections PROGNOSIS: A prediction as to the progress, course, of the head, neck, and pleura. There are two distinct and outcome of a disease. DNA groups designated as P. intermedia I PROGRESSIVE SYSTEMIC SCLEROSIS and 11. (Scleroderma): A chronic disorder of unknown PREVOTELLA MELININOGENICA: Formerly cause characterized by progressive fibrosis of skin called Bacteroides melaninogenicus. Gram-negative, and multiple organs, and by vascular insufficiency. non-motile, anaerobic, rod-shaped bacteria. Oral structures become indurated and stiff; radiographically the periodontal ligament spaces PROBE: A slender instrument with a blunt end may be thickened. suitable for use in exploring a channel, wound, sinus,

pocket, etc. PROPHYLAXIS, ANTffiIOTIC: The administration PERIODONTAL P.: A calibrated probe used to of antibiotics to patients without evidence of infection measure the depth and determine the configuration to prevent microbial colonization and thus avoid or of a periodontal pocket. reduce subsequent postoperative complicatiuns.

PROBING DEPTH: The distance from the soft tissue PROPHYLAXIS, ORAL: The removal of plaque, (gingiva or alveolar mucosa) margin to the tip of the calculus, and stains from the exposed and unexposed periodontal probe during usual periodontal diagnostic surfaces of the teeth by scaling and polishing as a probing. The health of the attachment apparatus can preventive measure for the control of local irritational affect the measurement. factors. See: Periodontal Maintenance. CLINICAL ATTACHMENT LEVEL P.: The distance

from the cemento-enamel junction to the tip of the PROPIONIBACTERIUM PROPIONICUS: periodontal probe during usual periodontal diagnostic Formerly called Arachnia propionica. Gram-positive, probing. The health of the attachment apparatus can non-motile, facultative, rod-shaped bacteria found in affect the measurement. supra- and subgingival plaque. ------43

PROPIONIBACTERIUM SSP.: Gram-positive, non­ PSEUDOMEMBRANE: A false membrane, such as motile, anaerobic, rod-shaped bacteria primarily is seen in necrotizing ulcerative periodontitis. isolated from subgingival plaque. PSEUDO POCKET: See: Periodontal Pocket,

PROPRIOCEPTOR: Sensory nerve terminals that Pseudopocket. give information concerning movement and position PULPECTOMY: The complete removal of the dental of the body and its parts. pulp.

PROSTAGLANDINS: A group of fatty acid com­ PULPITIS: Inflammation of the dental pulp. pounds derived from arachidonic acid by the cyclo­ : Surgical amputation of the coronal oxygenase pathway that are potent regulators of a portion of the dental pulp. variety of biological processes; aspirin and ibuprofen See: are inhibitors of cyclooxygenase. PULP STONE (Nodule): Denticle.

PULP VITALITY TESTS: PROSTHESIS: An artificial part designed to replace a Electrical, thermal, and part of the . invasive (e.g., test cavity) procedures used to DENTAL P.: An artificial replacement of a lost part of determine the status of the dental pulp.

the natural dentition or oral cavity. PURPURA: Hemorrhage into the tissues with resultant FIXED PARTIAL DENTURE: See: Denture. changes in color varying from red to purple. fading to REMOVABLE PARTIAL DENTURE: See: Denture. brownish-yellow, and then disappearing. TEMPORARY P.: A fixed or removable restoration PURULENT: Accompanied by or containing pus. designed to be replaced with a more permanent appliance. PUS: A product of inflammation consisting of leukocytes, degenerated tissue elements, tissue fluids, PROSTHETICS: The art and science of supplying and microorganisms. missing parts of the human body. PUSTULE: A small, circumscribed elevation on the PROTEOGLY CANS: Extracellular and cell surface skin containing pus. macromolecules (decorin, syndecan, etc.) composed PYOGENIC: A pus-producing substance or agent. of a protein core with sites for the attachment of one

or more glycosaminoglycan chains; functions in cell : See: Granuloma, adhesion, growth, and organization of the Pyogenic. extracellular matrix. PYORRHEA: An archaic term for several periodontal

PROTO-ONCOGENE: A gene in the normal human diseases. genome that appears to have a role in normal cellular physiology and is often involved in regulation of normal cell growth and proliferation. Products of ----;[Q]I----- proto-oncogenes may have important roles in normal QUADRANT: One of the four sections into which the cellular differentiation; as a result of somatic dental arches can be divided, as determined by an mutations, these genes may become oncogenic. imaginary midline between the central incisors, PROTRUSION: Indicating: teeth or other maxillary dividing each dental arch into two halves. and mandibular structures that are positioned anterior QUINOLONES: A class of synthetic, broad spectrum to the normal or to the generally accepted standard. antibacterial agents that exhibit bactericidal action.

PROVISIONAL SPLINT: A device used to provide temporary stabilization of mobile teeth. ------1[IDt----- PROXIMAL: Nearest to the center. In dentistry, the

surface of a tooth adjacent to another tooth. RADICULAR: Pertaining to the root of a tooth and its adjacent structures. PROXIMAL WEDGE: A periodontal surgical procedure for removal of excessive soft tissue mesial RADIOLUCENT: Permitting the passage of roentgen or distal to a tooth or teeth in an arch. See: Wedge rays or other forms of radiant energy; radiolucent Procedure, Distal Wedge. areas appear dark on exposed film. 44

RADIOPAQUE: Not penetrable by roentgen rays or regeneration typically refers to regeneration of other form of radiant energy; radiopaque areas appear periodontal attachment. Barrier techniques, using light or white on the exposed negative film. materials such as expanded polytetrafluoroethylene, polyglactin, polylactic acid, calcium sulfate and RANULA: See: Cyst, Retention. collagen, are employed in the hope of excluding REATTACHMENT: To attach again. The reunion of epithelium and the gingival corium from the root or epithelial and connective tissue with a root surface. existing bone surface in the belief that they interfere Not to be confused with new attachment. with regeneration. PER IODONTAL R.: Restoration of lost periodontium. RECALL MAINTENANCE: See: Periodontal

Maintenance. REGISTRATION (Bite): A record of jaw relationships used in the mounting of casts on an RECESSION: Location of marginal periodontal articulator. tissues apical to the cemento-enamel junction.

GINGIVAL R.: Location of the gingival margin apical REITER'S SYNDROME: A condition of unknown to the cemento-enamel junction. cause, usually seen in young men, characterized by SURGIC AL R.: Location of the marginal tissues apical urethritis, , conjunctivitis, and mucocutaneous to the cemento-enamel junction as a result of lesions. . REJECTION: An immunological response to RECIPIENT SITE: The site into which a graft or incompatibility in a transplanted organ. transplant material is placed. ATTACHMENT LEVEL, REL ATIVE: See: Relative Attachment Level. RECOMBINANT DNA: Deoxyribonucleic acid that

has been modified by deletion or addition of genetic RELEASING INCISION: See: Incision. information. REMISSION: A diminution or abatement of the signs RECORD: See: Clinical Record. and/or symptoms of a disease; also the period during which such diminution occurs. RECURRENCE: Reappearance or return, as of

inflammation, or disease that has been successfully REMOVABLE APPLIANCE: A dental prosthesis treated. that attaches to the teeth and can be removed by the patient. RE-ENTRY: To reopen a site that has undergone ORTHODONTIC R. A.: An appliances that affect periodontal surgery to improve, observe, or enhance tooth movement. results obtained from the initial operation. PROSTHETIC R. A.: A Prosthesis that take the place REFERRED SYMPTOMS: Symptoms perceived in or perform the function of the missing tooth or teeth. tissues distant to and unrelated to the true diseased REPAIR: Healing of a wound by tissue that does not site. fully restore the architecture or the function of the REFLECTION: The elevation and folding back of all, part. or part, of the soft tissue to expose the underlying REPLANTATION, TOOTH: The replacement of a structures. See: Surgery, Periodontal. totally luxated (accidentally or intentionally) tooth REFRACTORY: Persistent; patients or sites that into its socket. continue to demonstrate disease after appropriate RESECTION: Excision of some portion of a structure therapy. such as bone, gingiva, or a tooth root. REGENERATION: Reproduction or reconstitution of RESIDUAL RIDGE: That portion of the dental ridge a lost or injured part. and its soft tissue covering that remains following the GUIDED TISSUE (Bone) R.: Procedures attempting removal of teeth. to regenerate lost periodontal structures through differential tissue responses. Guided bone RESISTANCE: Inherent ability of an individual or an regeneration typically refers to ridge augmentation or organism to protect against the damaging effects of bone regenerative procedures; guided tissue physical, chemical, or microbiologic agents. 45

RESOLUTION: The subsidence of a pathologic RIBOSOMAL RNA (rRNA): Combines with state. ribosomal proteins to form the peptide assembly structures in the cell. RESORPTION: A loss of substance from tissues that TRANSFER RNA (tRNA): Binds and delivers an normally are calcified, such as the dentin or amino acid to the ribosome according to the order cementum of teeth, or of the alveolar process. The specified in the mRNA for synthesis of proteins. condition may be physiologic or pathologic. BONE R.: Bone loss due to osteoclastic activity. RIDGE AUGMENTATION: See: Augmentation, CAVERNOUS R.: Bone loss leaving hollow spaces. Edentulous Ridge.

EX TERNAL R.: Resorption of tooth structure ROOT: I. The anatomic pqrtion of the tooth usually beginning on the external surface. covered with cementum. 2. The anatomic part of a IDIOPATHIC R.: Loss of calcified tissues without tooth normally within the alveolar bone and attached apparent cause. to it by the periodontal ligament. IN TERNAL R.: beginning from R. AMPU TATION: The removal of part or all of a root within the pulp. from a tooth.

REST POSITION, PHYSIOLOGIC: The postural R. CANAL: The space within the root of a tooth position of the mandible when an individual is containing connective tissue, nerves, and blood resting comfortably in an upright position and the vessels, and connecting the pulp chamber with the associated muscles are in a state of minimal apex of the root. contractual activity. R. CANAL THERAPY (Endodontic Therapy): Treatment of a tooth, usually performed by RETENTION: The maintenance and stabilization of completely removing the pulp, disinfecting the the teeth in the position into which they were moved; pulp chamber and root canal, and filling these holding in the proper position of a removable spaces with inert sealing material. Usually done prosthesis. in a tooth with an irreversibly damaged pulp. See: RETE RIDGES: See: Pegs, Epithelial. R. CURET TAGE: Curettage, Root. R. DENU DATION: Exposure of a portion of a root as RETRACTOR: An instrument designed for use in the result of recession. retracting the soft tissues during an operation. R. FRAGMEN T: A portion of the root, usually the root tip, retained in the jaws following the incomplete RETROFILLING: A method of sealing the root canal extraction, or incomplete resorption of the primary of a tooth by an apical approach. tooth.

RETROGNATHISM: A condition of facial R. FUSION: A union of merging of roots of multi­ disharmony in which one or both jaws are posterior to rooted teeth. If roots from adjacent teeth are fused, normal in their craniofacial relationships; usually the condition is called concrescence.

used in reference to the mandible. R. HY PERSENSITIVITY: See: Dentinal Hypersensitivity. RETROMOLAR PA D: The soft tissue located behind R. PLANIN G: A treatment procedure designed to the terminal mandibular molar. remove cementum or surface dentin that i� rough,

RETRUDED POSITION: See: Centric Relation. impregnated with calculus, or contaminated with toxins or microorganisms. See: Scaling. REVERSE ARCHITECTURE: See: Architecture. R. PREPARATION: Use of instruments or chemicals

RIBONUCLEIC ACID (RNA): Polymer composed on roots to eliminate irritants, prevent bacterial of ribonucleotides; three types of RNA function in accumulation, and encourage . translation of information from genes (DNA) to R. PROXIMITY: Closeness of roots of adjacent teeth. proteins. In some viruses, RNA is also the genetic R. RESECTION: Surgical removal of all or a portion material. of a tooth root.

MESSENGER RNA (mRNA): A transcript of the R. RESORPTION: Loss or blunting of some portion coding region of a gene. of a root, sometimes idiopathic, but also associated 46

with orthodontic tooth movement, inflammation, SCLEROSIS: An induration or hardening, usually of trauma, endocrine disorders, and neoplasia. chronic inflammatory origin, produced by hyperplasia R. RETENTION: Preservation of an endodontically of the interstitial fibrous connective tissue. In the jaws treated root in the alveolus when the coronal portion it is characterized by an increased calcification as in of the tooth has been removed or lost in order to condensing ostei tis. maintain the integrity of the edentulous ridge. : Malnutrition caused by a dietary deficiency R. SUBMERGENCE: A surgical procedure to cover a of vitamin C. Oral manifestations may include retained root with soft tissue. ulcerations, mucosal hemorrhage, and gingival : Gram-positive, non­ enlargement. motile, anaerobic, rod-shaped bacteria frequently SEBACEOUS: Relating to sebum; oily; fatty. found in association with periodontal diseases. SECRETION: The formation and release of a product RUGAE: The irregular ridges in the masticatory by glandular activity. mucosa covering the anterior part of the hard SEDATION, CONSCIOUS: palate. A minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway --�ffiJl----- and respond appropriately to physical stimulation and verbal command; produced by pharmacologic or non­ SACCHAROLY TIC: The ability of some pharmacologic methods, or a combination thereof. microorganisms to catabolize carbohydrates The goal of conscious sedation is to render the patient (generally ). free of fear, anxiety, and apprehension during a treatment procedure. SAGITTAL PLANE: The anteroposterior plane or section parallel to the long axis of the body. SEDATIVE: An agent, usually a drug, that produces physiologic changes to soothe, lessen irritability, and SALIVA: The secretions of the major and minor allay excitement and activity in the apprehensive salivary glands. patient.

SALIVARY CALCULUS: See: Calculus, Dental. SELECTIVE GRINDING: See: Grinding, Selective.

SCALER: An instrument for removing calculus or SELENOMONAS SPUT/GENA: Gram-positive, other deposits from the surfaces of teeth. anaerobic, rod-shaped bacteria displaying "tumbling" SONIC S.: An instrument vibrating in the sonic range motility. Primarily isolated from subgingival plaque. (approximately 6,000 cps) that, accompanied by a SENSITIVITY: The ability of a diagnostic test to stream of water, can be used to remove adherent detect a disease, when present, in a diseased deposits from teeth. popUlation. Sensitivity = True Positives divided by the ULTRASONIC S.: An instrument vibrating in the sum of True Positives plus False Negatives, or ultrasonic range (approximately 25,000 to 30,000 TP/(FN+TP). True Positives are correct positive cps) which, accompanied by a stream of water, can be diagnoses; False Negatives are incorrect negative used to remove adherent deposits from teeth. diagnoses. Diagnostic �creening tests are designed to SCALING: Instrumentation of the crown and root have high sensitivity (usually at the expense of surfaces of the teeth to remove plaque, calculus, and specificity) to minimize the number of diseased See: stains from these surfaces. Root Planing. patients who go undetected. See also: Specificity.

SCALLOPED: A curved design of an incision or SEPSIS: Presence in blood or tissues of pathogenic border. microorganisms or their products.

SCAR: Fibrous tissue replacing normal tissues SEPTICEMIA: Systemic disease associated with the destroyed by injury or disease. presence and persistence of pathogenic microorganisms or their toxins in the blood. SCLERODERMA: See: Progressive Systemic Sclerosis. SEPTUM: A partition of hard or soft tissue. 47

INTERALVEOLAR S.: That portion of the alveolar SOFT TISSUE: Any non-calcified tissue. In process that lies between the roots of adjoining teeth. periodontics, usually refers to the oral mucous INTERRADICULAR S.: That portion of the alveolar membranes including the gingiva. process that lies between the roots of multirooted SONIC SCALER: See: Scaler, Sonic. teeth.

SOUNDING: Penetration of anesthetized soft tissue SEQUESTRATION: The separation of necrotic bone by a probe in order to determine the topography of the from the surrounding healthy bone thus forming a alveolar process. sequestrum.

SPASM: A sudden, involuntary, generally painful SEQUESTRUM: A mass of non-vital bone that has contraction of a muscle or groups of muscle become separated from healthy bone. fibers. SESSILE: Having a broad base of attachment; not SPECIFICITY: The ability of a diagnostic test to pedunculated. detect the absence of a disease in a healthy SEXTANT: One of the six relatively equal sections population. Specificity = True Negatives divided by into which the dental arches can be divided. Anterior the sum of True Negatives plus False Positives, or sextants contain the incisor teeth and canines; TN/(FN+TN). True Positives are correct positive posterior sextants include the premolar and molar diagnoses; False Negatives are incorrect negative teeth. diagnoses. Diagnostic tests with high specificity are

SHELF, BUCCAL: Cortical bony surface of the often used to confirm the presence of a malady first mandible extending from the alveolar ridge to the suggested by a highly sensitive but less specific external oblique line in the vestibular region. screening test. See also: Sensitivity.

SIALADENITIS: Inflammation of a salivary gland. SPECIMEN: A sample or part taken to determine the character of the whole for diagnostic purposes. SIALAGOGUE: Any substance or agent that promotes the secretion and flow of saliva. SPECTRUM, ANTmACTERIAL: The range of antimicrobial activity of a drug. SIALOLITH: A salivary stone (calculus).

SPICULE: A slender, pointed, needle-like body such SIALORRHEA: Excessive flow of saliva. as a spicule of bone. SIGN: An objective indication of disease discoverable SPIROCHETES: Helical (cork-screw), Gram­ by the clinician upon evaluation of the patient. See negative, highly motile bacteria, characterized by a also: Symptom. flexible cell wall. They are markedly increased in SINUS: A cavity or hollow space in a bone or other number in periodontal pockets. The major genus in tissue such as the dilated channels for venous blood in pockets in the ssp. the cranium or liver. SPLINT: Any apparatus, appliance, or device MAXILLARY S.: See: Antrum. employed to prevent motion or displacement of S. TRACT: A fistula or tract leading to a suppurating fractured or movable parts. cavity. DENTAL S.: An appliance designed to immobilize and SLOUGH: Necrotic tissue in the proce�s of separating stabilize loose teeth. from viable portions of the body. SPLINTING, OF ABUTMENTS: The joining of SMEAR: A thin daub of blood, pus, or extraneous two or more teeth into a rigid unit. matter on a glass slide stained and mounted for study under the microscope. SPLINTING, OF MUSCLES: Prolonged muscle spasms that inhibit or prevent movement of a joint or SOCKET: A hollow or depression into which a corre­ appendage. sponding part fits. See: Alveolus. DRY S.: Localized osteitis of the alveolus following SPORADIC: Single; scattered; not epidemic; tooth extraction due to infection or loss of the blood occurring at isolated geographical and/or temporal clot. loci, especially when referring to a disease. 48

STAPHYLOCOCCUS AUREUS: Gram-positive, non­ S. MEDICAMENTOSA: Eruptive lesions of the oral motile, aerobic bacteria isolated from the gingival mucosa resulting from the ingestion of a systemic crevice and capable of producing suppurative lesions. allergen, usually a medication. Occur as cocci, clusters, pairs, or chains. S. VENENATA: Lesions caused by exposure to contact allergens. STAPHYLOCOCCUS EPIDERMIS: Spherical. non­ motile, aerobic bacteria with Gram-positive cell : The combination walls. They are found in supragingival plaque. The of all the structures of the mouth and jaws used in majority of S. epidermis are catalase negative and speech, respiration, mastication, and deglutition. cause infection in compromised hosts, particularly in INTERMEDIUS: Gram­ cancer patients. positive, facultative cocci that have been associated

STASIS: The arrest or cessation of flow of any body with refractory periodontitis. fluid, especially blood. STREPTOCOCCUS MITIOR: Formerly called S.

STATIC: In a state of rest or equilibrium; not dynamic; viridans. Gram-positive, non-motile, aerobic, pertaining to that which is stationary. spherical bacteria that form chains and are isolated from the human respiratory tract and from certain STATISTICS: A collection of numerical facts pertain­ clinical conditions. including infective endocarditis. ing to a subject; the science that deals with collection, organization, and analysis of such facts. STREPTOCOCCUS MITIS: Gram-positive. non­ motile, aerobic cocci that tend to form chains and are STENOSIS: Narrowing or stricture of a duct, canal, or found in dental plaque. It is difficult to define S. mitis vessel. as it does little physiologically and is antigenically

STENT: I. A device used in conjunction with a heterogeneous. It is often defined by exclusion (i.e., surgical procedure to immobilize hard or soft tissue if oral Streptococci are not S. salvarius, S. sanguis, or and to protect a healing wound. 2. An acrylic S. mutans, it is often S. mitis). appliance used as a positioning guide or support. STREPTOCOCCUS ORALIS: Gram-positive, non­

STERILITY: The absence of all forms of life. motile, facultative cocci that are found primarily in plaque of healthy individuals or in healthy sites in STERILIZATION: A process whereby all individuals with periodontal disease. microorganisms as well as other forms of life are killed. STREPTOCOCCUS SANGUIS II: Gram-positive, non-motile, aerobic cocci that form chains and are STEROID HORMONES: A large family of found in dental plaque. It is also isolated from blood biologically important hormones containing a cultures of patients with subacute bacterial tetracyclic (cyclopentanophenanthrene) nucleus. endocarditis. S. sanguis is grouped into type I and II STILLMAN'S CLEFT: An epithelial downgrowth according to surface antigens. Type I serotype appears leading to a splitting of the gingiva. to adhere better to salivary pellicles than type II strains. STIMULATOR, INTERDENTAL: A device designed for massage of interproximal soft tissues. STREPTOCOCCUS SSP.: Gram-positive, non-motile, facultative bacteria that represent a major glUUp of STIMULUS: An excitant that produces a functional oral bacteria. Normal constituent of plaque, but also or trophic reaction in a receptor or an irritable associated with streptococcal diseases elsewhere in tissue. the body. : The pitted, orange-peel appearance STREPTOCOCCUS VIRIDANS: See: Streptococcus frequently seen in attached gingiva. Mitior. STOMA : Any minute orifice or opening on a free STRESS: I. Force exerted by mechanical means. 2. In surface. dentistry, the pressure on teeth due to masticatory : Inflammation of the soft tissues of the muscle activity. 3. Reactions of a body to forces of a oral cavity. deleterious nature. infections. and various abnormal 49

states that tend to disturb its normal physiologic SUPPORTING STRUCTURES OF A TOOTH: equilibrium (homeostasis). 4. Stimuli that, when See: Periodontium. impinging upon an individual, produce SUPPORTIVE PERIODONTAL TREATMENT: disequilibrium. Should these compensating See Periodontal Maintenance. reactions be inadequate or inappropriate, they may lead to disorders. SUPPURATION: The formation of pus.

STROMA: The supporting tissue or extracellular SUPERERUPTION: The eruption of teeth beyond the matrix of an organ. normal occlusal plane.

SUBACUTE: Denotes a phase of a disease between SURFACE TRANSLO CATING BACTERIA the acute and chronic stages. (STB): Gram-negative, motile, rod-shaped bacteria that have a gliding movement and are found in dental SUBGINGIVAL CALCULUS: See: Calculus, plaque. They include , Subgingival. , and Capnocytophaga.

SUBLUXATION: An incomplete dislocation. SURFACTANT: An agent that acts on the surface to reduce interfacial surface tension between two liquids SUBSTANTIVI TY: Duration of time a chemical is or between a liquid and a solid. in contact with a particular substrate; protracted

release of a chemical. Related to clearance of a SURGERY: I. That branch of medical science chemical. concerned with the treatment of diseases or injuries by means of manual or operative methods. 2. The SUBTRACTION RADIO GRAPHY: A procedures performed by a surgeon. 3. The photographic or digital method of attenuating the performance or procedures of an operation. image representing unchanged structures from the IMPLANT S.: Procedures concerned with the compared radiographic images of the same anatomic placement, uncovering, and removal of implants and image, thereby making changes easier to detect. the repair or modificatjon of associated hard or soft DIGITAL S. R.: A radiographic image subtraction tissues. method in which the pre- and postprocedure MUCOGINGIVAL S.: Procedures designed to correct radiographic images are subtracted from each other defects in the morphology, position, or enhance the within the computer memory and the resulting dental gingival junction, since defects in the subtracted image is displayed on the monitor. morphology of the gingival and alveolar mucosa PHOTOGRAPHIC S. R.: A radiographic image can accelerate the course of periodontal disease, or subtraction method in which a mask film (negative) is interfere with the successful outcome of periodontal made from the preprocedure radiograph. When this treatment. mask film is superimposed and viewed over the OSSEOUS S.: Procedures to modify bone support postprocedure film, the resultant image is a altered by periodontal disease, either by reshaping the subtraction image containing the structure (or alveolar process to achieve physiologic form without contrast medium) that is the difference between the removal of alveolar supporting bone, or by the the pre- and postprocedural radiographs. removal of some alveolar bone, thus changing the SUCULAR FLUID: See: Gil!gival Fluid. position of the crestal b,'nc relative to the tooth root. See: Ostectomy; Osteoplasty. SUPERNUMERARY: In excess of the regular or PERIODONTAL S.: Any surgical procedure used to normal number. treat periodontitis or to modify the morphology of the SUPPORTING CUSPS (Centric Holding Cusps): periodontium. Those cusps of teeth that contact the fossae of the RECONSTRUCTIVE S.: The use of surgical opposing teeth to support centric occlusion. In the procedures to restore a body part to a more normal normal adult tooth arrangement, these are the palatal appearance or function. cusps of the maxillary posterior teeth, the facial cusps RE-ENTRY S.: A second stage procedure of the mandibular posterior teeth, and the incisal accomplished to improve, enhance, or evaluate results edges of the mandibular anterior teeth. obtained from the initial operation. 50

SURGICAL DRESSING: See: Periodontal Dressing. disk is located anterior or antero-medial to the condylar head when the jaw is closed. When the jaw SUTURE : I. The fixed, fibrous union of two bones. is open the disk assumes the normal relationship to 2. Material used in closing a surgical or traumatic the condylar head and articular eminence. wound with stitches. 3. The act or process of uniting a MENISCAL DISPLACEMENT WITHOUT wound, either surgical or accidental, through suturing. REDUCTION: The condition wherein the articular

SYMPTOM: Any subjective evidence of a disease or a disk is always located anterior or antero-medial to the patient's condition as perceived by the patient. See condylar head regardless of whether the jaw is open SIGN. or closed.

SYNDROME: A group of signs and symptoms of TEMPOROMANDIBULAR JOINT (TMJ): The disordered function related to one another by means connecting sliding hinge mechanism between the of some anatomical, physiological or biochemical mandible and the . peculiarity. Does not include a precise cause of illness TERATOGENESIS: but provides a framework for investigation and The induction of malformation management. in the fetus, often by a drug (e.g., thalidomide).

TETRACYCLINES: A group of broad-spectrum anti­ biotics, either natural or semi-synthetic. They inhibit ------1001---- protein synthesis by their action on microbial ribosomes and have anti-metalloproteinase activity. All T-CELL: See: Lymphocyte. have similar toxic and pharmacologic properties,

TABLE, OCCLUS AL: The occlusal surface of the differing mainly in their absorption and suitability for premolars and molars. various modes of administration. They are effective against both Gram-positive and Gram-negative TARTAR: See: Calculus, Dental. bacteria, as well as rickettseae, chlamydiae, and myco­ TAUROD ONTISM: A variation in tooth form plasmas. They deposit in all mineralizing tissues. affecting some or all of the primary and secondary THERAPY: Treatment of disease. molars, marked by elongation of the body of the tooth ANTIBIOTI C T.: The treatment of disease by the local so that the pulp chambers are large apico-occlusally or systemic administration of antibiotics. and the roots are reduced in size. PERIODONTAL T.: Treatment of periodontal diseases TELANGIECTASIA: Permanent dilation of pre­ aimed at arresting or reversing their progression. existing blood vessels, creating small focal red lesions THROMB OCYTHEMIA: An abnormal increase in usually in the skin or mucous membranes. the number of circulating platelets. TEMPOROMANDIBULAR DIS ORDERS (TMD): : A collection of medical and dental conditions A decrease in the affecting the temporomandibular joint (TMJ) and/or number of circulating platelets. muscles of mastication and other contiguous tissue TIC : A spasm; involuntary contraction or twitching components. Includes myofascial pain-dysfunction usually of the facial and muscles. syndrome (MPD); meniscal displacement with or T. DOULOUREUX: See: Paroxysmal Trigeminal without reduction (internal derangement); degenerative Neuralgia. joint disease (osteoarthritis); ; and other disorders of systemic origin, facial growth TISSUE: An aggregation of similarly specialized cells disharmonies, traumatic injuries, and . united in the performance of a particular function INTERNAL DERANGEMENT: In reference to TITANIUM: A uniquely biocompatible, non-toxic, temporomandibular disorders, an abnormal bio-inert, metal commonly used for dental implants. relationship of the articular disk to the mandibular condyle, fossa and/or articular eminence. TITANIUM ALLOY: Alloys of 6% aluminum and MENISCAL DISPLACEMENT WITH 4% vanadium typically are utilized to increase the

REDUCTION: The condition wherein the articular tensile and fatigue strength, as well as to resist 51

corrosion. These alloys also form a titanium oxide : A general term for a supporting or (Ti02) surface layer that interfaces with the bone. anchoring strand of connective tissue, such as a strand extending from a capsule into the substance of the TITANIUM OXIDE: A surface layer, 10 to 100 enclosed organ. angstroms thick, formed within a millisecond when a TRABECULAE OF BONE: cut surface of pure metallic titanium is exposed to air. Anastomosing bony This layer has ceramic properties and is resistant to spicules in cancellous bone forming a meshwork of corrosion, effectively protecting the implant against intercommunicating spaces filled with connective chemical attack in biological fluids. tissue.

TRANQUILIZER: A drug with a calming, soothing TOLERANCE: I. The ability to endure or be less effect. responsive to a stimulus over a period of continued exposure. 2. The power of resisting the action of a TRANSDUCTION: The process by which genetic poison or of taking a drug continuously or in large material (DNA) is transmitted from one bacterial cell doses without injurious effect. 3. Decreasing response to another via a bacterial virus (phage). to continued use of the same dose of a drug. TRANSILLUMINATION: The passage of light

TOMOGRAPHY: A general term for a technique that through body tissues for the purpose of examination.

provides a distinct image of any selected plane TRANSLATION: I. Movement of the condyle­ through the body, while the images of structures that meniscus complex of the temporomandibular joint lie above and below that plane are blurred. Also called over the articular eminence. 2. The movement of a "bodysection ." tooth (bodily movement) through alveolar bone without change in inclination. TONGUE THRUST: The infantile pattern of the suckle-swallow movement in which the tongue is TRANSMUCOSAL: That portion of the oral implant placed between the incisor teeth or alveolar ridges system (e. g., the abutment) that passes through the resulting sometimes in anterior open bite, mucosa. deformation of the jaws, and abnormal function. TRANSPLANT: I. To transfer tissue from one part to 2. TONUS, MUSCLE: The slight continuous contraction another. The tissue or organ taken from a body for of muscle that aids in the maintenance of posture and grafting into another portion of the body or into in the return of blood to the heart. another individual.

TRANSSEPTAL FIBEROTOMY: See: Gingival TRAUMA: Damage to the teeth Fiberotomy. and/or adjacent soft tissues as a result of aggressive toothbrushing. : Any fluid substance that has passed through a membrane or tissue surface; sometimes TOOTH EXTRUSION: Overeruption. associated with inflammation.

TOPICAL: Restricted to a surface area. TRANSVERSION: Displacement of a tooth from its proper numerical position in the jaw. TOPOGRAPHY: The description of an anatomical surface region. TRAUMA: A wound or injury whether physical or psychological. TORUS: An elevation, a swelling, a bulging OCCLUSAL T.: See: Occlusal Trauma. projection, a protuberance. TRAUMATISM: T. MANDIBULARIS: A bony exostosis on the lingual The physical or psychic state aspect of the mandible, generally in the premolar­ resulting from an injury or wound. OCCLUSAL T.: See: molar region; commonly bilateral. Occlusal Traumatism. T. PALATINUS: A bony protuberance occurring at the TRAUMATOGENIC: Capable of producing a wound midline of the hard palate. or inJury.

TOXIN: A poison of animal, vegetable, or microbial TREATMENT PLAN: The course of therapy and re­ ongln. assessments designed for a patient. 52

TRENCH MOUTH: See: Periodontitis, Necrotizing ULTRAS TRUCTURE: Fine structure beyond the Ulcerative. resolution power of the light microscope; e.g., may be visible or implied using electron or other TREPHINE: A surgical instrument for removing a technologies. disk or cylinder of bone or other tissue. UNDULATE: Having an irregular, wavy border; said TREPONEMA DENT/COLA: A long, thin, of a colony of microorganisms. corkscrew-like, Gram-negative, anaerobic spirochete that has been implicated as a possible etiologic agent UPRIGHTING: The movement of an inclined tooth to of chronic periodontitis. The characteristic motility a more vertical axial inclination. and morphology of this organism may be discerned URTICARIA: A vascular reaction of the skin marked by darkfield microscopy. by the transient appearance of smooth, slightly

TRIF URCATION: The area where a tooth divides elevated wheals and attended by severe itching. inlo three distinct roots. T. INVASION: The extension of periodontitis or -----f[Y]t----- pulpitis into a bifurcation area.

TRIGEMINAL: Relating to the fifth cranial VARICELLA ZOSTER (, Herpes Zoster): (trigeminal) nerve. Caused by the herpetovirus (varicella zoster virus); a painful papular or vesicular eruption is seen usually : Inability to open the mouth due to spasm unilaterally on the skin or oral mucosa following the of the muscles of mastication. path of the involved sensory nerve. The patient

TROCHE: A medicated tablet meant to be dissolved exhibits fever and malaise. in the mouth. VASCULARIZATION: The process of becoming

TROUGH, GINGIVAL: See: Gingival Crevice. vascular; the natural or surgically induced development of vessels in a tissue. TUBERCULE: A small nodule or eminence. VASOCONSTRICTION: Narrowing or decrease in TUBEROSI TY: A protuberance or elevation of a the lumen size of a blood vessel, especially an bone. arteriole. MAXILLARY T.: The most distal portion of the VASOCONSTRICTOR: An agent that promotes maxillary alveolar ridge. decrease in blood vessel diameter. Used in dentistry T. REDUCTION: The surgical excision of fibrous or to prolong anesthesia, and to reduce bleeding during bony tissue of the . surgical procedures. TUMEFACTION: A swelling; the state of being VASODEPRESSOR: I. Having the effect of lowering swollen or the act of swelling. the blood pressure through reduction in peripheral TUNNEL PREPARATION: A surgical procedure resistance. 2. An agent that causes vasodepression. performed on a multirooted tooth, usually a : Dilation or increase in the lumen mandibular molar, resulting in a completely opened of a blood vessel, especially an arteriole. furcation to provide access for oral hygiene. VEILLONELLA SSP.: Gram-negative. non-motile, TURGID: Congested; swollen. anaerobic cocci found in supra- and subgingival plaque. -----f[!TII----- VENIPUNC TURE: Puncture of a , as in an intravenous injection.

ULCER, ULCERATION: A lesion on the surface of VERRUCA: An epidermal neoplasm caused by a skin or mucosa characterized by absence of by virus; a wart. epithelium; usually with inflammation. VERTICAL DIMENSION: A vertical measurement

ULTRASONIC SCALER: See: Scaler, Ultrasonic. of the face between any two arbitrarily selected points 53

that are conveniently located. one above and one WIDMAN FLAP PROCEDURE, MODIFIED:

below the mouth, usually in the midline. See: Flap, Modified Widman. OCCLUSAL V.D.: The vertical dimension of the face WOLINELLA RECTA: See: Campylobacter Rectus. when the teeth are in contact in centric occlusion.

REST V.D.: The vertical dimension of the face with the WORKING SIDE CONTACTS: Contacts of teeth mandible in postural position. on the side of the articulation toward which the

VESICLE: An elevation of the skin or mucous mandible has been moved. membrane containing a watery fluid and less than WOUND: An injury to living tissue; a forcible 5 mm in diameter. See: Bulla. interruption of the continuity of any tissue.

VESTIBULOPLASTY: The surgical modification of the gingiva-mucous membrane relationships including deepening of the vestibular trough, altering --�OOI----- the position of the frenulum or muscle attachments, and widening of the zone of attached gingiva. XERODERMA: Excessive dryness of the skin due to

VINCENT'S ANGINA: Painful membranous a slight increase of the horny layer and diminished ulceration of the oropharynx and usually cutaneous secretion. associated with necrotizing ulcerative periodontitis. XERORADIOGRAPHY: A dry photoelectric process VINCENT'S INFECTION: See: Periodontitis. for recording x-ray images using metal plates coated Necrotizing Ulcerative. with a semiconductor, such as selenium.

VIRULENCE: The disease-producing power of a XEROSTOMIA: Dryness of the mouth due to microorganism. inadequate salivary secretion.

VIRUS: One of a group of minute (15 to 300 X-LINKAGE (Sex-Linkage): Inheritance of certain nanometers) infectious agents characterized by a lack characteristics determined by genes located in the sex of independent metabolism and by the ability to chromosomes. replicate only within living cells.

VITALITY TEST: See: Pulp Vitality Tests.

VITALOMETER: A device that measures the ------1001----- response of a tooth to an electric stimulus to aid in determining pulpal vitality. YEAST: A general term that includes single-celled, usually rounded fungi. Most reproduce by budding and some may transform into a mycelial (mold) stage. ------I�I----- They may become pathogenic in the oral cavity, particularly in immunocompromised individuals. WEAR FACET: See: Facet.

WEDGE PROCEDURE: A surgical procedure designed to �educe excessive soft tissue from an edentulous area such as the maxillary tuberosity. See: -----1�I----- Distal WeJge. ZYMOGEN: An inactive precursor that is converted to WHEAL (Hive, Welt): An acute, circumscribed, active enzyme by the action of another substance.

transitory area of edema of the skin; an urticarial lesion. Proenzyme. .