an an tom i his to log i jaring an periodontal
TRANSCRIPT
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ANATOMI & HISTOLO
JARINGAN PER
O
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BLOK BASIC DENTAL SCIENC
Program Studi/ Jurusan Kedokteran Gig
TA. 2011/ 2012
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Referensi : Berkovitz BKB., HollanHistology and Embriolo
Fedi PF., Vernino AR.,
Periodontic Syllabus. E
Manson JD., Eley BM. 1Periodontics. Editor Sua
Newman MG., Takei H
Periodontology. 10th E
Putri MH., Herijulianti
Penyakit Jaringan KerJuwono. Jakarta: EGC.
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Deskrips
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STR(the to
1.
2.3.
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Anantom
Histolog
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Liga
pem
serame
pro
bon
1
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PERIODONTAL FIBERS
Elemen terpenting dari ligamen periodontal adalahprincipal fibers (serabut2 dasar) terdiri atas kolagen
tersusun dlm bundles dan mengikuti alur gelombang
(longitudinal section)Fibers pada sambungan antara principal fibers dengan
sementum dan tulang serabut Sharpeys (sharpey
fibers)
The principal fibers 6 group : transeptal, alveolacrest, horizontal, oblique, apical dan interradicular.
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Group Transeptal Serat transisi antara serat gingiva
utama ligamen periodontal. Meluas pd permukaan inte
di atas puncak septum interdental.
Group Alveolar Crest Serat meluas dan berjalan
sementum (tepat di bawah junctional epithelial) men
tulang alveolar.
Fungsi: menahan gigi di dalam soket jika ada tekanan
dan lateral.
Group Horizontal Serat meluas tegak lurus dengan
dari sementum ke tulang alveolar.
Fungsi: idem atas
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Group Ob
Serat me
oblique da
Menerima
Group Inpercabang
Group Api
tulang pad
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4 types cells : 1. Connective tissue cells
2. Epithelial rest cells
3. Immune system cells
4. Cells ~ with neurovascular elements
Connective tissue cells : fibroblasts, cementoblasts, dan cementoclasts di permukaan osseus dan
periodontal ).
Ephitelial rest cell (Malassez) : Berada pd ligamen
sementum, apikal dan servikal. Berkurang seiring usia.
Immune system cells : neutrophils, lymphocytes, macr
eosinophils.
SUBSTANSI
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SUBSTANSI
DASAR
Consist of 2 main components :
1. Glycosaminoglicans (hyaluronicacid & proteoglycans)
2. Glycoprotein (fibronectin & laminin)
Also has a high water content (70%)Kadang ditemukan massa terkalsifikasi : cementicles
Cementicles may develop from calcified epithelial rests,
small spicules of cementum or alveolar bone traum
displaced into periodontal ligament, from calcified sh
fibers and from calcified, trombosed vessels with
periodontal ligament.
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1.
2.
3.
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1. Physical functions :
Melindungi pembuluh darah dan saraf dari
tekanna mekanik
Menyalurkan tekanan oklusal ke tulang
alveolar Melekatkan gigi ke tulang alveolar
Memelihara hubungan jaringan gingiva ke
gigi
Sebagai peredam tekanan oklusal (shock
absorption)
2
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3. Nutritional and sensory functions :
Menghantarkan tekanan taktil dan sensasi
nyeri melalui jalur trigeminal
4 types of neural transmission :
1. free endings : treelike config carry painsensation
2. ruffini-like mechanorespt apical area
3. coiled meissners corpuscles mechanorespt -
midroot
4. spindlelike pressure and vibration ending -
apex
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Se
(av
pema
se
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Organic matrix : 50%-55%
Type I collagen (90%)
Type III collagen (5%)
Cementocytes
Proteoglycans*
Glycoprotiens
Phosphoprotiens
Inorganic content: Hydroxyapetites (45-50%)
KOMPOSISI SEMENTUM
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Ada 2 tipe sementum : Acellular (prim
Cellular (sekunder). Keduanya berisi ma
interfibrilar terkalsifikasi dan fibril-fibril kolag
Tipe Acellular banyak ditemukan di dae
koronal akar, dan tipe Cellular banyak ditemu
di daerah apikal dan bifurkasi akar gigi.
TIPE SEMENTUM
A ll l
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Adalah cementum yg pertamakali terbentuk,yang menutupi sekitar cervical atau akar
Tidak mengandung sel
Terbentuk sebelum gigi mencapai occlusalplane (erupsi)
Ketebalannya 30 - 230 m
Serabut sharpey membentuk sebagian besarstruktur acellular cementum.
Selain itu, jg mengandung fibril2 kolagen ygterkalsifikasi dan tersusun tak beraturan atau
paralel thd permukaan.
Acellular
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conte
sourc
site
thickn
Menurut SCHROEDER :
1. AAC Acellular afibrilar cementum
2. AEFC Acellular Extrinsic Fiber Cementum
3. CMSC Cellular Mixed Stratified Cementum4. CIFC Cellular Intrinsic Fiber Cementum
5. Intermediate cementum
KLASIFIKASI SEMENTUM
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CEJ CEMENTOENAMEL JUNCTION
Terdapat 3 tipe :
60 % - 65 % kasus cementum overlap dgn em
30 % - edge to edge joints exist
5 % - 10 % - cementum and enamel fail to meet
CDJ CEMENTODENTINAL JUNCTION
The terminal apical area of the cementum where
joins the internal root canal dentin.
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KETEBALAN SEMENTUM
coronal dr akar = 16-60m ( se-rambut)
1/3 apikal & furkasi = 150-200m
lebih tebal permukaan distal drpd mesial
Sementum memiliki permeabilitas, memungkinkancairan dr pulpa dan permukaan luar akar.
cellular cementum, terdapat canaliculi yg berhub
dgn tubulus dentin. Permeabilitas berkurang
bertambahnya usia.
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1. Cemental aplasia / hypoplasia tidak
ada cellular cementum
2. Cemental hyperplasia /
hypercementosis penebalan sementum
3. Resorpsi Sementum local, sistemik,
idiopatik
4.
t
5.
li
ABNORMALITAS SEMENTUM
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Tul
ada
danme
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Pr
er
se
bo
Prke
Tu
be
tub
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PEMBAGIAN PROSESUS
ALVEOLAR
Alveolar Bone Proper
1 Al l b
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1. Alveolar bone proper
Lapisan tipis tulang yg mengelilingi akar dan m
periodontal. Nama lainnya adalah lamina du
disebut juga plat kribriform (cribriform plate) /
2. Cancellous bone (trabeculare/ spongy)
Di antara tulang alveolar proprium dan tulang k
Tulang kanselus berisi sumsum tulang.
3. Compact bone (cortical)
terbentuk dari tulang haversi (haversian bone) d
lamellae).
GAMBARAN HISTOLOGIS
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Lamina dura
Alveolar
prope
GAMBARAN HISTOLOGIS
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1. Cells of Alveolar Bone
Osteoblas, osteoklas dan osteosit
2. Extra-cellular Matrix Terdiri atas 2/3 bahan anorganik (calciu
phosphate)dan 1/3 bahan organik (collagen with small amounts of non collagenous proteins).
KOMPOSISI TULANG ALVEOLAR
Osteoblas membentuk matrix organik yg m
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Osteoblas membentuk matrix organik yg mdisebut Osteoid (prebone), yang kemu
membentuk tulang (bone).
Osteoblas yg terjebak dlm matrix tulangberlokasi dalam lakuna (ruang dalam tulan
melalui celah kecil disebut canaliculi.
Resorpsi tulang terkait dengan sel bernam
merupakan sel berinti banyak dan ditemuka
tulang yang cekung (Howshipslacunae).
Di dalam tulang alveolar, lakuna terdapa
(outer), endosteal (marrow) maupun pe
periodontal pada tulang
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Prosesus alveolar yang sehat mengelilingi akgigi, 1-2mm dari CEJ.
Kontur prosesus alveolar sesuai dengan tonjo
akar dan posisi gigi.
Ketinggian dan ketebalan plat fasial dan
lingual dipengaruhi oleh posisi gigi, bentuk d
ukuran akar, serta daya oklusi (hubung
antagonisnya).
KONTUR TULANG ALVEOLAR
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Gi
ya
tip
yg
(mi
Gi
da
ko
kec
FENESTRASI DEHISENSI
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FENESTRATION- isolated areas which the
root is denuded of bone and root surface is
covered only by periosteum and overlying
gingiva.
DEHISCENCE - denuded areas extend
through the marginal bone.
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SELAM
erim