牙周病学绪论和解剖生理双语第2版-同济口腔医学课件.ppt

牙周组织的解剖生理 The Normal Periodontium Anatomy of the Periodontium PDL静止下呈波浪状，使牙有微小生理动度 转动支点： 单根：根尖１／３与根中１／３交界 多根：诸牙根之间的空间 最窄处位于根中部 牙周膜的细胞成分 Cellular Elements Four types of cells have been identified in the PDL: 1, Connective tissue cells 结缔组织细胞: Fibroblasts (most common cells), Cementoblasts, Osteoblasts ( 成纤维细胞 ,成牙骨质细胞, 成骨细胞)， 2, Epithelium rest cells : Malassez 上皮剩余细胞 3, Defense cells 防御细胞： 巨噬细胞 肥大细胞 嗜酸性粒细胞 4, Neurovascular cells 神经血管相关细胞 ( 5 , 未分化间充质细胞 ) 成纤维细胞是牙周膜中最常见的细胞: 卵圆或细长,多伪足突起,合成胶原,降解陈旧胶原,一生中参与牙周膜牙骨质和牙槽骨的不断改建 SEM 相差显微镜 Fibroblast are the common cells in the PDL, They synthesize collagen and have also been shown to possess the capacity to phagocytose “old” collagen fibers and degrade them by enzyme hydrolysis. Thus, collagen turnover to be regulated by fibroblasts. Epithelium rests 上皮剩余细胞 MALASSEZ Epithelium rests are considered to be remnants of Hertwig’s sheath, which disintegrates during root development. Epithelium rests proliferation when stimulated and participate in the formation of periapical cysts and lateral root cysts 沟内上皮 Sulcular Epithelium 1, Thin, nonkeratinized, stratified squamous epithelium 非角化复层鳞状上皮（不全角化）,缺乏角化层和颗粒层 2, Local irritation (contact with the tooth, bacterial flora) of sulcus prevents sulcular keratinization . 有角化潜力, 龈沟内炎症的刺激，与牙面的接触, 使之非角化,口腔上皮同样 3, Itmay act as a semipermeable membrane ; 半透膜的作用-沟内物质与组织间的互透 Sulcular Epitheliun 结合上皮 Junctional epithelium The JE consists of a collar-like band of stratified squamous nonkeratinizing epithelium. It is three to four layers thick in early life, but the number of layers increases with age to 10 or even 20; 沟内上皮根方呈领圈状附着于牙冠(釉质)或牙根(牙骨质)的上皮, 非角化复层鳞状上皮，无钉突。 The length, ranges from 0.25 to 1.35 mm 正常附着在釉牙骨质界，冠方为龈沟底，长度0.25-1.35mm Epithelium attachment by means of an internal basal lamina to tooth, external basal lamina to gi