العملي

GINGIVADr. Hussein AL Dabbgh.\ periodontist

Introduction Macroanatomy of Gingiva -Marginal Gingiva -Gingival Sulcus  -Attached Gingiva -Interdental Gingiva Microanatomy of Gingiva: --Gingival Epithelium -Outer / Oral Epithelium-Sulcular Epithelium-Junctional Epithelium-Interface Between Epithelium And Connective Tissue-Gingival Connective Tissue -Cellular Elements-Gingival Fibers

MACROANATOMY OF GINGIVA

Anatomically Free or Marginal Gingiva. Attached Gingiva. Interdental Gingiva. Functionally Part facing oral cavity. Part facing the tooth.

Normal Clinical and Microscopic Features:

-Color -Size -Contour -Shape -Consistency -Surface Texture -

INTRODUCTION

The gingiva covers the alveolar process, and it is the only one of the periodontal tissues that under healthy conditions is directly visible upon inspection.

s
“Gingiva is the part of the oral mucosa that covers the alveolar processes of the jaws and surrounds the necks of the teeth”.


Oral Mucosa consists of : # Masticatory Mucosa - Gingiva - covering of Hard palate. # Specialized Mucosa - Dorsum of Tongue . # OMM lining remainder of oral cavity.

Free or Unattached or Marginal Gingiva :

Terminal edge or border of gingiva surrounding the teeth like a collar.Usually 1 mm wide.Demarcated from attached gingiva by a shallow depression – free gingival groove- 50 % .

Gingival Sulcus

V –shaped. Depth of Gingival Sulcus :Ideal conditions - zero.Clinically - 2 – 3 mm. Histologic -1.8 mm with variations from 0 to 6 mm. Shallow crevice or space around the tooth bounded by surface of tooth on one side and the epithelium lining the free margin of the gingiva on the other.

Attached Gingiva

Continuous with marginal gingiva & is firm, resilient & tightly bound to the underlying periosteum of the alveolar bone. The facial aspect of the attached gingiva extends to the relatively loose & movable alveolar mucosa from which it is demarcated by the MGJ.

Width of AG

distance b/w the MGJ & projection on the external surface of the bottom of gingival sulcus/ periodontal pocket. Greatest in incisor region : 3.5 --- 4.5 mm in maxilla 3.3 --- 3.9 mm in mandible. Least in the first premolar area 1.9 mm in maxilla 1.8mm in mandible :

MGJ remains stationary throughout adult life. On lingual aspect, AG terminates at the junction with the lingual alveolar mucosa, which is continuous with the mucous membrane lining the floor of mouth. On palatal surface, it blends with the equally firm, resilient palatal mucosa.

Attached gingiva: To protect the periodontium from injury caused by frictional forces encountered during mastication To dissipate the pull on the gingival margin created by the muscles of the adjacent alveolar mucosa.

Interdental Gingiva :

occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact. can have a pyramidal or Col shape. PYRAMIDAL SHAPE- In this the papilla is located immediately beneath the contact point. It is present in anterior teeth


COL SHAPE It is valley like depression that connects the facial and lingual papilla and conforms to the shape of interproximal contact and present in posterior teeth Its epithelium is non keratinised and same as junctional epithelium

Microscopic anatomy of gingiva:

*

* Diffrence between J.E and O.E & S.E: 1-The size of the cells in the J.E is larger than O.E. 2-The intercellular space in the J.E is wider than in the O.E. 3- The number of desmosomes is fewer than O.E, this may explain the susceptaibilty to tear during probingand it is greater permeability to migrate cells fluid. 4- The junctional and sulcular E. Are not thick as O.E because they are not keratinized and in health have no rete pegs. 5-Cells of J.E turnover rate is very high (4-6 days) comapared to O.E that has longest turnover rate (6-12 or up to 40 days). 6- J.E forms the attachment of the gingiva to the tooth surface while O.E and S.E have no attachment to the tooth surface


* Connective tissue (CT) : The connective tissue of the gingiva is known as lamina propria and consists of 2 layers: #The papillary layer : it consists of papillary rojection between the eithelial rete pegs. #The reticular layer : it is contiguous with the periosteum of the alveolar bone


*

* The oral epithelium consists of 4 layers of cells: Stratum basale. Stratum spinosum. Stratum granulosum. Stratum corneum.


*

Classification of gingival fibers :

*


*

*