Anatomy Of The Periodontium (I), THE GINGIVA Flashcards
Define Periodontal Health
Periodontal health can be defined as a state
free from inflammatory periodontal disease
that allows an individual to function normally
and avoid consequences (mental or physical)
due to current or past disease.
Why do we define Periodontal Health
- To categorize gingival and periodontal disease prevalence in populations.
- To Establish acceptable therapeutic end points to periodontal therapies.
- To systematically assess the biological burden of periodontal inflammation.
- To evaluate an individual’s risk for future disease development.
What are the Microbiological Determinants of Clinical Periodontal Health?
Supragingival plaque composition
Subgingival biofilm composition
What are the Host Determinants of Clinical Periodontal Health?
Local predisposing factors
1. Periodontal pockets
2. Dental restorations
3. Root anatomy
4. Tooth position and crowding
Systemic modifying factors
1. Host immune function
2. Systemic health
3. Genetics
What are the Environmental Determinants of Clinical Periodontal Health?
Smoking
Medications
Stress
Nutrition
Constituents of the Periodontium
- The Gingiva
- Periodontal Ligament
- Cementum
- Alveolar Bone
What is the Gingiva?
The gingiva is the part of the oral mucosa that
surrounds the tooth and covers the alveolar
ridge and tooth root to a level just coronal to
the cemento-enamel junction.
Write a Short note on Free Gingiva.
• Aka unattached gingiva.
• Is coral pink in color & forms a cuff or collar 1-2 mm wide around the neck of the tooth.
• Has a scalloped outline.
• Surface is smooth and firm.
• Forms the soft tissue wall of the gingival sulcus.
•This cuff may be separated from the tooth carefully with a periodontal probe.
Write a short note on Attached Gingiva
• Is aka the ‘functional mucosa’.
• Is continuous with the marginal
gingiva.
• It is firm, resilient and tightly bound to the underlying
periosteum of the alveolar
bone.
• Has small depressions on its
surface- ‘stippling’ like an
orange peel.
P
Interdental gingiva (interdental papillae)
• This occupies the interproximal space beneath
the area of the tooth contact.
• It can be pyramidal or have a ‘‘col’’ shape in
premolar/molar teeth depending on the
contact point between the 2 adjoining teeth
and degree of gingival recession.
Microscopic Features of the Gingiva
Gingiva has a stratified squamous epithelium
overlying the central core of connective tissue (CT).
Cells found in the Gingiva
• The principal cell type of the gingival epithelium is the keratinocyte.
• Other cells types are the;
- clear cells or non-keratinocytes (Langerhans cells, Merkel cells, melanocytes, fibroblasts, chronic inflammatory cells) lymphocytes, plasma cells (store information on antigens & produce antibodies).
What is Gingival Crevicular fluid (GCF)?
This fluid contains components of CT, epithelium, inflammatory cells, serum & microbial flora residing in the gingival margin or the sulcus (pocket).
• In health, the gingival sulcus has a small amount of the gingival fluid.
• In inflammation, however, the fluid flow
increases, and its composition start to resemble
that of an inflammatory exudate.
• Hence, the fluid can be either a transudate or an exudate.
Gingival Connective Tissue (CT)
• The connective tissue (CT) of the gingiva is known as the lamina propria.
• The gingival CT is composed primarily of
collagen fibers (about 60% by volume),
fibroblasts (5%), vessels, nerves, and matrix
(about 35%).
• Type I collagen forms the bulk of the lamina
propria and provides the tensile strength to
the gingival tissue.
• It has a cellular and an extracellular
compartment composed of fibers and ground
substance.
• The ground substance fills the space between
fibers and cells and has a high content of
water.
List the Gingival fibers?
• Dentogingival
• Alveologingival
• Circular/Circumferential
• Transseptal
• Dentoperiosteal
