Gingiva Anatomy

Question 1

What’s gingival parts ?

Answer 1

Attached Gingiva
Marginal Gingiva or Free Gingiva or Unattached Gingiva
Interdental gingiva

Question 2

What’s marginal gingiva ?

Answer 2

collar-like fashion
well-adapted to the tooth surface
not attached to the tooth
1 mm wide
the soft-tissue wall of the gingival sulcus.
It may be separated from the tooth surface with aperiodontal probe

Question 3

What’s attached gingiva ?

Answer 3

Resilient and firmly attach to alveolar bone and keratinized
Bounded by mucogingival folds and gingival groove to marginal gingiva

Question 4

What’s attached gingiva function ?

Answer 4

protect the soft tissues during oral function, and its absence, especially around implants, has been shown to increase the propensity to inflammation.

Question 5

The width of attached gingiva increases with which factors ?

Answer 5

age and in supra erupted teeth

Question 6

What’s interdental gingiva ?

Answer 6

occupies the gingival embrasure, -interproximal space beneath the contact points.

pyramidal or cone shape in anterior area
Inverted cone in posterior region

Question 7

What’s interdental gingival parts ?

Answer 7

facial papilla,
lingual papilla
col (valley-like )depression in proximal surface between 2 teeth ( non keratinized ) initial site of disease

In diastema it’s absent

Question 8

What’s dentogingival apparatus components ?

Answer 8

Epithelium ( sulcular , junctional ) , CT , bone

Question 9

What’s the gingival sulcus ( gingival crevice ) depth ?

Answer 9

0.33-3mm , in interproximal area more deep

Question 10

What’s the tissue in dentigingival apparatus ?

Answer 10

Sulcular epithelium most coronal part of gingival until JE that is 0.97-1mm until CEJ then CT 1.07mm
JE and CT called biological width

So insert probe it will reach half way of JE

Question 11

What’s sulcular depth , JE , CT ?

Answer 11

Sulcus , 1mm
JE 0.97mm CT 1.07mm ( BW 2.04 )

Question 12

What’s BW dimension surround teeth ?

Answer 12

Incisors and caninesв=1.75в•›mm;
Premolarsв=1.97mm;
Molars=2.08mm.

Question 13

What’s BW function what’s the difference between sulcular and JE ?

Answer 13

It’s the seal of tooth that protect from bacterial and toxins invasion into periodonium .
JE not permeable as sulcular.
In implant these seal doesn’t exist only bone , also before prosthodontics ensure that you have healthy seal surround the abutment !!!!!

Question 14

Whts gingival groove ?

Answer 14

Found only in 33% of adult it’s a small depression above marginal gingival separate it from attached gingival

Question 15

What’s gingival sulcus and its lining ?

Answer 15

Between gingival margin and tooth laterally bound by non keratinized sulcular epithelium and apical by JE
1mm loosen by probe.

Question 16

What’s interdental gingival extend ?

Answer 16

Between the teeth coronal to alveolar crest , below contact point
It’s why you should have open contact point and not apically should be some in center

Question 17

Which epithelium is keratinized and which not ?

Answer 17

Outer epithelium keratinized
Sulcular not keratinized cause it inside face the tooth
JE not keratinized
Col in proximal area not

Question 18

The main function of the gingival epithelium- to protect the deep structures how does it achieve?

Answer 18

by proliferation and differentiation of the keratinocytes
Proliferation of keratinocytes takes place by mitosis in the basal layer and a larger number begins to migrate to the surface .

Question 19

The main morphologic changes in gingival?

Answer 19

progressive flattening of the cell ,

production of keratohyaline granules

the disappearance of the nucleus

Question 20

To which structure attached gingival connect and how ?

Answer 20

To alveolar bone by periosteum
To cementum by CT fibers
epithelium attachment to teeth above CEJ

Question 21

What’s attached gingival composition ?

Answer 21

Keratinized epithelium and laminate propria of dense well organized fiber bundle with few elastic fibers.
Firmly attach to underlying structures and teeth to withstand masticatory forces and frictional stress.

Question 22

Where is the narrowest band of attached gingival found ?

Answer 22

Facial surface of mandibular canines and 1st premolar
Lingual surface adjacent to mandibular incisors and canines

MB root of maxillary first molar may cause dehiscence and man 3rd molar

Question 23

Attached gingival width ?

Answer 23

1-9mm widest in maxillary facial lateral incisors
Narrowest mandibular facial canines + first premolar

Question 24

What’s the attached gingival colour and depend on what ?

Answer 24

Collar pink , depend on vascularity , degree of keratinization , melanin cells presence , thickness of epithelium ,

Question 25

In which pathological cases stippling is absent ?

Answer 25

Underlying CT edema , gingival collagen fibers degradation

Some times due variation in gingival topography

Question 26

All oral epithelium is stratified squamous epithelium can be keratinized and not what’s this surfaces ?

Answer 26

Keratinized : PALATAL most keratinized and FACIAL attached gingiva ( orthokeratinozed )
Buccal , ventral of tongue

Non keratinized: specialized and lined mucosa , soft palate , buccal aspect of checks , alveolar mucosa , cervicular epithelium .

Question 27

The penetration of the probe depends on ?

Answer 27

probe diameter,
probing force,
level of inflammation
Probing depth-2-3 mm

Question 28

What’s gingival cervical fluid functions ?

Answer 28

1) cleanse material from the sulcus,
2) contain plasma proteins that may improve adhesion of the epithelium to the tooth,
3) possess antimicrobial properties
4) exert antibody activity to defend the gingiva.

Question 29

What’s the function of non keratinized JE ?

Answer 29

epithelial attachment
barrier function
immunity defense of body
Impermeable to invasion

Question 30

What’s the composition of gingival CT ?

Answer 30

Lamina propria Cells + extracellular matrix (ground substance+ fibers +blood vessels )
Fibers

Question 31

What’s gingival fibers types ?

Answer 31

Fibers:
a. Collagen fibers
b. Reticulin fibers
c. Oxytalan fibers
d. Elastin fibers.

Question 32

What’s the principle group of gingival fibers ?

Answer 32

Dentogingival fibers:
Alveolar gingival fibers
Dentoperiosteal fibers
Circular fibers
Trans-septal fibers

Question 33

What’s the SECONDRY group ?

Answer 33

Periosteogingival fibers:
interpapillary fibers
Transgingival fibers
Intercircular fibers
Intergingival fibers
Semicircular fibers
Oxytalan fibers:
Elastin fibers

Question 34

What’s the functions of gingival fibers ?

Answer 34

a.brace the marginal gingiva firmly against the tooth.

b. help to withstand the forces exerted by mastication. without being deflected away from the tooth surface

c. unite the free gingiva to the root cementum and the adjacent attached gingiva

Question 35

The CT the laminate propera layer consist of what layer ?

Answer 35

(1) a papillary layer subjacent to the epitheliumthat consists of papillary projections between the
epithelial ( rete pegs )

(2) a reticular layer that is contiguous with the periosteum of the alveolar bone

Question 36

Gingival by colour ?

Answer 36

The attached gingiva - pink and stippled
The alveolar mucosa is red, smooth, and shiny
accumulation of melanin pigmentation is normal- Physiologic Pigmentation

Question 37

Shape and interdental gingiva depend on ?

Answer 37

1. the presence or absence of a contact point between the adjacent teeth,
2. the distance between the contact point and the osseous crest,
3. the presence or absence of some degree of recession..

Question 38

Size of gingiva depend on ? Why it’s important clinically ?

Answer 38

The size of the gingiva corresponds with the sum of cellular and intercellular elements and their vascular supply.

Alteration in size is a common feature of gingival disease

Question 39

The gingiva contour depends on?

Answer 39

1. the shape of the teeth
2. their alignment in the arch,
3. the location and size of the area of proximal contact,
4. the dimensions of the facial and lingual gingival embrasures

Question 40

Texture ?

Answer 40

Stippling orange peel.
Absence in disease .
When the gingiva is restored to health after treatment, the stippled appearance returns

Question 41

Position ?

Answer 41

refers to the level of margin of gingiva to the tooth.

When the tooth erupts into the oral cavity, the margin and sulcus are at the tip of the crown; as eruption progresses, they are seen closer to the root.