Gingiva Anatomy Flashcards
What’s gingival parts ?
Attached Gingiva
Marginal Gingiva or Free Gingiva or Unattached Gingiva
Interdental gingiva
What’s marginal gingiva ?
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
What’s attached gingiva ?
Resilient and firmly attach to alveolar bone and keratinized
Bounded by mucogingival folds and gingival groove to marginal gingiva
What’s attached gingiva function ?
protect the soft tissues during oral function, and its absence, especially around implants, has been shown to increase the propensity to inflammation.
The width of attached gingiva increases with which factors ?
age and in supra erupted teeth
What’s interdental gingiva ?
occupies the gingival embrasure, -interproximal space beneath the contact points.
pyramidal or cone shape in anterior area
Inverted cone in posterior region
What’s interdental gingival parts ?
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
What’s dentogingival apparatus components ?
Epithelium ( sulcular , junctional ) , CT , bone
What’s the gingival sulcus ( gingival crevice ) depth ?
0.33-3mm , in interproximal area more deep
What’s the tissue in dentigingival apparatus ?
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
What’s sulcular depth , JE , CT ?
Sulcus , 1mm
JE 0.97mm CT 1.07mm ( BW 2.04 )
What’s BW dimension surround teeth ?
Incisors and caninesв=1.75в•›mm;
Premolarsв=1.97mm;
Molars=2.08mm.
What’s BW function what’s the difference between sulcular and JE ?
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 !!!!!
Whts gingival groove ?
Found only in 33% of adult it’s a small depression above marginal gingival separate it from attached gingival
What’s gingival sulcus and its lining ?
Between gingival margin and tooth laterally bound by non keratinized sulcular epithelium and apical by JE
1mm loosen by probe.
What’s interdental gingival extend ?
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
Which epithelium is keratinized and which not ?
Outer epithelium keratinized
Sulcular not keratinized cause it inside face the tooth
JE not keratinized
Col in proximal area not
The main function of the gingival epithelium- to protect the deep structures how does it achieve?
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 .
The main morphologic changes in gingival?
progressive flattening of the cell ,
production of keratohyaline granules
the disappearance of the nucleus
To which structure attached gingival connect and how ?
To alveolar bone by periosteum
To cementum by CT fibers
epithelium attachment to teeth above CEJ
What’s attached gingival composition ?
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.
Where is the narrowest band of attached gingival found ?
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
Attached gingival width ?
1-9mm widest in maxillary facial lateral incisors
Narrowest mandibular facial canines + first premolar
What’s the attached gingival colour and depend on what ?
Collar pink , depend on vascularity , degree of keratinization , melanin cells presence , thickness of epithelium ,
In which pathological cases stippling is absent ?
Underlying CT edema , gingival collagen fibers degradation
Some times due variation in gingival topography
All oral epithelium is stratified squamous epithelium can be keratinized and not what’s this surfaces ?
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 .
The penetration of the probe depends on ?
probe diameter,
probing force,
level of inflammation
Probing depth-2-3 mm
What’s gingival cervical fluid functions ?
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.
What’s the function of non keratinized JE ?
epithelial attachment
barrier function
immunity defense of body
Impermeable to invasion
What’s the composition of gingival CT ?
Lamina propria Cells + extracellular matrix (ground substance+ fibers +blood vessels )
Fibers
What’s gingival fibers types ?
Fibers:
a. Collagen fibers
b. Reticulin fibers
c. Oxytalan fibers
d. Elastin fibers.
What’s the principle group of gingival fibers ?
Dentogingival fibers:
Alveolar gingival fibers
Dentoperiosteal fibers
Circular fibers
Trans-septal fibers
What’s the SECONDRY group ?
Periosteogingival fibers:
interpapillary fibers
Transgingival fibers
Intercircular fibers
Intergingival fibers
Semicircular fibers
Oxytalan fibers:
Elastin fibers
What’s the functions of gingival fibers ?
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
The CT the laminate propera layer consist of what layer ?
(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
Gingival by colour ?
The attached gingiva - pink and stippled
The alveolar mucosa is red, smooth, and shiny
accumulation of melanin pigmentation is normal- Physiologic Pigmentation
Shape and interdental gingiva depend on ?
- the presence or absence of a contact point between the adjacent teeth,
- the distance between the contact point and the osseous crest,
- the presence or absence of some degree of recession..
Size of gingiva depend on ? Why it’s important clinically ?
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
The gingiva contour depends on?
- the shape of the teeth
- their alignment in the arch,
- the location and size of the area of proximal contact,
- the dimensions of the facial and lingual gingival embrasures
Texture ?
Stippling orange peel.
Absence in disease .
When the gingiva is restored to health after treatment, the stippled appearance returns
Position ?
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.
