lec3-Gingiva

gingiva 2
presented by :
dr. noor sabah irhayyim
Normal microscopic feature of gingiva
-Thegingiva consists of fibrous connective tissue known as lamina 
properia covered by stratified squamous epithelium.
-gingival epithelium may be differentiated as follows: 
1-oral epithelium: which faces the oral cavity 
2-Sulcular epithelium: which faces the tooth in the gingival sulcus 
without being in contact with the tooth surface.
3-Junctional epithelium: which provides the contact between the 
gingiva and the tooth.
CT, gingival
connective
tissue
ES, 
enamel space
JE, 
junctional
epithelium
OE, oral 
epithelium
SE, 
sulcular
epithelium
Oral epithelium:
-It covers the crest and the outer surface of the marginal and attached 
gingiva. It is either keratinized (no nuclei) or parakeratinized (retained
nuclei). The boundary between the oral epithelium and the underlying
connective tissues has a wavy course.
-The projection of the epithelium cells into he connective tissues are 
known as ( Rete Pegs). The intervening connective tissue portion which
project into the epithelium are called connective tissue papillae.
-This alternating pattern of depression and protuberances of the 
connective tissue papillae and epithelium rete pegs thought to give the
attached gingiva (the stippling appearances)
The oral epithelium consists of four layers of
cells
1-Stratum basale: Basal layer of cuboidal cells along the basement membrane . This 
is where epithelial cell replication and cell differentiation begins.(melanocytes are
found in this layer)
2-Stratum spinosum: the cells appear to have cytoplasmic spines. This is the thickest 
cell layer and Langerhans cells are found in this layer.
3-Stratum granulosum: Keratohyaline granules may be seen in this layer. Cells 
appear to be flattened.
4-Stratum corneum: This is the layer where both para or the orthokeratinized occur. 
It is the most superficial layer.
-The epithelium cells are formed as basal cells and gradually they undergo the 
process of keratinization, this is achieved by proliferation and differentiation of these
cells ( change to the characteristic of each of the cell layer) as they migrate
towards the surface layer.
SC, stratum corneum
(cornified layer)
SG,stratum 
granulosum (granular
layer)
SS, stratum
spinosum (spinous
layer)
SB,stratum basale
(basal layer)
CT, connective 
tissue
The oral epithelium contains the following
types of cells:
1- Keratinocytes cells: These are Keratin producing cells which 
comprise about 90% of the total cell population. These cells undergo
continuous proliferation and differentiation from basal layer to the
surface of epithelium. Keratin may be found in the stratum corneum
and contribute to the protective function of epithelium.
2-Melanocytes: cells of basal layer that produce melanin pigment 
granules.
3-Langerhans cells: these cells play a role in the defense mechanisms 
of the oral epithelium. They have an immunological function by
recognizing and processing antigens.
4-Markel cells: these are located in the deeper layers of the epithelium 
, harbor nerve ending. They have been identified as tactile receptors.
Pigmented gingiva of dog showing melanocytes (M) in the basalepithelial layer and
melanophores (C) in the connective tissue (Glucksman technique).
Human gingival epithelium, oral aspect. Immunoperoxidase technique showing Langerhans
cells. Function: On infectionof an area of skin, the local Langerhans' cells will take up and
process microbialantigensto become fully-functional antigen-presenting cells
Under a normal condition, there is complete equilibrium between cell renewal and 
desquamated (cell turn over). It takes approximately 3-4 weeks for keratinocytes to
migrate from basal layer until reach the outer epithelial surface, where it become
desquamated from stratum corneum.
Basal cells are found immediately adjacent to the connective tissue and are 
separated from this tissue by a basement membrane (basal lamina).
The basement membrane consists of : 
1-Lamina lucida: which is located immediately beneath the basal cell layer. 
2- lamina densa: located beneath the lamina lucida, from this structure the 
acchoring fibers project into the connective tissue.
-The epithelial cell are joined together by structure known as desmosome, which is 
composed of two hemi desmosome separated from each other by granulated
material.
Normal human gingiva stained with the periodic acid-Schiff (PAS) histochemical method.
The basement membrane (B) is seen between the epithelium (E) and the underlying
connective tissue (C). In the epithelium, glycoprotein material occurs in cells and cell
membranes of the superficial hornified (H) and underlying granular layers (G). The
connective tissue presents a diffuse, amorphous ground substance and collagen fibers.
The blood vessel walls stand out clearly in the papillary projections of the
connectivetissue (P).
A hemi desmosome composed from the
following structures:
1- the outer leaflets (OL) 

2-the inner leaflet (IL) 
3-the attachment plaque (AP) 
Sulcular Epithelium
1-It lines the gingival sulcus . 
2- It is a thin, non keratinized stratified squamous epithelium without rete 
pegs and extend from the coronal limit of the junctional epithelium to the
crest of the gingival margin.
3-The sulcular epithelium important because it is thin and may act as a 
semipermeable membrane through which tissue fluid from the gingiva
seep into the sulcus and makes easier for bacterial products of dental
plaque to penetrate into the connective tissue of the gingiva and
stimulate the inflammation and tissue destruction , That why the sulcular
epithelium id considered as a poor barrier against bacterial infection.
Junctional epithelium (JE)
-the epithelium that attaches the gingiva to the surface of the tooth 
-it consists of stratified squamous non-keratinized epithelium 
-it is 3-4 layers thick in early life but the numbers of increases with age to 10-20 
-it is thicker in coronal portion nut become thinner towards cmento-enamel junction only 
a few cell layers
- the junctional epithelium cells can be grouped in two layers: the basal and suprabasal 
layer.
The epithelium is continuously renewed through cell division in the basal layer and the cell 
migrate coronally to the base of the gingival sulcus from they are shed ( cell turn over)
-the JE assume a key role in maintenance of periodontal health, it creates the firm 
epithelium attachment that connect the soft tissue to the tooth surface, it is quite
permeable and thus serve as a pathway for diffusion of products plaque bacteria to
connective tissue, there is also diffusion in the opposite direction moving towards the
sulcus of host defense substance, this help to maintain the immune response.
CT,connecti
ve tissue
ES, enamel
space
JE,junctiona
l epithelium
CT, connective
tissue
JE, junctional
epithelium
OE, oral
epithelium
S,gingival sulcus
SE, sulcular
epithelium
There are distinct differences between the JE,
sulcular and the oral epithelium :
1-The size of the cells in the JE is relatively larger than the oral epithelium 
2-the intercellular space in the JE is wider than in the oral epithelium. The intercellular 
space of the JE is preferred route for tissue fluid and inflammatory cells to migrate from
the CT to gingival sulcus.
3-The number of desmosome (intercellular junction) is fewer in the junctional epithelium 
than in the oral epithelium , this may explain the JE susceptibility to tear during probing
and it is greater permeability to migrate cells and fluid.
4-The sulcular and junctional epithelium are not as thick as the oral epithelium, because 
they are not keratinized and in health have no retepegs.
5-JE turnover rate is very high (4-6) days compared to oral epithelium that has longest 
turn over rate (6-12 days) or (up to 40 days).
6-JE forms the attachment of the gingiva to the tooth surface while oral and sulcular 
epithelium have no attachment to the tooth surface.
Gingival connective tissue:
The connective tissue of the gingiva known as the lamina 
properia and consists of two layer:
1-The papillary layer: it consists of papillary projections 
between the epithelium retepeges.
2-The reticular layer: it is contiguous with the periosteum of the 
alveolar bone
-The major components of the CT are: 
1-collagen fibers 60% 
2-cells 5% 
3-ground substances, blood vessels, nerve, and 
lymphatics(35%).
Cells of gingival CT:
1-Fibroblasts
2-Mast cells
3-macropgage
4-inflammatory cells
Ground substances of gingival CT
1-the matrix fill the space between fibers, cells and 
have high content of water, electrolytes, nutrition,
metabolites, glycoprotein and proteoglycan.
2-it is produced by fibroblast and some from the mast 
cells and other from the blood.
3-it is a medium for the cells of CT to embedded and 

for maintained the normal function of the CT
Blood vessels of gingiva
- gingival tissue has rich vascular supply which 

arise from the terminal branches of internal
maxillary artery.
-consist of 
1-supra periosteal vessels’ 
2-vessels from the PDL and bone 

Innervation of the gingiva
Nerve supply to gingiva derived from the terminal branches of 
the maxillary and mandibular branches of the trigeminal
nerve.
THANK 
YOU

lec3-Gingiva

Uploaded by

Copyright:

Available Formats

lec3-Gingiva

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

lec3-Gingiva

Uploaded by

Copyright:

Available Formats

gingiva 2

1- the outer leaflets (OL) 

3-it is a medium for the cells of CT to embedded and 

- gingival tissue has rich vascular supply which 

You might also like