The Gingiva

• The normal periodontium provides the

support necessary to maintain teeth in
function. It consists of four principal
components:
• gingiva, periodontal ligament, cementum, and
alveolar bone. Each of these periodontal
components is distinct in its location, tissue
architecture, biochemical composition, and
chemical composition,but all of these
components function together as a single unit.
The oral mucosa consists of the following three zones:
1. The gingiva and the covering of the hard palate,
termed the masticatory mucosa (The gingiva is the
part of the oral mucosa that covers the alveolar
processes of the jaws and surrounds the necks of the
teeth.)
2. The dorsum of the tongue, covered by specialized
mucosa .
3. The oral mucous membrane lining the remainder of
the oral cavity .
• Normal gingiva covers the alveolar bone and tooth
root to a level just coronal to the cementoenamel
junction.
• The gingiva is divided anatomically into marginal,
attached, and interdental areas .
Although each type of gingiva exhibits considerable
variation in differentiation, histology, and thickness
according to its functional demands, all types are
specifically structured to function appropriately
against mechanical and microbial damage.
 Marginal Gingiva
• The marginal or unattached gingiva is the
terminal edge or border of the gingiva that
surrounds the teeth in collarlike fashion . In
about 50% of cases, it is demarcated from the
adjacent attached gingiva by a shallow linear
depression called the free gingival groove.
 The marginal gingiva is usually about 1 mm wide,
and it forms the soft-tissue wall of the gingival
sulcus. It may be separated from the tooth surface
with a periodontal probe. The most apical point of
the marginal gingival scallop is called the gingival
zenith. Its apicocoronal and mesiodistal dimensions
vary between 0.06 and 0.96 mm.
 Gingival Sulcus
• The gingival sulcus is the shallow crevice
• or space around the tooth bounded by the
surface of the tooth on one side and the
epithelium lining the free margin of the
gingiva on the other side. It is V-shaped, and it
barely permits the entrance of a periodontal
probe.
-The clinical determination of the depth of
the gingival sulcus is an important diagnostic
parameter. Under absolutely normal or ideal
conditions, the depth of the gingival sulcus is 0
mm or close to 0 mm. These strict conditions of
normalcy can be produced experimentally only
in germ-free animals or after intense and
prolonged plaque control
• The depth of sulcus, as determined in
histologic sections, has been reported as 1.8
mm, with variations from 0 to6 mm; other
studies have reported 1.5 mm and 0.69 mm
• The clinical evaluation used to determine the
depth of the sulcus involves the introduction
of a metallic instrument (i.e., the periodontal
probe) and the estimation of the distance it
penetrates (i.e.,the probing depth).
 The histologic depth of a sulcus does not need
to be exactly equal to the depth of penetration
of the probe. The penetration of the probe
depends on several factors, such as probe
diameter, probing force, and level of
inflammation.
 Attached Gingiva
• The attached gingiva is continuous with the
marginal gingiva. It is firm, resilient, and
tightly bound to the underlying periosteum of
alveolar bone. The facial aspect of the
attached gingiva extends to the relatively
loose and movable alveolar mucosa; it is
demarcated by the mucogingival junction .
• The width of the attached gingiva is another
important clinical parameter. It is the distance
between the mucogingival junction and the
projection on the external surface of the
bottom of the gingival sulcus or the
periodontal pocket. It should not be confused
with the width of the keratinized gingiva,
although this also includes the marginal
gingiva
• The width of the attached gingiva on the facial
aspect differs in different areas of the mouth.
It is generally greatest in the incisor region
(i.e., 3.5 to 4.5 mm in the maxilla, 3.3 to 3.9
mm in the mandible) and narrower in the
posterior segments (i.e., 1.9 mm in the
maxillary first premolars and 1.8 mm in the
mandibular first premolars).
• The width of the attached gingiva increases by
the age of 4 years and in supraerupted teeth. On
the lingual aspect of the mandible, the attached
gingiva terminates at the junction of the lingual
alveolar mucosa, which is continuous with the
mucous membrane that lines the floor of the
mouth. The palatal surface of the attached
gingiva in the maxilla blends imperceptibly with
the equally firm and resilient palatal mucosa.
 Interdental Gingiva
• The interdental gingiva occupies the gingival
embrasure, which is the interproximal space
beneath the area of tooth contact. The
interdental gingiva can be pyramidal, or it can
have a “col” shape. In the former, the tip of one
papilla is located immediately beneath the
contact point; the latter presents avalley like
depression that connects a facial and lingual
papilla and that conforms to the shape of the
interproximal contact .
• The shape of the gingiva in interdental space
depends on the presence or absence of a
contact point between the adjacent teeth, the
distance between the contact point and the
osseous crest, and the presence or absence of
some degree of recession.
• The facial and lingual surfaces are tapered
toward the interproximal contact area,
whereas the mesial and distal surfaces are
concave. The lateral borders and tips of the
interdental papillae are formed by the mrginal
gingiva of the adjoining teeth.The intervening
portion consists of attached gingva
• If a diastema is present, the gingiva is firmly
bound over the interdental bone to form a
smooth, rounded surface without interdental
Papillae.
 Microscopic Features

• Microscopic examination reveals that gingiva

is composed of
1- stratified squamous epithelium .
2- central core of connective tissue .
 Gingival Epithelium

• Function of gingival epithelium :-

1- provide a physical barrier to infection and the
underlying gingival attachment .
2- play an active role in innate host defense
• There are three different areas gingival :-
1-Oral or outer epithelium .
2- Sulcular epithelium .
3- Junctional epithelium .
The principal cell type of the gingival epithelium is
Keratinocyte .
other cell of gingival epithilum are Nonkeratinocytes,
which include :
Langerhans cells, the Merkel cells, and the melanocytes
 Oral epithelium

Stratum basale

stratum stratum
corneu spinous
m m.

Stratum
granulosum.
• It covers the crest and outer surface of the
marginal gingiva and the surface of the
attached gingiva .It is kertinized or
parakertinized or combination of both
• The prevalent is parakeratinized.
Normally does not contain Merkel cells.
 Sulcular epithelium
• lines the gingival sulcus .
• It is a thin, nonkeratinized .
• Without rete pegs
• and extends from the coronal limit of the
junctional epithelium to the crest of the
gingival margin
 Basal
layer
spinous
layer
Despite these morphologic and chemical characteristics
the sulcular epithelium has the potential to keratinize if
(1) it is reflected and exposed to the oral cavity .
(2) the bacterial flora of the sulcus is totally eliminated .
Conversely, the outer epithelium loses its keratinization
when it is placed in contact with the tooth .
These findings suggest that the local irritation of
the sulcus prevents sulcular keratinization .
it may act as a semipermeable membrane :-
1- Because injurious bacterial products pass into
the gingiva .
2- tissue fluid from the gingiva seeps into the
sulcus
JUNCTIONAL EPITHELIUM
consists of acollar like band of stratified
squamous nonkeratinizing epithelium.
It is three to four layers thick in early life, but the
number of layers increases with age to 10 or even
20 layers.
• These cells can be grouped in two strata:
• basal and suprabasal.
• The length of the junctional epithelium
ranges from 0.25 to 1.35 mm.
• The junctional epithelium is attached to the
tooth surface (epithelial attachment) by
means of an internal basal lamina and to the
gingival connective tissue by an external basal
lamina that has the same structure as other
epithelial-connective tissue attachments else
where in the body.
The internal basal lamina

a lamina densa (adjacent to enamel )

a lamina lucida to which hemidesmosomes are

attached.
 Gingival Connective Tissue
• The connective tissue of the gingiva is known as the
lamina propria and consists of two layers:
1) a papillary layer
subjacent to the epithelium, which consists of papillary
projections between the epithelial rete pegs .
2) a reticular layer
contiguous with the periosteum of the alveolar bone.
• Connective tissue has :-
• Cellular
• An extracellular compartment composed of
fibers and ground substance
• The ground substance fills the space between fiber s and
cells, is amorphous, and has a high content of water.
• It is composed of
• proteoglycans, mainly
• hyaluronic acid and chondroitin sulfate .
• glycoproteins, mainly fibronectin. Fibronectin binds
fibroblasts to the fibers and many other components of the
intercellular matrix, helping mediate cell adhesion and
migration
• . Laminin is another glycoprotein found in the basal
laminae, which serves to attach it to epithelial cells.
The three types of connective tissue fibers

collagen,

reticular,
and elastic.
• Collagen type I forms the bulk
• of the lamina propria and provides the tensile strength
to the gingival tissue.
• Type IV collagen branches between the collagen type I
bundles and is continuous with fibers of the basement
• membrane and blood vessel walls.
• The elastic fiber system is composed of oxytalan,
• elaunin, and elastin fibers distributed among collagen
 Gingival Fibers
• The connective tissue of the marginal gingiva is densely
• Collagenous .
• - The gingival fibers have the following
• functions:
• 1. To brace the marginal gingiva firmly against the tooth
• 2. To provide the rigidity necessary to withstand the
• forces of mastication without being deflected away
• from the tooth surface
• 3. To unite the free marginal gingiva with the cementum
• of the root and the adjacent attached gingiva
 Cellular Elements
• Fibroblasts :-
Found between the fiber bundles. As in connective tissue
else where in the body, fibroblasts synthesize collagen
and elastic fibers as well as the glycoproteins and
glycosaminoglycans .
• Fibroblasts also regulate collagen degradation.
• Mast cell
• Macrophages
• monocytes. Adipose cells and eosinophils,
Blood supply of gingiva