Scribd Logo
Upload

Welcome to Scribd!

  • 349 views

    Gingiva

    Uploaded by

    dr_ahmad_zuhdi
    The gingiva consists of an epithelial layer and connective tissue layer. The epithelial layer is made up of stratified squamous epithelium and contains keratinocytes, Langerhans cells, and melanocytes. There are three types of gingival epithelium: oral, sulcular, and junctional epithelium. The junctional epithelium attaches the gingiva directly to the tooth and is important for host immune response. The gingival connective tissue contains collagen fibers and provides structure and nutrients to the gingiva. Together, the epithelial and connective tissue layers allow the gingiva to support the teeth and protect the underlying structures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd

    Gingiva

    Uploaded by

    dr_ahmad_zuhdi
    349 views29 pages
    The gingiva consists of an epithelial layer and connective tissue layer. The epithelial layer is made up of stratified squamous epithelium and contains keratinocytes, Langerhans cells, and melanocytes. There are three types of gingival epithelium: oral, sulcular, and junctional epithelium. The junctional epithelium attaches the gingiva directly to the tooth and is important for host immune response. The gingival connective tissue contains collagen fibers and provides structure and nutrients to the gingiva. Together, the epithelial and connective tissue layers allow the gingiva to support the teeth and protect the underlying structures.

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The gingiva consists of an epithelial layer and connective tissue layer. The epithelial layer is made up of stratified squamous epithelium and contains keratinocytes, Langerhans cells, and melanocytes. There are three types of gingival epithelium: oral, sulcular, and junctional epithelium. The junctional epithelium attaches the gingiva directly to the tooth and is important for host immune response. The gingival connective tissue contains collagen fibers and provides structure and nutrients to the gingiva. Together, the epithelial and connective tissue layers allow the gingiva to support the teeth and protect the underlying structures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    349 views29 pages

    Gingiva

    Uploaded by

    dr_ahmad_zuhdi
    The gingiva consists of an epithelial layer and connective tissue layer. The epithelial layer is made up of stratified squamous epithelium and contains keratinocytes, Langerhans cells, and melanocytes. There are three types of gingival epithelium: oral, sulcular, and junctional epithelium. The junctional epithelium attaches the gingiva directly to the tooth and is important for host immune response. The gingival connective tissue contains collagen fibers and provides structure and nutrients to the gingiva. Together, the epithelial and connective tissue layers allow the gingiva to support the teeth and protect the underlying structures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 29

    The Gingiva

    Embryology, Anatomy, Histology & Biochemistry Dr. Feryal Khlayfat Periodontist

    Periodontium

    Tissues which surround & support the teeth. Gingiva

    Periodontal ligament
    Alveolar bone Cementum

    GINGIVA
    Oral mucosa is divided into:
    masticatory
    lining specialised

    Part of masticatory mucosa


    Fibrous mucosa surrounding the necks of teeth, covering the coronal portion of the alveolar process.

    GINGIVA

    Consists anatomically of 3 main parts:


    1. Free gingiva 2. Attached gingiva 3. Interdental gingiva

    Free gingiva

    Extends from the gingival margin to the free gingival groove (FGG) at the level of the cementoenamel junction (CEJ). Can be separated form the tooth by a probe

    Depth of gingival sulcus (crevice) : 0-3 mm.

    Attached gingiva

    Extends from the FGG to the mucogingival junction (MGJ), except on the palate Firmly attached to bone & tooth to withstand masticatory forces withstand tooth brushing prevent movement of marginal gingiva Width varies in different parts of the mouth & increases with age.

    For Example

    Maxilla, buccally: widest around incisors, narrowest around premolars

    Mandible, lingually: narrowest around incisors, widest around molars.

    Keratinised Gingiva
    KG = FG + AG

    Interdental gingiva

    Interdental papilla.

    Shape determined by:


    Contact relationship between teeth

    width of proximal surfaces


    shape of the CEJ

    Anterior : Pyramidal

    Molars : Flattened in a buccolingual direction

    Between buccal & lingual papillae

    COL

    Clinical Features of Normal (healthy) Gingiva


    Colour: pink (physiologic/racial pigmentation) Contour: scalloped outline Margins: thin, knife-edge. Surface texture: stippled Consistency: resilient Pointed interdental papillae Probing depth: 0-3 mm.

    No bleeding on probing (BOP).

    HISTOLOGY

    The gingiva consists of 2 main types of tissue: 1. Epithelium 2. Connective tissue


    Epithelium is attached to the underlying connective tissue by a basement membrane.

    Epithelium
    Stratified squamous epithelium
    (parakeratinised) Thickness 0.2 - 0.3 mm

    Structure
    Main cell type :keratinocyte

    4 layers of these cells:


    1. stratum basale
    (basal cell layer)

    2. stratum spinosum
    (spinous cell layer)

    3. stratum granulosum
    (granular cell layer)

    4. stratum corneum (corneal or cell layer)

    Other cell types within gingival epithelium


    Langerhans cells: modified monocytes found in the suprabasal layer, playing a role in immunity Merkel cells: in deeper layers of epithelium at tips of rete ridges, contain nerve endings. Melanocytes: in basal and spinous cell layer, contain melanin

    Types of Gingival Epithelium


    Oral epithelium Sulcular epithelium

    Junctional epithelium

    Oral epithelium
    Faces the oral cavity, is parakeratinised, shows rete pegs and connective tissue papillae (?stippled texture). Turnover rate 10-12 days.

    Sulcular epithelium
    Faces the tooth without contacting it. Thin nonkeratinised stratified squamous epithelium (no granulosum and corneum layers), extends from the coronal end of the junctional epithelium to the crest of the gingival margin. Acts as a semipermeable membrane.

    Junctional epithelium
    Provides contact between gingiva & tooth. Stratified squamous nonkeratinised epithelium. 3-4 layers thick in early life, increasing to 10-20 later. Basal and suprabasal layers. Length = 0.25-1.35 mm. No rete pegs.

    Junctional Epithelium
    Attached to the tooth surface by an inner basal lamina & to gingival connective tissue by an outer basal lamina. The internal basal lamina consists of a lamina densa (adjacent to enamel) & the lamina lucida to which hemidesmosomes are attached

    Internal basal lamina: no type IV collagen

    The junctional epithelium is attached to cementum also by hemidesmosomes. Derived from the reduced enamel epithelium.

    Function
    Protection of underlying structures while permitting selective interchange with the oral environment Active production of cytokines, adhesion molecules, growth factors enzymes and antimicrobial peptides: laminins, laminin-receptors (integrins) Examples: -defensins, IL-1 , IL-8, EGF

    The gingival epithelium is an important initiator, regulator and mediator of the host immune response against periodontal pathogens

    Role of Epithelial ECM


    Cell adhesion Adhesion to tooth & besement membrane Regulation of water, nutrients and toxins diffusion.

    Renewal of gingival epithelium


    Cell division Cell shedding

    Epithelial thickness is maintained by a balance

    between cell division in the basal & spinous cell


    layers & cell shedding in the superficial layer.
    Outer epithelium: 10-12 days J. epithelium: 1-6 days.

    The Dentogingival junction

    Enamel + cementum (CEJ) + junctional


    epithelium + gingival fibres + adhesion

    proteins.

    Gingival Crevicular fluid (GCF)


    Present

    within gingival sulcus, has

    cleaning & antimicrobial effects, increases adhesion of gingiva to tooth.

    You might also like