the tissues that surround and support the teeth, including the gingiva, cementum, PDL and alveolar bone
3 anatomical parts of the gingiva (3)
- margina gingiva (unattached)
- attached gingiva
- inderdental gingiva
What demarcates the free gingiva from the attached gingiva?
the marginal groove
(or free gingival groove--only 50% observable)
separates from tooth with gentle probing
space between tooth and tissue-->normal probing depth 2-3 mm
What is considered a pathological probing depth?
4 mm or more
bound to periosteum of underlying bone and terminates at the mucoginigval junctions
What joins attached gingiva with alveolar mucosa
True/False: attached gingiva is generally stationary throughout adult life
The width of the attached gingiva is between the MGJ and the ____ ____ ____
base of the sulcus/pocket
what type of gingiva is found between gingival margin and MGJ
without keratinized gingiva what 4 things happen
- not connective tissue attachment
- less barrier
- more likely progression of periodontitis
- more likely progression of peri-implant mucositis/peri-implantitis
What is a way to gain KG?
free gingiva graft
occupies gingival embrasure space and is shaped either pyramidal or "col"
True/False: in areas of diastema, interdental papillae are typically not present
The interdental papillae have 4 different surfaces, what are they?
The depression in the gingival tissue underneath a contact area between the lingual papilla and facial papilla. Sort of like a volcano-shaped tissue under where two teeth contact one another.
Why does no papilla form with diastema?
If teeth arent touch together then the gums cannot feel the edge of the tooth and so the gums do not grow in so there are no papilla
central core of connective tissue covered by stratified squamous epithelium
histological type of gingiva
principle of function of gingiva
protection of deep structures (covering for the CT)
principle cell type in gingiva
keratinocyte characteristic that is the constant regneration and replacement of like cells
keratinocyte characteristic that is the morphologic changes relative to functional demands (nonkeratinized ↔ orthokeratinized
True/False: in the gingiva, renewal is continuous
dimension of the tissues are maintained by cell formation at the ____ ____ balancing shedding of cells at the _____
In what areas does mitotic rate increase?
in areas of inflammation
nonkeratinocyte cell that produces melanin, coloration (found also in CT)
nonkeratinocyte cell that have a role in immune response (oral and sulcular epithelium)
nonkeratinocyte cell that are the deep layers and harbor nerve endings and have a role in tactile sensation
Three types of epithelium in the oral cavity
- oral or outer epithelium
- sulcular epithelium
- junctional epithelium
What type of epi is oral or outer?
parakeratinized with nuclei
Epi that forms a covering for Crestal surface & Outer surface of Marginal Gingiva and the surface for attached gingiva
oral or outer epithelium
where is the location of sulcular epi and what are the dimensions?
lining of the gingival sulcus
it runs from junctional epi to the crest of the marginal gingiva
what type of epi is sulcular?
Thin, nonkeratinized stratified squamous
How can sulcular epi become keratinized (2)
- reflected and exposed to oral cavity
- contacting bacterial flora is eliminated
True/False: some findings suggest bacterial contact may prevent or diminished keratinization
Location and type of junctional epi
collar-like band, initially at the CEJ
how is junctional epithelium attached to enamel/dentin? (IMPORTANT)
What are the digestions of junctional epi? (numbers)
0.25-1.35 mm in width (approx 1 mm)
Functions of JE (2)
forms a biological seal to
anchor soft tissue to tooth structure
protect underlying periodontal fibers from bacterial insult
3 stages of apical migration of JE
- proportionate loss of gingival fibers
- proportionate loss of alveolar bone
- periodontal pocketing
difference between infra bony and supra bony pocket?
infrabony is the pocket formed below the alveolar bone
supra bony is the pocket formed above the alveolar bone
How does gingival (sulcular) fluid travel?
from the CT and through the sulcular epithelium
what are the 4 functions of the sulcular fluid
- cleanse material from sulcus
- provide plasma proteins for epithelial adhesion
- antimicrobial properties
- defense through antibodies
Healthy tissue sucular fluid ____, while inflamed tissue fluid _____
transudates--travel constantly from a higher concentration to lower (gradient fusion)
exudates--moves because of an inflammatory overload
Vast array of biochemical factors – diagnostic /prognostic biomarker
Also contains connective tissue, epithelium, inflammatory cells, serum, and microbial flora
Bacteria, GCF, blood - calculus