GINGIVA Introduction Macroanatomy of Gingiva Marginal Gingiva Gingival

GINGIVA

• Introduction • Macroanatomy of Gingiva -Marginal Gingiva -Gingival Sulcus -Attached Gingiva -Interdental Gingiva • Microanatomy of Gingiva -Gingival Epithelium -General Aspects -Outer / Oral Epithelium -Sulcular Epithelium -Junctional Epithelium -Interface Between Epithelium And Connective Tissue -Gingival Connective Tissue -Cellular Elements -Gingival Fibers

Blood Supply Lymphatic Drainage Gingival Innervation Correlation of Normal Clinical and Microscopic Features -Color -Size -Contour -Shape -Consistency -Surface Texture -Position • Effects of Aging on Gingival Epithelium and Connective Tissue • Conclusion • References • •

INTRODUCTION The gingiva covers the alveolar process, and it is the only one of the periodontal tissues that under healthy conditions is directly visible upon inspection.

Glickman : “Gingiva is the part of the oral mucosa that covers the alveolar processes of the jaws and surrounds the necks of the teeth”. A A P 1992 : The fibrous investing tissue, covered by keratinized epithelium, which immediately surrounds a tooth and is contiguous with its periodontal ligament and with the mucosal tissues of the mouth.

Oral Mucosa consists of : Masticatory Mucosa - Gingiva - covering of Hard palate. Specialized Mucosa - Dorsum of Tongue. OMM lining remainder of oral cavity. Structurally : Keratinized – - masticatory mucosa - vermilion border of the lip. Non keratinized - lining or reflecting mucosa, - specialized mucosa.

MACROANATOMY OF GINGIVA Anatomically v Free or Marginal Gingiva. v Attached Gingiva. v Interdental Gingiva. Functionally v Part facing oral cavity. v Part facing the tooth.

Free or Unattached or Marginal Gingiva : • Terminal edge or border of gingiva surrounding the teeth like a collar. • Usually 1 mm wide. • Demarcated from attached gingiva by a shallow depression – free gingival groove 50 %.

Gingival Sulcus • V –shaped. • Depth of Gingival Sulcus : Ideal conditions - zero. Clinically - 2 – 3 mm. Histologic -1. 8 mm with variations from 0 to 6 mm. • Shallow crevice or space around the tooth bounded by surface of tooth on one side and the epithelium lining the free margin of the gingiva on the other.

Attached Gingiva • Continuous with marginal gingiva & is firm, resilient & tightly bound to the underlying periosteum of the alveolar bone. • The facial aspect of the attached gingiva extends to the relatively loose & movable alveolar mucosa from which it is demarcated by the MGJ.

Width of AG • distance b/w the MGJ & projection on the external surface of the bottom of gingival sulcus/ periodontal pocket. • Greatest in incisor region : 3. 5 to 4. 5 mm in maxilla 3. 3 to 3. 9 mm in mandible • 1. 9 mm in maxilla 1. 8 mm in mandible Least in the first premolar area :

• MGJ remains stationary throughout adult life. • On lingual aspect, AG terminates at the junction with the lingual alveolar mucosa, which is continuous with the mucous membrane lining the floor of mouth. • On palatal surface, it blends imperceptibly with the equally firm, resilient palatal mucosa.

Significance of attached gingiva for the maintenance of periodontal health : • To protect the periodontium from injury caused by frictional forces encountered during mastication • To dissipate the pull on the gingival margin created by the muscles of the adjacent alveolar mucosa.

Interdental Gingiva : • occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact. • can have a pyramidal or Col shape. PYRAMIDAL SHAPEIn this the papilla is located immediately beneath the contact point. It is present in anterior teeth

COL SHAPE • It is valley like depression that connects the facial and lingual papilla and conforms to the shape of interproximal contact and present in posterior teeth • Its epithelium is non keratinised and same as junctional epithelium