Colis, Gwyneth L.

Periodontics

DMD 4A

ANATOMY AND PHYSIOLOGY OF PERIODONTIUM

PERIODONTAL TISSUES – these are the tissues that surrounds the teeth and support the teeth

o Gingiva – surrounds the teeth, part of mucosa that coves the alveolar process of the jaws and
surrounds the neck of teeth. It begins at mucogingival line and ends at cervix of each tooth

MARGINAL/UNATTACHED/FREE GINGIVA –
border of gingiva surrounding the teeth &
demarcated from the attached gingiva by free
gingival groove
ATTACHED GINGIVA – continuity to marginal
gingiva. Firm, resilient, and firmly bound to
underlying periosteum of alveolar bone
INTERDENTAL GINGIVA – occupies the
gingival embrasure and can be pyramidal or col shape.
o Periodontal Ligament, Cementum, & Alveolar bone – supports the teeth

JUNCTIONAL EPITHELIUM – surrounds the

neck of tooth, key role is to maintain
periodontal health. Works as a pathway for
diffusion of products from the metabolism of
bacteria
GINGIVAL FLUID – comes from gingival CT,
helps mechanical cleaning of sulcus, and has
antimicrobial properties

MICROSCOPIC FEATURES

Gingiva consist of CENTRAL CORE OF CT & STRATIFIED SQUAMOUS EPITHELIUM

CENTRAL CORE OF CT STRATIFIED SQUAMOUS EPITHELIUM

o Fibers o Keratinized/Para keratinized

o Ground substance o Non-keratinized
o Cells

GINGIVAL FIBERS – brace the marginal gingiva firmly against the tooth, provide rigidity to withstand
forces of mastication, and unite the free marginal gingiva with cementum of root and adjacent attached
gingiva.
CORRELATION OF CLINICAL AND MICROSCOPIC FEATURES

 Color – coral pink

 Size - The bulk of cellular and
intercellular elements and their vascular
supply
 Consistency, Shape, & Contour – firm
and resilient
 Texture – peel orange appearance and
smooth in borders

THE TOOTH-SUPPORTING STRUCTURES

 PERIODONTAL LIGAMENT – a CT that surround the root and connects to the bone

Components of PDL
o Alveolar crest fibers
o Horizontal fibers
o Interarticular fibers
o Oblique fibers
o Apical fibers

CELLULAR ELEMENTS FUNCTION OF PDL

1. CONNECTIVE TISSUE CELLS - Fibroblasts, o PHYSICAL – attachment of teeth to

cementoblasts and osteoblasts.
2. Epithelial rest cells (Malassez): Close to
the cementum, more numerous at the
apical area.
3. Immune system cells: Neutrophils,
lymphocytes, macrophages, etc.
4. Cells associated with neurovascular
elements
bone, transmission of occlusal forces,
resistance to impact, and maintenance
of gingival tissues in proper relationship
to teeth.
o Formative and Remodeling: Cells of the
PDL participate in the formation and
resorption of cementum and bone.
o Nutritional and Sensory: By the blood
vessels and sensory nerve fibers that
transmit tactile, pressure and pain
sensations.

 CEMENTUM – has calcified tissues that forms the outer surface of anatomic root
o Acellular – first to foem before the tooth reach the occlusal plane. Covers the cervical
third or half of root and it doesn’t contain cells.
o Cellular – formed after the tooth reaches the occlusal plane. More irregular and contains
cells (cementocytes). Less calcified than the a cellular type.
 ALVEOLAR BONE - portion of jaws that forms and support the tooth sockets. Formed when
tooth erupts to provide the osseous attachment to the tooth and disappear gradually after the
tooth is loss. (alveolar bone proper, cancellous trabeculae, & external plate of cortical bone)