GINGIVA

ASHNA JOHNSON(4TH BDS)

GUIDE:DR APPORVA
CONTENTS
• INTRODUCTION
• CLINICAL FEATURES
• MACROSCOPIC STRUCTURE OF GINGIVA
• MICROSCOPIC STRUCTURE OF GINGIVA
• GINGIVAL CONNECTIVE TISSUE
• GINGIVAL FIBERS
• BLOOD SUPPLY,NERVE SUPPLY, LYMPHATIC
• REFERENCE
GINGIVA
The gingiva is the part of the masticatory mucosa , which covers the alveolar process and
surrounds the cervical portion of the teeth .The gingiva is anatomically divided into
marginal,attached and interdental areas
 CLINICAL FEATURES
Color
The color of the attached and marginal gingiva is generally described as a coral pink . It is
produced by the thickness and degree of keratinization of the epithelium and presence of
keratinization of the epithelium and presence of pigment containing cells
Size
The size of the gingiva corresponds with the sum total of the bulk cellular and intercellular
elements and their vascular supply
Contour
The marginal gingiva envelopes the tooth in a collarlike fashion and follows a scalloped outline
on the facial and lingual surfaces.
Shape
In the anterior region of dentition ,the interdental papilla is pyramidal in form , whereas the
papilla is more flattened in a buccolingual direction in the molar region
Consistency
The gingiva is firm and resilient and is tightly bound to the underlying bone
Surface texture
Surface texture is similar to that of an orange peel and is referred to as stippled .it is viewed by drying the
gingiva.
The attached gingiva is stippled ;the marginal gingiva is not
Position
The position of the gingiva is the level at which the gingival margin is attached to the tooth
 STRUCTURE OF GINGIVA
Macroscopic features
1.Marginal gingiva
2.Attached gingiva
3.Interdental gingiva
Microscopic features
Epithelium
1.Oral epithelium
2.Sulcular epithelium
3.Junctional epithelium
Basal lamina
Connective tissue
Cells
1.Mast cells
2.Fibroblasts
3.Eosinophils
4.Macrophages
5.Adipose cells
Fibers
1.Collagen fibers
2.Reticulin fibers
3.Elastin fibers
Neurovascular bundles
1.Nerves
2.Vessels
3.Lymphatics
MARGINAL GINGIVA
Free gingiva is defined as the terminal edge or border of gingiva surrounding the teeth in a collar like
fashion
It develops apical to the base of the gingival sulcus and appears in histological sections as a v shaped notch
at an epithelial ridge
It is demarcated from the adjacent attached gingiva by a shallow linear depression called free gingival
groove
 ATTACHED GINGIVA
The attached gingiva is continuous with the marginal gingiva .it is firm, resilient and tightly bound to the underlying periosteum of
the alveolar bone

The width of the attached gingiva on the facial aspect differs in different areas of the mouth .it is greatest in incisor region (3.5-
4.5mm in maxilla ,3.3-3.9mm in mandible )and narrower in posterior segments(1.9mm in maxillary first premolars and 1.8mm in
mandibular first premolars

The surface texture of the attached gingiva is stippled like orange peel .most prominent on facial surfaces and disappears in old age
Function
As a barrier
As a support
As a stress bearer
 INTERDENTAL GINGIVA
The interdental gingiva occupies the gingival embrasure which is the interproximal space beneath
the area of the tooth contact.

The interdental gingiva can be pyramidal, or col shaped

In the presence of diastema ,the interdental papilla will be absent

The lateral borders and tips of the inter dental papilla are formed by continuation of marginal
gingiva and intervening portion by the attached gingiva
GINGIVAL SULCUS
It is defined as the shallow crevice or space around the tooth,bounded by the surface of the tooth on one
side and the epithelial lining the free margin of the gingiva on the other
It is v shaped and barely permits the entrance of a periodontal probe
The so called probing depth of a clinically –normal gingiva sulcus in humans is 2-3
Histologic depth of gingival sulcus is 1.8mm
 EPITHELIUM

The gingival epithelium consists of stratified squamous epithelium. The principal cell type of the gingival
epithelium is keratinocyte and the other cells are langerhans cells ,melanocytes ,Merkel cells. The different
areas are

1.Oral epithelium
2.Sulcular epithelium
3.Junctional epithelium
 ORAL EPITHELIUM

The oral or outer epithelium covers the crest and outer surface of the marginal gingiva and the surface of
the attached gingiva .
Oral epithelium is 0.2-0.3mm in thickness
It is keratinized or parakeratinized .
It is composed of 4 layers-stratum basale ,stratum spinosum ,stratum granulosum,and stratum corneum
Stratum basale
Cells in the basal layer :single layer of cuboidal to columnar
Their nuclei are round to ovoid
Situated away from the basement membrane

Stratum spinosum
Large polyhedral cells
Short cytoplasmic processes resembling spines
Prickly appearance
Desmosomes located between the cytoplasmic processes of adjacent cells

Stratum granulosum
Flatter and wider cells larger than spinous cell layer
Cells contain Small granules that stain Immensely with hematoxylin
Stratum corneum
Surface layer
Composed of very flat cells
Eosinophilic, do not contain any nuclei
This pattern of maturation is called orthokeratinization
 SULCULAR EPITHELIUM

Sulcular epithelium lines the gingival sulcus.

It is thin ,non keratinized stratified squamous epithelium without rete pegs and it extends from the coronal
limit of the functional epithelium to the crest of gingival margin
The sulcular epithelium is extremely important,it may act as a semipermeable membrane through which
injurious bacterial products pass into the gingiva and through which the tissue fluids from the gingiva
seeps into the sulcus
 JUNCTIONAL EPITHELIUM
The junctional epithelium consists of a collar like band of stratified squamous nonkeratinizing epithelium.

It is 3-4 layers thick in early life ,but the number of layers increase with age to 10 or even 20 layers

The junctional epithelium is formed by the confluence of the oral epithelium and reduce d enamel epithelium during tooth eruption

The junctional epithelium is attached to the tooth surface by means of an internal basal lamina .it is attached to the gingival connective tissue by an external basal
lamina

Functions of junctional epithelium

1.Acts as a barrier
2.Allows GCF flow
3.Has rapid turnover rate
4.Provide attachment to the tooth
5.Secretes antimicrobial peptides
GINGIVAL CONNECTIVE TISSUE
The major components of the gingival connective tissues are collagen fibers (60%), Fibroblasts (5%),
vessels, nerves, and matrix.
The connective tissue of the gingiva is known as lamina propria and contains 2 layers –papillary layer and
reticular layer
Connective tissue has a cellular compartment and extracellular compartment composed of fibers and
ground substance. Ground substance consists of proteoglycans and glycoproteins
GINGIVAL FIBERS
The connective tissue of the marginal gingiva is collagenous and it contains collagen fiber bundles called
gingival fibers .These fibers consists of type 1 collagen

Principle group of fibers

1.Dento-gingival fibers
2.Alveolo-gingival fibers
3.Dento –periosteal fibers
4.Circular fibers
5.trans-septal fibers
BLOOD, LYMPHATIC AND NERVE SUPPLY

Blood supply
Three major sources of blood supply to the gingiva are
1.Supraperiosteal arterioles
2.Vessels of periodontal ligament
3.Arterioles emerging from the crest of the inter-dental septa
Lymphatic drainage
Lymphatic drainage of the gingiva brings in the Lymphatics of connective tissue papilla .it progresses to the periosteum of the alveolar
process and then to regional lymph nodes
Nerve supply
Nerve supply to gingiva is derived from fibers arising from nerves in the PDL and from labial, buccal and palatal nerves
REFERENCE
Newmann and caranza clinical periodontology (Third south asia edition)