Chapter 10- Gingival and Dentogingival Junctional Tissue- Orofacial Anatomy

Test 2

Gingival Tissue

Gingival Tissue

-Most important tissue of the orofacial region for the dental professional to know and understand

Healthy gingiva is a

healthy barrier

non-healthy gingiva

gateway for periodontal disease

Attached gingiva

masticatory mucosa

appears healthy and pink, firm, immobile, stippled when dried

anterior region of attached gingiva

maxillary incisor region= 3.5 to 4.5mm (greatest)

mandibular incisor region= 3.3 to 3.9mm

posterior region of attached gingiva

maxillary posterior quadrants= 1.9mm

mandibular 1st premolars= 1.8mm (narrowest, recession the worst here)

marginal gingiva, or free gingiva

at the gingival margin of each tooth; scalloped

translucent, lacks stippling, mobile, pink, dull, firm

free gingival crest

most coronal part (closest to crown of the tooth)

free gingival groove

slight depression that separates the attached gingiva from the marginal gingiva

masticatory mucosa is mainly what keratinized tissue

orthokeratinized

free gingival groove like

crest of wave over teeth

interdental papilla, gingiva

an extension of the attached gingiva

fills in the area between teeth apical to their contact areas to prevent food impaction

interdental papilla shape for anterior teeth

conical shape

interdental papilla shape for posterior teeth

blunted shape buccolingually

gingival col

a non-visible concave shape of tissue between the facial and lingual gingival surfaces

gingival col only see

on M and D, only when spacing or EXT area

gingival col

mainly present on posterior tooth; anterior very narrow

thin-covered by non-keratinized marginal gingiva

labial and facial papilla meet at

gingiva col

col is more susceptible to

periodontal disease

optimal smile line clinical appearance

should reveal the least amount of maxillary facial gingival tissue as possible under the lip line

gummy smile

excessive display of maxillary facial gingiva tissue

what causes gummy smile

abnormal eruption, excessive tissue, lip muscles could be hyperactive, excessive protrusion of the maxillae, erupt too far

sulcular epithelium

stands away from the tooth, goes all the way around

creates a gingival sulcus that is filled with gingival crevicular fluid

GCF

gingival crevicular fluid

GCF

minimal of these in healthy state

from the blood supply of lamina propria

keep col healthy

have WBCs and immunoglobulins

induces inflammatory responses

passes into oral cavity to mix with saliva

immunoglobulins

G, M, A, keep col healthy

when inflammatory responses or gingivitis, what happens

more GCF present to fight inflammation

junctional epithelium

deeper extension of sulcular epithelium

lines the floor of the gingival sulcus

attached to the tooth surface by way of the epithelial attachment (EA)

Junctional epithelium can be attached to

enamel, cementum, or dentin

when probing the junctional epithelium, what stops the probe?

the epithelial attachment

sulcular epithelium

consists of stratified squamous epithelial

nonkeratinized

cells tightly packed

histology of junctional epithelium

smooth

cells loosely packed with intercellular spaces allowing permeability of WBCs

more permeable than other gingival tissue

thinner than sulcular epithelium

GCFs moves in here

Junctional epithelium has

15-30 cells thick at floor

3-4 cells thin at apical part

healthy gingival sulcus

gingival sulcus measured with

probe

variations of gingival sulcus

pressure, readings, ability to penetrate tissue

JE is formed as

root is formed

takes 3-4 years for

definitive JE to completely form, no root yet

Erupt, but has no floor, then

3-4 years later the full tooth is formed

with active periodontal disease

marginal gingiva, attached gingiva, and interdental papilla can become enlarge (blows up)

gingiva enlarges (edema)

due to infection

gingival tissue becomes _____ with perio

red, increased blood flow

stippling may be lost

margin becomes closer to the crown of the tooth

width of gingiva decreases

with gingival recession

can occur WITH OR WITHOUT perio disease

gingival margins becomes more apical, closer to the apex of the tooth

how does gingival recession occur

perio disease, tooth position, abrasion, abfraction, aging process, tight lingual attachments

gingival hyperplasia

high overgrowth

overgrowth of the interproximal gingiva resulting from drugs for seizure control

can have with or without perio

gingivitis

when damaging agents from biofilm and toxins enter the JE

signs and symptoms of gingivitis

acute or chronic inflammation and edema

increased # of WBCs

epithelial ulceration with tissue thinning

number 1 sign of gingivitis

BLEEDING

Bleeding on Probing (BoP)

early gingivitis, due to perio probe damaging blood vessels in the capillary plexus of the lmaina propria

periodontitis

advanced gingivitis with BONE LOSS

increase in amount of GCF in order to fight microbial attack

EA loss

tooth loss

periodontal pocket