The Gingiva
Dr /Abdel-latif Galal
Lecturer of oral Medicine&
Periodontology
Masticatory mucosa:
Masticatory mucosa covers the gingiva and hard palate.
Gingiva or Gum :
• Thick (250µm) keratinized epithelium (either orthokeratinized or
parakeratinzed) with no submucosa.
• It extends from dentinogingival junction to the alveolar mucosa.
Gingiva clinically can be classified into 3 parts:
Free gingiva, attached gingiva and interdental papilla.
Free gingiva (unattached or marginal gingiva)
• It is that part of the oral mucosa that
surrounds the necks of the teeth. It is
differentiated apically from the attached gingival by
the free gingival groove.
• The inner side of it forms the gingival sulcus
• The free gingival mucosa is composed of
stratified squamous epithelium that may be
keratinized, or parakeratinzed
Attached gingiva
• It’s firm , resilient and tightly bound to
underlying periosteum of alveolar bone.
• The attached gingiva lies between the free
gingival groove and the alveolar mucosa.
• The junction of the attached gingiva and the
alveolar mucosa is called mucogingival junction.
• The color of the marginal and attached
gingiva is generally described as "coral
pink“.
• In healthy mouth attached gingiva shows
stippling (orange-peel appearance)
(depression & elevation which
correspond to epithelium ridges &
connective tissue papilla)
Interdental papilla
• It’s occupies the gingival embrasure (which is
the interproximal space between two adjacent
teeth).
• It’s surface is triangular in 3 dimension
• The color of the gingiva is generally coral pink
but it becomes red in inflammation, sometimes
it’s brown because of increase melanin
pigmentation.
Gingival Epithelium
• Stratified squamous epithelium:
• oral or outer epithelium
• sulcular epithelium
• junctional epithelium /epithelial
attachment.
Oral or Outer Epithelium
• The oral or outer epithelium covers the
crest and outer surface of the marginal
gingiva and the surface of the attached
gingiva.
• It is keratinized or parakeratinized
Gingival sulcus
• Is a groove developed between the tooth surface
and the free gingiva.
• It is lined with epithelium of non keratinized type
Called sulcular epithelium.
• Extends from free gingival margin to the
junctional epithelium.
• Gingival sulcus has a depth 0.5 – 3 mm; any depth
greater than 3 mm can be considered a pathologic
state ( periodontal pocket ).
Sulcular epithelium
• The sulcular epithelium lines the gingival sulcus .
• It is a thin, nonkeratinized, stratified squamous epithelium without rete pegs
and extends from the coronal limit of the junctional epithelium to the crest of
the gingival margin .
• The sulcular epithelium good resistance to mechanical forces and
impermeability to fluid and cells.
Junctional epithelium:
• The epithelium that attaches the gingiva to the
surface of the tooth. It forms the base of the sulcus
• Stratified squamous non-keratinizing epithelium ; 3-
4 layers thick in early life, but with age to 10-20
layers.
• More permeable than sulcular epithelium
• The attachment of the JE to the tooth is
reinforced by the gingival fibers; hence, the JE and
the gingival fibers are considered a functional
unit, referred to as the dentogingival unit.
• Junctional epithelium is firmly attached to the tooth surface, forming an
epithelial barrier against plaque bacteria.
• Disturbances of epithelial attachment results in deepening of the sulcus which
is a sign of gingival/periodontal disease
The gingiva
Types of cells in the oral epithelium:
1 Keratinocytes cell
It is the principal cell type of oral epithelium
comprises about 90% of the total cell population,
responsible for the production to of keratin which
contributes the protective function of the
epithelium.
The gingiva
Types of cells in the oral epithelium
2
Melanocyte cells
Responsible for the production of melanin
pigment and can be found in the basal cell layer.
Langerhans cell
They play a role in defense mechanism of the
oral epithelium. They have an immunological
function by recognizing and processing antigens.
The gingiva
Types of cells in the oral epithelium
Merkel cells
They are located in the deeper layers of
epithelium, they have nerve ending and have
been identified as tactile receptors.
The gingival connective tissue (CT)
Cells of the connective tissue
▪Fibroblast: the most predominant cells of the
CT (65%). They synthesize collagen, elastic
fibers and the connective tissue matrix,
and they regulate collagen degradation.
▪Mast cells: it is responsible for the
production of certain components of the
matrix, and they produce vasoactive
substances which may control the flow of
blood through the tissue.
▪Macrophages: They have a phagocytic action
and involved in the defense mechanism.
The gingival connective tissue (CT)
The connective tissue fibers:
(which are formed by the fibroblasts cells).
▪Collagen fibers: which is the most
predominant type of fibers
▪Reticulin fibers
▪Oxytalan fibers
▪Elastin fibers
The functions of gingival fibers
[Link] braces the marginal gingiva firmly against the
tooth.
2. It helps to withstand the forces exerted by
mastication
The gingival connective tissue (CT)
The arrangement of the gingival fibers is
described as principal group fibers which are:
1. Dentogingival fibers: they project from the
cementum in a fan- like conformation
towards the crest and outer surface of the
marginal gingiva. They provide support to the
gingiva by attaching it to the tooth.
2. Alveolar gingival fibers: they extend from
the periosteum of the alveolar crest coronally
into the lamina propria. Their function is to
attach the gingiva to the alveolar bone
3. Dentoperiosteal fibers: they arise from
the cementum near the cementoenamel
junction and insert into the periosteum of the
alveolar bone and protect the periodontal
ligament.
4. Circular fibers: they surround the tooth in a
ring like fashion and course through the
connective tissue of the marginal and
attached gingiva
5. Trans-septal fibers: they are located
interproximally, they extend from cementum
of one tooth to the cementum of
neighboring tooth. They protect the
interproximal bone and maintain tooth to
tooth contact.