Anatomy ,structure & function of periodontium.pptx

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1. Anatomy ,structure & function of periodontium Dr .Mohammad Eissa ahmadi

2. AGENDA Anatomy ,structure & function of periodontium Gingiva Cementum 01 03 PDL 02 Alveolar one 04

3. Periodontal tissue divided into : Gingiva Attachment apparatus Ligament periodontal Cementum ,Alveolar bone

4. Normal mucosa Masticatory Specialized Lining 00 01 02 03 gingiva, hard palate tissue mucus of dorsum of tongue Other area of oral mucosa

5. پوشاننده استخوان و جذردندان تا CEJ درکرونال 01 Gingiva

6. Gingiva is divided into : 3 parts Marginal gingiva Attached gingiva Inter dental papilla

7. 1. Marginal gingiva Gingiva Terminal edge or border of gingiva (collar) Usually about 1mm of wide In 50% cases (free gingival groove) Gingival zenith

8. Sulcus gingivalis Gingiva Shallow spaces around the tooth between …. V shape Barely permit the entrance of probe average depth 2-3mm (0mm-6mm )

9. Periodontal probes Probing depth : قطر قوه یا نیروی اندازه التهاب

10. Kinds of probes 1. Simple … straight 2. Nebers … curved

11. 2. Attached gingiva firm , resilient Continuous with FMG Width (more important in clinic ) … distance between mucogingival junction and projection on the external surface of bottom of gingival sulcus or periodontal pocket

12. Cont … Width of attached gingiva differs in different area Incisor region 3.5-4.5 mm maxilla , 3.3-3.9 mm mandible Premolar region 1.9mm maxilla ,1.8 mm mandible 4 years old & supra erupted teeth

13. 3. Interdental gingiva (papilla ) Shape : Contact point of two teeth Presence of recession If Diastema is present ….

14. stratum basalis stratum spinosum stratum granulosum stratum corneum Epithelium layers

15. Gingival epithelium (GE ) According to function… Junctional epithelium Sulcular epithelium Oral or external epithelium

16. Function of gingival epithelium … Protection (main function) Role in the change of PH

17. Covers the tip and outer surface of marginal gingiva and surface of attached gingiva parakeratinazed Keratinization degree palate>gingiva>dorsum of tongue>facial mucosa Oral or outer epithelium G .epith K & para k K1,k2,k10,k12 0.2-0.3 mm

18. Gingival epithelium 1. keratinocyte 2. Non keratinocyte (melanocyte ,langerhance , Markel)

19. Keratinization Flattening Increase of intercellular contact and gen of keratohelain In visible nucleus Ortho keratinized (no nucleus in cornum)/ para keratinized (pyknotic nucleus ) Odland bodies / keratinosome Acid phosphatase enzyme

20. Thin , non keratinized squamous epithelium , without rete pegs Cover the internal surface of gingival sulcus Sulcular epithelium G .epith Non k K1,k2,k10,k12 + k4,k13,k19 K19 = 40 KD K1= 68 KD

21. Stratified squamous nonkeratinized epithelium 3 or 4 thick layers (in early life) increase with age 10 to 20 layers Dent gingival unit (maintaining of FMG) Junctional epithelium G .epith K5,k14,k19 Turn over 1-6 day REE + OE = JE Danto gingival unit = ∑ JE + Gingival fiber

22. Continuous renewal 24 hours ( morning>night ) Inflammation Renewal of gingival epithelium

23. Gingival fluid (sulcular fluid) definition Flow : connective tissue gingival sulcus Contain… (connective tissue , epithelium , serum , and microflora)

24. Clean sulcus gingivalis Contains plasma protein Antibacterial Antibody activity Function …

25. Collagen fibers (60%) Fibroblasts (5%) Nerve & vessels Most important matrix Gingival connective tissue 35%

26. Connective tissue contain 2 layer called LAMINA PROPRIA Papillary layer Reticular layer Cont …

27. Gingival fibers Connective tissue of marginal gingiva has Collagen (type 1) Dent gingival Circular Trans gingival Semi circular Transgingival

28. Has 3 function Brace marginal gingiva to the tooth 2. Resistant against occlusal forces 3. Junction of FMG – cementum & attached .. Cont …

29. Gingivodental group Facial , lingual , interproximal from cementum to the gingiva

30. Circular group Cross from the marginal and interdental gingiva Ringlike fashion

31. Transeptal group Interproximal From tooth - tooth Lie the area of between epithelium base of gingival sulcus and alveolar crest classified with principle fiber of PDL Other 2 group Semicircular fibers (proximal --- proximal) 2. Transgingival fibers ( lat face to …)

32. Transseptal fiber

33. Repair of gingival connective tissue Because of high turnover rate no scar …

34. Blood supply, Lymphatic , Nerve Has three sources of blood supply 1.Supraperiostal arterioles 2. Vessels of PDL 3. arterioles

35. Meshwork Messiner Krause receptor Spindle shape bodies Nerve supply

36. Macroscopic feature of gingiva

37. Color Coral pink Factor affecting: Vascular supply Thickness of epithelium Degree of keratinization Pigment cell

38. Pegmentation Melanin Hard plate 61% Gingiva 60% Mucose membrane 22% Tongue 15% 3 hr after birth Repigmentation

39. Size Cellular element Intercellular elements Vesseles

40. Contour Shape of tooth Alignment of tooth Location&size of the area of proximal contact Facial and lingual embrasure Flat surface Mesio -distal concavity

41. Shape Proximal surface Location&shape of embrasure Triangular anterior teeth Squrare in posterior teeth

42. Consistency Firm and resilient Lamina propria & mucoperiosteum alveolar bone

43. Surface tissue Stippled texture Varies with age Absent in infancy Appears about 5 years Increase in adulthood Disappear in old age

44. Position Gingival margine with attached teeth 0-3mm coronal to CEJ

45. Continuing Tooth eruption Active eruption Passive eruption Active eruption is coordinated with attrition Cement and bone regenerate in apex and furcation Apical EJ &crest 1.07mm Gingival recession

46. A Picture Is Worth a Thousand Words Thanks! DO YOU HAVE ANY QUESTIONS ?