Clinical features of healthy gingiva

I think the topic itself is pretty self-explanatory

1. Clinical features of healthy gingiva Submitted to : department of periodontology

2. Gingiva is basically the anatomical term for the gums. found in the oral cavity (clinically) In an adult, normal gingiva covers the alveolar bone and tooth root to a level just coronal to the cej (cementoenamel junction ) The gingiva is divided anatomically into marginal, attached, and interdental areas all types are specifically structured to function appropriately against mechanical and microbial damage What is gingiva ? Marginal Interdental Attached

3. The marginal or unattached gingiva is the terminal edge or border of the gingiva that surrounds the teeth in collar like fashion The marginal gingiva is usually about 1 mm wide, and it forms the soft-tissue wall of the gingival sulcus In about 50 % of cases it is demarcated from the adjacent attached gingiva by a shallow linear depression called the free gingival groove Marginal gingiva

4. The interdental gingiva occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact The interdental gingiva can be pyramidal , or it can have a “col” shape The shape of the gingiva in a given interdental space depends on the contact point between the two adjoining teeth and the presence or absence of some degree of recession Interdental gingiva

5. The attached gingiva is continuous with the marginal gingiva It is firm, resilient, and tightly bound to the underlying periosteum of alveolar bone The facial aspect of the attached gingiva extends to the relatively loose and movable alveolar mucosa; it is demarcated by the mucogingival junction The width of the attached gingiva is another important clinical parameter The width of the attached gingiva on the facial aspect differs in different areas of the mouth.40 It is generally greatest in the incisor region (i.e., 3.5 to 4.5 mm in the maxilla, 3.3 to 3.9 mm in the mandible) and narrower in the posterior segments (i.e., 1.9 mm in the maxillary first premolars and 1.8 mm in the mandibular first premolars Attached gingiva

6. Clinically significant features of healthy gingiva color size contour consistency shape position

7. The color of the attached and marginal gingiva is generally described as “ coral pink ”; it is produced by the vascular supply, the thickness and degree of keratinization of the epithelium, and the presence of pigment-containing cells The color varies among different persons and appears to be correlated with the cutaneous pigmentation. It is lighter in blond individuals with fair complexions than in swarthy, dark-haired individuals The attached gingiva is demarcated from the adjacent alveolar mucosa on the buccal aspect by a clearly defined mucogingival line The alveolar mucosa is red, smooth, and shiny rather than pink and stippled COLOUR

8. Melanin is a non– hemoglobin-derived brown pigment with the following Characteristics : Melanin is responsible for the normal pigmentation of the skin, the gingiva, and the remainder of the oral mucous membrane Melanin is responsible for the normal pigmentation of the skin, the gingiva, and the remainder of the oral mucous membrane Melanin pigmentation in the oral cavity is prominent in black individuals Physiological pigmentation According to Dummett,73 the distribution of oral pigmentation in black individuals is as follows: gingiva, 60%; hard palate, 61%; mucous membrane, 22%; and tongue, 15%. Gingival pigmentation occurs as a diffuse, deep-purplish discoloration or as irregularly shaped brown and light-brown patches

9. The contour or shape of the gingiva varies considerably and depends on the shape of the teeth and their alignment in the arch The marginal gingiva envelops the teeth in collar like fashion and follows a scalloped outline on the facial and lingual surfaces It forms a straight line along teeth with relatively flat surfaces A thin and clear gingiva is found in one third of the population and primarily in females with slender teeth with a narrow zone of keratinized tissue, whereas a clear, thick gingiva with a broad zone of keratinized tissue is present in two thirds of the population and primarily in males contour

10. The gingiva presents a textured surface similar to that of an orange peel and is referred to as stippled Stippling is best viewed by drying the gingiva. (The attached gingiva is stippled; the marginal gingiva is not) The central portion of the interdental papillae is usually stippled, but the marginal borders are smooth Stippling is less prominent on lingual than facial surfaces and may be absent in some persons Microscopically, stippling is produced by alternate rounded protuberances and depressions in the gingival surface Stippling is a form of adaptive specialization or reinforcement for function. ( It is a feature of healthy gingiva ) and the reduction or loss of stippling is a common sign of gingival disease The surface texture of the gingiva is also related to the presence and degree of epithelial keratinization (Keratinization is considered a protective adaptation to function. It increases when the gingiva is stimulated by toothbrushing) Surface texture

11. The position of the gingiva is the level at which the gingival margin is attached to the tooth When the tooth erupts into the oral cavity, the margin and sulcus are at the tip of the crown; as eruption progresses, they are seen closer to the root. POsition

12. The shape of the interdental gingiva is governed by the contour of the proximal tooth surfaces and the location and shape of the gingival embrasures When the proximal surfaces of the crowns are relatively flat faciolingually , the roots are close together The height of the interdental gingiva varies with the location of the proximal contact. Thus, in the anterior region of the dentition, the interdental papilla is pyramidal in form, whereas the papilla is more flattened in a buccolingual direction in the molar region shape