Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
Periodontium (2) – Gingiva
Microscopic features of gingiva
• The gingiva consists of a central core of connective tissue covered by stratified
squamous epithelium.
• Gingival Epithelium: Although it constitutes a continuous lining of stratified
squamous epithelium, three different areas can be defined from the morphologic and
functional points of view:
The oral or outer epithelium.
Sulcular epithelium
Junctional epithelium.
Oral or outer epithelium
1- The oral or outer epithelium covers the crest and outer surface of the marginal gingiva
and the surface of the attached gingiva.
2- It is keratinized or para-keratinized ( most prevalent) or presents various
combinations of these conditions. The surface is para-keratinized.
Sulcular epithelium
1- The sulcular epithelium lines the gingival sulcus.
2- It is a thin, non-keratinized stratified squamous
epithelium without rete pegs.
3- It extends from the coronal limit of the junctional
epithelium to the crest of the gingival margin.
- As with other non-keratinized epithelia, it lacks
stratum granulosum and corneum and normally does
not contain merkel cells.
- Despite these morphologic and chemical
characteristics, the sulcular epithelium has the
potential to keratinize if:
(1) It is reflected and exposed to the oral cavity.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
(2) The bacterial flora of the sulcus is totally eliminated.
The sulcular epithelium is extremely important because it may act as a semi-
permeable membrane through which injurious bacterial products pass into the
gingiva and tissue fluid from the gingiva seeps into the sulcus.
JUNCTIONAL EPITHELIUM
1- The junctional epithelium consists of a collar-like band of stratified squamous non-
keratinizing epithelium. 2-It is three to four layers thick in early life, but the number
of layers increases with age to 10 or even 20 layers.
3-The length of the junctional epithelium ranges from 0.25 to1.35 mm.
4- The junctional epithelium is attached to the tooth surface (epithelial attachment)
by means of an internal basal lamina and to the gingival connective tissue by an
external basal lamina.
5- Also, The junctional epithelium attaches to afibrillar cementum present on the
crown (usually restricted to an area within 1 mm of the cemento-enamel junction) and
root cementum.
Cells of gingival
Keratinocytes
epithelium
Melanocytes
Langerhans cells
Non-
Keratinocytes Merkel cells
Cells of gingival epithelium
1- Keratinocytes:
They are the principal cell type of the gingival epithelium, they constitute 90% of
gingival epithelial cells.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
2- Non-Keratinocytes (Clear cells)
A-Melanocytes:
They are dendritic cells located in the basal and spinous layers of the gingival
epithelium. They synthesize melanin in organelles called melanosomes. Melanin
granules are phagocytosed and contained within other cells of the epithelium and
connective tissue, called melanophages or melanophores.
B- Langerhans cells:
1- They are dendritic cells located among keratinocytes at all supra-basal levels.
2-They belong to the mononuclear phagocyte system as modified monocytes derived from the
bone marrow.
3- Langerhans cells have an important role in the immune reaction as antigen-presenting
cells for lymphocytes.
4- They are found in oral epithelium of normal gingiva and in smaller amounts in the sulcular
epithelium; they are probably absent from the junctional epithelium of normal gingiva.
C- Merkel cells
They are located in the deeper layers of the epithelium, harbor nerve endings, and are
connected to adjacent cells by desmosomes. They have been identified as tactile perceptors.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
The Gingival Sulcus
The gingival sulcus is the shallow, V-shaped space or
groove between the tooth and gingiva that encircles
the crown. It is lined by sulcular epithelium. The
depth of the sulcus is bounded apically by the gingival
fibers of the connective tissue attachment and
coronally by the free gingival margin. The probing of
normal gingival sulcus is between 0 – 3 mm. The
gingival crevicular fluid (GCF) is a serum transudate
that contains microbial and host products that arise
as a result of the current inflammatory host–biofilm
interaction. It contains a fluid that seeps into it from
the gingival connective tissue through the thin sulcular epithelium.
Functions of the gingival crevicular fluid
Washing of the materials from the gingival sulcus by flushing action.
Its plasma proteins improve epithelial adhesion to teeth.
Has defensive mechanism by its immunoglobulins.
Has an antibacterial effect on oral micro-organisms.
Has essential growth factors for many micro-organisms.
Methods of collection of GCF
1- Absorbing paper strips which can be placed within the sulcus or at its entrance
2- Twisted threads placed around and into the sulcus which were placed in the
gingival crevice around the tooth, and the amount of fluid collected was estimated by
weighing the sample thread.
3- Micropipette which permits the collection of fluid by capillarity. Capillary tubes
of standardized length and diameter are placed in the pocket, and their content is
later centrifuged and analyzed.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
(a) (b) (c)
(a) Positioning of paper strip overlying the tooth, gingiva, and alveolar mucosa for obtaining GCF at P1A
(alveolar mucosa) and P1B (gingival margin); (b) positioning of paper strip at gingival margin without
penetrating gingival sulcus-P2; (c) positioning of paper strip into gingival sulcus.
Measurement of the amount GCF
Staining methods
Electronic methods by a device called the
periotron
Gingival Connective Tissue
The connective tissue of the gingiva is known as the lamina propria which is a thin
layer of loose connective tissue which lies beneath the epithelium and together with
the epithelium constitutes the mucosa and consists of two layers:
Papillary layer subjacent to the epithelium, which consists of
papillary projections between the epithelial rete pegs.
Reticular layer contiguous with the periosteum of the alveolar
bone.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
Functions of lamina propria
Hydration and nutrition of epithelium via its extensive blood supply.
Anchoring epithelium by fibrils attached to basement membrane.
Differentiation to other cells such as fibroblasts by its stem cells.
The ability for regeneration and repair after periodontal surgery through
granulation tissue.
Collagen
Cellular Fibers Elastic
Components of
connective tissue
Extracellular Reticular
Ground
Proteoglycans
substances
-Collagen fibers forms the bulk of the lamina propria and provides the tensile
strength to the gingival tissue
- The elastic fiber system is composed mainly of oxytalan. It is distributed among
collagen fibers.
Gingival fibers
The dense collagen bundles of the gingiva, sometimes referred to as the
gingival ligament, is divided into two main groups
1- Principal fibers: 2- Secondary fibers
1- Principal gingival fibers
a- Dentogingival group: extends from the cervical part of the cementum to I the
lamina propria of the gingiva and constitutes the roost numerous group of fibers.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
b-Alveogingival group arises from the alveolar crest and extend into the lamina
propria.
c-Dento-periosteal group extends from the
cemenfum into the periosteum of the alveolar
crest and the periosteum of the facial and lingua/
surfaces of the alveolar bone.
d-Circular group: a small group of fibers that
forms a band around the neck of the tooth
interlacing with other groups of fibers in the free
gingiva, binding it to the tooth surface.
e-Transseptal fibers: extend interproximally
over the alveolar bone crest and are embedded in
the cementum of adjacent teeth; they form an
interdental ligament. These fibers keep all the
teeth aligned. These fibers may be considered as
belonging to the gingiva because they don't have
osseous attachment.
2-Secondary gingival fibers:
Semi-circular, Inter-circular, Inter-papillary, Inter-gingival, Trans-gingival and
Periosteo-gingival.
Cells of gingival connective tissues
1- Fibroblasts: The predominant cells in the gingival connective tissue. They are
found between the fiber bundles. Fibroblasts synthesize collagen and elastic fibers as
well as the glycoproteins and glycosaminoglycans of the intercellular substance.
Fibroblasts also regulate collagen degradation.
2- Mast cells: which are distributed throughout the body and numerous in the
connective tissue of the oral mucosa and the gingiva.
3- Macrophages and histiocytes are present as components of the mononuclear
phagocyte system and are derived from blood monocytes.
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Periodontium (2) – Gingiva وضاح عبد الناصر نعمان الحاج/د
4- Inflammatory cells: Lymphocytes, plasma cells, neutrophils and eosinophils
usually are present in small amounts in clinically normal gingiva, but they are not
normal components of the gingiva. They are important in the host defense
mechanism.
Blood supply of the gingiva
- The main blood supply of the gingiva is performed by interdental arteries from
alveolar bone through the zuckerkandel and Hirschfeld canals.
- Also superficial branches from the lingual, mental and palatine arteries.
Lymphatic drainage of the gingiva
They accompany blood vessels and drain mainly into and mandibular lymph nodes
except:
1- The palatal gingiva is drained into deep cervical lymph nodes.
2- Third molar are drained into jugulo-diagestric lymph nodes.
3- The labial and lingual gingiva of the mandibular incisor region is drained to the
sub-mental lymph nodes
The nerve supply
The gingiva is well innervates through branches
from inferior and superior alveolar nerve,
nasopalatine and greater palatine nerves.
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