The gingiva (sing. and plur.: gingiva), or gums, consists of the
mucosal tissue that lays over the alveolar
bone.
General Description
Gingiva are part of the soft tissue lining of the mouth. They surround the teeth and provide a seal around them. Compared with
the soft tissue linings of the lips and cheeks, most of the gingiva are tightly bound to the underlying bone and are designed to
resist the friction of food passing over them. Healthy gingiva is usually coral pink, but may contain physiologic pigmentation.
Changes in color, particularly increased redness, together with edema and an increased tendency to
bleed, suggest an inflammation that is possibly due to the accumulation of bacterial plaque.
A diagram of the periodontium. A,
crown of the
tooth,
covered by
enamel. B, root of the tooth, covered by
cementum. C,
alveolar bone. D, subepithelial
connective tissue. E,
oral epithelium. F,
free gingival margin. G, gingival sulcus. H,
principle gingival fibers. I, alveolar crest fibers of the
PDL. J, horizontal fibers of the PDL. K, oblique fibers of the PDL.
Subdivisions of Gingiva
The gingiva is divided anatomically into marginal, attached and interdental areas.
Marginal Gingiva
The marginal gingiva is the terminal edge of gingiva surrounding the teeth in collar like fashion. In about 50% of
individuals, it is demarcated from the adjacent, attached gingiva by a shallow linear depression, the free gingival groove.
Usually about 1 mm wide, it forms the soft tissue wall of the gingival sulcus. The marginal
gingiva is supported and stabilized by the gingival fibers.
Attached Gingiva
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, from which it is demarcated by the mucogingival junction. Attached gingiva
may present with surface stippling.
Interdental Gingiva
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 have a "col" shape.
Diseases of the Gingiva
The gingival cavity microecosystem, fueled by food residues and saliva, can support
the growth of many microorganisms, of which some can be injurious to health. Improper or insufficient oral hygiene can thus lead to many gingival and periodontal disorders, including gingivitis or pyorrhea, which are major causes for tooth failure.
Recent studies have also shown that Anabolic steroids are also closely associated with
gingival enlargement requiring a gingivectomy for many cases.[1]
Characteristics of Healthy Gingiva
Colour
Healthy gingiva usually has a colour that has been described as "coral pink." Other colours like red, white, and blue can
signify inflammation (gingivitis) or pathology. Although the text book color of gingiva is
"coral pink", normal racial pigmentation makes the gingiva appear darker. Because the color of gingiva varies due to racial
pigmentation, uniformity of colour is more important than the underlying color itself.
Contour
Healthy gingiva has a smooth arcuate or scalloped appearance around each tooth. Healthy
gingiva fills and fits each interdental space, unlike the swollen gingiva papilla seen in gingivitis or the empty interdental
embrasure seen in periodontal disease. Healthy gums hold tight to each tooth in
that the gingival surface narrows to a "knife-edge" thins at the free gingival
margin. On the other hand, inflamed gums have a "puffy" or "rolled" margin.
Texture
Healthy gingiva has a firm texture that is resistant to movement, and the surface texture often exhibits surface stippling. Unhealthy gingiva, on the other hand, is often swollen and mushy.
Reaction to Disturbance
Healthy gums usually have no reaction to normal disturbance such as brushing or periodontal probing. Unhealthy gums on the
other hand will show bleeding on probing (BOP) and/or
purulent exudate (pus).
Additional images
See also
Sources
- Willmann, Donald. PERI 5081 - Freshman Periodontics. UTHSCSA, 2006. 2.3.1
External links
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