Macroscopic and Microscopic features of gingiva with complete picture of histological variations - Dr Harshavardhan Patwal

1. Presented by ,
Dr Harshavardhan Patwal

3. OMM consist of 3 zones:
a.Masticatory mucosa-25%
b.Specialized mucosa-15%
c. Lining mucosa-60%

4. DEFINITION: It is that part of the oral mucous membrane that
covers the alveolar process and the cervical portions of the
teeth.
CLINICAL FEATURES:
gingiva is anatomically
divided into:
a.Marginal gingiva
b.Attached gingiva
c.Interdental gingiva

5. INTERDENTAL GINGIVA
Interdental
gingiva

6. Gingiva is histologically divided into:
Epithelium
Connective tissue

7.  Various portions are seen to orginate from distinct
portions of odontogenic sequence and developing
oral mucosal tissues.
 Non-keratinized junctional epi Enamel organ.
 Non- keratinized sulcular epithelium & keratinized
gingival epi oral mucosa.

8.  PROTECTIVE BARRIER.
 FORMS AN ATTACHMENT APPARATUS TO THE TOOTH SURFACE.
 BIDIRECTIONAL MOVEMENT OF SUBSTANCES.
 CAPABLE OF REACTING TO EXTERNAL STIMULI.
 PRODUCES POTENT ANTIMICROBIAL PEPTIDES
gingival epithelium is an
important initiator, mediator,
regulator of host responses..

9. 3 DIFFERENT FORMS OF STRATIFIED SQUAMOUS EPITHELIA
ARE:
a. Orthokeratinized epithelium
b. Non-keratinized epithelium
c. Parakeratinized epithelum
2 MOST IMPORTANT PROCESS RESPONSIBLE FOR
FORMATION OF SUPERFICIAL LAYER OF EPITHELIUM
ARE:
 Epithelial proliferation.
 Epithelial maturation.
Maturation in the oral cavity follows two main pattern:
 Keratinization(Cornification).
 Non-keratinization.

10. DEPENDING ON THE LOCATION OF GINGIVAL EPITHELIUM
Oral or outer epithelium
Sulcular epithelium
Junctional epithelium

11.  covers the crest and outer surface of marginal gingiva and
surface of attached gingiva.
 0.2-0.3mm in thickness.
 Either keratinized or parakeratinized.
Keratinized epithelim shows 4 distinct layers-
- Stratum Basale
- Stratum Spinosum
- Stratum Granulosum
- Stratum Corneum

13. Keratinised epithelium non-keratinised epithelium

14. SULCULAR EPITHELIUM
lines the gingival sulcus.
 thin, non-keratinized stratified squamous epithelium without
rete pegs.
Extends from the coronal limit of the junctional epithelium to the
crest of gingival margin.
JUNCTIONAL EPITHELIUM
 consist of a collar like band of stratified squamous Non-
keratinizing epithelium.
 It is formed by the confluence of oral epithelium and reduced
enamel epithelium.
Dentogingival unit: Junctional epithelium along with gingival
fibres forms the dentogingival unit.

16.  Tonofilaments and Desmosomes are what distinguishes them as
epithelial cell.
 Tonofilaments- fibrous proteins, synthesized by ribosomes, appr
8nm, chemically they represent a class of intercellular proteins
known as Cytokeratins.
Keratins-are a family of related proteins that are the predominant
cytoskeletal proteins in all epithelia.
C1, C2, C10, C11, C12- seen in most keratinized epithelia.
C5-C14- Stratification specific cytokeratins.
C6-C16- Highly proliferative epithelium.
C4-C13- Eosophageal type Cytokeratin.
C19- Non-keratinized, Parakeratinized.
 An important property of the epithelium is its ability to function
as a barrier, and this depends on its cohsiveness.
 Cohisiveness is provided through-viscous intercellular material,
Desmosomes, Hemidesmosomes, Tonofilaments.

17. DESMOSOME

18. HEMIDESMOSOMES
GAP AND TIGHT
JUNCTIONS

19.  Melanocytes
Merkels cells
Inflammatory cells
Langerhans cells

21.  The connective tissue supporting the oral epithelium is termed Lamina
propria.
Divided into
•The superficial papillary-Collagen fibres are loosely
arranged.
•The deeper reticular layer
 Lamina propria consist of cells, Blood vessels,
neural elements, fibres embedded in Ground
substance (matrix).

22. o Fibroblasts.
o Macrophages.
 Melanophage
 Siderophage
o Mast cells.
o Inflammatory cells
 PMNs
 Lymphocytes
 Plasma cells

23.  Collagen fibres.
 Reticulin Fibres.
 Oxytalan Fibres.
 Elastic Fibres

25.  Main constituent of connective tissue matrix are
protein carbohydrate macromolecules.
 They are divided as Proteoglycans and
Glycoproteins.

26. •Coral pink/pigmentation.
• Knife -like margin.
• Papilla fill to contacts.
•Firm and resilient.
•Attached gingiva stippled.
•Free gingival margin 1-3mm coronal
to CEJ.
• Scalloped to follow bone contours.

27. Color:

28. Size:
Size –can change with increase in connective tissue
and/or inflammatory components

29. Contour:
Contour maybe related to the tooth positioning

30. Shape- Correlated with the shape of the teeth and
contacts/embrasures

31. Consistency-Firm,resilient
and bound to the bone.
 Surface texture-Attached
gingiva is stippled (orange
peel appearance).This is due
to the normal
protruberances and
depression in the gingiva.
 Position-Level at which
gingiva is attached to the
tooth.Changes as the teeth
erupts.
Elevations and depressions are
responsible for stippled
appearence

32. Active- Coronal movement of the teeth.
Passive- Apical migration of gingiva

33. Thank
you