Though scientific evidence is equivocal at this point,most of us would agree that its better to have at least 3 mm of keratinized tissue around implant restorations. On attached gingiva is part of the desna river, which is closely linked with cement cervical third root and periosteum connective tissue cover alveolar bone. Periodontal anatomy dental hygiene denhyg 1114 with. The thickness of the attached gingiva significantly decreased with age for both the arches p 1 the gingiva and perio ligament flashcards from sara g. Inserted into the alveolar periosteum and splay out into the attached gingiva. Width of attached gingiva on attached gingiva is the largest in the incisors and indigenous areas ranging from 3. The marginal gingiva is stabilized by the gingival fibers that have no bony support.
The attached gingiva is continuous with the oral epithelium of the free gingiva and is firmly bound to the underlying periosteum of the alveolar bone. The width of attached gingiva can vary dramatically between patients and within an individuals mouth, from as. Lower pm lingual, then lower incisors, facial thickest. Pdf gingival crevicular fluid composition and clinical. The anatomy and physiology of the healthy periodontium. When your image is fully attached to the cover of your composition book you can use an exacto knife to tidy up the edges. Gcf is an exudate of varying composition found in the sulcusperiodontal pocket. Can be separated form the tooth by a probe depth of gingival sulcus crevice. Attached gingiva article about attached gingiva by the. The gingival margin, or free gingival crest, at the most superficial part of the marginal gingiva, is also easily seen clinically, and its location should be recorded on a patients chart. Attached gingival tissue is primarily composed of quizzn. Study 43 periodontal anatomy flashcards from emily g.
Anatomy learning strategies free ebook labeling diagrams flashcard. The gingiva is composed of mucosa that is designed for chewing. Reduced width of attached gingiva can be corrected with mucogingival surgeries. The enlargement affects the attached gingiva, as well as gingival margin and interdental papillae in contrast to druginduced overgrowth, which is often limited to gingival margin and interdental papillae. The gingiva is composed of fibrous tissue covered by mucous membrane that is firmly attached to the periosteum of the alveolar processes of the mandible and maxilla. The amount of attached gingiva is considered insufficient when stretching the lip or cheek induces movement of the free gingival margin. Gum, also called gingiva, plural gingivae, in anatomy, connective tissue covered with mucous membrane, attached to and surrounding the necks of the teeth and adjacent alveolar bone. Depresson that separates free and attached gingiva free gingival line. Position of gingival margin and junctional epithelium. Cosmetic repair of recession and inadequate attached gingiva. The width of the attached gingiva varies in different areas of the mouth.
Gums, also called gingiva, are the fleshy, pink connective tissue thats attached to the neck of the tooth and the cementum. On the palate, the whole mucosa is keratinised and there is. On attached gingiva lies between the free gum and mucous alveolar ridge fig. Attached gingiva is a part of keratinized gingiva which aids in increase resistance to external injury and contribute in stabilization of gingival margin.
The colgate periodontal education program gingival. It is firm, dense, sometimes stippled, and tightly bound down to the underlying periosteum, tooth and bone. Gingival attachment definition of gingival attachment by. Attached gingival tissue is primarily composed of the inflammatory response in periodontal pathology is caused by bacterial products from plaque which 1. Variations exist in the width of the attached gingiva reported in the literature. This article will highlight the two main types of gingiva. Orban first described the term attached gingiva as that part of the gingiva that is firmly attached to the underlying tooth and bone and is stippled on the surface. It is the part of gingiva that fills the area between two adjacent teeth apical to the contact area. In lightskinned individuals the gingiva can be readily distinguished from the adjacent dark red alveolar mucosa by its lighter pink color. The role of keratinized tissue and attached gingiva in. The interdental papillae are pyramidal in shape and occupy the interdental spaces beneath the contact points of the teeth.
The attached gums are continuous with the marginal gum. Attached gingiva extends from the fgg to the mucogingival junction mgj attached gingiva. Position of the gingival margin and junctional epithelium the position of the gingival margin and junctional epithelium is influenced by the enlargement or recession of gingiva or by the apical migration of the junctional epithelium along the root surface gingival margin the gingival margin is 12 mm above the cej gingival margin at the enamel contour, junctional epithelium at the cej. Before the erupting teeth enter the mouth cavity, gum pads develop. The width of attached gingiva varies in different areas of the mouth and have been given a range of 19 mm, 14 mm, 05 mm. The width of attached gingiva varies in different areas of the mouth and have been given a range of 19 mm, 14 mm, 0g5 mm. From gingival margin to the free gingival groove fgg at the level of the cej. Attached gingiva and its significance linkedin slideshare. The periodontium is composed of four different tissue types, the gingiva, alveolar bone, cementum, and periodontal ligament, that vary in cellular composition, types, and amounts of proteins. Mead composition book, wide ruled, 100 sheets, 9 34 x 7 12, black marble 72936 average rating. Epithelial attachment an overview sciencedirect topics. Essentials of clinical periodontology and periodontics slideshare.
The gingiva is pink, firm in texture and extends from the free gingival margin to the mucogingival line. The way of periodontist is hard and the book will reflect the difficulty of that path. The simplest and most conservative treatment that has worked for me in the past to gain more buccal attached gingiva on the maxilla is to make a flap incision more palatal from where the implant is and displace it bucally. Vestibuloplasty is a preprosthetic surgical technique that has been developed to rebuild a sufficient vestibular depth by reducing the high muscle tensions that are streching to the maxillary or mandibular sides 3,4. The attached gingiva is an important anatomical component of the periodontium with clinical implications. Chapterchapter2 biology of periodontal tissues the gingiva macroscopic features microscopic features. It extends from the base of the free gingiva to the mucogingival junction figure 1. Dissipating physiological forces exerted by the muscular fibers of the alveolar mucosa on the gingival tissues. In the present study, the range of the mean width of attached gingiva varied from 1 mm to 4 mm. The attached gingiva is tightly adherent to the subgingival connective tissue and bone via deep rete pegs.
Histologic comparison of keratinized attached gingiva and nonkeratinized alveolar mucosa shows that attached gingiva is keratinized with thin, prominent epithelial ridges, and is firmly. The attached gingiva is continuous with the oral epithelium of the free. The basis for modern dental implants is a biologic process called osseointegration, in which materials such as titanium form an intimate. Where is the skinniestthinnest amount of attached gingiva. Different surgical approach to idiopathic gingival enlargement. Enough lingual keratinized gingiva at proposed implant site a free gingival graft is recommended on facial aspect to increase zone of keratinized tissue class 2. It pays to assess the location of the mucogingival junction prior to implant therapy in order to plan surgical approach from the decision to flap or not ive seen many who are so enamoured by the flapless technique that they. The attached gingiva on the lingual aspect of the mandible also extends from the free gingival groove to the mucogingival junction, but is continuous with the lining of the floor of the mouth. This article describes the different types of gingiva as well as covering the. Hello, i am trying to find out the answer to this question. The gingiva consists of a free gingival margin and attached gingiva. Repair of gum recession wayne nj, gum graft, gingival grafting. Gingiva is keratinised and stippling is frequently present. The gingival sulcus is a shallow crevice that is bound apically by the coronal aspect of the junctional.
The gingiva is attached in part to the cementum of the tooth and in part to the alveolar bone. The width of attached gingiva is the distance between the mucogingival junction to projection of the external surface of the bottom of the sulcus or the periodontal pocket. Gum health and disease can have an effect on general health. Molecular and cell biology of the gingiva wiley online library. Attached gingiva definition of attached gingiva by. The importance of keratinized gingiva surrounding dental. The surface of gingiva is keratinised and may exhibit an orange peel appearance, called stippling. A dental implant also known as an endosseous implant or fixture is a surgical component that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, facial prosthesis or to act as an orthodontic anchor. Attached gingiva is a part of keratinized gingiva which aids in increase resistance to external injury and contribute in stabilization of gingival.
These are found in the oral cavity or mouth of a human being surrounding part of the teeth. It is keratinised to withstand the stress of ripping and tearing food. Anatomical relationship of normal gingiva in facial view a and in crosssection b. The width of the free gingiva and the attached gingiva consists of the total width of gingiva. If the attached gingiva is too thin or inadequate, the gum may then recede during or shortly after active orthodontics. At this point you can repeat steps 4 through 6 or start new with a different image to cover the back of your composition book. This book provides dentists, dental hygienists, dental therapists and. Attached gingiva is not movable, being bound down to the bone and cementum by connective tissue fibers, making it capable of withstanding forces from toothbrushing and chewing. Gingiva article about gingiva by the free dictionary. The free gingival margin is situated about 2mm coronal to the cementoenamel junction of the tooth and the attached gingiva extends from the base of the free gingiva to the mucogingival 4 gingival diseases their aetiology, prevention and treatment.
The attached gingiva is defined as the portion of the gingivae extending from the base of the gingival crevice to the mucogingival line. The loss of the attached gingiva affects the oral health as well as the aesthetics and in addition compromises the natural support of the teeth or the dentures 1,2. Although the band of keratinized tissue and attached gingiva is determined genetically, it may be affected by the presence of plaqueassociated inflammation or by the action of certain mechanical. Gingival crevicular uid composition and clinical importance. Similar to the variations seen in bowers study, the widest zone of attached gingiva was found in the incisors and the least. Position of gingival margin and junctional epithelium a thorough examination of the gingiva includes evaluation of color, size, shape form or contour, consistency, surface texture, position of the gingival margin and junctional epithelium, mucogingival junctions, bleeding and exudate. With your book facing down on a table you can cut around the pages to get a neat and tidy edge. Keratinized gingiva surrounds the necks of the teeth and is measured from the mucogingival junction to the free gingival margin. Assessment of gingival thickness with regards to age. They consist of mucosal tissue that covers the alveolar processes of the maxilla and mandible and finish at the neck of each tooth. It is not unusual for children, sometimes as young as 6, to require gingival grafting just before they get braces. The book is usually delivered within one week anywhere in india and within three weeks. The embryonic origin, composition, and histological and clinical appearance with.
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