"Gums" redirects here. For other uses, see Gum (disambiguation).
| Gingiva |
|
| Cross-section of a tooth with visible gums, or gingiva |
| Gray's |
subject #242 1112 |
| MeSH |
Gingiva |
| Code |
TA A05.1.01.108
TA A03.1.03.003
TA A03.1.03.004 |
The gingiva (sing. and plur.: gingiva), or gums, consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth.
|
Contents
- 1 General description
- 2 Macroscopic features of gingiva
- 2.1 Marginal gingiva
- 2.2 Attached gingiva
- 2.3 Interdental gingiva
- 3 Diseases of the gingiva
- 4 Characteristics of healthy gingiva
- 4.1 Colour
- 4.2 Contour
- 4.3 Texture
- 4.4 Reaction to disturbance
- 5 Additional images
- 6 See also
- 7 References
- 8 External links
- 9 Further reading
|
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 which helps resist the friction of food passing over them. Healthy gingiva are 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, principal gingival fibers. I, alveolar crest fibers of the periodontal ligament (PDL). J, horizontal fibers of the PDL. K, oblique fibers of the PDL.
Macroscopic features 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 half 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 papilla can be pyramidal or have a "col" shape. Attached gingiva is resistant to masticatory forces and always keratinised.
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. Gingival recession is when there is an apical movement of the gingival margin away from the biting (occlusal) surface.[1] It may indicate an underlying inflammation such as periodontitis[2] or pyorrhea,[2] a pocket formation, dry mouth[2] or displacement of the marginal gingivae away from the tooth by mechanical (such as brushing),[2] chemical, or surgical means.[3] Gingival retraction, in turn, may expose the dental neck and leave it vulnerable to the action of external stimuli, and may cause root sensitivity.[2]
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 described as the colour coral pink, variation in colour is possible. This can be the result of factors such as: thickness and degree of keratinization of the epithelium, blood flow to the gingiva, natural pigmentation, disease and medications.[4]
Since the colour of the gingiva can vary, uniformity of colour is more important than the underlying color itself. Excess deposits of melanin can cause dark spots or patches on the gums (melanin gingival hyperpigmentation). Gum depigmentation (aka gum bleaching) is a procedure used in cosmetic dentistry to remove these discolorations.
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 "knife-edge" thin 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. Healthy gingiva has an orange-peel like texture to it.
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.
Additional images
See also
- Gum graft
- Head and neck anatomy
- Periodontitis
References
- ^ Gingival Recession - Causes and treatment JADA, Vol 138. http://jada.ada.org. Oct 2007. American Dental Association
- ^ a b c d e mexicodentaldirectory.com > dental sensitivity Retrieved on August 2010
- ^ Mondofacto medical dictionary > gingival retraction 05 Mar 2000
- ^ Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
External links
Further reading
- Willmann, Donald. PERI 5081 - Freshman Periodontics. UTHSCSA, 2006. 2.3.1
|
|
This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (December 2007) |
|
Periodontology
|
|
Tissues of the periodontium
and their physiologic entities |
- Alveolar bone
- Biologic width
- Bundle bone
- Cementum
- Free gingival margin
- Gingiva
- Gingival fibers
- Gingival sulcus
- Junctional epithelium
- Mucogingival junction
- Periodontal ligament
- Sulcular epithelium
- Stippling
|
|
| Diagnoses |
- Chronic periodontitis
- Localized aggressive periodontitis
- Generalized aggressive periodontitis
- Periodontitis as a manifestation of systemic disease
- Necrotizing periodontal diseases
- Abscesses of the periodontium
- Combined periodontic-endodontic lesions
|
|
| Pathogenesis |
- A. actinomycetemcomitans
- Capnocytophaga sp.
- F. nucleatum
- P. gingivalis
- P. intermedia
- T. forsythia
- T. denticola
|
|
| Pathologic entities |
- Calculus
- Clinical attachment loss
- Edentulism
- Fremitus
- Furcation defect
- Gingival enlargement
- Gingival pocket
- Gingival recession
- Gingivitis
- Horizontal bony defect
- Linear gingival erythema
- Occlusal trauma
- Periodontal pocket
- Periodontal disease
- Periodontitis
- Plaque
- Vertical bony defect
|
|
Diagnosis, treatment planning,
prevention and
chemotherapeutic agents |
- Ante's law
- Brushing
- Bleeding on probing
- Chlorhexidine gluconate
- Enamel matrix derivative
- Flossing
- Hydrogen peroxide
- Mouthwash
- Oral hygiene
- Tetracycline
- Triclosan
|
|
| Periodontal armamentarium |
- Curette
- Membrane
- Probe
- Scaler
|
|
| Conventional therapy |
- Debridement
- Scaling and root planing
- Full mouth disinfection
|
|
Surgical therapy and
periodontal surgery |
- Apically positioned flap
- Bone graft
- Coronally positioned flap
- Crown lengthening
- Open flap debridement
- Free gingival graft
- Gingivectomy
- Guided bone regeneration
- Guided tissue regeneration
- Implant placement
- Lateral pedicle graft
- Pocket reduction surgery
- Sinus lift
- Subepithelial connective tissue graft
|
|
| Important personalities |
- Tomas Albrektsson
- Per-Ingvar Brånemark
- Gary Greenstein
- Jan Lindhe
- Preston D. Miller
- Willoughby D. Miller
- Carl E. Misch
- John Mankey Riggs
- Jay Seibert
- Jørgen Slots
- Dennis P. Tarnow
- Hom-Lay Wang
- James Leon Williams
- W. J. Younger
|
|
| Other specialties |
- Endodontology
- Orthodontology
- Prosthodontology
|
|
|
|
|
noco/cofa (c)/cogi/tumr, sysi
|
|
|
|
|
|
Head and neck anatomy, digestive system: Mouth anatomy (TA A05.1–2, TH H3.04.01, GA 11.1110–2, 1125–1141)
|
|
| Mouth |
Oral cavity
(including
mucosa) |
|
Vestibule
|
Lip (Upper, Lower, Vermilion border, Frenulum of lower lip, Labial commissure of mouth, Philtrum)
Cheek (Buccal fat pad)
|
|
|
OC proper
|
|
Palate/
roof of mouth
|
Hard palate · Soft palate · Palatine raphe · Incisive papilla
|
|
|
Gingiva
|
Interdental papilla · Gingival sulcus · Gingival margin · Free gingival margin · Gingival fibers · Junctional epithelium · Mucogingival junction · Sulcular epithelium · Stippling
Periodontium: Cementum · Gingiva · Periodontal ligament
|
|
|
|
|
Glands
|
Parotid gland/Parotid duct · Submandibular gland/Submandibular duct · Sublingual gland/Major sublingual duct
|
|
|
Teeth
|
see tooth anatomy
|
|
|
Tongue
|
dorsum (Taste bud, Median sulcus, Terminal sulcus, Foramen cecum, Lingual tonsils) · underside (Frenulum, Fimbriated fold, Sublingual caruncle) · Anterior · Posterior · Glossoepiglottic folds · Lingual septum
|
|
|
Oro-pharynx/
fauces |
Oropharyngeal isthmus/Isthmus of the fauces
Soft palate (Uvula, Palatoglossal arch, Palatopharyngeal arch, Plica semilunaris of the fauces)
Tonsillar fossa
Palatine tonsil
|
|
|
|
|
noco/cofa (c)/cogi/tumr, sysi
|
|
|
|
|
|
Dental anatomy (TA A05.1.03, GA 11.1112–1124)
|
|
| Teeth |
Permanent (incisor, canine, premolar, molar) · Deciduous
|
|
| Maxillary teeth |
Incisor: Central incisor, Lateral incisor, Canine
Premolar: First premolar, Second premolar
Molar: First molar, Second molar, Third molar
|
|
| Mandibular teeth |
Incisor Central incisor, Lateral incisor, Canine
Premolar: First premolar, Second premolar
Molar: First molar, Second molar, Third molar
|
|
| Parts |
Crown: Cusp (Cusp of Carabelli)
Pulp · Root canal (Apical foramen)
Cementoenamel junction · Enamel · Dental-enamel junction · Dentin · Dental papilla
Mammelon
Dental alveolus
|
|
|
|
|
noco/cong/jaws/tumr, epon, injr
|
dent, proc (endo, orth, pros)
|
|
|
|
|
Bones of head and neck, joints: cranial fibrous joints (A03.1.01–03, GA 2.178–199)
|
|
| Cranial syndesmoses |
- Pterygospinous ligament
- Stylohyoid ligament
|
|
| Cranial sutures |
- Cranial: frontoethmoidal
- frontal or metopic (frontal/frontal)
- coronal (frontal/parietal)
- occipitomastoid (occipital/temporal)
- lambdoid (parietal/temporal)
- sagittal (parietal/parietal)
- sphenoethmoidal
- sphenofrontal
- sphenoparietal
- sphenosquamosal (sphenoid/temporal)
- sphenopetrosal (sphenoid/temporal)
- squamosal (temporal/parietal)
- petrosquamous (temporal/temporal)
- Facial: palatomaxillary suture
- Sutura embryonica
- Sutura embryonica accessoria
- Cranial–facial: sphenozygomatic
- zygomaticotemporal
- zygomaticofrontal
|
|
| Dento-alveolar syndesmosis |
- Gomphosis: Periodontal fiber
- Periodontium
- Dental alveolus
- Gingiva
- Cementum
|
|
| Synostoses |
- Synostosis vomerina
- Synostosis mandibularis
- Synostosis frontalis
- Synostosis petrosquamosa
- Synostosis incisiva
|
|
|
|
|
noco (arth/defr/back/soft)/cong, sysi/epon, injr
|
|
|
|
|
