gingival

• adj.

• 歯肉の

関

gingiva、gum

　

WordNet

1. of or relating to the gums
2. cover, fill, fix or smear with or as if with gum; "if you gum the tape it is stronger"
3. any of various substances (soluble in water) that exude from certain plants; they are gelatinous when moist but harden on drying
4. exude or form gum; "these trees gum in the Spring"
5. become sticky
6. the tissue (covered by mucous membrane) of the jaws that surrounds the bases of the teeth (同)gum

PrepTutorEJDIC

1. 〈U〉ガム,ゴム(植物から分泌される乳状の液(水に溶け,空気中で凝固する) / 〈U〉ゴムのり / 〈U〉=chewing gum / =gum tree / 〈U〉目やに / …‘に'ゴムを塗る;…‘を'ゴムのりでつける / ゴムを分泌する;〈樹木が〉やにを出す
2. 歯ぐき
3. ちえっ!畜生!

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/03/25 03:27:12」(JST)

wiki en

[Wiki en表示]

For other uses, see Gums (disambiguation).

Gums
Cross-section of a tooth with gums labeled
Details
Identifiers
Latin	Gingiva
MeSH	A14.549.167.646.480
Dorlands /Elsevier	12390396
TA	A05.1.01.108 A03.1.03.003 A03.1.03.004
FMA	59762
Anatomical terminology [edit on Wikidata]

The gums or gingiva (sing. and plur.: gingivae), consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.

Structure

Gingiva are part of the soft tissue lining of the mouth. They surround the teeth and provide a seal around them. Unlike the soft tissue linings of the lips and cheeks, most of the gingivae are tightly bound to the underlying bone which helps resist the friction of food passing over them. Thus when healthy, it presents an effective barrier to the barrage of periodontal insults to deeper tissue. Healthy gingiva are usually coral pink in light skinned people, but may be naturally darker with melanin 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. Overall, the clinical appearance of the tissue reflects the underlying histology, both in health and disease. When the gingival tissue is not healthy, it can provide a gateway for periodontal disease to advance into the deeper tissue of the periodontium, leading to a poorer prognosis for long-term retention of the teeth. Both the type of periodontal therapy and homecare instructions given to patients by dental professionals and restorative care are based on the clinical conditions of the tissue.

A diagram of the periodontium. The crown of the tooth is covered by enamel (A). The root of the tooth is 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.

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. This slight depression on the outer surface of the gingiva does not correspond to the depth of the gingival sulcus but instead to the apical border of the junctional epithelium. This outer groove varies in depth according to the area of the oral cavity; the groove is very prominent on mandibular anteriors and premolars.

The marginal gingiva varies in width from 0.5 to 2.0 mm from the free gingival crest to the attached gingiva. The marginal gingiva follows the scalloped pattern established by the contour of the cementoenamel junction (CEJ) of the teeth. The marginal gingiva has a more translucent appearance than the attached gingiva, yet has a similar clinical appearance, including pinkness, dullness, and firmness. In contrast, the marginal gingiva lacks the presence of stippling, and the tissue is mobile or free from the underlying tooth surface, as can be demonstrated with a periodontal probe. The marginal gingiva is stabilized by the gingival fibers that have no bony support. 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 patient’s chart.

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. The tissue when dried is dull, firm, and immobile, with varying amounts of stippling. The width of the attached gingiva varies according to its location. The width of the attached gingiva on the facial aspect differs in different areas of the mouth. It is generally greatest in the incisor region (3.5 to 4.5 mm in the maxilla and 3.3 to 3.9 mm in the mandible) and less in the posterior segments, with the least width in the first premolar area (1.9 mm in the maxilla and 1.8 mm in the mandible). However, certain levels of attached gingiva may be necessary for the stability of the underlying root of the tooth.

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.

The col varies in depth and width, depending on the expanse of the contacting tooth surfaces. The epithelium covering the col consists of the marginal gingiva of the adjacent teeth, except that it is nonkeratinized. It is mainly present in the broad interdental gingiva of the posterior teeth, and generally is not present with those interproximal tissue associated with anterior teeth because the latter tissue is narrower. In the absence of contact between adjacent teeth, the attached gingiva extends uninterrupted from the facial to the lingual aspect. The col may be important in the formation of periodontal disease but is visible clinically only when teeth are extracted.

Interdental Areas

It is the part of gingiva which extends in between two teeth up to the contact point.There is a facial side interdental papilla and a lingual side interdental papilla.Interdental papilla has a summit(tip)and margins that are concave.The tip and the margins are unattached and the central portion attached.In inflammations the interdental papilla loses its concavity.

Characteristics of healthy gingiva

Color

Healthy gingiva usually has a color 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.

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), especially at the base of the interdental papillae. 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 less firm. Healthy gingiva has an orange-peel like texture to it due to the stippling.

Reaction to disturbance

Healthy gums usually have no reaction to normal disturbance such as brushing or periodontal probing. Unhealthy gums, conversely, will show bleeding on probing (BOP) and/or purulent exudate.

Clinical significance

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 peridontitis, 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. It may indicate an underlying inflammation such as periodontitis or pyorrhea, a pocket formation, dry mouth or displacement of the marginal gingivae away from the tooth by mechanical (such as brushing), chemical, or surgical means. Gingival retraction, in turn, may expose the dental neck and leave it vulnerable to the action of external stimuli, and may cause root sensitivity.

See also

• Gum graft
• Head and neck anatomy
• Periodontitis

References

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 小児における口腔軟部組織病変 soft tissue lesions of the oral cavity in children
• 2. 成人における歯肉炎および歯周炎：分類と歯科治療 gingivitis and periodontitis in adults classification and dental treatment
• 3. 外陰部の扁平苔癬 vulvar lichen planus
• 4. 美容適応としてのボツリヌス毒素：特定部位治療 botulinum toxin for cosmetic indications treatment of specific sites
• 5. 化学療法に関連した経口毒性 oral toxicity associated with chemotherapy

English Journal

• RP-HPLC assay of doxycycline in human saliva and gingival crevicular fluid in patients with chronic periodontal disease.

• Denić MS, Sunarić SM, Kesić LG, Minić IZ, Obradović RR, Denić MS, Petrović MS.SourceDepartment of Pharmacy, University of Niš, Faculty of Medicine, Bulevar dr Zorana Đinđića 81, 18000 Niš, Serbia. Electronic address: mdenic84farm@gmail.com.
• Journal of pharmaceutical and biomedical analysis.J Pharm Biomed Anal.2013 May 5;78-79:170-5. doi: 10.1016/j.jpba.2013.02.009. Epub 2013 Feb 20.
• A reversed-phased HPLC method with fluorescence detection was optimized and validated for determination of DOXY in human saliva and gingival crevicular fluid (GCF) with tetracycline as internal standard. Single step extraction with acetonitrile for both types of samples was performed. The separation
• PMID 23499916

• Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions.

• Bingham CO 3rd, Moni M.SourceaDepartment of Medicine, Division of Rheumatology bDepartment of Medicine, Division of Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, Maryland, USA.
• Current opinion in rheumatology.Curr Opin Rheumatol.2013 May;25(3):345-53. doi: 10.1097/BOR.0b013e32835fb8ec.
• PURPOSE OF REVIEW: This review was conducted to focus on the recent clinical and translational research related to the associations between periodontal disease and rheumatoid arthritis.RECENT FINDINGS: There is a growing interest in the associations between oral health and autoimmune and inflammator
• PMID 23455329

• Current concepts in hypophosphatasia: case report and literature review.

• Hollis A, Arundel P, High A, Balmer R.SourcePaediatric Dentistry, Leeds Dental Institute, Leeds, UK Harrogate and District NHS Foundation Trust, York, UK Paediatric Metabolic Bone Disease, Sheffield Children's Hospital, Sheffield, UK Pathologist (Head and Neck), Medical and Dental School, University of Leeds, Leeds, UK.
• International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children.Int J Paediatr Dent.2013 May;23(3):153-9. doi: 10.1111/j.1365-263X.2012.01239.x. Epub 2012 Jun 4.
• International Journal of Paediatric Dentistry 2013; 23: 153-159 Background.  Hypophosphatasia (HP) is characterized by defective mineralization of bone and teeth because of deficient alkaline phosphatase activity. There are generally six recognized clinical forms, of which the most severe is often
• PMID 22672232

Japanese Journal

• 原因薬物変更後に全顎的に著明な歯肉腫脹を呈した薬物性歯肉増殖症の１例

• 北海道歯学雑誌 37(2), 162-167, 2017-03
• NAID 120006219945

• 新生子牛に発生した歯肉の血管過誤腫 (日本獣医師会学会学術誌) -- (産業動物臨床・家畜衛生関連部門)

• 日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 70(2), 101-104, 2017-02
• NAID 40021102956

• Cryotherapy as a conservative treatment modality for gingival enlargement in a patient with Sturge-Weber Syndrome

• Intractable & Rare Diseases Research 6(2), 145-147, 2017
• NAID 130005695968

Related Links

• Gingiva | definition of gingiva by Medical dictionary

He discusses the impact of dental esthetics on quality of life; facial esthetics; the composition of an esthetic and functional dentoalveolar gingival unit or periodontal restorative interface, which takes into account the periodontal health ...

• Gingival - definition of gingival by The Free Dictionary

gin·gi·val (jĭn′jə-vəl, jĭn-jī′-) adj. 1. Of or relating to the gums. 2. Linguistics Alveolar. Thesaurus Antonyms Related Words Synonyms Legend: Adj. 1. gingival - of or relating to the gums Translations gin·gi·val a. gingival, rel. a la ...

Related Pictures

---

★リンクテーブル★

拡張検索	「Porphyromonas gingivalis」「gingival bleeding」「gingival hemorrhage」「gingival exudate」

「Porphyromonas gingivalis」

　　[★]

ラ

Porphyromonas gingivalis

日

ポルフィロモナス・ジンジバリス

同

ジンジバリス菌、

関

Bacteroides gingivalis、P. gingivalis、ポルフィロモナス属

• 歯周病原因菌の一種

「gingival bleeding」

　　[★]

• 歯肉出血

関

gingival hemorrhage、gum bleeding

「gingival hemorrhage」

　　[★]

• 歯肉出血

関

gingival bleeding、gum bleeding

「gingival exudate」

　　[★]

歯肉溝滲出液

関

gingival crevicular fluid