Dentistry - 4th year Periodontium is a collective term for all of the tissues and structures that surround the teeth and provide them with necessary support for normal functioning. The main parts of periodontium are: Oral mucosa Cementum
Alveolar process Periodontal ligament ORAL MUCOSA
Oral mucosa consists of three zones:
The gingiva and the covering of the hard palate (masticatory mucosa) Specialized mucosa that covers the dorsum of the tongue The oral mucous membrane GINGIVA
Gingiva covers the alveolar bone and the tooth root to a
level just coronal to the cementoenamel junction. According to anatomical features, gingiva is divided into: - marginal gingiva - attached gingiva - interdental areas MARGINAL GINGIVA The marginal or unnatached gingiva is the terminal border of gingiva that surrounds the teeth. Usually, its separated from the attached gingiva by a free gingival groove. The marginal gingiva is about 1mm wide and together with the tooth surface it forms the gingival sulcus. GINGIVAL SULCUS
The gingival sulcus is a shallow space
around the tooth thats bounded, on one side with the tooth surface, and on the other side by the epithelium lining the free margin of the gingiva. It is V shaped and normaly has a depth of around 1.8mm, which can be inspected by probing with a special periodontal probe. ATTACHED GINGIVA Anatomically, the attached gingiva is continuous with the marginal gingiva. Its firm, resilient and tightly bounded to the underlying periosteum. On one side its bounded by the free gingival groove and on the other side by the alveolar mucosa (mucogingival junction). One of the important clinical features is the width of the attached gingiva. Normal width is around 3.5mm in the anterior region and 1.8mm in the posterior segment. INTERDENTAL GINGIVA
The interdental gingiva occupies the interproximal spaces
beneath the contact points of teeth. It can be pyramidal and col- like in shape, depending on the distance between teeth. These gingival elevations are called interdental papillae and in case of diastema they are absent. COLOUR OF GINGIVA The colour of the attached and marginal gingiva is described as „coral pink“ and it depends of the vascularization, thickness and the degree of keratinization. On the other hand, the colour of the alveolar mucosa is red, smooth and shiny. SIZE OF GINGIVA The size of gingiva depends on all of the cellular and intercellular elements as well as the level of vascularization. Alterations in size are a common sign of gingival diseases. SURFACE TEXTURE OF GINGIVA
The surface of gingiva is stippled, and it can best be seen after
drying. This is produced by projections of gingival connective tissue into the overlying epithelium. Only attached gingiva is stippled, marginal is not. POSITION OF GINGIVA The position of gingiva is a level at wich the gingival margin is connected to the tooth. During tooth erruption, in the beginning, the gingival margin is at the tip of the crown and later it undergoes extensive remodeling, together with the oral mucosa. PERIODONTAL LIGAMENT
The periodontal ligament is composed of a
highly vascularized and higly cellular connective tissue that surrounds the tooth root and connects it to the inner wall of the alveolar bone. Histologically, its continuous with the connective tissue of gingiva. The basic elements of periodontal ligament are the periodontal fibers, cellular elements and ground substance. FUNCTIONS OF PERIODONTAL LIGAMENT
The functions of periodontal ligament are categorized as:
Physical Formative and remodeling Nutritional and sensory PHYSICAL FUNCTIONS
The physical functions of periodontal
ligament are providim of the soft tissue casing for nerves and blood vessels, transmission of occlusal forces to the bone, attachment of the teeth to the bone and resistance to impacts and occlusal forces. FORMATIVE AND REMODELING FUNCTION
This function is allowing the teeth and periodontium to
accomodate to stress and other occlusal and masticatory forces. The periodontal ligament helps all of the structures move together and find a suitable position. NUTRITIONAL AND SENSORY FUNCTION
The periodontal ligament supplies nutrients to the
cementum, bone and gingiva via the bloodvessels and also provides lymphatic drainage. The nerve supply of the periodontal ligament originates from the trigeminal nerve and they are transmitting tactile, pressure and pain sensations. CEMENTUM
Cementum is a calcified, avascular mesenchymal tissue that
forms the outer layer of ht eanatomic tooth root. Important clinical features of cementum are cementoenamel junction and the cementodentinal junction. CEMENTOENAMEL JUNCTION
This is of great clinical importance because
the connection betwen cementum and enamel can vary. Overlapping, butt joint or no contact might be possible. CEMENTODENTINAL JUNCTION
Cementodentinal junction is located at the terminal apical
area of the tooth root. This border is clinically used as a line untill which the obturating material during endodontic treatment should be placed. ALVEOLAR PROCESS
The alveolar process is a portion of the bone (maxilla or the
mandible) that forms the tooth sockets (alveoli). It forms the osseous attachment for periodontal ligament and other periodontic tissues. SOCKET WALL The socket wall consists of dense, lamellated bone thats oriented parallel to the tooth root and gives a surface for the attachment of the periodontal ligament. INTERDENTAL SEPTUM The interdental septum is a bony wall between adjacent teeth. Its borders are the socket walls and facial and lingual bony plates. The mesiodisal and faciolingual dimensions and shape of the interdental septum are determined by the size and shape of the teeth crowns and roots. THE END