The Gingiva

Embryology, Anatomy, Histology &

Biochemistry

Dr. Khansa Ababneh

 Periodontium
 Tissues which surround
& support the teeth.
 Periodontium
• Gingiva

• Periodontal
ligament

• Alveolar bone

• Cementum
Tooth Development & Eruption
Periodontal tissues develop
during tooth development
 Development of the periodontium
role of epithelial-mesenchymal interactions

Ectomesenchyme
Oral epithelium (dental follicle)

PDL
Alveolar bone
Gingival epithelium Cementum
Gingival CT
 Oral mucosa
 Masticatory mucosa

 Lining mucosa

 Specialised mucosa
 GINGIVA
 Part of masticatory
mucosa

 Fibrous mucosa
surrounding necks of
teeth

 covers the coronal

portion of the alveolar
process
 GINGIVA
3 main parts:
• Free gingiva

• Attached gingiva

3. Interdental gingiva
 Free gingiva
 From gingival margin to
the free gingival groove
(FGG) at the level of
the CEJ.

 Can be separated form

the tooth by a probe

 Depth of gingival sulcus

(crevice) : 0-3 mm.
 Attached gingiva
Extends from the FGG to the
mucogingival junction (MGJ)
 Attached gingiva
 On the palate,
the whole
mucosa is
keratinised
and there is
No MGJ
 Attached gingiva
 Firmly attached to underlying bone to:
 withstand masticatory forces

 withstand forces of tooth brushing

 prevent movement of marginal gingiva

 Width varies in different
parts of the mouth;
 between right & left sides

 between different people

 with age (increases)

 For example
 Maxilla, buccally:
widest around incisors, narrowest around premolars

 Mandible, lingually
narrowest around incisors, widest around molars.

 Is the width of the attached gingiva

important?
 Which is more important; width or thickness?
 Keratinised Vs Attached
Attached gingiva Keratinised gingiva
FG + AG

KG
 Interdental gingiva
 Also: interdental papilla.

 Shape determined by:

 Contact relationship
between teeth

 width of proximal
surfaces

 shape of the CEJ.

 Anterior : Pyramidal
 Molars : Flattened in a
buccolingual direction.
 Between buccal & lingual papillae

COL
 Clinical Features of normal (healthy) gingiva

 Colour: pink
(physiologic/racial
pigmentation)
 Contour: scalloped outline
 Margins: thin, knife-edge.
 Surface texture: stippled
 Consistency: resilient
 Pointed interdental papillae
 Probing depth: 0-3 mm.
 No bleeding on probing
(BOP).
 HISTOLOGY
 The gingiva consists of 2 main types of
tissue:

1. Epithelium
2. Connective tissue

• Epithelium is attached to the underlying

connective tissue by a basement
membrane.
 Epithelium
 Stratified squamous epithelium (parakeratinised)
 Function:
 Protection of underlying structures while permitting
selective interchange with the oral environment
 Active production of cytokines, adhesion molecules, growth
factors and enzymes
 Examples: β-defensins, IL-1 β, IL-8, EGF
 Main cell type : Structure
keratinocyte
 4 layers of cells:
1. stratum basale
(basal cell layer)

2. stratum spinosum
(spinous cell layer)

– stratum granulosum
(granular cell layer)

4. stratum corneum
(corneal or horny cell
layer)
• The oral mucosa is mostly
parakeratinised: stratum corneum
retains pyknotic nuclei

• Difference between ortho- & para-

keratinisation

• Cytokeratin (K1-K19)

• Other proteins: keratolinin,

involucrin & filaggrin.
 Other cell types
within the gingival epithelium

 Langerhans cells: modified monocytes found

in the suprabasal layer, playing a role in
immunity

 Merkel cells: in deeper layer of epitheium,

contain nerve endings

 Melanocytes: in basal and spinous cell layer,

contain melanin
 Types of Gingival Epithelium

 Oral epithelium

 Sulcular epithelium

 Junctional epithelium
 Oral epithelium
Faces the oral
cavity, is
parakeratinised,
shows rete pegs
and connective
tissue papillae
(responsible for the
stippled texture).
Turnover rate 10-12
days.
 Sulcular epithelium
Faces the tooth without
contacting it. Thin non-
keratinised stratified
squamous epithelium (no
granulosum and corneum
layers), extends from
the coronal end of the
junctional epithelium to
the crest of the gingival
margin. Acts as a semi-
permeable membrane.
 Junctional epithelium
 Provides contact between
gingiva & tooth.
 Stratified squamous non-
keratinised epithelium.
 3-4 cells thick in early life,
increasing to 10-20 later.
 Basal and suprabasal layers.
 Length = 0.25-1.35 mm. No
rete pegs.
 Junctional Epithelium
 Derived from the
reduced enamel
epithelium

 Attachment to tooth:
inner basal lamina

 Attachment to gingival
connective tissue: outer
basal lamina

 Lamina densa & lamina

lucida
 ECM of Epithelium
 Not abundant in gingival epithelium

 PG: CD44, HA, syndecan, decorin

 Glycoproteins: integrin family, e.g.:

α2β1, and ICAM-1 (in Jep & Oep)
 Differences between gingival epithelia
 Cell size/tissue volume in JE is > in OE

 Intercellular spaces in JE are > in OE

 No of desmosomes in JE is < in OE

 Difference in cytokeratin expression &

cell surface markers

 JE originates from REE; OSE & OE

originate from oral mucosa
Renewal of gingival epithelium
Cell Cell shedding
division
 The Dentogingival junction
 Enamel + cementum (CEJ) + junctional
epithelium + gingival fibres + adhesion
proteins.
Dentogingival epithelium
 Gingival Crevicular fluid (GCF)

 In gingival sulcus

 Cleaning & antimicrobial effects

 Increases adhesion of gingiva to tooth.

 Connective Tissue
• Cells:
 fibroblasts, mast cells, macrophages,
neutrophils, lymphocytes, plasma cells.
2. Collagen fibres
3. Extracellular matrix (ECM)
4. Nerves
5. Blood vessels
6. Lymphatics
 Fibres
 Collagen, elastin,
reticulin & oxytalan
fibres.

 Provide structure,
framework, increase
elasticity and resiliency
of gingiva.
 Fibres
 Arranged in groups :
 Transseptal
 Circular
 Dentogingival
 Dentoperiosteal
 ECM
 Medium in which all other components
are embedded.

 Consists of: water, proteins,

glycoproteins, proteoglycans &
growth factors:
 Collagen type I , III, V & VI
 Proteoglycans: decorin, biglycan, versican
 Integrins
 Fibronectin