Assessment of the width of attached gingiva using different methods in various age groups. Part of masticatory mucosa fibrous mucosa surrounding necks of teeth covers the coronal portion of the alveolar process gingiva 3 main parts. 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. Study 43 periodontal anatomy flashcards from emily g. The composition of cementum contains about 50% mineral substituted apatite. On attached gingiva lies between the free gum and mucous alveolar ridge fig.
The cej is normally the apical towards the root extent of the junctional epithelium. The presence of an intact mucogingival complex including an adequate width of attached gingiva has been considered as a critical component to the protective function of mucogingival complex. It is keratinised to withstand the stress of ripping and. 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. Mar 19, 2020 there are two types of gingiva that are clearly recognizable and they are known as the marginal gingiva that is mobile and the attached gingiva. The clinical importance of the mucogingival junction is in measuring the width of attached gingiva. 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. When replacing a tooth with an implant, a band of strong, attached gingiva. This article will highlight the two main types of gingiva. Oral mucosa is continuous with the skin but is entirely different in composition and structure due to the varied functions in the oral cavity. They reported that change in width of attached gingiva did occur but was variable, with greatest changes seen in gingivae which were narrow at baseline. Pdf increasing the amount of attached gingiva using a. Gingival attachment definition of gingival attachment by.
The attached gingiva gradually increases in size and it may take several years to reach adult size. If the gingiva moves with the instrument then the width od attached gingiva is considered inadequate. The amount of attached gingiva is considered insufficient when stretching the lip or cheek induces movement of the free gingival margin. On attached gingiva in the narrow premolar regions 1. This book provides dentists, dental hygienists, dental therapists and. It is firm, resilient and tightly bound to underlying periosteum, tooth of alveolar bone through connective tissue. The embryonic origin, composition, and histological and clinical appearance with. Similar to the variations seen in bowers study, the widest zone of attached gingiva was found in the incisors and the least. The gingiva is attached to the tooth, forming a seal that protects the underlying bone and helps provide a barrier against infection.
The anatomical features of gingiva are important in appropriate periodontal treatment planning. It is the part of gingiva that fills the area between two adjacent teeth apical to the contact area. There are two types of gingiva that are clearly recognizable and they are known as the marginal gingiva that is mobile and the attached gingiva. The composition of the associated microbial flora is similar for natural teeth and.
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. The relationship between the width of keratinized gingiva and gingival health by niklaus p. Gingiva project gutenberg selfpublishing ebooks read. Similar to the variations seen in bowers study, the widest zone of attached gingiva was found in the incisors and the. Though a number of studies suggest that a minimum of 2 mm width of keratinized gingiva, corresponding to 1 mm of attached gingiva is necessary for maintaining a good periodontal health,2,3. Proper diagnosis of a mucogingival deformity relies on clinical assessment of the recession present and soft tissue assessment, specifically the presence of adequate zone of attached gingiva. Keratinized and non keratinized areas of oral mucousa in. Inadequate attached gingiva definition of inadequate.
The book is usually delivered within one week anywhere in india and within. The importance of keratinized gingiva surrounding dental implants anita desai, dds, mds university of pittsburgh, 2015 purpose. It is demarcated from the attached gingiva by a shallow linear. If the attached gingiva is too thin or inadequate, the gum may then recede during or shortly after active orthodontics. It is firm, resillent and tightly bounded to the underlying periosteum of the alveolar bone. These are found in the oral cavity or mouth of a human being surrounding part of the teeth. It is similar in mineral composition and histologic appearance to bone.
Essentials of clinical periodontology and periodontics slideshare. The attached gingiva is tightly adherent to the subgingival connective tissue and bone via deep rete pegs. Attached gingiva article about attached gingiva by the free. Comparative evaluation of free gingival graft and alloderm. Anatomical relationship of normal gingiva in facial view a and in crosssection b. The gingiva consists of a free gingival margin and attached gingiva. Attached gingiva is a part of keratinized gingiva which aids in increase resistance to external injury and contribute in stabilization of gingival. This study was designed to determine the anatomic features of gingival in a group of dental students in tabriz, iran. Although the need for a socalled adequate amount of keratinized tissue for maintenance of periodontal health is questionable, the mucogingival junction serves. It is not unusual for children, sometimes as young as 6, to require gingival grafting just before they get braces. 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. If it is visible, the division between the shiny enamel and the slightly dull root cementum is very clear.
They consist of mucosal tissue that covers the alveolar processes of the maxilla and mandible and finish at the neck of each tooth. The periodontium 1 the gingiva and perio ligament at nicolet area technical college studyblue flashcards. The purpose of this study was to determine if keratinized gingiva has an effect on the success of implants. The width of the attached gingivamuch ado about nothing. 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. 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. 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. When the researchers examined patients who had stained gingiva versus those who did not, they found that earlystage lesions demonstrated a reddish blush of the oral mucosa and gingiva, while latestage lesions demonstrated increased blush of the oral tissues, as well as hyperplasia of the soft tissue or bone in the affected area. The gingiva is the tough insoluble protein mucosa a type of membrane that surrounds the teeth. The attached gingiva is firmly bound to the periosteum and to the dentition. 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.
Since the advent of co2 lasers, i have discontinued using the old technique. The attached gums are continuous with the marginal gum. From gingival margin to the free gingival groove fgg at the level of the cej. Attached gingiva definition of attached gingiva at. The gingiva is attached in part to the cementum of the tooth and. The gingiva surrounding a tooth has a 23 mm band of bright pink, very strong attached mucosa, then a darker, larger area of unattached mucosa that folds into the cheeks.
May 31, 2015 and if the free gingiva margin moves during stretching of lips then the attached gingiva is considered to be inadequate. Gum health and disease can have an effect on general health. Is a zone of attached gingiva of 5mm width adequate. As you probably already know, this leaves an attached zone of gingiva, perfect for stabilizing the poor fitting denture. A clinical study gouri bhatia 1, ashish kumar 2, manish khatri 2, mansi bansal 2, sameer saxena 2 1 department of periodontology, eklavya dental college, kotputli, jaipur, rajasthan, india 2 department of periodontology, institute of dental studies and technologies, modinagar. Attached gingiva the attached gingiva is continuous with the marginal gingival. The marginal gingiva is stabilized by the gingival fibers that have no bony support. The gingival sulcus is a shallow crevice that is bound apically by the coronal aspect of the junctional. Andinsobocki 28 monitored the facial gingiva in children for 2 years longitudinally. Mini marble composition books, thread bound notebooks, red, blue and green, 12ct, 600 total pages by greenbrier.
Repair of gum recession wayne nj, gum graft, gingival grafting. 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. How much attached gingiva is necessary for maintaining periodontal health after implants are placed in the anterior mandible. 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. It is more pronounced on the facial than on the lingual regions. The attached gingiva is defined as the portion of the gingivae extending from the base of the gingival crevice to the mucogingival line. Study 110 the periodontium 1 the gingiva and perio ligament flashcards from sara g.
Attached gingiva definition of attached gingiva by medical. The colgate periodontal education program gingival. Variations exist in the width of the attached gingiva reported in the literature. It is firm, resilient, and tightly bound to the underlying periosteum of alveolar bone. May 15, 2018 gums, also called gingiva, are the fleshy, pink connective tissue thats attached to the neck of the tooth and the cementum. The importance of keratinized gingiva surrounding dental. The relationship between the width of keratinized gingiva. It is firm, dense, sometimes stippled, and tightly bound down to the underlying periosteum, tooth and bone. I personally use a wide tip laser at 6 watts,in an.
It extends from the base of the free gingiva to the mucogingival junction figure 1. The way of periodontist is hard and the book will reflect the difficulty of that path. Width of attached gingiva on attached gingiva is the largest in the incisors and indigenous areas ranging from 3. Junctional epithelium an overview sciencedirect topics.
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. The free gingival groove is present in about 30 to 40% of adults and occurs most frequently in the mandibular premolar and incisor areas. The free gingiva is that portion of the unattached gingiva around the cervical region of each tooth. Something, such as a tie, band, or fastener, that attaches one thing to another. The je attaches to enamel in a patient without recession by a basal lamina and intercellular hemidesmosomes. Attached gingiva article about attached gingiva by the. Broadening of the attached gingiva indication matrix. In health, attached gingiva has a keratinized surface. The importance of keratinized gingiva surrounding dental implants. Periodontal anatomy dental hygiene denhyg 1114 with. The marginal gingiva has a more translucent appearance than the attached gingiva, yet. The width of the attached gingiva is defined as the distance between the mucogingival junction and the projection on the external surface of the bottom of the gingival sulcus or periodontal pocket 9. The anatomy and physiology of the healthy periodontium.
The gingiva or gums is the tissue that surrounds and protects the teeth and underlying bone. The gingiva has been traditionally subdivided into free, attached, and interdental gingiva. The mucogingival junction is identified by stretching the lip or cheek and simultaneously probing the pocket or by using a dull instrument to push the alveolar mucosa in. The facial aspect of the attached gingival extend to the relatively loose and movable alveolar mucosa, from which it is demarcated by the mucogingival junction. Gingiva article about gingiva by the free dictionary. This groove separates the free gingiva from the attached gingiva. Chapterchapter2 biology of periodontal tissues the gingiva macroscopic features microscopic features. Attached gingival tissue is primarily composed of quizzn.
Aim the purpose of this study is to evaluate the increase in the width of attached gingiva ag in singlemultiple adjacent teeth using variation of modified apically repositioned flap marf. Assessment of the width of attached gingiva using different. A clinical evaluation of anatomic features of gingiva in. Attached gingiva definition of attached gingiva by. Jul 08, 20 this groove separates the free gingiva from the attached gingiva. Cosmetic repair of recession and inadequate attached gingiva. The early concept was that attached gingiva is important to dissipate the force of muscle pull and unattached mucosa due to its mobility collects more plaque. The gingiva is pink, firm in texture and extends from the free gingival margin to the mucogingival line. The gingiva means the gum which is the area around the root of a tooth. The width of the attached gingiva was studied by bowers 1963, who concluded. Glossary of periodontal term 1972 attached gingiva is that portion of gingiva that extends from the base of gingival crevice to mucogingival junction. May 02, 2014 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.
When replacing a tooth with an implant, a band of strong, attached gingiva is needed to keep the implant healthy in the longterm. Attached gingiva definition at, a free online dictionary with pronunciation, synonyms and translation. In health, attached gingiva the oral mucosa covering the base of the alveolar bone maintenance care for a patient treated for periodontal disease includes periodic assessment of 1. The periodontium attaches the tooth to the jaw and is composed of gingiva, the periodontal ligament, cementum, and alveolar bone. Attached gingival tissue is primarily composed of the inflammatory response in periodontal pathology is caused by bacterial products from plaque which 1. Gums, also called gingiva, are the fleshy, pink connective tissue thats attached to the neck of the tooth and the cementum. The gingival fibers are the connective tissue fibers that inhabit the gingival tissue adjacent to.
Friedman surgical technique to provide a functionally adequate zone of keratinized attached gingiva is known as mucogingival surgeries. Dec 20, 2008 the anatomical features of gingiva are important in appropriate periodontal treatment planning. Its absence or presence is not related to the health of the gingiva. The cementoenamel junction cej is the junction between the anatomical crown and root. Depresson that separates free and attached gingiva free gingival line. It is keratinised to withstand the stress of ripping and tearing food. The attached gingiva is an important anatomical component of the periodontium with clinical implications. Attached gingiva is important because it is bound very tightly to the underlying alveolar bone and provides protection to the mucosa during functional use of the structures of the oral cavity during function, such as chewing. The periodontium 1 the gingiva and perio ligament at. 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 act of attaching or the condition of being attached. It forms a band around each tooth that ranges in width from1 to 9 mm.
The interdental papillae are pyramidal in shape and occupy the interdental spaces beneath the contact points of the teeth. In the present study, the range of the mean width of attached gingiva varied from 1 mm to 4 mm. 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. It is done by pushing the adjacent mucosa coronally with a dull instrument.
702 1607 1146 792 297 923 1376 1237 648 1591 1570 252 1126 776 1122 338 1564 1406 1055 615 818 1231 485 715 346 336 1287 1321 360 651 1457 382 675