Anatomy and physiology of periodontuim

2. Periodontal Tissues
Tissues that surround Tissues that support
the teeth the teeth
PERIODONTAL LIGAMENT
GINGIVA CEMENTUM
ALVEOLAR BONE

4. GINGIVA
Is the part of the oral mucosa that
covers the alveolar processes of the jaws
and surrounds the necks of the teeth.
Gingiva begins at the mucogingival line
and ends at the cervix of each tooth.

5. Marginal
G
I
N
G
I
V
A
Interdental Attached

6. Marginal, Unattached or Free Gingiva
It is the terminal edge or border of the gingiva
It is the terminal edge or border of the gingiva
surrounding the teeth and it is demarcated from the
surrounding the teeth and it is demarcated from the
attached gingiva by the free gingival groove.
attached gingiva by the free gingival groove.

7. Gingival Sulcus
Gingival
Gingival Sulcus
Fluid (0.5- 3mm)
Junctional
Epithelium

8. Junctional Epithelium Gingival Fuid
 Comes from the
Comes from the
Surrounds the necks of
Surrounds the necks of gingival connective
gingival connective
each tooth.
each tooth. tissue.
tissue.
Have a key role to maintain
Have a key role to maintain
the periodontal health.
the periodontal health.
 Helps to the
Helps to the
It works as a pathway for
It works as a pathway for
mechanical cleaning of
mechanical cleaning of
the diffusion of the products
the diffusion of the products the sulcus.
the sulcus.
from the metabolism of
from the metabolism of
bacteria.
bacteria.
 Has antimicrobial
Has antimicrobial
properties.
properties.

9. Attached Gingiva
It is a continuity to the marginal gingiva.
Is firm, resilient and firmly bound to the
underlying periosteum of alveolar bone

10. Interdental Gingiva (Papilla)
It occupies the gingival embrasure.
Can be pyramidal or has a “col” shape

11. The gingiva consists of
Central core of Stratified Squamous
Connective Tissue Epithelium
Keratinized or
Fibers
Parakeratinized
Ground Substance
Cells Non-keratinized

12. Gingival Fibres
Gingivodental
Fibres
Circular
Transseptal

13. Functions
Functions
 To brace the marginal gingiva firmly against the
tooth.
 To provide the rigidity necessary to withstand the
forces of mastication without being deflected away
from the tooth surface.
 To unite the free marginal gingiva with the
cementum of the root and the adjacent attached
gingiva.

14. Correlation of Clinical and
Microscopic Features
Colour Size
Coral The bulk of
Pink cellular and
intercellular
elements and
their vascular
supply

15. Correlation of Clinical and
Microscopic Features
Consistency Shape Contour
Firm and
Resilient

16. Texture
 Peel orange
appearance
(A. Gingiva and
central
portion of I. Papilla)
 Smooth in the
borders

18.  Periodontal Ligament.
 Cementum.
 Alveolar Bone

19. Periodontal Ligament
 Itis the connective tissue that surrounds
the root and connects it to the bone.

20. Periodontal Fibers
They are the most important component of the P. Ligament
and are arranged in 6 groups:
 Transseptal
 Alveolar Crest
 Horizontal
 Oblique
 Apical
 Interradicular

21. Cellular Elements
1. Connective tissue cells: Fibroblasts,
cementoblasts and osteoblasts.
2. Epithelial rest cells (Malassez): Close to
the cementum, more numerous at the
apical area.
3. Immune system cells: Neutrophils,
lymphocytes, macrophages, etc.
4. Cells associated with neurovascular
elements

22. Functions of the Periodontal Ligament
 Physical:
Attachment of the teeth to the bone,
transmission of the occlusal forces and
resistance to the impact of these forces and
maintenance of the gingival tissue in their
proper relationship to the teeth.

23. Functions of the Periodontal Ligament
 Formative and Remodelling:
Cells of the P. Ligament participate in the
formation and resorption of cementum
and bone.
 Nutritional and Sensory:
By the blood vessels and sensory nerve
fibers that transmit tactile, pressure and
pain sensetions.

24. Calcified tissue that forms the outer
surface of the anatomic root
C
E
Acellular Cellular
M
E
It is the first to be formed,
before the tooth reaches
N Formed after the tooth
reaches the occlusal plane.
the occlusal plane. T More irregular and contains
Covers the cervical third
or half of the root.
U cells (cementocytes).
Less calcified than the
It doesn't contain cells. M a cellular type.

25. Alveolar Bone
It is the portion of the jaws that forms
and supports the tooth sockets.
It’s formed when the tooth erupts to
provides the osseous attachment to
the tooth and disappears gradually
after the tooth is lost.
Cancellous Trabeculae
External plate of cortical bone
Alveolar bone proper

26. Radiographic Features

27. TASK
Write about:
 Fenestration.
Dehiscence.
Gingival Col.

28. Bibliography
 Carranza´s. Clinical Periodontology. 9th
ed. 2003. pg:15-55.
 Gururaja R. Textbook of Periodontology.
2nd ed. pg: 6.
 Klaus H. Color Atlas of Dental Medicine.
Periodontology. Vol 1. 1989. pg: 1- 10.