Periodontology
Oral Mucosa
 3 types
1. Masticatory mucosa
- Gingiva and hard palate
- Comes in contact with food during
mastication
- Stratified squamous epithelium
2. Lining mucosa
- Areas of the lips, cheeks, vestibule,
floor of the mouth, inferior surface of
the tongue (ventral) and soft palate
- Does not function in mastication
- Soft pliable and nonkeratinized
3. Specialized mucosa
- On dorsal surface of tongue
- Covered with lingual papillae
(depression or extension)
 Foliate papillae
 Filiform papillae
 Circumvallate papillae
 Fungiform papillae
 Functions
o Protection
 Protects deeper tissues and
organs
 Acts as major barrier to the
normal activities of seizing foods
and to resident population of
micro-organisms within the oral
cavity
o Sensation
 Provides considerable information
about events in oral cavity
 Perceive stimuli
 Receptors that respond to temp.
touch and pain
 Taste buds
 Receptors that signal satisfaction
of thirst
 Reflexes such as swallowing,
gagging and salivation
o Secretion
 Secretion of saliva which
contributes to maintenance of
moist surface
o Permeability and absorption
 Thinnest epithelial regions (floor
of mouth) – more permeable
that’s why drugs like nitroglycerin
are successfully absorbed when
held under the tongue
 Limit the penetration of toxins and
antigens
o Thermal regulation
 For animals only
 Panting to regulate body
temperature
Histologic Characteristics of Oral Mucosa
1. Surface epithelium
a. Keratinization
- Orthokeratinization
- Parakeratinization
- Incomplete parakeratinization
Layers of keratinized epithelium
1. Stratum corneum (keratinized layer)
a. Become dehydrated and
flattened and more resistant to
mechanical damage and
chemical solvents
b. Squames(hexagonal disk) are
lost by desquamation and
replaced by cells (maturation
mostly seen in orthokeratinizatin)
c. Rapid clearance is important in
limiting the invasion of
pathogenic mircro-organisms
d. 20 layers of squames
2. Stratum granulosum
a. Large flattened cells containing
small granules = keratohyalin
granules
3. Stratum spinosum
a. Several rows of larger elliptical or
spherical cells
b. Frequently shrink away
remaining in contact only at
points called intercellular bridges
or desmosomes
c. Spiny or prickle like
d. Peels of when there is disease
e. Increased thickness = acanthosis
f. Separation of cells caused by
loss of the intercellular bridges =
acantholysis
4. Stratum basale
a. Cuboidal or columnar cells
adjacent to basement membrane
b. Stratum germinativum are parts
that are capable of division
*Tonofilament
 Intermediate filaments, keratins
 Epithelial cells w/ this keratin filament=
keratinocyte
 Distinguish from non- keratinocytes
*Intercellular bridges/ Desmosomes
  Adhere by intracellular thickening= attachment
plaque, where tonofilament inserts
 Adhesion between epithelium & CT=
hemidesmosome, also has attachment plaque
where tonofilaments insert
 2 other types of connection
o Gap junction- allow electrical & chemical
communication b/w cells
o Tight junction- rare in oral epithelium, w/
no intercellular spaces
b. Non keratinization
- Layers of non keratinization
1. Stratum superficiale
a. Cells more flattened than in
preceding layers
b. Contain dispersed tonofilaments
and nuclei
c. Forma surface that is flexible and
tolerant of both compression and
distention because it it's filled
with loosely arranged filaments
that are not dehydrated
2. Stratum intermedium
a. Slight increase in cell size and
accumulation of glycogen cells
b. Keratohyalin granules can be
seen
3. Stratum basale
a. Cuboidal or columnar cells
containing separate
tonofilaments
b. Site of most cell divisions
c. Prickle cell layer
2. Lamina Propria
a. Papillary layer or CT papilla
- Connective tissue layer that indents the
epithelium
- Interdigitate with epithelial ridges or pegs
called rete ridges or pegs (corresponds to
stipples of attached gingiva)
b. Reticular layer
- Densely arranged connective tissue fibers
Histologically Normal Periodontium
 Gingival sulcus 0-3mm
o 0- in anterior teeth region, periodontal
probe can’t be inserted
 Clinical criteria for normal gingiva
o Pale/ Coral pink in color (aside from
African race)
o Firm, resilient
o Smooth marginal and papillary gingiva
o Attached gingiva has distinct stipples
(rough)
o Knife like edge, scallop shaped marginal
gingiva
o Does not bleed
 Function
o Contributes to the attachment of the teeth
& stabilization of their position on the
alveolar process
o Unites individual teeth to form a
continuous arch
o Forms the epithelial cuff (junctional
epithelium) that surrounds the neck of
each tooth & adheres to the tooth
surfaces, thereby maintaining the
continuity of the epithelial covering
o Provides a peripheral defense against
infection
 2 topographically distinct zone
1. Free gingiva
 Made up of a narrow band of tissue
that follows the scalloped contour of
the necks of the teeth & the CEJ
 Free gingival groove- separates free
gingiva from attached gingiva
a. Marginal gingiva
 Part of the free gingiva that
tapers into a knife like edge
extending along the cervical
level of the tooth on the labial
or buccal & lingual surfaces
 Healthy gingival sulcus 0-
3mm
 Pseudopocket- deepen
sulcus due to inflammation of
the gingiva w/o migration of
the junctional epithelium
 Pocket- deep sulcus w/
migration of junctional
epithelium towards the apex
b. Interdental papilla/ papillary
portion
 Gingival tissue in the
interdental space
 Where facial and lingual
gingiva converge
o Gingival papilla- the
bulge
o Interdental col- the
constriction, usually
found at PM and M
where there is wide
contact area; non
keratinized epithelium
  Gingival sulcus- b/w the tooth
surface & the free gingiva, a
shallow groove extends
around the circumference of
the tooth, 0-3mm depth for
healthy gingival sulcus
2. Attached gingiva
 Normally 1-9mm
 The part that is attached to the teeth
and the alveolar bone
 Coronally bounded by free gingival
groove & apically by mucogingival
junction
 Facial surface of both jaws- adjacent
to alveolar mucosa
 Lingual surface of mandible- adjacent
to the mucosa of the floor of the
mouth
 Palatal surface of the maxilla- no
attached gingiva, as immovable
palatal mucosa extends all the way to
free gingiva
 Interdental folds- slight depressions in
between the roots of the teeth
 Stipples/ Stipplings- responsible for
the rough appearance of the attached
gingiva
 Mucogingival junction- separates the
free gingiva from the attached gingiva
Structural elements (Dentogingival junction)
1. Epithelial attachment/ Junctional epithelium
 Free gingiva lies on enamel & adheres to the
tooth surface by this
2. Connective tissue attachment
 Between crest of alveolar bone & CEJ, fiber
bundles of the gingival CT inserts into the
supraalveolar cementum
Dentinogingival Junction
 Anatomical feature concerned w/ attachment of the
gingiva to the tooth
 Epithelium portion of gingiva is ectodermal in origin
 Consists of 3 fundamental compartments
1. Junctional epithelium
 Derived from reduced enamel
epithelium+ oral epithelium
 Extends from the CEJ to the bottom of
the gingival sulcus
 Previously known as the epithelial
attachment, epithelial cuff, inner
attachment epithelium
 Normally has high turnover rate
2. Oral sulcular epithelium
 Lines the lateral wall of the gingival
sulcus & is continuous w/ the occlusal
end of junctional epithelium apically & w/
oral gingival epithelium occlusally
 Structurally resembles oral gingival
epithelium
 Frequently parakeratinized
 Far less permeable than junctional
epithelium
3. Oral gingival epithelium
 Part of the epithelium lining of the entire
oral cavity & resembles the epithelium of
the hard palate
 The keratinization can progress to
varying degrees, one can distinguish 3
grades of keratinization according to the
completeness of the transition.
a. Orthokeratinization- about 20-
30% of the gingiva, the stratum
corneum is made up of
keratinized cells w/o nuclei
b. Parakeratinization- approximately
50-70%, the stratum corneum is
made up of keratinized cells w/
pyknotic nuclei & remnants of
cytoplasmic organelle
c. Incomplete parakeratinization-
least common type, 7-10% seen
only in marginal gingiva, consists
of 2 types of cells: parakeratinized
stratum corneum cells & cells that
are not keratinized