DEPARTMENT OF PERIODONTOLOGY & IMPLANTOLOGY

SUBHARTI DENTAL COLLEGE & HOSPITAL, MEERUT

 Gingiva is the part of masticatory mucosa which
covers alveolar bone & surrounds the cervical portion
of teeth.

Anatomically gingiva is divided into 3

parts :-
1. Marginal
2. Attached
3. Interdental.

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 Alveolar Mucosa

Mucogingival Junction

Marginal Gingiva

Attached Gingiva

Interdental Gingiva
 MICROSCOPIC ANATOMY

Gingiva consists of 2 parts -

1. Overlying
epithelium

2. Underlying
connective tissue.

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General Aspects Of Gingival Epithelium

• Stratified squamous epithelium.

• Predominantly cellular.

• The epithelium compartment –

1. Physical barrier to infection.
2. Active role in host defence.
3. Integrating innate & acquired immune
response.

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Gingival epithelium responds to bacteria by-

1. Increase proliferation
2. Alteration of cell signalling events.
3. Change in differentiation.
4. Cell death.

Alteration in tissue Homeostasis

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 Epithelial cells

Non
Keratinocytes Keratinocytes

1. Melanocyts
2. Langerhans cells
3. Merkel cells
4. Inflammatory
cells

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 Keratinocytes

• Principal cells.
• Occupies 90% of the epithelium.
• They are formed by Keratinization and produce
Keratin.
• Keratinocytes interconnected by Desmosomes.

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 Non Keratinocytes

• Also called as CLEAR CELLS.

• Occupie 10% of epithelium.

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. 1. Melanocytes-
• .

▪ Stellate cells with dendritic process-

premelanosomes/melanosomes.
▪ The intensity of gingival color depends on number
and aggregation patteren of melanosomes.
▪ Located in basal layer and spinous layer & produce
melanin.
▪ Consist of tyrosine.

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 TYROSINE

Premelanosomes

DOPA MELANIN

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 2. Langerhans cells

• Located among keratinocytes at all supra-basal layer.

• They belongs to mononuclear phagocyte system.
• Consist of elongated granules- MACROPHAGES with antigenic
properties.
• Important role in immune reactions.
• They consist g- specific granules i.e. BIRBECK’S GRANULES.

Adenosine triphosphatase activity

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 3. MERKEL CELLS

• Neural crest and epithelial origin.

• Located in the deeper layers of epithelium.
• Connected to adjacent cells by desmosomes.
• They harbour nerve endings.
• Identified as tactile perceptors.

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 4. INFLAMMATORY CELLS
Plasma cells Lymphocytes Monocytes Macrophages

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 KERATINIZATION PROCESS
• The protective nature of gingival epithelium is due to
keratinization process.
• Achieved by proliferation and differentiation.
• Basal layer by mitosis.
• Leads to the production of orthokeratinized epithelium.

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 Morphological Changes Associated With
Keratinocyte Maturation

• Progressive flattening of cells

• Increase in cell size

• Progressive loss of intracellular organelles

• Increase of tonofilaments

• Keratohyaline granules

• Membrane-coated granules

• Cell surface changes (marked folding; desmosomes; formation of cornified

envelope)
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KERATINIZATION

PARAKERATINIZATION
ORTHOKERATINIZATION

-only 15% area of gingival -75% is parakertiained

epithelium is orthokeratinized.
- Pyknotic nuclei in stratum
- No nuclei in stratum corneum. corneum.
- Well defined stratum -Keratohyaline granules
granulosum. dispersed.

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 KERATIN PROTEIN

k1 keratin polypeptide- main component of stratum

corneum.
Other proteins-
1. Keratolinin
2. Involucrin
3. filaggrin- it forms matrix of epithelial cells called as
corneocytes.

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TONOFILAMENTS

• The morphologic expression of the cytoskeleton of keratin

proteins.
• Radiate in a brushlike fashion from the attachment plaques
into the cytoplasm of the cells.

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 CELL JUNCTIONS

HEMIDESMOSOMES DESMOSOMES TIGHT GAP JUNCTION

JUNCTION

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1. HEMIDESMOSOMES

Specialized junctional
complexes, that
contribute to the
attachment of
epithelial cells to the
underlying basement
membrane.

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2. DESMOSOMES

• Connection between keratinocytes revealed at electron

microscopic level.
• Consist of 2 dense attachment plaques with an
intermediate gap.
• Acts as specific sites for signale transduction.
• They participates in – regulation of gene expression
- cell proliferation.
-cell differentiation.

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Desmosome

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 3. ZONA OCCLUDENS (tight
junctions)

• Less frequently observed.

• Membranes of adjacent cells
appear to be fused.
• Allows ions and small molecules to
passs from one cell to another.

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LAYERS OF EPITHELIUM
• Gingival epithelium is stratified squamous epithelium
which consist of 4 layers of strata.

1. Stratum basale
2. Stratum spinosum
3. Stratum granulosum
4. Stratum corneum.

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STRATUM BASALE
• Basal layer.
• Stratum germinativum.
• Cuboidal cells.
• Undergoes mitotic division - keratinocytes.
• Keratinocytes are formed - Divisions of the stem cells
• They synthesise some protein of basal lamina.
• Basal cells are connected to the basal lamina-
Hemidesmosomes
• With each other- Desmosomes.

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STRATUM SPINOSUM
• Cells are irregular and polyhedral.
• 10 to 20 layers.
• They are having cytoplasmic processes, gives prickly appearance.
• Cohesion between cells by desmosomes, with intercellular
protein-carbohydrate complex.

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STRATUM GRANULOSUM
• Cells are flat and wider, this layer is so named because of
the presence of keratohyline granules.

• Granules contain filaggrin that helps to aggregate

tonofilaments to form keratin.

• This layer still synthesize protein.

• More dense tonofilaments.

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STRATUM CORNEUM
• The corneocytes are formed by the bundle of keratin
tonofilaments embedded in amorphous matrix of filaggrin.

• Cells are larger and flatter, does not synthesize protein.

• Keratohyline granules and other cell organelles are

disappeared.

• No nuclei or pyknotic nuclei.

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 Morphologically and functionally
gingiva is divided into 3 parts.

1. Oral Epithelium
2. Sulcular Epithelium
3. Junctional Epithelium

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 ORAL EPITHELIUM

• It extends from gingival margin to alveolar

mucosa.
• It covers clinical visible part of marginal
gingiva and attached gingiva.
• It is 0.2 – 0.3mm thick.
• Keratinized- ortho/ para.

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 SULCULAR EPITHELIUM

EXTENSION:
• Coronally-height
• It of the
lines the gingival free gingival margin
sulcus.
Apically-
Faces thesloughing surface
tooth without of junctional
being contact epithelium
with tooth.
•• It
Itexihibits
is thin nonthe same 4 epithelial
keratinised strata but a definitive and
stratified
cornified
squamous layer is absent.
Epithelium.
• K9,K13 and K14 Proteins.
• It contains Langerhan’s cells.

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• Acts as a semipermeable membrane

1. bacterial products pass

into the gingiva.
2. Tissue fluid from the gingiva
seeps into the sulcus.

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 JUNCTIONAL EPITHELIUM

Epithelantz Junctional
By Gotelieb Epithelium
in 1921 By Stern

• Consist of collar like bands of stratified Squamous non

keratinized epithelium.
• Forms the tissue attachment to the tooth.
• 3- 4 layers, increases with age- 10 to 20 layers.
• Length -0.25 to 1.35 mm.
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It consist of 2 layers of strata-

1. Basal layer 2. Supra basal layer

facing C.T. facing tooth.

• Lysosomes bodies & PMNs present routinely.

• PMNs increase- plaque & gingival inflammation.
• Also contains - k5, k14,K19.
• Cells of junctional epithelium-
1. Production of Laminin.
2. Role in adhesion mechanism. 38
Attachment of junctional Epithelium

• Attached to the tooth- internal basal lamina.

• Attached to the gingival C.T.- external basal lamina.
• Internal basal lamina consist of- lamina densa+ lamina lucida.
• Attachment of the J.E. to the tooth reinforced by gingival
fibers forms a unit- DENTO GINGIVAL UNIT.

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 FUNCTIONS

• Forms the attachment to the tooth forming epithelial barrier against

plaque bacteria.
• Allows access of GCF, inflammatory cells and components of
immunological host defence.
• Exhibits rapid turnover rate i.e. 1 to 6 days, which consist of host
parasite equilibrium and rapid repair of damaged tissue.

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Connective Tissue & Epithelium
Interface
• Basal lamina acts as the connecting cord between the
epithelium & connective tissue.

• It is special structure organised as thin sheet immediately

adjacent to the epithelium and is 400A⁰ thick.

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 Basal lamina

Lamina lucida Lamina densa

Electrolucent
20 to 40 nm wide Electrodense
Glycoprotien 20 to 100nm wide
(laminin) Type iv collagen

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SIGNIFICANCE OF BASEMENT MEMBRANE

Acts as
Plays
dynamic sieve major role
controlling in giving
the response
movement of to tissue
molecules.
injury

Helps in
epithelium
connective tissue
attachment
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RENEWAL OF GINGIVAL EPITHELIUM
• Constant renewal.
• Thickness maintained by new cell formation in basal, spinous
cells & shedding on cell surfaces.
• MITOTIC RATE- 24 hours periodically.
• Buccal Mucosa, Hard Palate.
• Sulcular , Junctional Epithelium.
• Marginal , Attached Gingiva.

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Cuticular structures
• Thin, acellular structures with homogenous matrix.
• Listgarten classification-

1. Acquired coating 2. Coating of

(exogenous origin) developmental origin.
eg. Saliva, bacteria, eg. REE, coronal
calculus, stains. cementum, dental cuticle.

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GINGIVAL CONNECTIVE TISSUE
• LAMINA PROPRIA.
• Fibrous connective
tissue.
• Consist of two layers-
1. Papillary layer- Subjacent to
epithelium, consist of papillary
projections.
2. Reticular layer- it is
contiguous with periosteum.
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 Fibroblast
Cellular
Mast cells
compartment
Macrophages

Gingival Connective Inflammatory cells

Tissue

Fibres
Extracellular
compartment Ground substance

Nerves and vessels

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 Fibroblast
Cellular Mast cells
compartment
Macrophages

Gingival Connective Inflammatory cells

Tissue

Fibres
Extracellular
compartment Ground substance

Nerves and vessels

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1. Fibroblast

• Mesenchymal in origin.
• Present between fibre bundles.
• Play role in- development, maintenance, repair of gingival C.T.
• It synthesis collagen, elastin fibers, glycoprotein and GAG.
• Secrete metalloproteinase in an inactive form.
• Also regulate collagen degradation through phagocytosis and
secretion of collagen.

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 2. Mast cells
• Numerous in the connective tissue of the oral mucosa and
gingiva.
• These are responsible for the production of certain
component of matrix.
• Also produce vasoactive substances – Histamine and
Heparin.

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 3.MACROPHAGES AND HISTIOCYTES
• Components of the mononuclear phagocyte system (reticulo-
endothelial system) and are derived from blood monocytes.
• Act as scavenger.
• Activated macropghages release neutrophill chemotactic
factors PG and IL1 - regulate immune response.

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4.INFLAMMATORY CELLS :

• Neutrophils- relatively high numbers in both the gingival

connective tissue and the sulcus.

• Small foci of plasma cells and lymphocytes- near the base of

the sulcus.

• These present in small amounts in clinically normal gingiva.

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 Fibroblast
Cellular
Mast cells
compartment
Macrophages

Gingival Connective Inflammatory cells

Tissue

Fibres
Extracellular
compartment Ground substance

Nerves and vessels

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Extra cellular elements

FIBERS- Collagen
Reticulin
Elastin
The Elastic Fiber System Is Composed Of –
Oxytalan
Elaunin
Elastin

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1. Collagen

• Type 1 & 3
• Made bulk of Lamina propria
• Provides tensile strength
• Type 4- provides branches
between type 1 and with BM
& blood vessesl walls.

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2. RETICULIN FIBERS:

• Present in epithelium-connective tissue interface

• Exihibit argyrophilic properties

• They also occur in large number in tissue surrounding the

blood vessels

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3. ELASTIC FIBERS

Present in association with

the blood vessels

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4. OXYTALAN FIBERS
• Are scarce in gingiva but numerous in PDL.

• Composed of fibrils with diameter of 150 A

• Immature fibers

• Parallel to the long axis of tooth

• FUNCTION- unknown

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Ground substance

• Fills space between fibers & cells.

• Amorphous.
• Produced by fibroblast cells.
• Consist of- Protein carbohydrate complex
1. proteoglycans- GAG ( hyaluronic acid) &
chondroitin sulphate.
2. glycoprotein- fibronectin
Osteonectin
Laminin. 62
Ground substance matrix is necessary :

connective tissue cells and fibers are • Medium

Medium embedded. • Medium

Maintenance normal function of connective tissue.

water, electrolytes, nutrients, metabolites to

Transportation and from the cells.

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 GINGIVAL FIBERS

• The connective tissue of marginal

gingiva is densly collagenous,
containing a prominent system of
collagen fiber bundles called as
gingival fibres.
• Type 1 collagen.

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1. To brace the marginal gingiva firmly
against the tooth.
2. To provide the rigidity necessary to withstand
the forces of mastication.
3. Unite the free marginal gingiva with the
cementum of the root and the adjacent
attached gingiva.

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 PRINCIPAL SECONDARY
FIBERS FIBERS

1. Periostogingival
1. Dentogingival
2. Interpapillary
2. Alveologingival
3.Transgingival
3. Circular
4. Intercircular
4. Dentoperiosteal
5. Intergingival
5. Transeptal
6.Semicircular

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1. DENTOGINGIVAL GROUP
▪ Embeded in cemetum.
▪ Extends to periosteum.
▪ Interproximally extends to crest of
Interdental Gingiva.
▪ Facial, lingual and interproximal surfaces.

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2.ALVEOLOGINGIVAL—
✓ Attach gingiva to bone
Originate – periosteum of alveolar crest
Attached - attached gingiva
3.DENTOPERIOSTEAL –anchor tooth
to periosteum, protect the periodental ligament
Originates – cementum
Insertion – alveolar process

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4. CIRCULAR GROUP-
▪ Course through connective tissue of
marginal & interdental gingiva and encircle
tooth in ring like fashion.

5. TRANSEPTAL-
▪ Present interproximally.
▪ Maintain relationship of adjacent
teeth.
▪ Extends between cementum of
approximating teeth.

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SECONDARY FIBERS
1. TRANSGINGIVAL
2. INTERPAPILLARY
3. INTERCIRCULAR
4. INTERGINGIVAL
5. SEMICIRCULAR

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1. TRANSGINGIAVL- Secure alignment of the teeth in the
arch.

2. INTERPAPILLARY- Provide support of interdental gingiva.

3. INTERCIRCULAR- Stabilize teeth in arch n maintain arch
integrity .
4. INTERGINGIVAL- Provide support and contour of
attached gingiva.
5. SEMICIRCULAR- at interproximal surface, below CEJ.

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 BLOOD SUPPLY TO THE GINGIVA
1. Supra-periosteal Arterioles- Facial and
lingual surfaces of the alveolar bone.
2. Vessels of periodontal ligament-
extends into the gingiva.
3. Arterioles- emerging from the
crest of the interdental septa.
anastomose with vessels of periodontal
ligament.

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 Regular, repetitive, layered pattern of
Healthy blood vessels.

Irregular, vascular plexus pattern, micro-

Inflammation vessels- looped and dilated, convoluted
appearance.

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LYMPHATICS

• Diffuse excess fluid, cellular and protein debris,

microorganism & other elements.
• Control diffusion and resolution of inflammatory process.
supplied from lymphatics of C.T. papillae.

Progress into periosteum

Regional Lymph nodes

SUBMAXILLARY GROUP 74
GINGIVAL INNERVATION

• Mostly myelinated.
• Closely associated with blood vessels.
• Arising from PDL from labial, buccal, & palatal nerves
prsesnt in C.T.
• Receptors are seen as free endings within the papillary layer
of the lamina propria.

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THE FOLLOWING NERVE STRUCTURES ARE PRESENT IN
THE CONNECTIVE TISSUE:

1. Meshwork of terminal argyrophilic fibers, some of which

extend into the epithelium.
2. Messner type tactile corpuscles.
3. Krause type end bulbs which are temperature receptors.
4. Encapsulated spindles.

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 THANK YOU

Dr. Soundarya Singh

Lecturer
Department of Periodontology
Subharti Dental College and Hospital
Meerut

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