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The periodontium is defined as the tissues puting and back uping the dentition ( Hassell, 1993 ) . It is composed of the undermentioned tissues: alveolar bone, root cementum, periodontic ligament and gum ( Lindhe et al. , 2008, Hassell, 1993 ) . The chief map of the periodontium is to attach the tooth to the bone of the jaws for equal map and to keep the unity of the surface of the masticatory mucous membrane of the unwritten pit ( Lindhe et al. , 2008 ) . It undergoes alterations with age, and is subjected to morphologic alterations in relation to functional changes and changes in the unwritten environment ( Lindhe et al. , 2008 ) . The healthy gum usually covers the alveolar bone and root to a degree merely coronal to the cementoenamel junction ( Fig. 1 ) . The gum is classified into the free fringy gum, the interdental gum and the affiliated gum ( 187 ) .
Gingivas are portion of the soft tissue liner of the oral cavity. They surround the dentitions and supply a seal around them. Compared with the soft tissue liners of the lips and cheeks, most of the gum are tightly bound to the underlying bone and are designed to defy the clash of nutrient passing over them ( Lindhe 2008 ; Narayanan 1996 ) . Healthy gum is normally coral pink, but may incorporate physiologic pigmentation. Changes in colour, peculiarly increased inflammation, together with hydrops and an increased inclination to shed blood, propose an redness that is perchance due to the accretion of bacterial plaque ( Capa N, 2007 ) .
The gum is divided anatomically into fringy, affiliated and interdental countries. The fringy gum is the terminal border of gum environing the dentition. In about half of persons, it is demarcated from the adjacent, attached gum by a shallow additive depression, the free gingival channel ( Capa N, 2007 )
The fringy gum is supported and stabilized by the gingival fibres. The affiliated gum is uninterrupted with the fringy gum. It is steadfast, resilient, and tightly bound to the underlying periosteum of alveolar bone. The facial facet of the affiliated gum extends to the comparatively loose and movable alveolar mucous membrane, from which it is demarcated by the mucogingival junction. Attached gum may show with surface stippling ( Schroeder HE, 1997 )
The interdental gum occupies the gingival port, which is the interproximal infinite beneath the country of tooth contact. The interdental gum can be pyramidic or have a “ gap ” shape.Attached gum is immune to masticatory forces and ever keratinised ( Stephen Burke Dent IV, 1994 ) .
Healthy gum normally has a colour that has been described as “ coral pink. ” Other colorss like ruddy, white, and blue can mean redness ( gingivitis ) or pathology. It has a smooth arcuate or scalloped visual aspect around each tooth. It besides fills and fits each interdental infinite, unlike the swollen gum papilla seen in gingivitis or the empty interdental port seen in periodontic disease. Healthy gum clasp tight to each tooth in that the gingival surface narrows to “ knife-edge ” thin at the free gingival border. On the other manus, inflamed gums have a “ puffy ” or “ rolled ” border. It has a steadfast texture that is immune to motion, and the surface texture frequently exhibits surface stippling. Unhealthy gum, on the other manus, is frequently conceited and mushy ( Seyedmajidi M, 2009 ) .
The gingival fibres are the connective tissue fibres that inhabit the gingival tissue adjacent to the dentition and aid keep the tissue steadfastly against the dentition ( Itoiz, ME, 2002 ) . They are chiefly composed to type I collagen, although type III fibres are besides involved These fibres, unlike the fibres of the periodontic ligament, in general, attach the tooth to the gingival tissue, instead than the tooth to the alveolar bone ( Schroeder HE, 1997 ) .
The gingival fibres hold the fringy gum against the tooth, supply the fringy gum with adequate rigidness to defy the forces of chew without falsifying, function to stabilise the fringy gum by unifying it with both the tissue of the more stiff affiliated gum every bit good as the cementum bed of the tooth ( Itoiz, ME, 2002 ) . There are three groups within which gingival fibres are arranged, they are dentogingival group, round group and transseptal group.
The junctional epithelial tissue is that epithelial tissue which lies at the base of the gingival sulcus. It attaches to the surface of the tooth with hemidesmosomes ( W.B. Saunders, 2002 ) . It lies instantly apical to the sulcular epithelial tissue, which lines the gingival sulcus from the base to the free gingival border, where it interfaces with the epithelial tissue of the unwritten cavity.Cells in the junctional epithelial tissue tend to hold broad inter-cellular infinites, to let the transmittal of white blood cells from blood vass to bottom of the gingival sulcus, to assist forestall disease. Damage to the junctional epithelial tissue consequences in it being irregular in texture, instead than smooth, and the formation of “ pocket ” epithelial tissue, which is a primary symptom of gingiva disease.
The sulcular epithelial tissue is that epithelial tissue which lines the gingival sulcus. It is apically bounded by the junctional epithelial tissue and meets the epithelial tissue of the unwritten pit at the tallness of the free gingival border. The sulcular epithelial tissue is nonkeratinized ( W.B. Saunders, 2002 ) .
The periodontic ligament, normally abbreviated as the PDL is a group of specialised connective tissue fibres that basically attach a tooth to the alveolar bone within which it sits. These fibres help the tooth withstand the of course significant compressive forces which occur during mastication and remain embedded in the bone ( Sloan, P, 1978 ; Sloan, P, 1979 ) .
Another map of the PDL is to function as a beginning of proprioception, or centripetal excitation, so that the encephalon can observe the forces being placed on the dentitions and react consequently. To accomplish this terminal, there are force per unit area sensitive receptors within the PDL which allow the encephalon to spot the sum of force being placed on a tooth during mastication, for illustration. This is of import because the open surface of the tooth, called enamel, has no such sensory receptors itself.
In add-on to the PDL fibres, there is another set of fibres, known as the gingival fibres, which attach the dentitions to their next gingival tissue. Both the gingival fibres, every bit good as the PDL fibres, are composed chiefly of type I collagen ( Ten Cate, A. R, 1998 ) .
The PDL is one of the four back uping tissues of a tooth, otherwise referred to as the periodontium. They are about 0.2 millimeters in breadth, and these dimensions lessening with age ( C. Kober, B, 2006 ) . As stated, the PDL fibres are composed chiefly of type I collagen, although type III fibres are besides involved. Compared to most other ligaments of the organic structure, these are extremely vascularized.
The PDL fibres are categorized harmonizing to their orientation and location along the tooth, such as collagen fibres, gingival fibres, trans-septal fibres, alveolar crest fibres, horizontal fibres, oblique fibres, apical fibres, and interradicular fibres ( Quigley, M.B, 1970 ; Cohn, S.A, 1972 ; Cohn, S.A, 1972 ) .
Cementum is a specialised calcified substance covering the root of a tooth. Cementum is excreted by cells called cementoblasts within the root of the tooth and is thickest at the root vertex. Its colour is xanthous and it is softer than enamel and dentin due to being less mineralized ( Jones SJ, 1972 ) .
The chief function of cementen within the tooth is to function as a medium by which the periodontal ligaments can attach to the tooth for stableness. Hence, its bottom surface is tangent to the periodontic ligaments running through the jaw ( via collagen fibres ) , and the upper part of the surface is steadfastly cemented to the dentin of the tooth. It besides meets the enamel lower on the tooth at the cemento-enamel junction. Here the cementum is known as noncellular cementum due to its deficiency of cellular constituents, and screens about 1/3-1/2 of the root ( Groeneveld MC, 1994 ) . The more permeable signifier of cementen, cellular cementum, covers 1/3-1/2 of the root vertex, where it binds to the dentin. There is besides a 3rd type of cementum, afibrillar cementum, which sometimes extends onto the enamel of the tooth.
The mucogingival junction is the intervention between the more apically located alveolar mucous membrane and the more coronally located affiliated gum of the air sac ( Schroeder HE, 1979 ) . There exists a mucogingival junction on all four gingival surfaces on which there exists freely impermeable alveolar mucous membrane: the facial gum of the upper jaw and both the facial and linguistic gum of the mandible. The palatine gum of the upper jaw is uninterrupted with the tissue of the roof of the mouth, which is bound down to the palatine castanetss. Because the roof of the mouth is barren of freely movable alveolar mucous membrane, there is no mucogingival junction ( W.B. Saunders, 2002 ) .
Hassell, TM. ( 1993 ) . Tissues and cells of the periodontium. Periodontol 2000 3, 9-38.
Lindhe, J. , Karring, T. , and Araujo, M. ( 2008 ) . Anatomy of the periodontium. In Clinical periodontology and implant dental medicine, Lindhe, J. , Karring, T. , and Lang, N.P. 4th erectile dysfunction Blackwell Publishing Limited pp. 3- ? .
Carranza ‘s Clinical Periodontology, W.B. Saunders, 2002, 17-23.
Itoiz, ME ; Carranza, FA: The Gingiva. In Newman, MG ; Takei, HH ; Carranza, FA ; editors: Carranza ‘s Clinical Periodontology, 9th Edition. Philadelphia: W.B. Saunders Company, 2002. 26-7.
Jan Lindhe, Niklaus P. Lang, and Thorkild Karring Clinical Periodontology and Implant Dentistry. Wiley-Blackwell ; 5 edition, 2008.