Anatomic characteristics of periodontium.
Periodontium is the definition of the tissue that surrounds the teeth. It supports them and attaches them to the bone. It contains different types of tissue that have different characteristics and functions in the oral cavity. Periodontium plays a significant role in maintaining stability and health in the entire oral cavity.
Periodontium includes Gingiva, periodontal ligaments, cementum, and alveolar bone.
Gingiva is one of the most important components of periodontium. If supports our teeth during mastication of our food and furnishes it with blood supply and its inatomy plays an important role in avoiding the food being stacked in between our teeth ( interproximal space).
Gingiva is described as coral pink or pale pink and its bordered between CEJ ( cemento enamel junction) and mucogingival junction ( a line not well defined that separates the attached gingival with oral mucosa). Gingiva has two important components:
The free gingiva or free marginal gingiva is 1.5 to 2 mm and surrounds the teeth creating a collar or wrap around them. Right after free gingiva apically ( towards the root direction) there is the attached gingiva which is distinguished with the free gingiva by a grove that is called free gingival grove ( a slightly depressed area between two types of gingiva that corresponds to the depth of the sulcus. This grove is mostly expressed on premolars and mandibular anteriors. occurs in 50% of the times and it depends from tooth to tooth. One characteristic of the free gingiva in comparion with the attached gingiva is that free gingival is softer and loose. Free gingiva is less visible in posterior teeth and often ends in a knife edged tip next to the tooth surface. The papillae are the gingival that fills the empty space between the teeth ( proximal-embrasure ). These papillae are also called interdental papillae or just papillae. Papillae between the anterior teeth have the shape of a reversed triangle and is narrower compared to the posterior papillae that are wider in the base and have not the same height as the anteriors papillae. When the papillae are broad as we can often see them in posterior teeth, there is a nonkeratinezed area called COL. Col is a slight depression of tissue that is located between buccal and lingual interdental papillae. To better understand where exactly COL is located think of the papillae as a reversed triangle. Cool is loated right on the coronal vertice. Col in fact can be described as a depression created as a consequence of the fusion of two papillae. It is usually found on posterior teeth because the interproximal embrasure on posterior teeth is wider then anteriors. When adjacent teeth don’t touch each other
( whether anterior or posterior teeth) the interdental space is wide and therefore the papillae and col will be absent. In this case instead of free gingiva a more keratinized tissue called attached gingival will be formed.
Is firmly attached to the bone. The width of the attached gingival varies from individual to individual and from tooth to tooth. The average width of attached gingival varies from 3.4 to 3.9 mm. in the palate attached gingiva blends with the oral mucosa and its hard to distinguish any border or significant demarcation between them. Its interesting to know that there’s no minimum width required in order to determine a periodontal health. Attached gingival is keratinized or parakeratinized ( half keratinized) and it has a stippled texture in healthy status. Non stippled gingiva is a sign of inflammation and presence of periodontal disease ( not always, in some cases some exceptions are made).