The objective of the study was to determine if there was any correlation between gingival stippling and thickness. It occurs in response to the bacteria that live in biofilms at the gingival margin and in the sulcus. The junctional epithelium is the area where the gingiva is bound to the tooth. Part of oral mucosa that covers the alveolar processes of the jaws and surrounds the necks of the teeth. Gingiva definition of gingiva by medical dictionary. The prosthetic management of gingival aesthetics british. Gingival stippling, thats orange peel look of healthy gingival surface is a distinguishing feature of the attached gingiva 1. Rounded free gingiva forming a sulcus between tooth and gingiva. A shallow linear depression, the gingival groove, can be observed in some areas, distinguishing the free gingival margin from the attached gingiva. On the other hand, inflamed gums have a puffy or rolled margin. Gingiva comprises of two parts free gingiva and attached gingiva. Metal toxicity knowledge for medical students and physicians. Impact of thyroid hormone dysfunction on periodontal disease. This presentation will dictate the importance of attached gingiva in health and disease and the various controveries and studies related to it.
Clinically, a pink gingiva with marked stippling can be seen to cover almost all the tooth, in many cases preventing. Pain may be associated due to secondary traumata via brushing, flossing or chewing. The clinician however, must take in consideration that its pattern and extent varies in different mouth areas, among persons and with age. Anatomical relationship of normal gingiva in facial view a and in crosssection b. The fremitus test was positive with the presence of. Healthy gums hold tight to each tooth in that the gingival surface narrows to knifeedge thin at the free gingival margin. Free gingival margin thicker and rounder due to cervical constriction of primary teeth flaccid and retractable immature connective tissue, immature gingival fiber system, increased vascularization attached gingiva appears less dense and redder thinner, less keratinized epithelium incidence of stippling 35% greater width. The gingival sulcus is v shaped shallow crevice or space around the tooth bounded by the surface of the tooth on one side and the epithelium lining the free margin of the gingiva on the other side. It surrounds each tooth to form a collar of tissue with a potential space or gingival sulcus crevice hidden between itself and the tooth. It is demarcated from the adjacent attached gingiva by a shallow linear depression, the free gingival groove.
A free powerpoint ppt presentation displayed as a flash slide show on id. Pdf diagnosis of periodontal disease, a frequent disorder in dogs, rests mainly upon the assessment of changes affecting the gingiva. A systemic clinical approach requires an orderly examination of the gingiva for color, contour, consistency, position, ease and severity of bleeding, and pain. On clinical examination, there was minimal local deposits, generalized grade ii type of inflammatory enlargement with loss of stippling, spontaneous bleeding, and the presence of periodontal pockets of 57 mm. The free gingival margin is the interface between the sulcular epithelium and the epithelium of the oral cavity. The free gingival groove lies approximately at the same level of the bottom of the gingival sulcus. Gingival stippling in young adult males rosenberg 1967. Gingival enlargement associated with acute myelocytic. In adults, this lesion frequently represents as firm, pink, uninflammed mass, and it seems to grow from below the free gingival margininterdental papilla figure figure1a. Scribd is the worlds largest social reading and publishing site.
The tissue when dried is dull, firm, and immobile, with varying amounts of stippling. Prevalence of gingival stippling among 48 years old children. The elucidation of gingival stippling is always contentious as there is no sufficient availability of clinical. Gingival stippling is a characteristic of the healthy attached gingiva and its diminution or loss has been considered as a sign of gingival disease. Epidemiology and indices of gingival and periodontal disease. The aim of this study was to examine the gingival stippling in children. Each of the buccal, mesial, lingual and distal surfaces of the gingival tissues is given a score of 03.
The gingiva consists of a free gingival margin and attached gingiva. Gingival overgrowth may vary from isolated mild enlargement of interdental papilla or a uniform enlargement which may affect either one or both jaws. Only one child showed stippling in the free gingiva, too, but this. Pdf prevalence of gingival stippling among 48 years old. Clinical features of gingivitis authorstream presentation. Outlines the problems associated with soft tissue and in particular gingival defects such as recession.
Usually, the gingiva is swollen with lack of stippling and coloring that is pale red to deep purple. In the early primary dentition, gingivitis is uncommon. The degree of keratinization and the prominence of stippling appear to be related. The gingiva often possess a textured surface that is referred to as being stippled engraved. The anatomy and physiology of the healthy periodontium. The free gingival groove follows the contour of the cementoenamel junction. The histological and immunohistochemical findings in one of the sections showed it to be characteristic of schwannoma. The degree of keratinization and stippling are related and depend on each other. Free gingiva the zone closest to the tooth crown is the free gingiva, which is the tissue that is not firmly attached to the tooth or alveolar bone. Attached gingiva firm, resilient, and tightly bound to the underlying periosteum of alveolar bone mucogingival junction absent on palate stippling orange peel appearance 10.
Loss of gingival stippling, one of the early symptoms of periodontal disease in the human, could also indicate early periodontitis in. Stippling is restricted to the attached gingiva, i. Electronic measurement of gingival color by digital image is a noninvasive reproducible inexpensive method of. And hence there is need for the best evidence in this field. In the presence of gingival inflammation, the gingiva is red, edematous, bleeds on slight provocation or spontaneously, and is swollenenlarged associated with loss of stippling. What is stippling of gingiva and how is it formed and. Gingivitis is characterized by inflammation of the gingival tissues with no loss of attachment or bone. Epidemiology and indices of gingival and periodontal disease sven poulsen, dr odont. The lesion, provisionally diagnosed as idiopathic gingival enlargement, was completely excised and divided into two sections. Gingival and dentogingival junctional tissue pocket. The attached gingiva is a masticatory mucosa see chapter 9.
Discussion the texture of the gingival surface may be similar to orange peel and is referred to gingival stippling 5. It is caused by intersection of epithelial rete ridges. Gingival overgrowth associated with leukemia is characterized by progressive enlargement of the interdental papillae and the marginal and attached gingiva, and, in severe cases, the crowns of the teeth may be covered. Request pdf prevalence of gingival stippling in children gingival stippling is a. Gingival extension procedures using free palatal mucosal autografts or. This interface exists at the most coronal point of the gingiva, otherwise known as the crest of the marginal gingiva because the short part of gingiva existing above the height of the underlying alveolar process of maxilla, known as the free gingiva, is not bound down to the. Healthy attached gingiva is pink in color, with some areas of melanin pigmentation possible see figures 210 and 922. Conflation of gingival overgrowth and schwannoma bmj. Usually this stippling from the gingiva is lost in cases of. Prevalence of gingival stippling in children request pdf.
Hereditary gingival fibromatosis hgf is a rare disorder characterized by a benign, nonhemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. The width of the attached gingiva varies according to its location. It has been observed that thick gingiva has coarse and diffuse stippling whereas thin gingiva has fine and scanty stippling. The free gingival margin covers the cementoenamel junction cej and the gingival papillae fill the embrasures. The texture of the gingival surface may be similar to orange peel and is referred to gingival stippling.
Prevalence of gingival stippling among 48 years old. Attached gingiva is very important in maintaining the health and integrity of the marginal gingiva. Prevalence of gingival stippling in children allen press. Maintenance of gingival health post professional care. The result was also showed nonsignificant association of gingival stippling between upper and lower jaws as the p value was 0.
The authors describe a seminal case report of a 10yearold boy with enlarged gingivae in relation to his maxillary anterior teeth. Outlines the various management techniques for the improvement of gingival aesthetics. Exposure to toxic amounts of heavy metals such as mercury, lead, chrome, and cadmium can be harmful to the human body, potentially causing both acute symptoms e. Free gingival groove the free gingival groove, a shallow depression on the outer surface of the gingiva, is about 1 to 2 mm apical from the margin of the gingiva and is slightly apical to the level of the cementoenamel junction. The anatomy and physiology of the healthy periodontium will be described in its. Determining factors for periodontal disease progression and treatment outcome neha joshi1, manvi chandra agarwal 2. University of illinois, college of dentistry, 808 south wood street, chicago, illinois. While free gingiva surrounds the tooth creating a collar around the crown, it is portion of the gingiva which extends from. There is no interference with normal masticatory function, the tooth is firm. Ppt oral mucosa powerpoint presentation free to view. Inflammation, bleeding upon probing, and pocket depths are the most important diagnostic aids or signs of gingival or periodontal. Stippling is a consequence of the microscopic elevations and depressions of the surface of the gingival tissue due to the connective tissue projections within the tissue. Clinical gingival health is identified by minimal sulcus depth, stippling, gingival colour of pale or coral pink with a knife edge that adapts closely around the tooth with no evidence of bleeding when probed. Gingival stippling definition of gingival stippling by.
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