corelation between microscopic and macroscopic features of gingiva- dr harshavardhan patwal
TRANSCRIPT
![Page 1: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/1.jpg)
Presented by ,Dr Harshavardhan Patwal
![Page 2: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/2.jpg)
![Page 3: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/3.jpg)
OMM consist of 3 zones:
a.Masticatory mucosa-25%
b.Specialized mucosa-15%
c. Lining mucosa-60%
![Page 4: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/4.jpg)
DEFINITION: It is that part of the oral mucous membrane that covers the alveolar process and the cervical portions of the teeth.
CLINICAL FEATURES:
gingiva is anatomically divided into:
a.Marginal gingivab.Attached gingivac.Interdental gingiva
![Page 5: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/5.jpg)
INTERDENTAL GINGIVA
Interdental gingiva
![Page 6: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/6.jpg)
Gingiva is histologically divided into:
Epithelium
Connective tissue
![Page 7: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/7.jpg)
Various portions are seen to orginate from distinct portions of odontogenic sequence and developing oral mucosal tissues.
Non-keratinized junctional epi Enamel organ.
Non- keratinized sulcular epithelium & keratinized gingival epi oral mucosa.
![Page 8: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/8.jpg)
PROTECTIVE BARRIER.
FORMS AN ATTACHMENT APPARATUS TO THE TOOTH SURFACE.
BIDIRECTIONAL MOVEMENT OF SUBSTANCES.
CAPABLE OF REACTING TO EXTERNAL STIMULI.
PRODUCES POTENT ANTIMICROBIAL PEPTIDES
gingival epithelium is an important initiator, mediator, regulator of host responses..
![Page 9: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/9.jpg)
3 DIFFERENT FORMS OF STRATIFIED SQUAMOUS EPITHELIA ARE:
a. Orthokeratinized epitheliumb. Non-keratinized epitheliumc. Parakeratinized epithelum
2 MOST IMPORTANT PROCESS RESPONSIBLE FOR FORMATION OF SUPERFICIAL LAYER OF EPITHELIUM ARE:
Epithelial proliferation.
Epithelial maturation. Maturation in the oral cavity follows two main pattern:
Keratinization(Cornification). Non-keratinization.
![Page 10: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/10.jpg)
DEPENDING ON THE LOCATION OF GINGIVAL EPITHELIUM
Oral or outer epithelium
Sulcular epithelium
Junctional epithelium
![Page 11: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/11.jpg)
covers the crest and outer surface of marginal gingiva and surface of attached gingiva.
0.2-0.3mm in thickness.
Either keratinized or parakeratinized.
Keratinized epithelim shows 4 distinct layers- - Stratum Basale - Stratum Spinosum - Stratum Granulosum - Stratum Corneum
![Page 12: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/12.jpg)
![Page 13: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/13.jpg)
Keratinised epithelium non-keratinised epithelium
![Page 14: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/14.jpg)
SULCULAR EPITHELIUMlines the gingival sulcus. thin, non-keratinized stratified squamous epithelium without rete pegs.Extends from the coronal limit of the junctional epithelium to the crest of gingival margin.
JUNCTIONAL EPITHELIUM consist of a collar like band of stratified squamous Non-keratinizing epithelium. It is formed by the confluence of oral epithelium and reduced enamel epithelium.Dentogingival unit: Junctional epithelium along with gingival fibres forms the dentogingival unit.
![Page 15: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/15.jpg)
![Page 16: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/16.jpg)
Tonofilaments and Desmosomes are what distinguishes them as epithelial cell. Tonofilaments- fibrous proteins, synthesized by ribosomes, appr 8nm, chemically they represent a class of intercellular proteins known as Cytokeratins.Keratins-are a family of related proteins that are the predominant cytoskeletal proteins in all epithelia.C1, C2, C10, C11, C12- seen in most keratinized epithelia.C5-C14- Stratification specific cytokeratins.C6-C16- Highly proliferative epithelium.C4-C13- Eosophageal type Cytokeratin.C19- Non-keratinized, Parakeratinized. An important property of the epithelium is its ability to function as a barrier, and this depends on its cohsiveness. Cohisiveness is provided through-viscous intercellular material,Desmosomes, Hemidesmosomes, Tonofilaments.
![Page 17: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/17.jpg)
DESMOSOME
![Page 18: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/18.jpg)
HEMIDESMOSOMES
GAP AND TIGHT JUNCTIONS
![Page 19: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/19.jpg)
MelanocytesMerkels cellsInflammatory cellsLangerhans cells
![Page 20: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/20.jpg)
![Page 21: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/21.jpg)
The connective tissue supporting the oral epithelium is termed Lamina propria.Divided into •The superficial papillary-Collagen fibres are loosely arranged.•The deeper reticular layer
Lamina propria consist of cells, Blood vessels, neural elements, fibres embedded in Ground substance (matrix).
![Page 22: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/22.jpg)
o Fibroblasts.o Macrophages.
Melanophage Siderophage
o Mast cells.o Inflammatory cells
PMNs Lymphocytes Plasma cells
![Page 23: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/23.jpg)
Collagen fibres. Reticulin Fibres. Oxytalan Fibres. Elastic Fibres
![Page 24: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/24.jpg)
![Page 25: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/25.jpg)
Main constituent of connective tissue matrix are protein carbohydrate macromolecules.
They are divided as Proteoglycans and Glycoproteins.
![Page 26: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/26.jpg)
•Coral pink/pigmentation.
• Knife -like margin.
• Papilla fill to contacts.
•Firm and resilient.
•Attached gingiva stippled.
•Free gingival margin 1-3mm coronal to CEJ.
• Scalloped to follow bone contours.
![Page 27: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/27.jpg)
Color:
![Page 28: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/28.jpg)
Size:
Size –can change with increase in connective tissue and/or inflammatory components
![Page 29: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/29.jpg)
Contour:
Contour maybe related to the tooth positioning
![Page 30: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/30.jpg)
Shape- Correlated with the shape of the teeth and contacts/embrasures
![Page 31: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/31.jpg)
Consistency-Firm,resilient and bound to the bone.
Surface texture-Attached gingiva is stippled (orange peel appearance).This is due to the normal protruberances and depression in the gingiva.
Position-Level at which gingiva is attached to the tooth.Changes as the teeth erupts.
Elevations and depressions are responsible for stippled appearence
![Page 32: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/32.jpg)
Active- Coronal movement of the teeth.Passive- Apical migration of gingiva
![Page 33: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/33.jpg)
Thank you
![Page 34: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/34.jpg)
![Page 35: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/35.jpg)
![Page 36: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/36.jpg)
![Page 37: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/37.jpg)
![Page 38: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/38.jpg)
![Page 39: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/39.jpg)
![Page 40: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/40.jpg)
![Page 41: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/41.jpg)
![Page 42: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/42.jpg)
![Page 43: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/43.jpg)
![Page 44: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/44.jpg)
![Page 45: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/45.jpg)
![Page 46: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/46.jpg)
![Page 47: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/47.jpg)
![Page 48: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/48.jpg)
![Page 49: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/49.jpg)
![Page 50: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/50.jpg)
![Page 51: Corelation between microscopic and macroscopic features of gingiva- Dr Harshavardhan Patwal](https://reader035.vdocuments.us/reader035/viewer/2022062900/58ea1a361a28ab064e8b63c9/html5/thumbnails/51.jpg)