The gums or gingiva (plural: gingivae ), consists of mucosal tissue located above the lower jaw and upper jaw in the mouth. Health gums and diseases can have an impact on general health.
Video Gums
Structure
The gums are part of the soft tissue layer of the mouth. They surround the teeth and give seals around them. Unlike the soft tissue lining of the lips and cheeks, most of the gums are tied tightly to the underlying bone which helps withstand the friction of food that passes through it. So when it is healthy, it presents an effective barrier to the periodontal sequence of insults to the deeper tissues. Healthy gums are usually pink in light skinned people, but may be naturally darker with melanin pigmentation.
Color changes, especially increased redness, along with swelling and increased tendency to bleed, suggest an inflammation that may be caused by accumulation of bacterial plaque. Overall, the clinical appearance of the tissues reflects the underlying histology, both in health and disease. When gum tissue is unhealthy, it can be a gateway for periodontal disease to progress to deeper tissues of the periodontium, leading to a poorer prognosis for long-term retention of teeth. Both types of periodontal therapy and homecare instruction given to the patient by the dentist and restorative treatment are based on the clinical condition of the tissue.
The gums are divided anatomically into marginal areas, attached and interdental.
Marginal gums
Marginal gums are the ends of the gums that surround the teeth in a collar-like manner. In about half of individuals, it is constrained from adjacent gums, attached by shallow linear depression, free gingival groove. Mild depression on the outer surface of the gums is not related to the depth of the gingival sulcus but rather to the apical border of the junctional epithelium. This outer groove varies profoundly according to the area of ​​the oral cavity; the grooves are very prominent on the anterior and premolars of the mandible.
The marginal sugars vary in width from 0.5 to 2.0 mm from the free gingival peak to the attached gingiva. The marginal gingiva follows a scalloped pattern formed by the contours of the cementoenamel (CEJ) tooth joint. Marginal gingiva has a more transparent appearance than inherent gingiva, but has the same clinical appearance, including tilting, dullness, and firmness. In contrast, the marginal gingiva has no stippling presence, and the tissue moves or is free of the underlying surface of the tooth, as can be demonstrated by periodontal examination. Marginal gingiva is stabilized by gingival fibers that have no bone support. The gingival margin, or the free gingival symbol, in the shallowest part of the marginal gingiva, is also readily seen clinically, and its location should be recorded on the patient chart.
Attached chewing gum
Gums are attached continuously with marginal gums. It is firm, resilient, and firmly bound to the underlying alveolar bone periosteum. The facial aspect of the inherent gum extends to the relatively loose and moving alveolar mucosa, from which it is limited by the mucogingival junction. The attached sap may appear with surface solidification. The tissues when dried are dull, loud, and immobile, with varying amounts of rounding. The width of the inherent candy varies according to its location. The width of the gums attached to different facial aspects in different areas of the mouth. It is generally the largest in the dental region of the series (3.5-4.5 mm in the maxilla and 3.3 to 3.9 mm in the lower jaw) and less in the posterior segment, with width at least in the first premolar region (1.9 mm in the maxilla and 1.8 mm in the lower jaw). However, a certain level of inherent gums may be necessary for root stability of the underlying tooth.
Interdental gums
Interdental gums are located between the teeth. They occupy the gingiva embrasure, which is the interproximal space beneath the tooth contact area. The interdental papilla may be pyramidal or have a "col" shape. Gums attach resistance to the strength of chewing and covered in keratin.
Col varies in depth and width, depending on the stretch of tooth surface touching. The covering epithelium of cab consists of adjacent gum marginal gear, except that it is not keratinized. It is particularly present in the posterior gingiva interdental broad posterior teeth, and is generally absent with the interproximal tissues associated with the anterior teeth because the latter tissue is narrower. In the absence of contact between adjacent teeth, the attached sap is not disturbed from the face to the lingual aspect. Colon may be important in the formation of periodontal disease but is seen clinically only when the tooth is extracted.
- Interdental Area
It is part of the gum that extends between two teeth to the point of contact. There are interdental facial papilla facial and lingual interdental papilla. The interdental Papilla has a peak and a concave margin. The ends and margins are unbound and the center is attached. In inflammation the interdental papilla loses its concavity.
Maps Gums
Characteristics of healthy gums
Color
Healthy gums usually have a color that has been described as a "pink reef." Other colors such as red, white, and blue may indicate inflammation (gingivitis) or pathology. Although depicted as a pink coral color, color variations are possible. This could be the result of factors such as: the thickness and degree of epithelium keratinization, blood flow to the gums, natural pigmentation, illness and drugs.
Because the color of the gums can vary, color uniformity is more important than the underlying color itself. Excess melanin deposits can cause dark spots or patches of gums (melanin gingival hyperpigmentation), especially in the base of the interdental papillae. Gum depigmentation (aka rubber bleaching) is a procedure used in cosmetic dentistry to eliminate these color changes.
Contour
Healthy gums have a curved appearance or fine teeth around each tooth. Healthy gums fill and adjust every space between the teeth, unlike swollen gum papilla seen in gingivitis or empty interdental lesions seen in periodontal disease. Healthy gums are firmly attached to each tooth because the gum surface narrows to the thin "edge of the blade" at the free gingival margin. On the other hand, inflamed gums have "swollen" or "rolled over" margins.
Texture
Healthy gums have a firm texture that is resistant to movement, and surface textures often show surface stippling. Unhealthy gums, on the other hand, are often swollen and less strong. Healthy gums have a texture like orange peel due to stippling.
Reaction to interruption
Healthy gums usually have no reaction to normal disorders such as brushing or periodontal probing. Unhealthy gums, on the other hand, will show bleeding on probing (BOP) and/or purulent exudates.
Clinical interests
The microecosystem of the gingival cavity, triggered by food and saliva residues, can support the growth of many microorganisms, some of which can harm health. Improper or inadequate oral hygiene can lead to a lot of gum and periodontal disorders, including gingivitis or periodontitis, which is a major cause of dental failure. Recent studies have also shown that anabolic steroids are also closely related to gingival enlargement that requires gingivectomy for many cases. The gingival recession is when there is an apical movement of the gum margin away from the surface of the bite (occlusal). This may indicate an underlying inflammation such as periodontitis or pyorrhea, pocket formation, dry mouth or marginal gum movement away from the teeth by mechanical means (such as brushing), chemistry, or surgery. Gingival retraction, in turn, can expose the tooth neck and make it vulnerable to external stimulus action, and can cause root sensitivity .
See also
- Gum
- Head and neck anatomy
- Periodontitis
References
Source of the article : Wikipedia
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