Questions and Answers
What is the thickness of the keratinized epithelium of the gingiva?
What is the term for the groove that differentiates the free gingiva from the attached gingiva?
What is the color of the gingiva in a healthy mouth?
What is the term for the depression and elevation seen on the surface of the attached gingiva?
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What is the term for the epithelium that surrounds the necks of the teeth?
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What is the term for the union of the oral epithelium and the reduced enamel epithelium of the developing tooth?
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What is the term for the space between two adjacent teeth?
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What is the term for the part of the gingiva that is tightly bound to the underlying periosteum of the alveolar bone?
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What type of epithelium covers the crest and outer surface of the marginal gingiva and the surface of the attached gingiva?
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What is the function of the junctional epithelium?
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What is the depth of the gingival sulcus?
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What type of fibers are present in the gingival connective tissue?
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What is the characteristic of sulcular epithelium?
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What is the consequence of disturbance of epithelial attachment?
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What is the characteristic of junctional epithelium?
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What is the purpose of the junctional epithelium and gingival fibers?
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Which structure initiates the formation of the dental root?
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What is the function of the epithelial diaphragm?
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During root formation, which cells differentiate into odontoblasts?
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What is the outcome of the disintegration of Hertwig's epithelial root sheath?
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At what stage does the root sheath development begin?
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What is the shape of the first formed part of the root sheath?
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Which of the following is NOT a function of Hertwig's epithelial root sheath?
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What is the outcome of the compensatory movement of eruption?
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What is formed at the bifurcation area during the development of multi-rooted teeth?
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What happens to the epithelial root sheath (HERS) as root formation progresses?
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Where are the epithelial cell rests of Malassez found?
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What can occur if the continuity of HERS is broken before dentin formation?
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What may occur if the HERS does not degenerate at the proper time?
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What can result from the inner cells of HERS differentiating into ameloblasts?
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Which of the following describes the consequence of chronic inflammation affecting the epithelial rests of Malassez?
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What is the primary role of the epithelial diaphragm in multi-rooted teeth formation?
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Study Notes
Masticatory Mucosa
- Covers the gingiva and hard palate
- Composed of thick (250µm) keratinized epithelium (either orthokeratinized or parakeratinized) with no submucosa
- Develops from the union of oral epithelium and reduced enamel epithelium of the developing tooth
Gingiva
- Clinically classified into 3 parts: free gingiva, attached gingiva, and interdental papilla
- Free gingiva:
- Surrounds the necks of the teeth
- Differentiated apically from the attached gingival by the free gingival groove
- Inner side forms the gingival sulcus
- Composed of stratified squamous epithelium that may be keratinized or parakeratinzed
- Attached gingiva:
- Firm, resilient, and tightly bound to underlying periosteum of alveolar bone
- Lies between the free gingival groove and the alveolar mucosa
- Junction with the alveolar mucosa is called the mucogingival junction
- Color is generally described as "coral pink"
- Shows stippling (orange-peel appearance) in healthy mouths
- Interdental papilla:
- Occupies the gingival embrasure (interproximal space between two adjacent teeth)
- Surface is triangular in 3 dimensions
Gingival Epithelium
- Stratified squamous epithelium
- Consists of:
- Oral or outer epithelium (covers the crest and outer surface of the marginal gingiva and the surface of the attached gingiva)
- Sulcular epithelium (lines the gingival sulcus)
- Junctional epithelium (lines the junction between the gingival epithelium and the tooth surface)
Gingival Connective Tissue
- Composed of three types of connective tissue fibers:
- Collagen
- Reticular
- Elastic
Gingival Sulcus
- A groove developed between the tooth surface and the free gingiva
- Lined with epithelium of non-keratinized type derived from oral epithelium
- Extends from the free gingival margin to the junctional epithelium
- Depth is 0.5 – 3 mm; any depth greater than 3 mm can be considered a pathologic state (periodontal pocket)
Junctional Epithelium
- Stratified squamous non-keratinizing epithelium
- 3-4 layers thick in early life, increasing to 10-20 with age
- More permeable than sulcular epithelium
- Provides attachment of the gingival epithelium to the tooth in the cervical area by the gingival fibers
- Forms an epithelial barrier against plaque bacteria
- Disturbances of epithelial attachment result in deepening of the sulcus, a sign of gingival/periodontal disease
Root Development
- Begins after enamel and dentin formation has reached the future cementoenamel junction
- Hertwig's epithelial root sheath (HERS) forms a double layer of cells that initiate formation of the dental root and determines the number, shape, length, and dimensions of the roots
- The epithelial diaphragm maintains a constant size of the primary apical opening, which finally becomes the apical foramen
Fate of Epithelial Root Sheath
- Disintegrates as root formation progresses
- Leaves behind discrete clusters of epithelial cells, separated from the surrounding connective tissue by a basal lamina, known as the epithelial cell rests of Malassez
- Found in the periodontal ligament (PDL) throughout life
Root Formation Anomalies
- Lateral canals: if the continuity of HERS is broken before dentin formation, resulting in accessory root canals connecting the PDL with the main root canal
- Exposed dentin: if HERS does not degenerate at the proper time, remaining adherent to dentin, with no cementum formation, resulting in exposed dentin, particularly in the cervical region, causing cervical sensitivity later in life
- Enamel pearls: HERS may also remain adherent to the dentin in the cervical area near the furcation zone, with inner cells differentiating into functional ameloblasts and producing enamel droplets known as enamel pearls, found between the roots of permanent molars
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Description
Quiz about the structure and classification of masticatory mucosa and gingiva, including their composition and development.
