Electronic measurement of gingival color by digital image is a noninvasive reproducible inexpensive method of. Gingival enlargement associated with acute myelocytic. 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. The objective of the study was to determine if there was any correlation between gingival stippling and thickness. Gingival stippling is a characteristic of the healthy attached gingiva and its diminution or loss has been considered as a sign of gingival disease. Maintenance of gingival health post professional care. The radiovisiograph presented with horizontal and vertical bone loss with generalized 1040% of bone reduction as seen in.
Gingiva comprises of two parts free gingiva and attached gingiva. 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. Gingival stippling definition of gingival stippling by. 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. It surrounds each tooth to form a collar of tissue with a potential space or gingival sulcus crevice hidden between itself and the tooth. Epidemiology and indices of gingival and periodontal disease sven poulsen, dr odont. What is stippling of gingiva and how is it formed and.
The elucidation of gingival stippling is always contentious as there is no sufficient availability of clinical. Rounded free gingiva forming a sulcus between tooth and gingiva. The authors describe a seminal case report of a 10yearold boy with enlarged gingivae in relation to his maxillary anterior teeth. Metal toxicity knowledge for medical students and physicians. A shallow linear depression, the gingival groove, can be observed in some areas, distinguishing the free gingival margin from the attached gingiva.
A systemic clinical approach requires an orderly examination of the gingiva for color, contour, consistency, position, ease and severity of bleeding, and pain. Request pdf prevalence of gingival stippling in children gingival stippling is a. Prevalence of gingival stippling among 48 years old. Clinical features of gingivitis authorstream presentation. Part of oral mucosa that covers the alveolar processes of the jaws and surrounds the necks of the teeth.
The clinician however, must take in consideration that its pattern and extent varies in different mouth areas, among persons and with age. Usually this stippling from the gingiva is lost in cases of. 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. Epidemiology and indices of gingival and periodontal disease. Anatomical relationship of normal gingiva in facial view a and in crosssection b. Conflation of gingival overgrowth and schwannoma bmj. The free gingival groove lies approximately at the same level of the bottom of the gingival sulcus. The degree of keratinization and the prominence of stippling appear to be related. Gingiva definition of gingiva by medical dictionary. 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. Impact of thyroid hormone dysfunction on periodontal disease. The anatomy and physiology of the healthy periodontium will be described in its.
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. And hence there is need for the best evidence in this field. This presentation will dictate the importance of attached gingiva in health and disease and the various controveries and studies related to it. The free gingival margin is the interface between the sulcular epithelium and the epithelium of the oral cavity. 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. The degree of keratinization and stippling are related and depend on each other. Healthy gums hold tight to each tooth in that the gingival surface narrows to knifeedge thin at the free gingival margin. Gingival stippling, thats orange peel look of healthy gingival surface is a distinguishing feature of the attached gingiva 1. Determining factors for periodontal disease progression and treatment outcome neha joshi1, manvi chandra agarwal 2. 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. There is no interference with normal masticatory function, the tooth is firm. The texture of the gingival surface may be similar to orange peel and is referred to gingival stippling.
Gingivitis is characterized by inflammation of the gingival tissues with no loss of attachment or bone. Pdf prevalence of gingival stippling among 48 years old. Discussion the texture of the gingival surface may be similar to orange peel and is referred to gingival stippling 5. The fremitus test was positive with the presence of. The attached gingiva is a masticatory mucosa see chapter 9. The lesion, provisionally diagnosed as idiopathic gingival enlargement, was completely excised and divided into two sections.
Healthy attached gingiva is pink in color, with some areas of melanin pigmentation possible see figures 210 and 922. 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. Loss of gingival stippling, one of the early symptoms of periodontal disease in the human, could also indicate early periodontitis in. Ppt oral mucosa powerpoint presentation free to view. Only one child showed stippling in the free gingiva, too, but this. The free gingival margin covers the cementoenamel junction cej and the gingival papillae fill the embrasures. 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 aim of this study was to examine the gingival stippling in children. Attached gingiva firm, resilient, and tightly bound to the underlying periosteum of alveolar bone mucogingival junction absent on palate stippling orange peel appearance 10. The junctional epithelium is the area where the gingiva is bound to the tooth.
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. The anatomy and physiology of the healthy periodontium. Each of the buccal, mesial, lingual and distal surfaces of the gingival tissues is given a score of 03.
The tissue when dried is dull, firm, and immobile, with varying amounts of stippling. The prosthetic management of gingival aesthetics british. Prevalence of gingival stippling in children request pdf. University of illinois, college of dentistry, 808 south wood street, chicago, illinois. In the early primary dentition, gingivitis is uncommon. 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. Prevalence of gingival stippling in children allen press. Pdf diagnosis of periodontal disease, a frequent disorder in dogs, rests mainly upon the assessment of changes affecting the gingiva. Outlines the problems associated with soft tissue and in particular gingival defects such as recession.
The gingiva consists of a free gingival margin and attached gingiva. Gingival and dentogingival junctional tissue pocket. While free gingiva surrounds the tooth creating a collar around the crown, it is portion of the gingiva which extends from. Inflammation, bleeding upon probing, and pocket depths are the most important diagnostic aids or signs of gingival or periodontal. It is caused by intersection of epithelial rete ridges. It has been observed that thick gingiva has coarse and diffuse stippling whereas thin gingiva has fine and scanty stippling. 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. Gingival overgrowth may vary from isolated mild enlargement of interdental papilla or a uniform enlargement which may affect either one or both jaws. Clinically, a pink gingiva with marked stippling can be seen to cover almost all the tooth, in many cases preventing. On the other hand, inflamed gums have a puffy or rolled margin. The gingiva often possess a textured surface that is referred to as being stippled engraved. It occurs in response to the bacteria that live in biofilms at the gingival margin and in the sulcus. Usually, the gingiva is swollen with lack of stippling and coloring that is pale red to deep purple.
A free powerpoint ppt presentation displayed as a flash slide show on id. It is demarcated from the adjacent attached gingiva by a shallow linear depression, the free gingival groove. 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. Stippling is restricted to the attached gingiva, i. Outlines the various management techniques for the improvement of gingival aesthetics. Pain may be associated due to secondary traumata via brushing, flossing or chewing. Prevalence of gingival stippling among 48 years old children. The width of the attached gingiva varies according to its location. The result was also showed nonsignificant association of gingival stippling between upper and lower jaws as the p value was 0. Gingival stippling in young adult males rosenberg 1967. Attached gingiva is very important in maintaining the health and integrity of the marginal gingiva.
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