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(6) Gingiva & Oral Mucosa (Clinical Implications (Age Change (1) Dry,…
(6) Gingiva & Oral Mucosa
Clinical Implications
Diagnose
Local Anesthetic
Suturing
Medication
Gingiva
Rete Pegs
Age Change
1)
Dry
2)
Smooth
(Less filiform)
3)
Fragile/Thin
4) Less
Langerhans Cell
5)
Varicose vein
6)
Sebaceous glands increase
Mucosa Functions
L
ubrication
I
mmunological
P
rotective
S
ensory
Mucosa Types
Masticatory
Location
:
Attached gingiva
Free gingiva non-keratinized
No submucosa
Hard palate
Keratinized/Parakeratinized
No Submuocsa
Lamina Propria binds to bone
Dorsal tongue surface
Properties
:
Firm
Rubber-like
Histology
:
Keratinized Stratified Squamous Epithelium
Thin / No Submucosa
Lining
Location
:
Buccal
Labial
Alveolar Mucosa
Minor salivary glands
Elastin
Floor of mouth
Non-keratinized
Thin (
Route for drug administration
)
Extensive submucosa
Soft palate
Non-keratinized
Elastin, thin collagen
Mucosa glands in submucosa
Lingual Tonsils
Properties
:
Soft
Moist
Stretchy
Histology
:
Non-keratinized Epithelium
Elastin in Submucosa & Lamina Propria
Specialized
Location
:
Dorsal tongue surface
Properties
:
Filliform Papilla: Keratinized (Abrasive Cleaning)
Fungiform Papilla: Non-Keratinized
Circumvallate Papilla: Non-Keratinized
Folate Papilla: Non-Keratinized
Histology
:
Taste Buds
Keratinized
Mucosa Structure
(Histological)
Epithelium
Non-keratinized
Superficiale
Intermedium
Basal (Simple cuboidal)
Para-Keratinized
: Nucleated
Orthokeratinized
: No Nucleus
Cells
Keratinocytes (90%)
Produce keratin
Non-keratinocytes (10%)
Melanocytes
Neural Crest
Produce melanin
Basal Layer
Langerhans Cells
Monocyte linage
Dendritic cells
APC
Merkel Cells
Mechanoreceptors
Neural Crest
Basal Layer
Receptor
Common in
Masticatory
Less in
Lining
Keratinized
Corneum (No Organelles, Tonofilaments+Protein/Keratin)
Granulosum (Mature, No Organelles, Tonofilament/fibril)
Spinosum (Ovoid, Keratinocytes, Desmosomes)
Basal (Simple cuboidal)
Lamina Propria
ECM
Collagen Fibres 1, 3, 5
Ground Substance
Proteoglycans
Glyocoproteins
Macrophages, Mast, Lymphocytes
Nerves, Blood Vessels,
Salivary Glands
Cells
Fibroblast
(Main)
Support
Nutrition for Epithelium
Sensory
Denfense
Macrophages/Lymphocytes
Phagocytosis
APC
Mast Cell
Inflammation
Endothelial Cells
Lining of BV & LV
Plasma Cells
Produce Immunoglobulins
Submucosa
Ground Substances
Sebaceous glands
Salivary glands
Not present in Mucoperiosteum
Bone
Anatomical Parts
Lip
Outer: Skin
Kertinized
Middle: Vermilion zone
Keratinized
No glands
Need constant moisture
Red from blood vessels
Thin / translucent
Inner: Labial Mucosa
Non-keratinized
Salivary glands
Lining Mucosa
Muco-cutaneous Junction
Muco-gingival Junction
Dent-gingival Junction
Gingiva
Masticatory mucosa
Tooth
Gingiva
Fastest collagen turnover rate (among oral cavity)
Attachment
Epithelium
Surfaces
Junctional Gingival Epithelium
Faces tooth
Tooth
contact
gingiva
Non-keratinized
Healthy - No Rete Pegs
Highly vascular/innervated
Rapid turnover / renewing
Larger cells
Less desmosomes / tonofilaments
Lower glycolytic enzyme activity
No acid phosphatase activity
Wide intercellular spaces
Oral Gingival Epithelum
Faces Oral Cavity
Keratinized
Sulcular Gingival Epithelium
Faces tooth
Tooth
no contact
gingiva
Thin/Cuboidal
No Merkel cells
Non-keratinized
Junctional Epithelium Attachment:
To Tooth:
Hemidesmosomes
of
Epithelium & Basal Laminae
To Each Other:
Desmosomes
(Signalling/Differentiation)
Basal Laminae (1): Facing Enamel; Inner
Basal Laminae (2): Facing Lamina Propria; Outer
Attachment
Free
: Non-Keratinized
Attached
: Keratinized
Lamina Propria
Gingival Crevicular Fluid
From blood vessels around PDL/JE
To Gingival Sulcus
Increase during inflammation
Orientation of Collagen Fibres
Circular
Horizontal
Alveolo-gingival
Bone to Gingiva
Dento-gingival
Tooth to Gingiva
Dento-periosteal
Cementum to Periodontium
Trans-septal
Horizontal
Distinct Features
Fibroblast
:
No alkaline phosphatase
Less proteins
More prostaglandins (response to histamine)
ECM
Less ground substance
Proteoglycans/Glycoproteins
Immune cells
Nerves/BV/Salivary Glands
Less Collagen
More hyaluronan
Lower turnover
