Factors affecting DGJ

1. Factors affecting the dentogingival
junction
Prepared by:
Rawan Abdelhamid elbahnasy
,Abdelrahman Nasr ,Bassant
Mohamed ,Rawan Ashraf ,Haya
Abdelmonsef
Under Supervision:
A.Prof Samah Kamel

2. Introduction:
 What is the dentogingival junction?
It’s the zone which attaches the gingiva to the tooth
(the enamel or the cementum)
 Nature:
-Consists of both epithelium and lamina propria
--permeable
 Parts:
-Junctional epithelium
-Sulcular epithelium
-Oral epithelium: not a part mainly it’s continuation

3.  Functions:
The dentogingival junction is of crucial importance in periodontal
host defense both structurally and functionally.
Functionally it:
-acts as a barrier
-antimicrobial defence
-GCF flow

4. Factors affecting Dentogingival
junction
Bacterial
Factors
Periodontal
Disease
Passive Eruption
Mechanical
Stimulation

5. Effect of bacteria and
bacterial products:
Oral biofilm releases induction molecules like
autoinducer-2
These molecules enhances biofilm formation and
changes virulence gene expression.
 Pathogens such as P. gingivalis allows overgrowth of
pathogens due to weakening of host immunity.

6. These pathogens release gingipains to
counter the innate immunity response of
the junctional epithelium’s cells.
These virulence factors specifically degrade
components of the cell-to-cell contacts.
Therefore, the junctional epithelium is
converted to a pocket epithelium.

7. -The occurrence of periodontitis is a complex process that occurs in several steps
and affect the tooth supporting tissues and may lead to tooth loss.
 DAT cells degeneration creates a suitable
niche for bacterial adhesion
 Formation of gingival pockets is considered as
the first step in periodontitis
Effect of periodontal
diseases:
Effect of periodontal
diseases:

8.  Effect on collagen fibers which leads to loss of teeth supporting structures
 Decreased Mitosis and increased apoptosis has been shown at sites of
severe inflammation and can be followed by apical migration of junctional
epithelium
 Tissue capacity for repair by removal of plaque and resolution of the
inflammation

9.  The passive eruption is known as movement of the gingiva apically or away from the
crown of the tooth to the level of cementoenamel junction (CEJ) after the tooth has
erupted completely. This help in the gradual exposure of the crown
 It consist of 4 stages that occur during lifetime of the human.
Effect of Passive
Eruption:

10.  ALTERED PASSIVE ERUPTION
Altered passive eruption is the failure of the dental/gingival complex to migrate apically
past stage 2 and expose the entire clinical crown to obtain a normal position at the base
of the sulcus relative to the CEJ so creating an excessive gingival display and, in turn, in
some circumstances, it may reveal a clinical aspect also known as the “gummy smile.”
and short clinical crown.
Diagnosis
The key to arriving at the diagnosis of altered passive eruption also involves the location
of the CEJ in the gingival sulcus. If the CEJ is not detectable in the gingival sulcus and the
other etiologies of excessive gingival display are ruled out by using a dental explorer, a
diagnosis of altered passive eruption can be made.
Treatment
A gingival surgery (gingivectomy and gingivoplasty) is recommended which is a surgical
technique to position the gingival margin more apically should be planned.

11. Effect of mechanical
stimulation:
 Since the junctional epithelium is located at a strategically important but also
delicate site, it may be expected that it should be very well-adapted to cope
with mechanical insults.
 Mechanical factors affecting the junctional epithelium include:
1. Oral hygiene practices: e.g. dental flossing may be accompanied by
undesired trauma to the junctional epithelium.
2. clinical probing: Clinical probing results in a mechanical disruption
of the junctional epithelial cells from the tooth.

12.  Dental Implants: The peri-implant epithelium always
originates from epithelial cells of the oral mucosa, as opposed
to the junctional epithelium around teeth. several marker
molecules involved in the defence mechanisms against the
bacteria are also expressed in the peri-implant epithelium.
3. Dental treatment:
 Gingivectomy: the
application of gingivectomy
techniques would completely
remove the junctional
epithelium. In humans, a
new junctional epithelium
after gingivectomy may form
within 20 days.

13. Resources:
https://medical-dictionary.thefreedictionary.com/dentogingival+junction (2009)
https://www.slideshare.net/foziasultana3/dento-gingival-junction (jun, 2018)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412119/#__ffn_sectitle (July
26, 2012)
https://journals.sagepub.com/doi/full/10.1177/154405910508400102 (jan
1,2005)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343974/ (2017)
https://www.hindawi.com/journals/ijd/2012/821383/ (2012)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055067/ (may 2014)
https://www.aegisdentalnetwork.com/id/2015/07/predictable-treatment-for-
gummy-smiles-due-to-altered-passive-eruption (July, 2015)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239760/ (2014)
https://journals.sagepub.com/doi/full/10.1177/154405910508400102 (2015)

14. Thank you