periodontics \ oral histology

3. The gingival sulcus
is an area of potential space between
a tooth and the surrounding gingival
tissue.
It is lined by two entities:
-Apically by the gingival fibers of
connective tissue attachment .
_Coronally by free gingival margin .

4. The gingival sulcus
Under normal conditions the depth
of the sulcus is variable.45% of all
measured sulci are below 0.5 mm
,the average sulcus is 1.8mm
the shallower sulcus is the more
likely that the gingival margin is
not inflamed

6. THE SULCULAR EPITHELIUM
Its stratified squamous
epithelium ,non keratinized .
Para keratinized that is
continuous with the oral
epithelium and lines the
lateral surface of the sulcus .
Its lacks epithelial ridges so
forms a smooth contact with
lamina properia

7. THE SULCULAR
EPITHELIUM
Apically it overlaps the
coronal border of the
junctional epithelium
this epithelium shares many
of the characteristics of oral
epithelium including good
resistance to mechanical
forces and relative
impermeability to fluid and
cells

9. the junctional epithelium
Its the stratified non keratinizing
epithelium that surround the tooth like
a collar .
its attached by one broad surface to
the tooth and by the other to the
gingival connective tissue
The junctional epithelium has two
basal lamina:
oOne that faces the tooth (internal basal
lamina )
oThe other faces connective tissue
(external basal lamina)

10. the junctional epithelium
The desquamative shedding
surface of the junctional epithelium
is located at its coronal end which
also forms the bottom of the
gingival sulcus
The junctional epithelium is more
permeable than oral or sulcular
epithelium It serves as the
perferential route for the passage of
bacterial products from the sulcus in
to connective tissue into the sulcus

12. THE SULCULAR EPITHELIUM THE JUNCTION EPITHELIUM
1. It is epithelium that surround
the tooth like a collar .
2. It is more permeable than oral or
sulcular epithelium It serves as
the perferential route for the
passage of bacterial products
from the sulcus in to connective
tissue and fluid and cells from C.T
into the sulcus
1. It is continuous with the oral
epithelium and lines the lateral
surface of the sulcus .
2. It characterized by good
resistance to mechanical forces
and relative impermeability to
fluid and cells

13. Development of the junctioanal epithelium
As the erupting tooth approaches the
overlying epithelium, the external
cells of the reduced enamel
epithelium proliferate, causing the
epithelial covering of the enamel to
thicken.

14. Development of the junctioanal epithelium
 Proliferation of the externel cells
of the reduced enamel epithelium
begins around the cusp tips and
slowly progresses toward the
cervix of the tooth

15. Development of the junctioanal epithelium
proliferating cells eventually displace
any remaining reduced ameloblasts, thus
replacing the relatively inert reduced
enamel epithelium with an epithelial
collar of cells with a high turnover
rate. This collar of cells with a high
turnover rate is the early junctional
epithelium.
Eventually, the entire reduced enamel
epithelium will become replaced by
junctional epithelium.

17. Development of the junctioanal epithelium
After accomplishing of amelogenesis
(protective stage) the ameloblast secrete
or leave structure less material on enamel
surface primary enamel cuticle .
The enamel organ becomes reduced in
thickness (reduced enamel epithelium )
and function as aprotection against
contact with connective tissue ,to inhibit
cementum deposition or enamel
resorption
The reduced enamel epi thelium
consists of two layers
1-the reduced ameloblast
2-remnant of the dental organ

18. Development of the junctioanal epithelium
The ameloblast develop hemidesmosomes
to attach the reduced enamel epithelium to
the surface of the enamel at the time of
eruption the reduced enamel epithelium
secrete desmolytic enzymes causing
degenerating of the of the c.t present
between it and the oral mucosa (desmolytic
stage of amelo blasts )
The outer layer of the reduced enamel
epithelium and the cells of the oral
epithelium proliferate into the degenerated
c.t. to form amass of cells over the erupting
tooth the epithelial plug.

20. Development of the junctioanal epithelium
Cell death in th middle portion of plug cause formation of epithelial lined canal
through which tooth will erupt with out hemorrhage
Once the tip of the crown appear in the oral cavity reduced enamel epithelium will
be called primary attached epithelium
And the the shallow groove present between the tooth and the gingiva is called
GINGIVAL SULCUS
The cells of primary attached epithelium (PAE) originate from reduced enamel
epithelium and attached to tooth by primary enamel cuticle
When primary attachment epithelium is replaced by oral epithelium its called
secondary attached epithelium that attaches by secondary enamel cuticle.

21. Primary enamel cuticle Secondary enamel cuticle
1. Binds secondary attached
epithelium to the enamel surface
2. It is formed finally when the teeth
erupt
1. Binds primary attached epithelium
to the enamel surface
2. It is formed initially at the
protective stage
Primary attached epi. Secondary attached epi.
1. It is Primary attachment
epithelium replaced by oral
epithelium
2. attached by secondary enamel
cuticle
1. originate from reduced enamel
epithelium
2. attached to tooth by primary
enamel cuticle

22. Shift of the dento gingival junction
 The dentogingival junction is an anatomical
and functional interface between the gingiva
and the tooth structure.
 Dento gingival junction is the region where
the tooth is attached to gingival and is form
as soon as the tooth erupts in the oral cavity.
 It provides attachment of the gingiva to the
enamel surface via hemidesmosomes
 with time the position of the gingiva of the
surface change

23. Shift of the dento gingival junction
 Components
1. Epithelial component is derived from
reduced dental (enamel) epithelium
and oral epithelium.
2. The connective tissue component is
derived from the lamina propria of the
oral mucosa.
 The attachment of the functional
epithelium to the tooth is reinforced with
the gingival fibers, which brace the gingival
against the tooth surface.

24. Dento gingival junction

25. Shift of the dento gingival junction
almost entire enamel is covered by
epithelium when the tip of the enamel
first emerge through the mucous
membrane of the oral cavity .
the eruption of teeth continuous until it
reach the plan of occlusion.
 the firmness strength of the dentino
gingival junction beacause of connective
tissue attachment of epithelium to
enamel is not week as the crown
continuous on to the oral cavity
the attachment separate from the enamel
surface gradually

27. Shift of the dento gingival junction
 when the tip of the enamel first emerge through the mucous membrane of
the oral cavity . one third to one fourth of enamel is still covered by the gingiva
The actual movement of teeth towards occlusal plane called acitve
eruption
The separation of primary attached epithelium from the enamel
surface called passive eruption

28. THE SHIFT OF DENTINO GINGIVAL
JUNCTION INVOLVE
 First stage
 Occur in the primary teeth till one year
before shedding in the permanent teeth
20_30.
 the bottom of the sulcus present on
the enamel and the apical end of the
AE on the cement enamel junction.
 Clinical crown is less than anatomical
crown.

29. THE SHIFT OF DENTINO GINGIVAL
JUNCTION INVOLVE
 Second stage
 Occur till age of the 40 or even later.
 The bottom of the sulcus still present
on the enamel and the apical end of the
AE on cementum.
 the clinical crown is less than
anatomical crown.

30. THE SHIFT OF DENTINO GINGIVAL
JUNCTION INVOLVE
 Third stage
 It is unhealthy condition.
 The bottom of the sulcus present at the
CEJ and the apical end at cementum.
 The clinical crown equal to the
anatomical crown.

31. THE SHIFT OF DENTINO GINGIVAL
JUNCTION INVOLVE
 Fourth stage
 It is unhealthy condition.
 From 60 years later .
 The bottom of the sulcucs and apical
end on the cementum.
 The clinical crown is longer than
anatomical crown

32. •As the original sulcular
depth increase and apical
migration of the junctional
epithelium simultaneously
tack place.
•pathosis has occurred to have
true periodontal pocket
aprobing measurment of 4
mm must be clinically
evidence.

33. The periodontal pocket
 It results in:
1. A bluish-red vertical zone from
the gingival margin to the
alveolar mucosa.
2. Gingival bleeding.
3. Suppuration & tooth mobility
4. And diastema formation.
 symptoms such as localized
pain or pain "deep in the bone"
are suggestive of the presence
of periodontal pockets

34. Done by:
Ban mohammed