This document provides an overview of the oral mucosa, gingival sulcus, dentogingival junction, and their development. It discusses the structure and development of the junctional epithelium. It also describes age-related changes to the oral mucosa and clinical considerations regarding injuries to the junctional epithelium and connections between oral and systemic health.

2. ORAL MUCOSA
PRESENTATION BY SYEDA KHADIJAH BANOORI
BDS 1ST YEAR
KMU-IDS KOHAT

3. GINGIVAL SULCUS AND
DENTOGINGIVAL JUNCTION
DEVELOPMENT OF ORAL
MUCOSA
AGE CHANGES
CLINICAL CONSIDERATIONS

4. OBJECTIVES
 INTRODUCTION OF ORAL MUCOSA
 GINGIVAL SULCUS AND DENTOGINGIVAL JUNCTION
 Gingival sulcus
 Dentogingival junction
 Development of dentogingival junction
 Shift of dentogingival junction
 Primary and secondary cuticles
 Epithelial attachment
 DEVELOPMENT OF ORAL MUCOSA
 AGE CHANGES
 CLINICAL CONSIDERATIONS

5. ORAL MUCOSA
Mucous membrane lining the
inside of oral cavity including the
lips and cheeks

6. GINGIVAL
SULCUS/
CREVICE:
SPACE BETWEEN
THE INNER
ASPECT OF
GINGIVA AND
TOOTH


7. DENTOGINGIVAL JUNCTION
 Junction between gingiva and tooth
 JUNCTIONAL EPITHELIUM/ATTACHMENT EPITHELIUM :
 Resembles reduced enamel epithelium
 Extends to 2mm on the surface of tooth
 Turnover rate : 5-6 days

8. SULCULAR AND JUNCTIONAL
EPITHELIUM
 SULCULAR EPITHELIUM:
 The epithelium lining the gingival sulcus from base to the free gingival margin.
 Sulcular epithelium is non keratinized in humans.
 The sulcular epithelium is continuous with the Oral epithelium and attachment
epithelium
 SULCUS DEPTH : 0.5-1.8mm (average : 2mm )
 ATTACHMENT EPITHELIUM/JUNCTIONAL EPITHELIUM:
 Epithelium located at the base of gingival sulcus
 Attaches the gingival connective tissue to the tooth

9. DENTOGINGIVAL JUNCTION

10. JUNCTIONAL EPITHELIUM
STRUCTURE
 A layer of basal cells and few layers of flattened cells
 Intercellular spaces are found
 INTERCELLULAR SPACES:
 Negative point: bacteria enter, infections occur
 Positive point : Neutrophils, Macrophages ,Langerhans cells increase resistance
to infections

11. JUNCTIONAL
EPITHELIUM
STRUCTURE

12. DEVELOPMENT OF DENTOGINGIVAL
JUNCTION
1. Formation of reduced enamel epithelium
2. Reduced Enamel Epithelium fuses with oral epithelium
3. Tooth erupts after perforation in fused epithelia
4. Formation of gingival sulcus and primary attachment epithelium

13. 1. Formation of
reduced enamel
epithelium

14. 2. Reduced Enamel
Epithelium fuses
with oral
epithelium

15. 3. Tooth erupts
after perforation in
fused epithelia

16. 4. Formation of
gingival sulcus and
primary
attachment
epithelium

17. SHIFT OF DENTOGINGIVAL
JUNCTION
 Attachment epithelium separates from the enamel surface gradually
while the crown emerges
 ACTIVE ERUPTION :
 Actual movement of the teeth towards the occlusal plane
 PASSIVE ERUPTION :
 Separation of primary attachment epithelium from the enamel
Reduced enamel
epithelium
Primary attachment
Epithelium
Gingival Epithelium
(secondary
attachment
epithelium)

18. STAGES OF SHIFT
 STAGE 1:
 Gingival sulcus on Enamel Covered Crown
 Attachment epithelium on CEJ
 DURATION: 20-30 years
 Clinical crown smaller than Anatomical Crown
 STAGE 2:
 Gingival sulcus on Crown
 Attachment Epithelium on Cementum surface
 DURATION : 40 years
 Clinical crown smaller than anatomical Crown

19.  STAGE 3:
 Gingival sulcus on CEJ
 Attachment epithelium on Cementum
 Clinical crown is same length as Anatomical Crown
 STAGE 4: (Gingival Recession )
 Gingival sulcus + Attachment epithelium on Cementum
 DURATION : 50-70 years
 Anatomical crown is smaller than Clinical Crown

21. PRIMARY AND SECONDARY ENAMEL
CUTICLE
PRIMARY ENAMEL
CUTICLE (Nasmyth
membrane)
 Thin membrane on the entire surface of
enamel
 Formed by ameloblasts
SECONDARY ENAMEL
CUTICLE
 Membrane on the surface of enamel and
extends along the cementum
 Formed when ameloblasts are replaced by
oral epithelium
 DENTAL CUTICLE: secondary enamel
cuticle + cemental cuticle

22. DENTAL
CUTICLE

23. EPITHELIAL ATTACHMENT
 Epithelial attachment refers to the mechanism of attachment of the
junctional epithelium to a tooth.
 WIDTH: 40nm
 Occurs by attachment of hemidesmosomes to internal basal lamina

24. JUNCTIONAL
EPITHELIUM

25. EPITHELIAL ATTACHMENT

26. DEVELOPMENT OF ORAL MUCOSA
 EPITHELIUM:
 Epithelium is made from both ectoderm and endoderm
 Epithelium of Anterior part of oral cavity (Gingiva , hard palate, cheeks etc) is derived from ectoderm
 Epithelium of the structures that develop from branchial branches (tongue , epiglottis , pharynx ) is
derived from endoderm
 Vestibular lamina : 6 weeks
 Keratinized and nonkeratinized mucosa become apparent : 13-20 weeks
 PAPILLA :
 Lingual papilla: 7th week
 Circumvallate and Foliate papilla : 10-12 weeks
 LAMINA PROPRIA fibers : 6-20 weeks

27. AGE CHANGES
 Oral mucosa becomes smooth and dry (due to decrease in salivary secretion)
 Filiform Papilla decrease
 Varicose veins form on ventral part of tongue – LINGUAL VARICES
 Cell mediated immunity decrease ( due to decrease in Langerhans cells)
 LAMINA PROPRIA:
 Cellularity decrease
 Collagen increase.
 NERVES AFFECT: Loss of sensitivity to stimuli and taste perception
 Gingival recession

28. CLINICAL CONSIDERATIONS
 ORAL CAVITY IS THE MIRROR OF GENERAL HEALTH OF A
PERSON .
 Disease conditions such as Nutritional deficiencies ,anemia ,endocrine
disturbances causes changes in oral cavity
 Normal colour of mucosa: PALE PINK
 Reddish colour appear in Inflammatory conditions
 Pale colour in anemia
 INJURY OF JUNCTIONAL EPITHELIUM : through toothbrushing, flossing,
traumas
 Gingival recession : causing sensitivity of exposed dentin

29. SYSTEMATIC
DISEASES AND
MOUTH BODY
CONNECTION

30. PERIODONTAL
DISEASE
 INFECTION OF THE GUMS
 Caused by poor brushing and
flossing habits that allow
plaque to buildup on teeth
and harden

31. PERIODONTAL
POCKET
 DEEPENED GINGIVAL
SULCUS
 Formed due to periodontal
disturbances

32. THANK YOU .