Gingiva

The gums ( gingiva Latin ) is a part of the oral mucosa. It is part of the masticatory mucosa that covers the alveolar ridge and the teeth surrounding cervical. The gingiva surrounds the epithelial cuff ( junctional epithelium ) the neck of the tooth and thus seals the entry point of the tooth in the jaw bone with respect to the oral cavity. It is the epithelial component of the gums. Extensions and / or recesses of the gingival sulcus to be referred to as a periodontal pocket. Apical is the gingiva on the loose alveolar mucosa, from which they by the mucogingival junction ( mucogingival ) adjacent to. The palate and maxillary alveolar process are covered with masticatory mucosa.

Free and attached gingiva

The gingiva is divided into free and attached gingiva. The free gingiva also includes the interdental gingival papillae, ranging from the gingival margin to apical to the "free gingival sulcus ", which is approximately at the level of the cemento-enamel border. The attached gingiva ( " attached gingiva " ) is limited by the coronal free Gingivafurche or by a line through the cemento-enamel border. It is apical to the mucogingival junction ( marks the transition into the alveolar mucosa ) limited. The attached gingiva is connected by connective tissue fibers fixed to the underlying alveolar bone and cement.

Histology

The epithelium of the ( masticatory ) free gingiva, one divides into

• The oral epithelium, which is directed towards the oral cavity,
• The oral crevicular epithelium, which is directed to the tooth, but still has no tooth contact, and
• The junctional epithelium, which makes contact betw gingiva and the tooth.

The attached gingiva one divides into

• The stratum basale ( germinativum )
• The stratum spinosum
• The stratum granulosum
• The stratum corneum ( orthokeratinisiert, but if the nucleus is present: parakeratinized )

The gum consists histologically of a stratified squamous epithelium, which has only a few horny layers. As a sub- skin ( subcutaneous ) is missing, the gums can not be moved. Gums can not be reproduced.

The sulcus between the tooth and gum is called the gingival sulcus ( " gingival sulcus "). In healthy periodontal conditions, probing depth in humans is approximately 2 mm. The furrow facing this epithelium is the inner junctional epithelium. This will free the tooth divided sliding sulcular epithelium and the Haftepithel connected by hemidesmosomes with the cementum in the.

The triangular shaped gums between the teeth is called the " papilla " ( papilla interdentalis ), the boundary line between the gums and the sliding dark red mucous membrane called the mucogingival or mucogingival junction.

Gum disease

A regular cleaning of the sulcus of bacterial plaque and food particles is necessary to inflammation of the gums ( gingivitis) to prevent that can quickly develop unnoticed to periodontitis. When brushing himself often, this results in a transient bacteremia, no matter what method of teeth cleaning will be used.

Extensions and / or recesses of the gingival sulcus to be referred to as a periodontal pocket, said periodontal pockets having a depth of 3.5 mm or more can be considered as a sign of a disease. The metric depth at which a need for treatment for a bag present treatment is individually different and is determined by the degree of inflammation present there (bleeding ) significantly. In approximately 5 mm pocket depth changes because the oxygen supply is no longer there to ensure that dominate microbial spectrum of germs, anaerobes.

In inflammatory periodontal pockets of the underlying bone recedes in the rule. Then the entire attachment apparatus is involved in the disease process, and it originated periodontitis. This is known as real gum pockets. If there is no bone loss and yet a periodontal pocket (eg, increase in size of the gums when taking certain medications ), it is called pseudo bags.

The treatment is taken in a systematic treatment of periodontal disease by the statutory health insurance.

Gingival pockets

The anchorage of the tooth in the tooth socket is performed by a Gomphosis, ie a tooth is merely suspended over the Sharpey's fibers in his bone compartment and not anchored firmly to this. So there is a natural gap ( = periodontal ligament ) between the tooth and bone, in which the Sharpey's fibers and PDL are. In this gap bacteria can penetrate. In particular, those who are in this environment feel very comfortable ( = obligate anaerobes ), multiply and cause inflammation, where the Sharpey's fibers are damaged. The periodontium is back and it caused in periodontal Entzündungsnieschen, the so-called gum pockets that can be filled again and again acutely with pus. Gingival pockets are signs of periodontal disease, periodontitis see ( colloquially periodontal disease ).

When gum pockets differs dentistry gum pockets between genuine and pseudo bags. A pseudo case occurs when the gum swelling around the affected tooth around and in an artificial bag is formed. A "real" gum pocket to go against occurs when a gap is caused by bone loss of the alveolar bone between the gum and tooth. See also: gingival sulcus.