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Histology of oral gingiva

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Histology of oral gingiva Powered By Docstoc
					                         E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                         Tarrson Family Endow ed Chair in Periodontics.

HISTOLOGY OF ORAL        Professor and Chairman Division of Associated Clinical Specialties
                         UCLA School of Dentistry
MUCOSA AND GINGIVA AND
PALATE
                                                     E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                     Tarrson Family Endow ed Chair in Periodontics.

                                                     Professor and Chairman Division of Associated Clinical Specialties
THE MUCOGINGIVAL JUNCTION DELINEATES THE ORAL
                                                     UCLA School of Dentistry
MUCOSA WHICH IS VASCULAR ,HAS LOOSE COLLAGEN AND
ELASTIC FIBERS AND MUSCLE .IT IS COVERED BY A THIN
LAYER OF NON KERATINISED EPITHELIUM.THIS PERMITS
THE MOVEMENT AND STRETCHING ASSOCIATED WITH
MASTICATION ,SPEECH AND FACIAL EXPRESSION.
                                               E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                               Tarrson Family Endow ed Chair in Periodontics.

UPPER MOLAR ON THE LEFT ARE THE LOOSE          Professor and Chairman Division of Associated Clinical Specialties
ELASTIC BUCCAL ORAL MUCOSA BLENDING INTO       UCLA School of Dentistry
THE DENSE FIRM GINGIVA .ON THE RIGHT GINGIVA
AND PALATE ARE SIMILAR WITH DENSE FIRM
COLLAGEN COVERED WITH KERATINISED
STRATIFIED SQUAMOUS EPITHELIUM
       E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
       Tarrson Family Endow ed Chair in Periodontics.

       Professor and Chairman Division of Associated Clinical Specialties
       UCLA School of Dentistry




ORAL   MUCOSA
                                                E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                Tarrson Family Endow ed Chair in Periodontics.

THE ARROWS SHOW MUSCLE FIBERS SURROUNED BY      Professor and Chairman Division of Associated Clinical Specialties
LOOSE ELASTIC CONNECTIVE TISSUE IN ORAL         UCLA School of Dentistry
MUCOSA ATTACHING TO CRESTAL BONE. ABOVE THIS
THE DENSE NON ELASTIC COLLAGEN OF THE GINGIVA
RESISTS MUSCLE PULL FROM MOVING THE GINGIVAL
MARGIN AWAY FROM THE TOOTH SURFACE THIS
REULTS IN GINGIVAL MARGIN STABILITY WITH NO
PROGRESSIVE GINGIVAL RECESSION
                                                           E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                           Tarrson Family Endow ed Chair in Periodontics.
THE FUNCTION OF GINGIVA IS DIFFERENT FROM ORAL
MUCOSA.GINGIVA MUST RESIST THE MECHANICAL        Professor and Chairman Division of Associated Clinical Specialties
STIMULI OF COURSE FOOD PARTCLES IMPINGINGING ON  UCLA School of Dentistry
IT DURING MASTICATION AS WELL AS HAVING LARGE
ACCUMULATIONS OF PLAQUE BACTERIA IN DIRECT
CONTACT WITH THE GINGIVAL SULCUS. GINGIVALTISSUE
MUST FORM A SEAL IN THE SULCUS THAT PROTECTS THE
UNDERLYING TISSUE FROM SUB GINGIVAL PLAQUE.
ANDPREVENTS LOSS OF TISSUE FLUID.
                                                              E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                              Tarrson Family Endow ed Chair in Periodontics.

THE OUTER SURFACE OF GINGIVA IS COVERED WITH A THICK Professor and Chairman Division of Associated Clinical Specialties
LAYER OF KERATINISED SRATIFIED SQUAMOUS EPITHELIUM UCLA School of Dentistry
WITH FINGER LIKE PROJECTIONS [RETE PEGS] INTO THE
DENSE COLLAGEN UNDERNEATH. THE STRONG ATTACMENT
OF COLLAGEN TO EPITHELIUM BETWEEN THE RETE PEGS
CAUSES THE GINGIVA TO HAVE
 A STIPPLED SURFACE WHEN IT IS NORMAL AND NOT
INFLAMED
                                                   E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                   Tarrson Family Endow ed Chair in Periodontics.
THE TIP OF THE GINGIVAL CREST HAS AN OUTER LAYER
                                                   Professor and Chairman Division of Associated Clinical Specialties
OF KERATIN WHILE THERE IS NO KERATIN ON THE        UCLA School of Dentistry
EPITHELIUM LINING THE GINGIVAL SULCUS
                                           E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
THE BASAL LAYER IS ATTACHED TO THE
                                           Tarrson Family Endow ed Chair in Periodontics.
BASEMENT MEMBRANE BY HEMI DESMOSOMES.
BASAL CELLS PROLIFERATE AND PASS THROUGH   Professor and Chairman Division of Associated Clinical Specialties
THE VARIOUS LAYERS UNTIL THEY REACH THE    UCLA School of Dentistry
SURFACE AND HAVE BECOME INACTIVE AND ARE
DESQUAMATED OFF AS DEMOSOMES FAIL TO
HOLD THE CELLS TOGETHER.   ON THE
KERATINISED OUTER GINGIVAL SURFACE THESE
CELLS HAVE LOST THEIR NUCLEI AND
CYTOPLASMIC ORGANELLES AND HAVE
ACCUMULATED KERATIN GRANULES
                                               E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                               Tarrson Family Endow ed Chair in Periodontics.

                                               Professor and Chairman Division of Associated Clinical Specialties
OUTER SURFACE OF GINIVA. TEN DAYS AFTER        UCLA School of Dentistry
LABELLING PROLIFERATING BASAL CELLS WITH
H3 THYMIDINE MANY OF THE CELLS HAVE
PASSED TO THE OUTER SURFACE AND BECOMED
KERATINISED .CELL TURNOVER IS 10 TO 12 DAYS.
                                                            E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
ELECTRON MICROGRAPH 47,000
                                                            Tarrson Family Endow ed Chair in Periodontics.
MAGNIFICATION OF EPITHELEAL-
CONNECTIVE TISSUE JUNCTION. Pv = pinocytotic                Professor and Chairman Division of Associated Clinical Specialties
vesicles of basal eptihelial cells secreting glycoprotein   UCLA School of Dentistry
laminin for the lamina lucida layer of basement
membrane. h= lamina densa layer type IV collagen
from connective tissue with adjacent epithelial attachent
organelle hemi-desmosome binding the epithelium to
the connective tissue.
                                        E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                        Tarrson Family Endow ed Chair in Periodontics.
ELETRON MICROGRAH 32,000
MAGNIFICATION. SUPRA BASILAR            Professor and Chairman Division of Associated Clinical Specialties
EPITHELIAL CELL WITH ACTIVE NUCLEUS,    UCLA School of Dentistry
MITOCHONDRIA , ENDO PLASMIC RETICULUM
AND GOLGI COMPLEX..
                                            E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                            Tarrson Family Endow ed Chair in Periodontics.

                                            Professor and Chairman Division of Associated Clinical Specialties
ELECTRN MICROGRAPH SUB SURFACE EPITHELIAL   UCLA School of Dentistry
CELL. NO NUCLEUS, NO FUNCTIONING
CYTOPLAMIC ORGANELLES. PERIPHERY OF CELL
STILL JOINED TO ADJACENT CELLS BY
DEMOSOMES, TIGHT JUNCTIONS AND
INTERMEDIATE JUNCTIONS,
                                         E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                         Tarrson Family Endow ed Chair in Periodontics.
SURFACE EPITHELIAL CELL. NO
CYTOPLASMIC NOR NUCLEAR ACTIVITY.        Professor and Chairman Division of Associated Clinical Specialties
COTAINS LIPIDS AND KERATINO-HYALINE      UCLA School of Dentistry
DEPOSITS., HELD TO SUB-SURFACE LAYER
BY DESMOSOMES WITH NO TIGHT OR
INTERMEDIATE JUNCTIONS SURVIVING. CELL
IS ABOUT TO BE DESQUAMATED.
                                            E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                            Tarrson Family Endow ed Chair in Periodontics.
IN SOME PATIENTS THE BASAL LAYER OF THE
GINGIVA CONTAINS MELANOCYTES--PIGMENT       Professor and Chairman Division of Associated Clinical Specialties
CONTAINING CELLS WHICH GIVE A BROWNISH      UCLA School of Dentistry
HUE TO PORTIONS OF THE GINGIVA. THERE ARE
ALSO AFEW CELLS IN THE CONNECTIVE TISSUE
WHICH HAVE TAKEN UP MELANIN GRANULES --
MELANOPHORES.
E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
Tarrson Family Endow ed Chair in Periodontics.

Professor and Chairman Division of Associated Clinical Specialties
UCLA School of Dentistry
                                             E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                             Tarrson Family Endow ed Chair in Periodontics.

ANOTHER TYPE OF CELL FOUND IN NORMAL         Professor and Chairman Division of Associated Clinical Specialties
GINGIVA ARE LANGERHANS CELLS . THESE CELLS   UCLA School of Dentistry
HAVE DENDRITIC EXTENSIONS AND ARE IN THE
SUPRA BASILAR LAYER.THEY FUNCTION AS
ANTIGEN PROCESSING CELLS AND ARE MODIFIED
MACROPHAGES.
                                       E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                       Tarrson Family Endow ed Chair in Periodontics.

                                       Professor and Chairman Division of Associated Clinical Specialties
ELECTRON MICROGRAPH OF A MERKEL        UCLA School of Dentistry
CELL FOUND IN THE DEEP LAYERS OF
EPITHELIUM. THEY FUNCTION AS TACTILE
PROPRIOCEPTIVE CELLS AND ARE
CONNECTED TO NERVE FIBERS.
THE CONNECTIVE TISSUE OF GINGIVA IS MADE UP   E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
OF MAINLY TYPE 1 COLLAGEN BUNDLES WIH SOME    Tarrson Family Endow ed Chair in Periodontics.
TYPE 1V FIBERS BETWEEN THE BUNDLES AND IN
THE BASEMENT MEMBRANE. THERE ARE AFEW         Professor and Chairman Division of Associated Clinical Specialties
ELASTIC FIBERS MADE UP OF ELASTIN ELAUNIN     UCLA School of Dentistry
AND OXYTALAN AMONG THE COLLAGEN FIBERS.
THE GROUND SUBSTANCE IS MAINLY PROTEO
GLYCANS---HYALURONIC ACID, CHONDROITIN
SULFATE AS WELL AS FIBRONECTIN A GLYCO
PROTEIN THERE ARE ALSO BLOOD VESSELS WHICH
HAVE TERMINAL LOOPS EXTENDING BETWEEN THE
RETE PEGS .NERVES PRESENT ARE MAINLY
MYELINATED WITHTACTILE RECEPTORS AND
TEMPERATURE RECEPTORS
                                        E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
SCANNING ELECTRON MICROGRAPH OF DENSE
COLLAGEN FIBERS OF GINGIVA              Tarrson Family Endow ed Chair in Periodontics.

                                        Professor and Chairman Division of Associated Clinical Specialties
                                        UCLA School of Dentistry
HEALTHY GINGIVA CONTAINS MANY
FIBROBLASTS AND A FEW INFLAMMATORY
CELLS SUCH AS MACROPHAGES
,NEUTROPHILS, PLASMA CELLS AND
LYMPHOCYTES.
                                         E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
THE MAJOR GROUP OF GINGIVAL FIBERS ARE   Tarrson Family Endow ed Chair in Periodontics.
THE GINGIVO DENTAL GROUP EMBEDDED IN
CEMENTUM AND FANNING OUT TO THE          Professor and Chairman Division of Associated Clinical Specialties
GINGIVAL MARGIN THE ELECTRO MICROGRAPH   UCLA School of Dentistry
SHOWS ORGANISED COLLAGEN FIBERS
ATTACHED TO CEMENTUM THERE ARE ALSO
CIRCULAR FIBERS IN A RING AROUND THE
TOOTH AND TRANSSEPTAL FIBERS BETWEEN
ADJACENT TEETH RUNNING HORIZONTALLY
AND ATTACHED AT EACH END TO THE
CEMENTUM OF EACH TOOTH
                                                  E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                  Tarrson Family Endow ed Chair in Periodontics.
THE GINGIVAL SULCUS EXTENDS FROM THE GINGIVAL
MARGIN APICALLY TO THE CEMENTO-ENAMEL JUNCTION.   Professor and Chairman Division of Associated Clinical Specialties
IT FORMS ASEAL AGAINST THE TOOTH AND ACTS AS A    UCLA School of Dentistry
BARRIER TO SUB GINGIVAL PLAQUE BACTERIA AND
PREVENTS FLUID LOSS FROM THE UNDER LYING
CONNECTIVE TISSUE
                                                 E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                                 Tarrson Family Endow ed Chair in Periodontics.
THE CORONAL HALF OF THE GINGIVAL SULCUS IS
LINED BY THE SULCULAR EPITHELIUM.THIS IS A NON   Professor and Chairman Division of Associated Clinical Specialties
KERATINISED STRATIFIED SQUAMOUS EPITHELIUM       UCLA School of Dentistry
THAT IS THINNER THAN THE OUTER GINGIVAL
EPITHELIUM AND IT SERVES AS A PROTECTIVE
BARRIER. THE APICAL HALF OF THE GINGIVAL
SULCUS IS LINED BY THE JUNCTIOAL EPITHELIUM
WHICH ACTS AS ASEAL AGAINST THE ENAMEL
SURFACE.
                                                 E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
JUNCTIONAL EPITHELIUM. THIN LAYER OF CELLS
10 TO 20 CELLS THICK TAPERING TO 1 TO 2 CELLS    Tarrson Family Endowed Chair in Periodontics.
AT APICAL END. e = enamel .BASAL CELLS AGAINST
                                                 Professor and Chairman Division of Associated Clinical Specialties
CONNECTIVE TISSUE PROLIFERATE WITH
                                                 UCLA School of Dentistry
TURNOVER RATE OF 1 TO 6 DAYS. CELLS MIGRATE
THROUGH TO BE EXFOLIATED INTO THE GINGIVAL
SULCUS. THE OUTER SURFACE OF THIS
EPITHELIUM FORMS A SEAL AGAINST THE ENAMEL
WITH A SECRETION OF A PROTEIN CUTICLE LIKE
SUBSTANCE AND PRESENCE OF HEMI-
DESMOSOMES
                                                    E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
ELECTRON MICROGRAPH JUNCTIONAL EPITHELIUM           Tarrson Family Endow ed Chair in Periodontics.
47,000 MAG ES enamel surface DL dental lamina. HD
hemidesmosome BL basal lamina M mitochondria.THE    Professor and Chairman Division of Associated Clinical Specialties
OUTER CELLS OF JUNCTIONAL EPITHELIUM HAVE A         UCLA School of Dentistry
HIGHLY SPECIALISED FUNCTION-- THEY ARE
METABOLICALLY ACTIVE, HAVE HEMI DESMOSOMES
SECRETE LAMININ AS A BASAL LAMINA AND THESE
TOGETHER WITH THE PROTEINS OF THE DENTAL
LAMINA ATTACH THE GINGIVA TO THE TOOTH AND
FORM A SEAL AT THE APICAL END OF THE GINGIVAL
SULCUS,
                                         E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
THE JUNCTIONAL EPITHELIAL SEAL IS        Tarrson Family Endow ed Chair in Periodontics.
ESSENTIAL FOR A HEALTHY GINGIVA .IT IS
DEPENDANT ON AN INTACT EPITHELIAL        Professor and Chairman Division of Associated Clinical Specialties
LAYER AND AND THE STRONG ORGANISED       UCLA School of Dentistry
COLLAGEN GINGIVAL FIBERS THAT KEEP THE
GINGIVA IN INTIMATE CONTACT WITH THE
TOOTH. A SIMILAR ARRANGEMENT CAN
OCCUR ON CEMENTUM ANB EVEN ON DENTAL
IMPLANTS.
      PALATAL MUCOSA                      E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
                                          Tarrson Family Endow ed Chair in Periodontics.

                                          Professor and Chairman Division of Associated Clinical Specialties
ON THE RIGHT SIDE IS THE PALATAL MUCOSA
                                          UCLA School of Dentistry
WHICH IS CONTINUOUS AND SIMLIAR WITH
THE GINGIVA IT IS COVERED WITH
STRATIFIED SQUAMOUS EPITHELIUM WITH A
HIGHLY KERATINISED SURFACE. AND HAS
UNDER THIS A DENSE LAYER OF COLLAGEN.
                                             E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
HIGHER POWER VIEW OF PALATE. EPITHELIUM
SAME AS GINGIVA PROVIDES ATHICK              Tarrson Family Endow ed Chair in Periodontics.
PROTECTIVE COVER AGAINST MECHANICAL.         Professor and Chairman Division of Associated Clinical Specialties
CHEMICAL AND THERMAL INSULTS THE             UCLA School of Dentistry
IMMEDIATE SUB MUCOSA IS DENSE COLLAGEN.
AND BELOW THIS IS A LOOSE CONECTIVE TISSUE
THAT CONTAINS MAJOR NERVES AND BLOOD
VESSELS. IN THIS TISSUE THERE ARE ADIPOSE
CELLS IN THE ANTERIOR PART OF THE PALATE
AND ACCESORY SALIVARY GLANDS IN THE
POSTERIOR PART. IN THE DEEPEST LAYER THERE
IS PERIOSTEUM COVERING THE PALATAL BONE.
E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
Tarrson Family Endow ed Chair in Periodontics.

Professor and Chairman Division of Associated Clinical Specialties
UCLA School of Dentistry
E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
Tarrson Family Endow ed Chair in Periodontics.

Professor and Chairman Division of Associated Clinical Specialties
UCLA School of Dentistry
E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
Tarrson Family Endow ed Chair in Periodontics.

Professor and Chairman Division of Associated Clinical Specialties
UCLA School of Dentistry

				
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