The document provides an overview of the periodontium, which includes the gingiva, periodontal ligament, cementum, and alveolar bone. It describes the microscopic and macroscopic structure of each component in detail. The gingiva is divided into marginal, attached, and interdental regions. It has an epithelial layer and connective tissue layer. The periodontal ligament connects the cementum to the alveolar bone and contains fibers and cellular elements. Cementum covers the root surface and comes in acellular and cellular varieties. The alveolar bone provides support and structure for the teeth. Each component works together to attach and support the teeth.

1. PERIODONTIUM
 PRESENTED BY –
 Dr. Prajakta .B. Gir.
 1st year PG
.
1

2. CONTENTS :-
 INTRODUCTION.
 STRUCTURES.
 A) GINGIVA ~
 1) Definition.
 2) Development.
2

3.  3) Macroscopic features =
 a} Marginal Gingiva
 b} Gingival Sulcus
 c} Attached Gingiva
 d} Interdental Gingiva
3

4.  4) Microscopic features =
 a} Gingival Epithelium
 b} Gingival Connective Tissue.
 5) Clinical features .
 6) Renewal of Gingiva.
4

5. B) PERIODONTAL LIGAMENT ~
1) Definition.
2) Cells of periodontal ligament.
3) Periodontal ligament fibres.
4) Functions.
5

6.  C) CEMENTUM ~
 1) Characteristics.
 2) Composition.
 3) Classification.
 4) Cells.
 5) Cementoenamel Junction.
 6) Cementodentinal Junction.
 7) Functions.
6

7.  D) Alveolar Bone ~
 1) Structure.
 2) Interdental Septum.
 3) Alveolar Crest.
 4) Functions.
7

8.  VASCULARIZATION OF PERIODONTIUM.
 AGE CHANGES IN PERIODONTIUM.
 PROSTHODONTIC CONSIDERATIONS.
 CONCLUSION.
 REFERENCES.
8

9. INTRODUCTION -
1} In Periodontium , ‘ Peri’ means ‘ around’ and ‘ odont’
means ‘ tooth’.
2} It is a multilayered complex of tissues that surrounds ,
attaches and supports each tooth to the underlying alveolar
bone.
3} It is also called as an ‘ Attachment Apparatus’ .
9

10.  4} It consists of 4 principal components :-
 A) GINGIVA.
 B) PERIODONTAL LIGAMENT.
 C) CEMENTUM.
 D) ALVEOLAR BONE.
10

11. 11

12. GINGIVA.
12

13. GINGIVA.
 Carranza : It covers the alveolar bone and tooth root to
a level just coronal to the cementoenamel junction.
 Lindhe : The gingiva is that part of the masticatory
mucosa which covers the alveolar process and surrounds
the cervical portion of the teeth.
13

14. DEVELOPMENT.
 GINGIVA = EPITHELIUM + CONNECTIVE TISSUE.
 Ectodermal origin Mesodermal origin.
14

15. MACROSCOPIC FEATURES :
 A) MARGINAL GINGIVA ~
 The marginal or unattached gingiva is the terminal edge
or border of the gingiva that surrounds the teeth in
collar-like fashion .
 The free gingiva is coral pink, and it is demarcated from
the adjacent attached gingiva by a shallow linear
depression called the free gingival groove(FGG).
15

16. 16

17.  The marginal gingiva is usually about 1 mm wide, and it
forms the soft-tissue wall of the gingival sulcus.
 Can be separated by a periodontal probe.
 The most apical point is called the ‘Gingival Zenith’.
 Apicocoronal = 0.06mm.
Mesiodistal= 0.96mm.
17

18. B) GINGIVAL SULCUS ~
 The gingival sulcus is a shallow crevice. (Orbans and
Mueller).
 It is ‘v’ shaped and barely permits the entrance of a
periodontal probe.
 It is bounded by tooth on one side and sulcular
epithelium on other side.
 The sulcus is coronal to the attachment of junctional
epithelium.
 The coronal extent of gingival sulcus is gingival margin .
18

19.  Ideal conditions, the depth of
the gingival sulcus - 0 mm
 The so-called probing depth
of a clinically normal gingival
Sulcus in humans is 2 to 3 mm.
19

20. C) ATTACHED GINGIVA ~
 The attached gingiva is continuous with the marginal
gingiva.
 It is firm, resilient, coral pink in color and tightly bound
to the underlying periosteum of alveolar bone.(GPT
2001)
 It often shows small depressions on the surface. The
depressions, named "stippling", gives the appearance as
of an orange peel.
20

21.  The facial aspect of the attached gingiva extends to the
relatively loose and movable alveolar mucosa; it is
demarcated by ‘the mucogingival junction’ .
21

22. 22

23. WIDTH OF ATTACHED GINGIVA :~
Maxilla incisor region: 3.5- 4.5 mm (greatest)
Mandible incisor region: 3.3 – 3.9 mm
Maxillary premolar: 1.9 mm
Mandibular first premolars: 1.8 mm
The width of the attached gingiva increases with age and in
supraerupted teeth.
The palatal surface of the attached gingiva in the maxilla blends
imperceptibly with the equally firm and resilient palatal mucosa.
23

24. D) INTERDENTAL GINGIVA :
 It is the portion of the gingiva that occupies the
interproximal spaces. It is the interdental extension of
the gingiva.(GPT 2001) The interdental gingiva can be
pyramidal, or it can have a “col” shape.
24

25.  COL : Valley like depression connecting facial and lingual
papilla.
25

26. MICROSCOPIC FEATURES :
 A) GINGIVAL EPITHELIUM :
 The gingival epithelium consists of a continuous lining
of stratified squamous epithelium.
 *FUNCTIONS*
 1. Mechanical , chemical, water and microbial barrier.
 2. Signaling function.
26

27.  The main function is to protect deep structures which is
achieved by proliferation and differentiation.
 mitosis. Biochemical and
 morphological events.
27

28. LAYERS OF GINGIVAL EPITHELIUM:
 Stratum Basale
 Stratum Spinosum.
 Stratum Granulosum.
 Stratum Corneum.
28

29.  Three types of surface keratinisation occurs in the
gingival epithelium:
 Orthokeratinised : complete keratinisation.
 Parakeratinised : intermediate stage.
 Non keratinised.
29

30. Cells present in gingival epithelium.
 KERATINOCYTES .
 NONKERATINOCYTES/CLEAR CELLS:
1. Langerhans cells
2. Merkel cells
3. Melanocytes
4. Inflammatory cells.
30

31. Types of gingival epithelium
 Oral or outer epithelium
 Sulcular epithelium
 Junctional epithelium
31

32. B) GINGIVAL CONNECTIVE TISSUE.
 The connective tissue supporting the oral epithelium is
termed lamina propria.
 Divided into 2 layers :
 a} Papillary layer – epithelial ridges.
 b} reticular layer – between papillary and underlying
 structures.
32

33. 33

34. Cells –
 Fibroblasts
 Mast cells
 Macrophages
 Inflammatory cells
 Fibers –
 Collagen
 Reticulin
 Oxytalan
 Elastin
34

35. GINGIVAL FIBRES:~
 The connective tissue of the marginal gingiva is densely
collagenous, and it contains a prominent system of
collagen fiber bundles called the ‘gingival fibers’.
 These fibers consist of type I collagen.
35

36. FUNCTIONS:~
 1. To brace the marginal gingiva firmly against the tooth.
 2. To provide the rigidity necessary to withstand the
forces of mastication without being deflected away from
the tooth surface .
 3. To unite the free marginal gingiva with the cementum
of the root and the adjacent attached gingiva.
36

37. 37

38. 38

39. 39

40. 40

41. CLINICAL FEATURES:~
 COLOUR:
 The color of the attached and marginal gingiva is
generally described as “coral pink”.
 This is due to –Vascular supply, degree of keratinization,
thickness and pigmentation.
41

42.  SIZE :
The size of the gingiva corresponds with the sum total of
the bulk of cellular and intercellular elements and their
vascular supply. Alteration in size is a common feature of
gingival disease.
 CONSISTENCY:
 Firm and resilient and tightly bound to the underlying bone.
42

43. CONTOUR :
 a . Marginal gingiva – Scalloped.
 b . Labial surface – accentuated.
 c . Lingual surface – Horizontal and thickened.
 SURFACE TEXTURE :
 Stippled or orange peel appearance.
43

44. POSITION:
 The position of the gingiva is the level at which the
gingival margin is attached to the tooth.
 When the tooth erupts into the oral cavity, the margin
and sulcus are at the tip of the crown; as eruption
progresses, they are seen closer to the root.
 Eruption consists of an active phase and a passive
phase. Active eruption is the movement of the teeth in
the direction of the occlusal plane, whereas passive
eruption is the exposure of the teeth via apical migration
of the gingiva.
44

45. RENEWAL :~
 Undergoes continuous renewal.
 Thickness is maintained = new cell formation + shedding
of old cells. The following have been reported as
turnover times for different areas of the oral epithelium:
 Palate, tongue, and cheek, 5 to 6 days;
 Gingiva-10 to 12 days, with the same or more time
required with age;
 And junctional epithelium, 1 to 6 days.
45

46. PERIODONTAL
LIGAMENT.
46

47. PERIODONTAL LIGAMENT.
 The periodontal ligament is composed of a complex
vascular and highly cellular connective tissue that
surrounds the tooth root and connects it to the inner wall
of the alveolar bone.
 The average width of the periodontal ligament space is
documented to be about 0.2 mm.
47

48. CELLULAR ELEMENTS :
 4 TYPES OF CELLS :
 1} Connective tissue cells- a) Fibroblasts
 b) Cementoblasts
 c) Osteoblasts.
 2} Epithelial rest cells.
48

49.  3} Immune system cells-
 a) Neutrophils
 b) Lymphocytes
 c) Macrophages
 d) Mast cells
 e) Eosinophils.
 4} Cells associated with Neuromuscular elements.
49

50. PERIODONTAL LIGAMENT FIBRES:
50

51.  1) TRANSSEPTAL - Extends interproximally over
the alveolar bone crest and are embedded in the
cementum of adjacent teeth.
 They are reconstructed even after destruction of the
alveolar bone that results from periodontal disease.
51

52.  ALVEOLAR CREST – Extends obliquely from
cementum just below the junctional epithelium to the
alveolar crest.
 Prevents extrusion of teeth.
 Resists lateral movement .
52

53.  HORIZONTAL - fibers Extend at right angles to the
long axis of the tooth from the cementum to the alveolar
bone.
 APICAL - Radiate in a rather irregular manner from
the cementum to the bone at the apical region of the
socket. They do not occur on incompletely formed roots.
53

54.  OBLIQUE - Which constitute the largest group in the
periodontal ligament, extend from the cementum in a
coronal direction obliquely to the bone. They bear the
vertical masticatory stresses and transform such stresses
into tension on the alveolar bone.
 INTERRADICULAR - Fan out from the cementum
to the tooth in the furcation areas of multirooted teeth.
54

55. FUNCTIONS :
 Physical
 Formative
 Remodeling
 Nutritional
 Sensory
55

56.  Physical Functions :
 1. Provision of a soft-tissue “casing” to protect the
vessels and nerves from injury
 by mechanical forces.
 2. Transmission of occlusal forces to the bone.
 3. Attachment of the teeth to the bone.
 4. Maintenance of the gingival tissues in their proper
relationship to the teeth.
 5. Resistance to the impact of occlusal forces (i.e. Shock
absorption)
56

57.  FORMATIVE AND REMODELING
FUNCTION:
 Cells of the periodontal ligament participate in the
formation and resorption of cementum and bone, which
occur during physiologic tooth movement, during the
accommodation of the periodontium to occlusal forces,
and during the repair of injuries.
57

58.  Nutritional and Sensory Functions :
 The periodontal ligament supplies nutrients to the
cementum, bone, And gingiva by way of the blood
vessels, and it also provides lymphatic drainage.
 periodontal ligament is abundantly supplied with
sensory nerve fibers that are capable of transmitting
tactile, pressure, and pain sensations via the trigeminal
pathways.
58

59. 59
CEMENTUM.

60. CEMENTUM.
60
 Cementum is specialized, mineralized, avascular
mesenchymal tissue that forms the outer covering of
anatomic root.
 Cementum begins at the cervical portion of the tooth at
the cementoenamel junction and continues to the apex.

61. PHYSICAL CHARACTERISTICS:
61
 Hardness < Dentin.
 Light yellow in color and lacks luster.
 Lighter in color than dentin .
 The thickness of cementum is approximately 20-50 µm
cervically (Thinest) and 200 µm apically(Thickest).

62. COMPOSITION:
62
 Inorganic content = 45-50%
 Organic content = 50-55%

63. TYPES OF CEMENTUM :
63
 Acellular cementum -

64. 64
 Cellular Cementum -

65. CLASSIFICATION:
65
 SCHROEDER CLASSIFICATION-
 1. Acellular Afibrillar Cementum (AAC)
 2. Acellular Extrinsic Fiber Cementum (AEFC)
 3. Cellular Intrinsic Fiber Cementum (CIFC)
 4. Cellular Mixed Stratified Cementum (CMSC)
 5. Intermediate Cementum

66. 66
 1) Acellular Afibrillar Cementum – Coronal Cementum.
 2)Acellular extrinsic Fibrillar Cementum – Cervical third
of root.
 3) Cellular Intrinsic Fibrillar Cementum – Middle to
apical third and interradicular Cementum.
 4) Cellular Mixed Stratified Cementum – Apical third of
root.

67. 67
CELLS :
 CEMENTOBLASTS -

68. 68
 CEMENTOCYTES -

69. CEMENTOENAMEL JUNCTION -
69
 The junction between the cementum and enamel at the
cervical region of the tooth is termed Cemento-Enamel
junction.
 Three types of relation exist at the cementoenamel
junction.

70. 70
1) Enamel overlaps Cementum : 60-65 %
2) Edge to Edge : 30 %
3) Gap junction : 5-10 %

71. 71

72. CEMENTODENTINAL JUNCTION -
72
 The terminal apical area of cementum where it joins the
internal root dentin is called Cementodentinal junction or
CDJ.
 Width of CDJ is 2 to 3um and remains relatively stable.

73. 73

74. FUNCTIONS :
74
 1) ANCHORAGE –

 To furnish a medium for the attachment of collagen
fibers that bind the tooth to alveolar bone.
 Connective tissue attachment to the tooth is impossible
without cementum.

75. 75
 2) ADAPTATION –
 Continuous deposition of cementum is of functional
importance as it makes functional adaptation of teeth
possible.
 Cementum is not resorbed under normal conditions.
 As the most superficial layer of cementum ages, a new
layer is deposited that keeps the attachment apparatus
intact.

76. 76
 3) REPAIR –
 Damage to roots such as fractures and resorptions can
be repaired by the deposition of new cementum.

77. 77
ALVEOLAR BONE.

78. ALVEOLAR BONE .
78
• Alveolar process is the portion of the maxilla and
mandible that supports the tooth sockets (alveoli).

79. STRUCTURE:
79
 The Alveolar process consists of :
 1) Alveolar bone proper.
 2) Supporting alveolar bone.

80. 80

81. 81
1) Alveolar bone proper -
 The alveolar bone proper is about 0.1–0.4 mm thick.
 It surrounds the root of the tooth and gives attachment
to principal fibers of the periodontal ligament.
 It is perforated by many openings that carry nerves and
blood vessels in to the periodontal ligament therefore it
is called cribriform plate

82. 82

83. 2) Supporting alveolar bone -
83
 Supporting alveolar bone is that part of the bone which
surrounds the alveolar bone proper and gives supports to
the socket. - It consists of two parts :
 A} Cortical plates
 B} Spongy bone :

84. 84

85. 85
A) Cortical plates ~
 It consists of compact bone and form the outer and inner
plates of the alveolar processes.
 It is continuous with the bony maxilla and mandible and
is much thicker in the mandible than in the maxilla.
 They are thickest in the mandibular premolar and molar
regions especially on the buccal side.

86. 86
B) Spongy bone ~
 It fills the area between cortical plates and the alveolar
bone proper.

87. INTERDENTAL SEPTUM :
87
 It consists of cancellous bone that is bordered by the
socket wall of approximating teeth and the facial and
lingual cortical plates.

88. 88

89. ALVEOLAR CREST :
89
 Forms when the inner and outer cortical plates meet.
 The margin is thin and knife edged of anterior teeth and
rounded in posterior teeth.
 Runs roughly parallel to the CEJ 1-3mm apical to it with
greater distance seen as the age progresses.

90. 90
 Average distance between CEJ and alveolar crest
1.08mm.
 This increases with age- 2.81mm

91. 91

92. FUNCTIONS :
92
 Houses the roots of teeth.
 Anchors the roots of teeth to the alveoli .
 Helps to move the teeth for better occlusion.
 Helps to absorb and distribute occlusal forces generated
during tooth contact.
 Supplies vessels to periodontal ligament.
 Houses and protects developing permanent teeth, while
supporting primary teeth.

93. 93
VASCULARIZATION OF
PERIODONTIUM :

94. 94
 The blood supply to the supporting structures of the
tooth is derived from the inferior and superior alveolar
arteries to the mandible and maxilla, and it reaches the
periodontal ligament from three sources: apical vessels,
penetrating vessels from the alveolar bone, and
anastomosing vessels from the gingiva.

95. AGE CHANGES :
95
 Thinning and decreased keratinization of the gingival
epithelium have been reported with age.
 the width of the PDL space will decrease if the tooth is
unopposed (i.e., hypofunction) or increase with
excessive occlusal loading .

96. 96
 An increase in cemental width is a common finding; this
increase may be 5 to 10 times wider than in those of
younger age.
 The increase in width is greater apically and lingually.

97. 97
PROSTHODONTIC
CONSIDERATIONS

98. 98
 An adequate understanding of the relationship between
periodontal tissues and restorative dentistry is paramount
to ensure adequate form, function, esthetics and comfort
of the dentition
 The relationship between periodontal health and the
restoration of teeth is intimate and inseparable.
Maintenance of gingival health constitutes one of the
keys for tooth and dental restoration longevity.

99. 99
BIOLOGICAL WIDTH:
 ‘ Biological width is the combined width of connective
tissue and epithelial attachment superior to the crestal
bone’. (Gargiulo et al. 1961)
 Later on, the term 'biologic width' was introduced by
Cohen to describe the space over the tooth surface,
occupied by the connective tissue and epithelial
attachments and this parameter being equivalent to the
distance between the bottom of the gingival sulcus and
the alveolar bone crest.

100. 100
 The total dimension of the epithelial attachment and
connective tissue attachment to the root .
(Assif et al. 1991)
The dimensions of the space that the healthy gingival
tissue occupies over the alveolar bone.
( Carranza 9th edition)

101. 101
 The biological width is considered to be essential for
maintaining healthy gingiva, especially in the case of
teeth which needs restoration.
 Biological width acts as a barrier to prevent entry of
microorganisms into the periodontium

102. 102

103. MARGIN PLACEMENT AND BIOLOGIC WIDTH
103
 1. Supragingival Margin
 2. Equigingival Margin
 3. Subgingival Margin.

104. Supragingival margin -
104
 It has the least impact on the periodontium. This margin
location has been applied in non-esthetic areas .
 ADVANTAGES~
1. Preparation of the tooth and finishing of the margin is
easiest
2. Duplication of the margins with impressions that can be
removed past the finish line without tearing or deformation
is the easiest with supragingival margins.

105. 105
 Fit and finish of the restoration and removal of excess
material is easiest
 Verification of the marginal integrity of the restoration is
easiest.
 The supragingival margins are least irritating to the
periodontal tissue.

106. 106

107. Equigingival margin -
107
 Favour more plaque accumulation than supragingival or
subgingival margins, and therefore result in greater
gingival inflammation.
 Any minor gingival recession would create an unsightly
margin display.

108. 108

109. Subgingival margin -
109
 Restorative considerations will frequently dictate the
placement of restoration margins beneath the gingival
tissue crest because of caries or tooth deficiencies, and/or
to mask the tooth/restoration interface.
 Sub gingival restorations demonstrated more quantitative
and qualitative changes in the micro flora, increased
plaque index, gingival index, recession, pocket depth and
gingival fluid.

110. 110

111. 111
Categories of biologic width
and margin placement
guidelines to prevent biologic
width violation.

112. 112
 According to Kois –
1) Normal Crest.
2) High Crest.
3) Low Crest.

113. 1) Normal Crest .
113
 In the Normal Crest patient, the mid-facial measurement
is 3.0 mm and the proximal measurement is a range from
3.0 mm to 4.5 mm. Normal Crest occurs approximately
85% of time. In these cases, the gingival tissue tends to
be stable for a long term. The margin of a crown should
generally be placed no closer than 2.5 mm from alveolar
bone. Therefore, a crown margin which is placed 0.5 mm
subgingivally tends to be well-tolerated by the gingiva,
and is stable long term in the Normal Crest patient.

114. 2) High Crest .
114
 High Crest is an unusual finding in nature and occurs
approximately 2% of the time. There is one area where
High Crest is seen more often: In a proximal surface
adjacent to an edentulous site. In the High Crest patient,
the mid-facial measurement is less than 3.0 mm and the
proximal measurement is also less than 3.0 mm . In this
situation, it is commonly not possible to place an
intracrevicular margin because the margin will be too
close to the alveolar bone, resulting in a biologic width
impingement and chronic inflammation.

115. 3) Low Crest .
115
 In the Low Crest patient group, the mid-facial
measurement is greater than 3.0 mm and the proximal
measurement is greater than 4.5 mm. Low Crest occurs
approximately 13% of the time. Traditionally, the Low
Crest patient has been described as more susceptible to
recession secondary to the placement of an
intracrevicular crown margin. When retraction cord is
placed subsequent to the crown preparation; the
attachment apparatus is routinely injured. As the injured
attachment heals, it tends to heal back to a Normal Crest
position, resulting in gingival recession.

116. 116

117. IMPORTANCE :
117
 Based on the sulcus depth the following three rules can
be used to place intracrevicular margins:
 1) If the sulcus probes 1.5 mm or less, the restorative
margin could be placed 0.5 mm below the gingival tissue
crest

118. 118
 2) If the sulcus probes more than 1.5 mm, the restorative
margin can be placed in half the depth of the sulcus.
 3) If the sulcus is greater than 2 mm, gingivectomy
could be performed to lengthen the tooth and create a 1.5
mm sulcus. Then the patient can be treated as per rule 1.

119. CROWN CONTOUR :
119
 The four guidelines to contouring crowns with emphasis
on access for oral hygiene will be described :
1) Buccal and lingual contours–flat, not fat! –
overcontouring is a greater periodontal hazard than
undercontouring.

120. 120
 2) Open embrasures ~
 If plaque is a primary etiologic factor in gingivitis, then
every effort should be made to allow easy access to the
interproximal area for plaque control.
 Open embrasure spaces will allow for this easy access.
An overcontoured embrasure will reduce the space
intended for the gingival papilla. The result is a broadening
of the col area, causing pressure and irritation on the
papilla.

121. 121
 3) Location of contact areas ~
Contacts should be high (directed incisally) and buccal
in relation to the central fossa .
 4) Furcations involvement ~
Furcations that have been exposed owing to loss of
periodontal attachment should be ‘‘fluted’’ or ‘‘barreled
out’’

122. PONTIC DESIGN :
122
 The pontic design of choice is the modified ridge lap for
posterior spaces and the ridge-lap facing for anterior
spaces.

123. 123
Comparison of periodontal
indexes between tooth an
implant

124. 124
 Periodontal indices are often used for evaluation of
dental implants.
 periodontal indices for dental implants:
(1) longevity,
(2) mobility versus rigid fixation,
(3) percussion,
(4) pain,
(5) probing depths,

125. 125
(6) bleeding index,
(7) crestal bone loss,
(8) radiographic evaluation,
(9) keratinized tissue, and
(10) periimplant disease.

126. Comparison of Tooth and Implant supported structures
126
Structure Tooth Implant
Connection to bone, Cementum ,bone,
periodontium
Osseointegration,
bone functional
ankylosis
Junctional epithelium Hemidesmosomes
and basal lamina
(lamina lucida and
lamina densa zones)
Hemidesmosomes
and basal lamina
(lamina lucida, lamina
densa, and sublamina
lucida zones)

127. 127
Connective tissue 12 groups: six insert
perpendicular to tooth
surfaces ↓collagen, ↑
fibroblasts
Only two groups:
parallel and circular
fibers; no attachment
to the implant surface
↑ collagen, ↓fibroblasts
Biological width 2.04–2.91 mm 3.08 mm (includes
sulcus)
Vascularity Greater; supraperiosteal,
and periodontal
ligament
Less periosteal
Probing depth 3 mm in health 2.5–5.0 mm (depending
on previous soft tissue
depth)

128. 128
Bleeding on
probing
More
reliable
Less reliable

129. CONCLUSION:
129
 Gingival tissues play a key role in the protection of
tooth structures and supporting periodontal tissues
against trauma and/or infection
 Making the gingival health, a very essential component
for the success of all periodontal treatment procedures.

130. 130
 The health and integrity of the periodontium is vitally
important for dental health and preventing inflammation
and infection and advising about regular and correct
brushing to clean and protect the periodontium is an
essential role for the dental professional.

131. REFERENCES:
131
 Clinical Periodontology By Carranza, 12th Edition
 Clinical Periodontology And Implant Dentistry By
Jan Lindhe, 4th Edition.
 Biology Of Periodontal Connective Tissue – Bartold
And Sampath Narayana
 Orbans - oral histology and embryology 13th edition –
GS kumar
 Ten cates oral histology 8th edition – Antonio Nanci

132. 132
 Periodontology 2000 article –the gingival tissues :the
architecture of periodontal protection. e
 Journal of Clinical and Diagnostic Research ·
November 2018; Hari Padmini et al
 Malthi k et al ;IJSRR 2013,3(2),188-198.