Periodontology Anatomy - Free Gingival Margin

The periodontium is the specialized tissues that provide two functions, surrounding and supporting the teeth. In addition to maintaining them within the maxillary and mandibular bones. The word is derived from the Greek terms peri-, which means "around" and -odont, which means "tooth". In a literary sense, periodontium translates to "around the tooth". Periodontics is the dental specialty that specifically docuses on the care and maintenance of these specific tissues. The specialty provides the support that is necessary to maintain functioning teeth. The practice consists of four main components which include the following:

1. Gingiva
2. Periodontal ligament (PDL)
3. Cementum
4. Alveolar bone proper

The free gingival margin is the area located between the sulcular epithelium and the epithelium of the oral cavity. This interface exists at the most coronal point of the gingiva, which is also known as the crest of the marginal gingiva.

The gingival margin (F) is the most coronal point of the gingiva. It is depicted as the top of the pink hill in the above diagram. The sulcular epithelium within the gingival sulcus (G) is located to the left, and the oral epithelium (E) is to the right.

The short part of gingiva which exists above the height of the underlying Alveolar process of maxilla, also known as the free gingiva, is not bound down to the periosteum that envelops the bone, it is able to move. However, as a result of the presence of gingival fibers, such as the dentogingival and circular fibers, the free gingiva remains pulled up against the surface of the tooth unless it is pushed away. One example where this occurs is with the use of a periodontal probe or from the bristles of a toothbrush.

Gingival retraction or recession

Gingival retraction or gingival recession occurs when there is a lateral movement of the gingival margin away from the surface of the tooth. When it is performed intentionally, it is called gingival retraction. In these cases, it is performed through the use of mechanical, chemical or electrical means to perform specific dental surgical procedures. When it occurs spontaneously or when it is not intentional, it is usually referred to as gingival recession. In these cases it may indicate the presence of underlying inflammation, the formation of a pocket or the displacement of the marginal gingivae away from the tooth through mechanical, chemical or surgical means. It may also expose the roots of the teeth, which is similar to what occurs with gingival recession.

Gingival retraction paste

The use of gingival retraction paste has been demonstrated to be the most successful in providing a dry field and imposing the least amount of injury on the surrounding periodontium. It also has a reduced ability to retract gingival tissues when compared to a retraction cord.

Gingival retraction cord

A gingival retraction cord, though more damaging to the gingival tissues, has proven to more effectively displace gingival tissues. As a result, it is recommended in cases where thick periodontium is present. Without the addition of any chemical material, such as epinephrine or sulphate compounds, the cord does not produce haemostasis at the sulcus on its own.