Periodontology Anatomy - Mucogingival junction

Marin Contemporary Perio & Implant Concepts

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 tissues found in the periodontium combine together to form an active group of tissues. The alveolar bone is almost completely surrounded by the subepithelial connective tissue of the gingiva. The connective tissue of the gingiva is covered by the various characteristic gingival epithelia. The cementum, which overlays the tooth’s root, is attached to the adjacent cortical surface of the alveolar bone. It is attached by the alveolar crest, horizontal and oblique fibers of the periodontal ligament.

A mucogingival junction is an anatomical feature which is found on the intraoral mucosa. The mucosa found on the cheeks and floor of the mouth are freely moveable and fragile. However, the mucosa around the teeth and on the palate are more firm and keratinized. Where these two tissue meet is referred to as a mucogingival junction.

There are three different mucogingival junctions in the mouth: on the facial of the maxilla and on both the facial and lingual of the mandible. The palatal gingiva of the maxilla is continuous with the tissue of the palate, which is connected to the palatal bones. As the palate is free from any freely moveable alveolar mucosa, there is no mucogingival junction present.

Clinical importance

The mucogingival junction is important from a clinical perspective as it is used to measure the width of attached gingiva. Attached gingiva is critical because it is bound very tightly to the underlying alveolar bone. It provides protection to the mucosa during the functional use, such as chewing, of the structures of the oral cavity. Without the attached gingiva, the freely moveable alveolar mucosa would likely suffer injury or trauma while patients performed eating and routine cleaning activities like brushing their teeth.

The width of attached tissue is crucial because it provides a greater protection against any insults to the tissue. Using the mucogingival junction as the boundary that demarcates the apical border of the attached gingiva, a periodontal probe in inserted into the gingival sulcus and measures how much of the keratinized gingiva coronal to the mucogingival junction is actually attached to the underlying bone. The depth of the gingival sulcus, which is determined by the depth where the probe enters the sulcus, is not attached to the underlying bone, and is not included in the total height of the keratinized tissue.

As an example, if the entire height of the keratinized gingiva, from the free gingival margin to the mucogingival junction is 8 mm, and the probing depth on the tooth at that specific location is 2 mm, the effective width of attached gingiva is 6 mm.

In the event that the probe enters the sulcus and can descend up to or go beyond the mucogingival junction, the area represents a mucogingival defect.

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