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The attached gingiva plays a critical role in maintaining periodontal stability and overall oral health. Defined by the GPT (1972), it is the portion of the gingiva that extends from the base of the gingival crevice to the mucogingival junction.
The attached gingiva is essential for providing strength, support, and protection to the teeth and surrounding tissues. In this blog, we will explore the functions of attached gingiva and why it is vital for both functional and aesthetic aspects of oral health.
Key Characteristics of Attached GingivaThe attached gingiva is continuous with the marginal gingiva and extends to the mucogingival junction on the facial aspect of both the maxilla and mandible. On the lingual side of the mandible, it terminates at the lingual alveolar junction. Some defining characteristics of the attached gingiva include:-
Firm and resilient: It is tightly bound to the underlying periosteum of the alveolar bone, providing a strong foundation.
Keratinized: This layer of keratinized tissue adds extra protection from the mechanical forces experienced during chewing.
Stippling: Present in 40% of individuals, stippling on the surface gives the gingiva a dimpled appearance, similar to orange peel.
The attached gingiva is separated from the alveolar mucosa by the mucogingival junction and from the marginal gingiva by the free gingival groove. Its width can vary based on age and tooth position, with the incisor region of the maxilla showing the widest attached gingiva.The functions of attached gingiva are numerous and integral to maintaining periodontal health. Below are the most important roles it plays:
1. Braces the Marginal GingivaThe attached gingiva provides structural support to the marginal gingiva, helping it maintain its position against the tooth. This support is crucial for preventing the recession of gum tissue and ensuring that the teeth remain stable over time.
2. Bears Masticatory ForceAttached gingiva is resilient enough to withstand the heavy forces generated during chewing (mastication). This protective function helps prevent damage to the underlying bone and other tissues, ensuring the teeth remain firmly in place.
3. Aids in Food DeflectionProperly positioned attached gingiva ensures that food is deflected away from the marginal gingiva and gum pockets, reducing the risk of food impaction, which could lead to gum irritation and plaque accumulation.
4. Facilitates Proper Tooth BrushingBy maintaining the correct alignment of the gingival margin, the attached gingiva ensures that toothbrush bristles effectively reach the gum line, aiding in efficient plaque removal.
5. Reduces Plaque AccumulationThe attached gingiva's role in bracing the marginal gingiva ensures a snug closure around the tooth, reducing the likelihood of plaque buildup in hard-to-reach areas. This function helps protect the teeth and gums from periodontal diseases.
6. Aesthetic ValueThe appearance of healthy, firm, and pink attached gingiva contributes to the overall aesthetics of the smile. An adequate width of attached gingiva also plays a role in the visual harmony of the gingival margin, especially in the anterior region of the mouth.
Width of Attached GingivaThe width of the attached gingiva varies depending on the location of the teeth and increases with age. According to Hall’s measurements, the attached gingiva in the maxillary incisor region is typically 3.5-4.5 mm, while the mandibular incisor region ranges from 3.3-3.9 mm. The premolar region has the narrowest attached gingiva, with the maxillary and mandibular first premolars showing widths of 1.9 mm and 1.8 mm, respectively.Conclusion
The attached gingiva is more than just a protective layer of tissue. Its primary functions, such as bracing the marginal gingiva, bearing masticatory force, and preventing plaque accumulation, make it an essential component of periodontal health. Understanding its role can help us diagnose and treat gingival and periodontal issues more effectively, ensuring better long-term outcomes for patients.
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