What Is the Gingival Sulcus?

Gum refers to the light-red structure that fits closely around the neck and adjacent alveolar bone. It consists of stratified flat epithelium and lamina propria. It is part of the oral mucosa. The blood vessels are rich, reddish, tough and elastic. Due to the lack of submucosa, it is directly connected to the periosteum, so the gums cannot move. Older people's gums often shrink and their teeth are exposed.

Gum refers to the light-red structure that fits closely around the neck and adjacent alveolar bone. It consists of stratified flat epithelium and lamina propria. It is part of the oral mucosa. The blood vessels are rich, reddish, tough and elastic. Due to the lack of submucosa, it is directly connected to the periosteum, so the gums cannot move. Older people's gums often shrink and their teeth are exposed.

Chinese name

Gums

Name

Human Anatomy Name

Gums overview

Human anatomy name. Also known as dentition (sound and meaning are the same gingival), gum. It refers to the meat on the gums, and it is divided into upper and lower gums. "Guidelines for Syndrome Treatment: Miscellaneous Diseases": "The upper and lower teeth are divided into the upper and lower arms, and the upper limbs belong to the Foot Yangming Stomach Meridian and the lower limbs belong to the Hand Yangming Large Intestine Meridian." The standard is placed on the gums and raised in qi and blood. "Gum lesions are often closely related to the stomach and kidneys. Also known as gums, also called pits. Refers to the tissue around the gum, divided into upper and lower gums. "Guidelines for Zhengzhi": "The upper sacrum belongs to the Foot Yangming Stomach Meridian, and the lower sacral belongs to the Hand Yangming Large Intestine Meridian". Tissue Organ Name. Also known as dentition (sound and meaning are the same gingival), gum. Refers to the flesh of the gums. Divided into upper and lower gums. "Guidelines for Syndrome Treatment: Miscellaneous Diseases": "The upper and lower teeth are divided into the upper and lower arms, and the upper limbs belong to the Foot Yangming Stomach Meridian, and the lower limbs belong to the Hand Yangming Large Intestine Meridian." The standard is placed on the gums and raised in qi and blood. "Fang (yao bite) name of the disease certificate. Alas, bite, bite also ("Guangyun"). Symptoms are bites for the upper and lower teeth, the mouth cannot be opened, and the teeth are closed tightly. Mostly caused by fiery internal heat, exogenous wind evil, or "inflammation for internal wind, signs of convulsions." "Secrets of Throat Experience": "Dentitions are born in the teeth, and the teeth are closed tightly. Even in the middle of the night, it's not difficult to heal, and it won't kill you. "Governing Law: It belongs to the fiery content, and those who feel wind and heat, should choose the agent to relieve wind and heat. Those who are agitated by internal wind and who have convulsions should choose Xifeng to relieve spasms. Anatomy. Alas, bite bone also ("Said the text"). Refers to the temporomandibular joint. Body part name. Also known as gums, also called pits. Refers to the tissue around the gum, divided into upper and lower gums. The upper gingival belongs to the foot yangming stomach meridian, and the lower gingival belongs to the hand yangming large bowel meridian. Gum inspection can be used as a reference for disease diagnosis. If the gums are white, it is a sign of blood deficiency; gum swelling and pain are often caused by burning stomachs; gum atrophy is mostly kidney deficiency.

Gum is the part of the oral mucosa that surrounds the neck and alveolar process. It is light pink and is a chewing mucous membrane. There is a clear boundary between it and the red alveolar mucosa, but there is no obvious boundary between it and the hard maxillary mucosa. Gum can be divided into three parts: free gingival, attached root and gingival papilla. The gingival surface is stratified squamous epithelium with keratinized or incomplete keratinized layers. The epithelial nail is longer and extends into the connective tissue.

Gums and surrounding structures

Gum surface is stratified squamous epithelium with keratinized or incomplete keratinized layer. The epithelial nail is longer and extends into the connective tissue. The gingival epithelium not only covers the exposed part of the gingiva, but also turns to the inside. The gingival sulcus wall is called the intrasulcus epithelium; a part attached to the tooth body is called the combined epithelium. The natural layer of the gum is a connective tissue fiber bundle interwoven in various directions. The most important component is collagen fibers, which account for 56% of all connective tissue. The most numerous cells in the gum are fibroblasts, mast cells are often found in the gums, and there are lymphocytes, plasma cells, and macrophages.

Free gingival: Also called marginal gingival, it is the part that is not attached to the tooth body. It is slightly redder and brighter than the attached gingival, and has a clear sculpted gingival margin.

Attached to the root of the free gingival, attached to the alveolar process and teeth, pink, tough texture. There are orange peel-like depressions on the surface, called stippling. Under the microscope, stippling is the proliferation of epithelial nails, and the surface epithelium falls off to form shallow depressions.

Gingival nipples: Also called interdental nipples, papillary protrusions of the gums between two teeth. Healthy adolescent healthy nipples often reach the point of contact, completely filling the interdental space.

The combined epithelium was also called adhering epithelium in the past. It was attached to the tooth surface in a ring shape, and was derived from the shrinking glaze epithelium. The adolescents' combined epithelium attaches to the enamel and attaches to the cementum when the gums recede. The thickness of the epithelium is about 15 to 18 rows of cells at the base of the gingival sulcus, which gradually becomes thinner toward the root tip, and the terminal end of the root consists of 1 to 3 rows of cells. The junction of the epithelium and connective tissue is a flat straight line without epithelial nails. The combined epithelium is composed of a basal layer and a basal layer. The basal layer is a cubic cell, and the basal layer is a flat cell. Its long axis is aligned parallel to the tooth surface. Combined with epithelial cells, there is a more obvious Golgi apparatus, which contains richer mitochondria, rough endoplasmic reticulum, and rare cytoplasmic filaments. Combining the epithelium with a half desmosome and the basal plate, which is closely attached to the tooth surface is called epithelial attachment.

Gingival sulcus: It is the space between the free gingiva and the teeth, and its depth is 0.5 to 2 mm. The epithelium of the gingival sulcus is a non-keratinized squamous epithelium with epithelial nails. Here the varying degrees of white blood cell infiltration in connective tissue indicate that the gingival sulcus is often stimulated by bacteria and food decomposition products, and a small amount of white blood cell infiltration is a manifestation of defensive effect.

Gum and gum-related disorders

1. Gingival hyperplasia: refers to the increase in cell size or the increase in the number of cell components, the non-inflammatory increase described in this disease, the epithelial and underlying connective tissue have significant proliferation changes, caused by non-local stimuli. If accompanied by inflammatory changes, it is due to secondary bacterial infection, local factors and systemic factors. For example: drug-induced gingival fibrosis. Spontaneous fibrous hyperplasia. Gingival fibromatosis. Non-inflammatory hyperplasia of the gums caused by factors other than local stimuli. It is mainly fibrous tissue and cell proliferation in the gums, and its prevalence is much lower than that of gums caused by inflammation. There are drug-induced gingival hyperplasia and gingival fibromatosis.

2. Gingival cancer: Malignant tumor that occurs in the gums. Molar area is more common, mostly ulcer infiltration. Clinical manifestations include early periodontal discomfort with gum ulcers, loose teeth, alveolar bone damage, numbness of the lips, X-rays, and CT examinations to assist diagnosis. Lymphatic metastasis is easy to occur, and pathological examination can confirm the diagnosis. Generally, a comprehensive treatment method is adopted, which can be operated with radiotherapy.

Gingival cancer is mostly highly differentiated squamous cell carcinoma, which is malignant, lower gingival cancer is more than upper gingival cancer, more men than women, is the most common type of oral cancer.

Gum cancer has a higher incidence in China. Generally, the lower gum is more than the upper gum, and it is more malignant. More men than women. Most are 40 to 60 years old. Often occurs in the molar area. The pathological type is mainly highly differentiated squamous cell carcinoma, which grows slowly, and the ulcer type is the most common. Early infiltration into the alveolar process and between the jaw bones, causing bone destruction, causing tooth loosening and pain. Maxillary gum cancer can invade the maxillary sinus and palate, and mandibular gum cancer can invade the floor of the mouth, cheeks, posterior molars and pharynx. Lymph node metastasis is more common on the affected side. Mandibular gingival cancer metastasizes earlier and is more common. Distant shifts are rare. The main treatment is surgery. Early-stage gingival cancer can also be treated with cryogenic freezing. Radiotherapy is only available for undifferentiated gum cancer. In early gum cancer, the primary foci and the jawbone can be resected as a block to maintain the continuity and function of the jawbone. If a cancerous tumor invades the jawbone, part or one side of the mandible should be removed. After removal, both ends of the broken bone should be fixed with stainless steel wire or fixed with a beveled guide to prevent the occlusal disorder of the jaw.

3. Gingival bleeding: Gingival bleeding is one of the common symptoms of periodontal tissue inflammation, and it is also an oral manifestation of certain systemic diseases. The main cause of chronic gum bleeding is chronic inflammation of the gums caused by local factors such as plaque, soft scale, calculus and other irritants. The most common ones are marginal gingivitis, periodontitis and proliferative gingivitis. Occlusal trauma, bad restorations and other irritation of the gums also often cause chronic inflammation and bleeding. In chronic inflammation, gingival blood vessels dilate, permeability increases, gingival pocket epithelium is eroded or thinned, coupled with irritation and friction of tartar, etc., often slow and easy to stop bleeding. Acute gingival inflammatory diseases, such as herpes gingivitis and necrotizing gingivitis, such gums have a large amount of bleeding and often do not stop easily. Necrotizing gingivitis often also causes significant bleeding of the gums during sleep at night. Gingival trauma, such as piercing of bone and fish bones, damage to brushing or toothpicks, can also cause temporary bleeding. Certain systemic diseases can also cause gum bleeding due to changes in coagulation function, such as leukemia, thrombocytopenic purpura, agranulocytosis, hemophilia, malignant anemia, and scurvy (vitamin C deficiency). The common characteristics of gum bleeding in systemic diseases are: Spontaneous continuous bleeding of the gums, bleeding points or ecchymosis under the oral mucosa and other parts of the body, and systemic symptoms. According to blood cell examination, bone marrow examination, and platelets Examinations such as counting, bleeding time, clotting time, clot contraction reaction, and blood pressure test can confirm the diagnosis.

Gingival bleeding is a symptom, and treatment should be performed for different causes. Any chronic inflammatory bleeding caused by local irritation should be cleaned, scraped, occlusally corrected, prosthetic, food impaction, etc .; bleeding caused by acute inflammation or trauma should be promptly treated for primary disease or Remove the trauma factor; for the bleeding of the gums caused by systemic diseases, we must first make a clear diagnosis, then treat the cause effectively, and do not allow gum surgery. Severe gum bleeding caused by systemic diseases often requires symptomatic treatment. Periodontal plugging is a more effective hemostatic method. Periodontal plugging agents also have astringent, analgesic, and anti-inflammatory effects. After it solidifies and hardens, it can play a role The function of compression to stop bleeding and splints. Before the treatment, the local irritants and dirt should be removed as much as possible, and the affected area should be washed with 3% hydrogen peroxide solution and then pressurized to stop bleeding. The suppository can generally be maintained for 3 to 7 days. Can also be applied with Yunnan Baiyao, gelatin sponge, starch sponge and other drugs, and then gauze strips on the top. The bleeding site is relatively fixed and localized, and caustic drugs such as silver nitrate rod and iodophenol can be used to burn the bleeding point. In special cases where hemostasis is not easy (such as hemophilia), dental impression gel pressurization can also be used to stop bleeding. Acute inflammatory gingival bleeding can be taken orally with traditional Chinese medicine. Guipi Decoction (Dangshen, Astragalus, Angelica, Longan Root, Sour Jujube Kernel, Saccharine, Atractylodes, Zhigancao). For severe bleeding cases, the application of systemic hemostatic drugs, such as vitamin K, and Anluoxue, can also be considered.