Attached Giniva- A Reliable Factor to Cling-To: Review Article
Abstract
Attached gingiva plays an important role in periodontal health. It is a topic of interest among dental professionals and dentists. All the specialties in dentistry deal with attached gingiva in their daily treatment procedures.
The attached gingiva is the part of the gingiva which is tightly attached to the underlying periosteum of the alveolar bone. Attached gingiva extending from the free margin of the gingiva to the mucogingival line minus the pocket or sulcus depth measured with a thin probe in the absence of inflammation. The significance of attached gingiva can be viewed from various specialties of dentistry like orthodontics, pedodontics, prosthodontics, etc. Adequate width of attached gingiva is necessary to prevent plaque accumulation and gingival recession. 2 mm of attached gingiva is necessary for periodontal health. It is a part of keratinized gingiva and helps to increase resistance to external injury and contribute to the stabilization of the gingival margin against frictional force. The firmness characteristic of attached gingiva is because of the connective tissue collagenous nature and due to its mucoperiosteum adherence. In order for the dentist to understand the attached gingiva various studies were conducted with appreciable findings. This article reviews the attached gingiva’s significance in dentistry.
References
Rambabu Dudala, Sunanda Halder, Savan Sunari Rajaram, Sandip Kulavi, Shahnaz, Amit De” Normal anatomy and clinical significance of attached gingiva: A review”, IJDSIR-January-2021, Vol.-4, Issue-, P.No.74-79. https://www.ijdsir.com/issue/pagedata/1498/Normal-anatomy-and-clinical-significance-of-attached-gingiva--A-review
Hassell TM. Tissues and cells of the periodontium. Periodontol 2000. 1993; 3: 9-38; doi: https://doi.org/10.1111/j.1600-0757.1993.tb00230.x
Jacob Pulikkotil, Shaju & Zade, RM. (2009). Width of attached gingiva in an Indian population: A descriptive study. Bangladesh Journal of Medical Science. 8. 64-67. Doi: https://doi.org/10.3329/bjms.v8i3.3985
Clinical Periodontology and Implant Dentistry-Jan Lindhe, 5th edition.
Florellini JP, Kim DM, Ishikawa SO. The gingiva. In: Newman, Michael G, Henry H Takei , Perry R. Klokkevold, and Fermin A. arranza. Carranza’s clinical periodontology. St. Louis. Elsevier Saunders. 2015; 12:9-39. https://www.worldcat.org/title/1059104640
The relationship between the width of keratinized gingiva and gingival health by Niklaus P. Lang and Harald Loe;1972; vol43 issu10; p623-627 doi: https://doi.org/10.1902/jop.1972.43.10.623
Rose ST, App GR. A clinical study of the development of the attached gingiva along the facial aspect of the maxillary and the mandibular anterior teeth in the deciduous transitional and permanent dentition. J periodontol. 1973; 44:131-149. doi: https://doi.org/10.1902/jop.1973.44.3.131
Saario M, Ainamo A, Mattila K, Suomalainen K, Ainamo J. The width of radiologically-defined attached gingiva over deciduous teeth. J clin periodontol. 1995; 22:895-898. doi: https://doi.org/10.1111/j.1600-051X.1995.tb01791.x
Saario M, Ainamo A, Mattila K, Ainamo J. The width of radiologically-defined attached gingiva over permanent teeth in children. J clinperiodontol. 1994; 21, 10: 666-669. doi: https://doi.org/10.1111/j.1600-051X.1994.tb00784.x
Ochsenbein C, Maynard JG. The problem of attached gingiva in children. ASDC J Dent child. 1974; 41, 4: 263-272. https://pubmed.ncbi.nlm.nih.gov/4602385/
Hall WB. Present status of soft tissue grading. J periodontol. 1977; 148:587-597. doi: https://doi.org/10.1902/jop.1977.48.9.587
Serio FG, Hawley CE. Lexi- Comp’s manual of clinical periodontics: A reference guide for diagnosis and treatment, ed. 2. Hudson, Lexi comp; 2002:95.
Langer B, Langer L. Subepithelial connective tissue graft for root coverage. J periodontol 1985; 56(12):715-720. doi: https://doi.org/10.1902/jop.1985.56.12.715
Wennström JL. Mucogingival considerations in orthodontic treatment. Semin Orthod. 1996 Mar; 2(1):46-54. doi: https://doi.org/10.1016/s1073-8746(96)80039-9
Wennstrom J, Lindhe J. Plaque-induced gingival inflammation in the absence of attached gingiva in Dogs. J Clin Periodontol. 1983; 10(3):266–276. doi: https://doi.org/10.1016/S1073-8746(96)80039-9
Wennstrom J, Lindhe J. Role of attached gingiva for maintenance of periodontal health. Healing Following excisional and grafting procedures in dogs. J Clin Periodontol. 1983; 10(2):206–221; doi: https://doi.org/10.1111/j.1600-051x.1983.tb02208.x
Mehta P, Lim LP. The width of the attached gingiva--much ado about nothing? J Dent. 2010 Jul; 38(7):517-25. doi: https://doi.org/10.1016/j.jdent.2010.04.007
Dannan A, Darwish M, Sawan M. How do the periodontal tissues react During the orthodontic alignment and leveling phase? VJO 2008; 8(1):1-7. http://www.vjo.it/wp-content/uploads/2010/09/perio.pdf
Wennström JL, Lindhe J, Sinclair F, Thilander B. Some periodontal tissue reactions to orthodontic tooth movement in monkeys. J Clin Periodontol. 1987 Mar; 14(3):121-9. Doi: https://doi.org/10.1111/j.1600-051X.1987.tb00954.x
Coatoam GW, Behrents RG, Bissada NF. The width of keratinized gingiva during orthodontic treatment: its significance and impact on periodontal status. J Periodontol. 1981 Jun; 52(6):307-13. doi: https://doi.org/10.1902/jop.1981.52.6.307
Wennström JL, Derks J. Is there a need for keratinized mucosa around implants to maintain health and tissue stability?. Clin. Oral Implants Res. 23 (Suppl. 6): 2012, 136– 146 https://doi.org/10.1111/j.1600-0501.2012.02540.x
Schroeder, H.E. & Listgarten, M.A. (1997). The gingival tissues: the architecture of Periodontal protection. Periodontology 2000; 13: 91–120. https://doi.org/10.1111/j.1600-0757.1997.tb00097.x
James RA, Schultz RL: Hemidesmosome and the adhesion of junctional epithelial cells to metal implants a preliminary report, J Oral Implantology; 1974; 4:294-302, https://pubmed.ncbi.nlm.nih.gov/4523138/
Schroeder, H.E. & Listgarten, M.A. (1997). The gingival tissues: the architecture of Periodontal protection. Periodontology 2000; 13: 91–120. doi: https://doi.org/10.1111/j.1600-0757.1997.tb00097.x
Meffert RM, Langer B, Fritz ME: Dental implant: a review, J Periodontol. 1992; 63(11):859-70: doi: https://doi.org/10.1902/jop.1992.63.11.859
Mehdi Adibrad, Mohammad Shahabu, Mahasti Sahabi, significance of the Width of Keratinized mucosa on the health status of the supporting tissue Around implants Supporting overdentures; J Oral Implantol (2009) 35 (5): 232–237; doi: https://doi.org/10.1563/AAID-JOI-D-09-00035.1
Adell R, Lekholm U, Rockler B, Branemark P-I, Lindhe J, Eriksson B, Sbordone L. Marginal tissue recession at osseointegrated titanium fixture (I). A 3-year longitudinal prospective study. Int J oral maxillofacial surgery. 1986; 15: 39-52. doi: https://doi.org/10.1016/S0300-9785(86)80010-2
Lindhe J, Berglundh T, Ericsson I, Liljenberg B, Marinello C. Experimental breakdown of peri-implant and periodontal tissues. A study in the beagle dog. Clin Oral Implants Res. 1992; 3:9–16. doi: https://doi.org/10.1034/j.1600-0501.1992.030102.x
Warrer K, Buser D, Lang NP, Karring T. Plaque-induced peri-implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys. Clin Oral Implants Res. 1995; 6:131–13; doi: https://doi.org/10.1034/j.1600-0501.1995.060301.x
Chung DM, Oh TJ, Shotwell JL, Misch CE, Wang HL. Significance of keratinized mucosa in maintenance of dental implants with different surfaces. J Periodontol. 2006; 77:1410–1420; doi: https://doi.org/10.1902/jop.2006.050393
Bouri A Jr, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. Int J Oral Maxillofac Implants. 2008 Mar-Apr; 23(2):323-6. doi: https://pubmed.ncbi.nlm.nih.gov/18548930/
Lang NP, Loe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol. 1972; 43:623–7. Doi: https://doi.org/10.1902/jop.1972.43.10.623
Miyasato M, Crigger M, Egelberg J. Gingival condition in areas of minimal and appreciable width of keratinized gingival. J Clin Periodontol. 1977; 4(3):200–9. doi: https://doi.org/10.1111/j.1600-051x.1977.tb02273.x
Wennström J, Lindhe J. Role of attached gingiva for maintenance of periodontal health. Healing following excisional and grafting procedures in dogs. J Clin Periodontol. 1983 Mar; 10(2):206-21. doi: https://doi.org/10.1111/j.1600-051x.1983.tb02208.x
