PERIODONTICS

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Correlation of Clinical and Microscopic Features

An understanding of the normal clinical features of the gingiva requires the ability to interpret them in terms of the microscopic structures they represent.

Color

  • The color of the attached and marginal gingiva is generally described as “coral pink” and is produced by the vascular supply, the thickness and degree of keratiniza­tion of the epithelium, and the presence of pigment-containing cells.
  • The color varies among different persons and appears to be correlated with the cutaneous pigmentation. It is lighter in blond individuals with fair complexion than in swarthy, dark-haired individuals.

Physiologic Pigmentation (Melanin)

  • Melanin, a non-hemoglobin-derived brown pigment, is responsible for the normal pigmentation of the, skin, gingiva, and remainder of the oral mucous membrane. Melanin pigmentation in the oral cavity is prominent in black individuals.
  • According to Dummett, the distribution of oral pigmentation in black individuals is as follows: gingiva, 60%; hard palate, 61%; mucous membrane, 22%; and tongue, 15%. Gingival pigmentation occurs as a diffuse, deep-purplish discoloration or as irregularly shaped, brown and light-brown patches. It may appear in the as early as 3 hours after birth.
  • Oral repigmentation refers to the clinic melanin pigment after a period of clinical depigmentation of the oral mucosa resulting from chemical, thermal, surgical, pharmacologic, or idiopathic factors.

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