What is Stippling of Gingiva and how is it formed and where it is seen

Stippling of Gingiva: Healthy gingiva presents a textured surface like that seen on the surface of an Orange Peel which is called as Stippled. It is also called as Alternate protuberances & depressions on gingival surface.

Stippling was thought to indicate good gingival health, but it has since been shown that smooth gingiva is not an indication of disease, unless it is smooth due to loss of previously existing stippling. Stippling is absent in Infants but it starts to appears in Children from the age of 4.

Stippling is a consequence of the microscopic  elevations and depressions of the surface of the gingival tissue due to the connective tissue projections within the tissue.

How and When can Stippling of Gingiva be seen ?

Stippling of Gingiva can best be seen on “Drying the Gingiva”

Which Type of Gingiva is Stippled and which is not ?

  • Attached Gingiva – Stippledstippling of gingiva
  • Interdental Gingiva – Stippled
  • Marginal Gingiva – Not Stippled

Attached Gingiva is bound to underlying alveolar bone, not the freely movable alveolar mucosa.

Where is Stippling seen Microscopically ?

  • Stippling is seen at the sites of fusion of the epithelial ridges or Rete Pegs and corresponds to the fusion of the valleys created by the connective tissue papillae
  • It is Microscopic elevations and Depressions of the surface of the gingival tissue due to the connective tissue projections within the tissue.
  • The Degree of Keratinization and Stippling are related and depend on each other.

Gingiva comprises of two parts – Free Gingiva and Attached Gingiva. While Free gingiva surrounds the tooth creating a collar around the crown, it is portion of the gingiva which extends from the attached gingiva on to the surface of the tooth. The attached gingiva extends from the free gingiva coronal to the alveolar mucosa in the apical portion of the tooth. Stippling is usually seen in attached gingiva as it is firmly attached to the underlying cementum and alveolar bone with the help of collagen fibers of the connective tissue. Stippling is lost as age progress, in most adult patients above 50 years there is no stippling of Gingiva.



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