Free gingival margin

The periodontium are specialized tissues which serve the two primary functions of surrounding and supporting the teeth. This maintains the teeth within the maxillary and mandibular bones. The word periodontium is from the Greek terms peri-, meaning "around" and -odont, meaning "tooth". When it is taken literally, periodontium translates to "around the tooth". Periodontics is a specialized dentistry practice which focuses on the care and maintenance of these tissues. The specialty provides the support necessary to maintain the function of the teeth. The practice consists of four key areas which include:

1. Alveolar Bone Proper
2. Cementum
3. Gingiva
4. Periodontal Ligament (PDL)

The free gingival margin is an area which is found between the sulcular epithelium and the epithelium of the oral cavity. This interface exists at the most coronal point of the gingiva or the gums. This may also be referred to as the crest of the marginal gingiva.

As depicted in the image, the gingival margin (F) is the most coronal point of the gingiva. It is pictured as the top of the pink arch. The sulcular epithelium within the gingival sulcus (G) is located to the left and the oral epithelium (E) is located to the right.

Because the short portion of the gingiva exists above the height of the underlying Alveolar process of maxilla, it is moble. However, due to the gingival fibers such as the dentogingival and circular fibers, the free gingiva remains in place next to the surface of the tooth unless it is pushed away. The free gingiva can pull away from the result of a periodontal probe or from the bristles of a toothbrush.

Gingival retraction or recession

Gingival retraction or recession can occur when there is a lateral movement of the gingival margin. This occurs in the direction opposite of the surface of the tooth. When this type of action is done intentionally, it is called gingival retraction. In these types of intentional cases, it is often performed along with the use of mechanical, chemical or electrical means and used to perform specific oral surgical procedures. However, when this type of movement occurs spontaneously or unintentionally, it is typically called a gingival recession. In cases of a gingival recession, it may indicate the presence of underlying inflammation, the formation of a pocket, or the displacement of the marginal gingivae away from the tooth. It may also expose the tooth’s roots, which is similar to what occurs in the event of gingival recession.

Gingival retraction paste

Use of a gingival retraction paste has been proven to be highly successful in providing the patient with a dry field and inflicting minimal harm to the surrounding periodontium. When compared to a gingival retraction cord, however, it has a reduced ability to retract gingival tissues.

Gingival retraction cord

While it is more damaging to the gingival tissues, a gingival retraction cord has proven to be the most effective in displacing gingival tissues. As a result, it is recommended in instances where a thick periodontium is present. Without the addition of any chemical substances, such as epinephrine or sulphate compounds, the cord does not produce haemostasis at the sulcus on its own.