Stippling (dentistry)

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The gingiva often possess a textured surface that is referred to as being stippled (engraved points).^[1] Stippling only presents on the attached gingiva bound to underlying alveolar bone, not the freely moveable alveolar mucosa or free gingiva. Stippling used to be thought to indicate health, but it has since been shown that smooth gingiva is not an indication of disease, unless it is smooth due to a loss of previously existing stippling.

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.^[1] The degree of keratinization and the prominence of stippling appear to be related.^[1] To be more specific, stippling occurs at sites of fusion of the epithelial ridges (also known as rete pegs – depression of epithelium) and correspond to the fusion of the valleys created by the connective tissue papillae (elevation of connective tissue papilla). An example of stippling could be dots found on a basketball or an orange.^[2]

References

^ ^a ^b ^c Itoiz ME, Carranza FA (2002). "The Gingiva". In Newman MG, Takei HH, Carranza FA (eds.). Carranza's Clinical Periodontology (9th ed.). Philadelphia: W.B. Saunders Company. p. 30. ISBN 978-0-7216-8331-7.
^ Lindhe J, Karring T, Lang NP (17 February 2003). Lindhe's Clinical Periodontology and Implant Dentistry (4th ed.). ISBN 978-1-4051-0236-0.

Dentistry involving supporting structures of teeth (Periodontology)

Anatomy

Disease

Diagnoses	Chronic periodontitis Localized aggressive periodontitis Generalized aggressive periodontitis Periodontitis as a manifestation of systemic disease Periodontosis Necrotizing periodontal diseases Abscesses of the periodontium Combined periodontic-endodontic lesions
Infection	A. actinomycetemcomitans Capnocytophaga sp. F. nucleatum P. gingivalis P. intermedia T. forsythia T. denticola Red complex Entamoeba gingivalis (amoebic) Trichomonas tenax
Other	Calculus Clinical attachment loss Edentulism Fremitus Furcation defect Gingival enlargement Gingival pocket Gingival recession Gingivitis Horizontal bony defect Linear gingival erythema Occlusal trauma Periodontal pocket Periodontal disease Periodontitis Plaque Vertical bony defect
Treatment and prevention	Periodontal examination Ante's law Brushing Bleeding on probing Chlorhexidine gluconate Flossing Hydrogen peroxide Mouthwash Oral hygiene Tetracycline Triclosan Host modulatory therapy

Treatment

Conventional therapy

Surgery

Important personalities

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