Sulcular epithelium

The sulcular epithelium is a thin, non-keratinized epithelial lining that forms the smooth inner wall of the gingival sulcus, extending from the gingival margin coronally to the dentogingival junction apically.[1][2] The gingival sulcus normally measures 0.5–3 mm in healthy individuals; an increase beyond this range may indicate pseudopocket formation or periodontal disease. The sulcular epithelium primarily acts as the protective barrier against foreign substances while also playing a crucial immunological role due to its semi-permeable nature. Structural and functional changes in the sulcular epithelium are observed during the onset and progression of periodontal disease.

In dental anatomy, the sulcular epithelium is that epithelium which lines the gingival sulcus.[3] It is apically bounded by the junctional epithelium and meets the epithelium of the oral cavity at the height of the free gingival margin. The sulcular epithelium is nonkeratinized.[3]

Anatomy/Location

Anatomically, the sulcus is bounded by the tooth surface on one side and the sulcular epithelium on the other, in a bucco-lingual dimension.[2] It typically contains gingival crevicular fluid which is a serum-like tissue transudate that diffuses through the sulcular epithelium from the post-capillary venules of the dentogingival plexus, providing a nutrient source for microbes along with desquamated epithelial cells, inflammatory cells, and bacteria.[2] Positioned immediately coronal to the junctional epithelium, the sulcular epithelium forms part of the dentogingival junction, a region where the mucosa meets the tooth surface and functions as an essential yet vulnerable seal against microbial entry.[2] It is continuous coronally with the oral epithelium at the gingival crest and cervically with the junctional epithelium, lacks keratinization under normal conditions, and varies from 2–3 cell layers coronally to 10–15 layers apically.[1][2]

Initially located on the cervical enamel in youth, the sulcus gradually migrates toward the cementoenamel junction and onto cementum with age and periodontal changes.[2] Although not directly exposed to the external oral cavity and therefore somewhat shielded from mechanical abrasion, its position within the sulcus makes it more permeable and particularly susceptible to microbial challenge.[4][2] While it remains non-keratinized under normal conditions, the sulcular epithelium has been shown to keratinize if repositioned away from the tooth or if the tooth is lost, demonstrating its inherent keratinization potential.[5]

Origin/Development

The sulcular epithelium originates developmentally during tooth eruption when the reduced enamel epithelium derived from the enamel organ fuses with the oral epithelium to form a continuous epithelial lining around the tooth.[6]

The junctional epithelium is attached coronally to the sulcular epithelium which is thicker. At the bottom of the sulcus is the junctional epithelium in which the development starts with the reduced enamel epithelium the protective layer of epithelial tissue that covers the enamel before the eruption of the tooth forming a seal.The rest of the part separating the junctional epithelium with the oral epithelium at the free gingival margin is covered by the sulcular epithelium. Gingival epithelium complex covers the alveolar bone to the neck of the tooth and the sulcular epithelium is a component or part of this complex which helps in the preservation of periodontal health.[7]

The sulcular epithelium is described as stratified but non-keratinized unlike the attached gingival epithelium which is keratinized.The sulcular epithelium expresses a characteristic cytokeratin pattern in particular keratins K4 and K13.[8]

References

  1. ^ a b Kumar, G.S. (2019). Orban's Oral Histology & Embryology (15th ed.). New Delhi, India: Elsevier. ISBN 9788131249834. {{cite book}}: Check |isbn= value: checksum (help)
  2. ^ a b c d e f g Nanci, Antonio (2017). Ten Cate's Oral Histology: Development, Structure, and Function (9th ed.). St. Louis, MO (Elsevier): Elsevier. ISBN 9780323485180.
  3. ^ a b Carranza's Clinical Periodontology, W.B. Saunders, 2002, page 23.
  4. ^ Lindhe, Jan; Lang, Niklaus P; Karring, Thorkild (2018). Clinical Periodontology and Implant Dentistry (6th ed.). Oxford, UK: Wiley-Blackwell. ISBN 9781118210472. {{cite book}}: Check |isbn= value: checksum (help)
  5. ^ Caffesse, R. G.; Nasjleti, C. E.; Castelli, W. A. (1977). "Keratinizing potential of sulcular epithelium". Journal of Periodontology. 48 (3): 140–146. doi:10.1902/jop.1977.48.3.140. hdl:2027.42/141308. PMID 402465.
  6. ^ Groeger, Sabine; Meyle, Joerg (2019-02-14). "Oral Mucosal Epithelial Cells". Frontiers in Immunology. 10 208. doi:10.3389/fimmu.2019.00208. ISSN 1664-3224. PMC 6383680. PMID 30837987.
  7. ^ Department of Molecular Cell Biology and Immunology, O/2 building room 11E05, VU University Medical Centre, Amsterdam UMC, Amsterdam, the Netherlands.; Gibbs, S; Roffel, S; Meyer, M; Gasser, A (2019-08-14). "Biology of soft tissue repair: gingival epithelium in wound healing and attachment to the tooth and abutment surface" (PDF). European Cells and Materials. 38: 63–78. doi:10.22203/eCM.v038a06. PMID 31410840.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  8. ^ Dabija-Wolter, G.; Bakken, V.; Cimpan, M. R.; Johannessen, A. C.; Costea, D. E. (2013). "In vitro reconstruction of human junctional and sulcular epithelium". Journal of Oral Pathology & Medicine. 42 (5): 396–404. doi:10.1111/jop.12005. ISSN 1600-0714. PMC 3664418. PMID 22947066.
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