Current concepts of the dentogingival junction: the epithelial and connective tissue attachments to the tooth

Abstract

This review leads to a concept in which the tissues of the dentogingival junction are dynamic rather that static. Even when they are pathologic, they can be reconstituted by repair. Both their cellular and extracellular components exhibit a high rate of turnover. Some of the cells are specialized for specific functions, such as attachment formation, and do not generate additional cells, but generative pools are always nearby. The cells are capable of movement and of positional change. The junctional epithelium can advance and retract. The cuticle width is alterable. The entire tissue is capable of regeneration after wounding. This dynamic group of tissues is well adapted for the healing of direct injuries produced during mastication. The tissues do remarkably well, over long periods, in their response to periodontal disease, whether due to direct bacterial or toxic damage, or to indirect damage via the migration of inflammatory cells into the lesion. The tissues show a capacity for repair and regeneration following the elimination of plaque formation and the resultant resolution of the inflammatory infiltrate. The complete story is not yet developed. The past 60 years are replete with fine contributions by distinguished workers. Additional contributions continue to be made. The inheritance from our predecessors has been used well and our expanded knowledge in this area now serves as the conceptual framework for further study.