Stippling (dentistry)

Photograph of the upper right quadrant, showing teeth #4-8, with a DO amalgam on #5. The stippled surface texture of the attached gingiva can be observed. Note how there is no stippling on the marginal gingiva, which is the millimeter or so of gingiva immediately adjacent to the teeth. Click on this photo to see the stippling in greater detail.

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. 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) and correspond to the fusion of the valleys created by the connective tissue papillae.^[2]

References

1 2 3 Itoiz, ME; Carranza, FA: The Gingiva. In Newman, MG; Takei, HH; Carranza, FA; editors: Carranza’s Clinical Periodontology, 9th Edition. Philadelphia: W.B. Saunders Company, 2002. page 30.
↑ Lindhe's Clinical Periodontology and Implant Dentistry, 4th Ed.

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

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	Debridement Scaling and root planing Full mouth disinfection Full mouth ultrasonic debridement

Surgery	Apically positioned flap Bone graft Coronally positioned flap Crown lengthening Open flap debridement Gingival graft Gingivectomy Guided bone regeneration Guided tissue regeneration Enamel matrix derivative Implant placement Lateral pedicle graft Pocket reduction surgery Socket preservation Sinus lift Subepithelial connective tissue graft Tools Curette Membrane Probe Scaler

Important personalities

Other specialties

Endodontology
Orthodontology
Prosthodontology

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