subgingivalen

Subgingival refers to the region beneath the gingival margin of a tooth. The subgingival space lies between the tooth root and the gingiva and includes the gingival sulcus in health and periodontal pockets in disease. It is lined by the junctional epithelium and contains periodontal connective tissue attachments and the root surface with cementum. This zone is less accessible to mechanical cleaning than the supragingival area.

The subgingival environment harbors a distinct microbial community. In health, the biofilm is relatively sparse and dominated by gram-positive cocci and nonmotile rods. In disease, the subgingival biofilm becomes more anaerobic and diverse, with pathogenic species that can promote inflammation and connective tissue breakdown. The pocket depth and root surface irregularities influence biofilm composition and persistence. The local environment, including gingival crevicular fluid, also affects microbial growth.

Clinically, subgingival biofilm is a primary driver of gingivitis and periodontitis. Pocket formation, clinical attachment loss, bleeding on probing, and radiographic bone loss reflect its consequences. Management focuses on disrupting subgingival biofilm and promoting reattachment. This includes thorough scaling and root planing, meticulous root debridement, and, when needed, flap surgery or other access-enhancing procedures. Regular maintenance is essential to control relapse.

Etymology and terminology: The term comes from Latin sub- meaning under and gingiva meaning gum. Subgingival (and the related noun form subgingivalen in some languages) describes processes or sites below the gingival margin. In dentistry, it is used to distinguish the area below the gum from the supragingival region.