Dimensions and Relations of the Dentogingival Junction in Humans
by AW GARGIULO,FM.WENTZ,D.D.S.,PH.D.,BALINT ORBAN 01 July 1961IN 1921, Gottlieb’s discovery of the epithelial attachment of the gingiva opened new horizons which served as the basis for a better understanding of the biology of the dental supporting tissues in health and disease. Three years later his pupils, Orban and Kohler (1924), undertook the task of measuring the epithelial attachment as well as the surrounding tissue relations during the four phases of passive eruption of the tooth. Gottlieb and Orban’s descriptions of the epithelial attachment unveiled the exact morphology of this epithelial structure, and clarified the relation of this structure to the enamel of the tooth.
Gottlieb 於 1921 年對牙齦上皮附著 (epithelial attachment) 的發現開啟了新 頁，為了解牙齒支持組織的健康和疾病的生物學奠定了基礎。三年後，他的學生 Orban 和 Kohler (1924) 承接了在牙齒被動萌發 (passive eruption) 的四個階段中，測量上皮附著以及周圍組織間的關係的任務。Gottlieb 和 Orban 對上皮 附著的敘述，揭露上皮結構的確切形態，並敘明該結構與牙釉質之間的關係。
In recent years the prevailing concept of the epithelial attachment was challenged by Waerbaug.3 He returned to the old concept of a potential space extending from the gingival margin to the cementoenamel junction. Waerhaug’s altered convictions were based upon several observations. These are: (1) he was able to insert a thin steel blade into this space without pressure. From histologic sections, he claimed that there was no difference between the epithelium of the intact areas and in the area where the blade was inserted. (2) In addition he claimed that after a gingival flap had been pulled away from the enamel surface and the flap repositioned, no difference could be seen between the operated and the non-operated areas. Repetition of these procedures by Orban4 have shown Waerhaug’s findings could not be verified under similar experiments. Gottlieb’s discovery was in the least reconfirmed; however Waerhaug’s challenge was not without benefit. The so-called strength of adherence of the epithelial attachment, and the organic nature of the attachment had to be reconsidered. The author’s are now inclined to subscribe to Weski’s5 idea; mainly that the epithelium after enamel maturation, produces a cementing substance that attaches the epithelium to the enamel surface and later to the surface of the cementum. It now seems impossible that Gottlieb’s original idea of a union between ameloblast and the forming and maturing enamel rods could survive the final calcification of the enamel matrix.
近幾年 Waerbaug 挑戰關於上皮附著普遍流行的觀念 3，他回歸從牙齦邊緣延伸到牙骨質牙釉質交界 (cementoenamel junction) 的潛在空間的舊觀念。以下觀察結果讓 Waerhaug 產生這種想法上的改變:(1) 他能在沒有施壓的情況下 將薄鋼刀片插入這個空間。從組織切片來看，他認為完整區域的上皮與刀片插 入區域的上皮之間沒有差異。(2) 此外，他認為在牙齦翻瓣 (gingival flap) 手術中，將牙齦從牙釉質表面拉開並復位後，手術區域和非手術區域之間沒有差 異。Orban4 重現這些步驟，但無法透過類似的實驗驗證 Waerhaug 的研究發 現;Gottlieb 的發現則再次不支持 Waerhaug 的研究結果。然而，Waerhaug 提出的挑戰並非沒有意義，我們必須重新思考上皮附著的黏著強度和附著的有機性質。筆者傾向於認同 Weski 的想法:牙釉質成熟後，上皮細胞產生一種黏合物質，讓上皮細胞能夠附著在牙釉質表面，之後再附著於牙骨質 (cementum) 表面。現在看來，Gottlieb 認為牙釉質母細胞 (ameloblast) 與正在形成和成熟的牙釉柱之間結合，並且在牙釉基質的最後鈣化後仍存在的想法，似乎是不可能的。
Discussions with Sicher (1959) 6 lead to the reconsideration of the mode of attachment and the formulation of a physiologic division of labor of the supporting tissues at the “dento-gingival junction.” This established the concept of the dentogingival junction as a functional unit composed of two parts: (1) the connective tissue fibrous attachment of the gingiva and (2) the epithelial attachment. The two separate components share a division of function.
Sicher (1959) 6 的討論讓我們重新思考附著的模式，以及「齒齦交界處」 (dentogingival junction) 支持組織 (supporting tissue) 如何進行生理分工。這也建立了齒齦交界處的概念，它是一個由兩部分組成的功能單位:(1) 牙齦的結締組織纖維附著，以及 (2) 上皮附著，這兩個獨立的組成間互相分工合作。
The biologic protection of the dentogingival junction is the function of the epithelial attachment. The epithelium attaches to the circumference of the tooth as a broad band the “attached epithelial cuff.” The epithelial attachment to the tooth is not firmly attached in spite of the fact that it is stronger than the individual cohesiveness of the epithelial cells. The firmness of the gingival attachment to the tooth is derived by the fibrous connective tissue bound to the cementum, alveolar bone and gingiva.
上皮附著的功能是作為齒齦交界處的生物保護。上皮作為「附著上皮袖口」 (attached epithelial cuff) 的寬帶，與牙齒周圍連接。儘管它比上皮細胞的個體內聚力更強，但與牙齒間的上皮附著並不牢固，牙齦附著在牙齒上的牢固性來自於與牙骨質、齒槽骨和牙齦結合的纖維結締組織。
Because of the dynamic alterations in the component parts of the dentogingival junction it is important to know their positions in all phases of eruption under normal conditions. The importance of this relation is enhanced when one considers the imbalance of these components in periodontal disease. Thus, these dimensions can serve as a base line for future studies involving the pathologic status of the dentogingival junction and serve as “the physiologic dentogingival junction.”
由於齒齦交界處的組成部分的動態變化，知道它們在正常條件下萌發的所有階段的位置便相當重要。當討論牙周病中這些成份失衡的情況時，這種關係就顯得更重要。因此，這些尺寸可以作為未來與齒齦交界處病理狀態相關研究的基準線，並作為「生理性齒齦交界處」(the physiologic dentogingival junction)。
The present study consisted of two parts; first to re-evaluate the measurements in the Orban-Kohler paper, but now as part of the dentogingival junction and not as a single isolated structure; and second to add new measurements. It also establishes a norm for the dentogingival junction in all phases, chronologic ages, surfaces and six measured distances.
本試驗包含兩個部份;首先重新評估 Orban-Kohler 研究中的測量值，但將之視為齒齦交界處的一部份，而不是單一的獨立結構;其次是加入新的測值。它還為所有階段、實際年齡、表面和六個測量距離中的齒齦交界處建立一個標準。
MATERIAL AND METHOD
材料與方法
The material for this study were the measurements obtained from human autopsy specimens by Dr. Balint Orban in earlier studies. Additional measurements were obtained from 30 human jaws in the collection of Dr. Rudolph Kronfeld. All specimens were taken at autopsy as block sections in order to obtain the component parts of the dentogingival junction intact. The age range was from 19 to 50 years. The specimens were fixed in 10% formalin, embedded in cellodin and 15–20u sections cut. The sections were stained in hemotoxylin and eosin.
這項試驗的材料是 Balint Orban 博士的早期研究中，從人體解剖檢體獲得的測量值。額外的測量值來自於 Rudolph Kronfeld 博士所收集的 30 個人類頜骨。為了取得完整的齒齦交界處的組成部分，所有檢體均在解剖時作為塊狀切片。年齡範圍為 19 至 50 歲。將檢體以 10% 福馬林固定，包埋在火棉膠 (cellodin) 中，切下 15–20u 切片。切片用蘇木紫-伊紅染色 (hematoxylin and eosin stain) 染色。
The measurements were made from the microscopic specimens of 30 jaws, 287 individual teeth and their respective dentogingival components. A total of 325 surfaces were measured; of these 83 were on the mesial surface, 82 were on the distal surface, 82 on the vestibular surface and 78 on the oral surface. All specimens were free of extensive pathology and fulfilled the requirements of clinically normal specimens. The actual measurements were made with a disc micrometer, and all are recorded in millimeters.
針對 30 個頜骨、287 顆單顆牙齒及其齒齦組成的顯微檢體 (microscopic specimen) 進行測量。共測量了 325 個表面，其中包括:83 個位於近心面 (mesial surface)，82 個位於遠心面 (distal surface)，82 個位於前庭面 (vestibular surface)，78 個位於口腔面 (oral surface)。所有檢體均無大規模的病理情形，符合臨床正常檢體的要求。採用圓盤千分尺進行實際測量，並以 mm 為單位。
A total of six different measurements were made for each individual specimen. These areas changed their relations in the four different phases of eruption in which measurements were made. In Figure 1, one can observe the various phases of passive exposure as established by Orban and Kohler in 1934.
每個獨立的樣本總共進行六次不同的測量。這些區域在進行測量的四個不同萌發階段中的關係產生變化。在圖 1 中，可以觀察到 Orban 和 Kohler 在 1934 年所建立的被動露出 (passive exposure) 的各階段樣貌。
The areas measured were: a) depth of the gingival sulcus, b) length of the attached epithelium, c) most apical point of the epithelial attachment from the cementoenamel junction, d) distance from the base of the sulcus to the cemento- enamel junction, e) distance of the cemento-enamel junction from the alveolar bone,f) distance from the most apical point of the epithelial attachment to the alveolar bone (connective tissue).
測量區域包含以下:a) 牙齦溝 (gingival sulcus) 的深度、b) 附著上皮的長度、 c) 從牙骨質牙釉質交界 (cementoenamel junction) 到最靠近根尖端 (most apical point) 的上皮附著、d) 從牙齦溝底部到牙骨質牙釉質交界的距離、e ) 從齒槽骨到牙骨質牙釉質交界的距離、f) 上皮附著從最靠近根尖端到齒槽骨(結締組 織)的距離。
FINDINGS
發現
The findings from each of the phases were analyzed according to the six individual measurements. All surfaces (mesial, distal, vestibular, oral) were placed in one average value for the given measurement. The analysis first was done according to each of the individual phases of eruption in the dynamic relation existing at the dentogingival junction throughout life. Results of the measurements were as shown in the following tables.
根據六個獨立的測量來分析每個階段的結果。所有表面(近心、遠心、前庭、 口腔)均置於一平均值。根據整個生命週期中，齒齦交界處在各個萌發階段的 動態關係進行分析。測量結果如下方表格所示。
TABLE I
Phase I Analysis 表一 第一階段分析
The number of specimen surfaces in the phase I analysis were 25. The total length of the dentogingival unit, (from the tip of the gingival margin to the crest of the alveolar bone) A+B+F, represents the magnitude of the dentogingival junction. For phase I this magnitude was 3.23 mm. The total attachment (B+F) was 2.43 mm. The average age for phase I was 24.5 years and the specimens ranged from 19 to 43 years.
第一階段分析 25 個檢體表面。齒齦單位的總長度，(從牙齦邊緣的尖端到齒槽骨骨脊 (crest of the alveolar bone)) 為 A+B+F，代表齒齦交界處的大小，其於第一階段為 3.23 mm。總附著 (B+F) 為 2.43 mm。第一階段的平均年齡為 24.5 歲，檢體的年齡範圍為 19 至 43 歲。
Due to the definite anatomy of phase I, measurement C was zero, those for B, and D; and E, and F, were equal. However, this relation is altered as the epithelial attachment progresses in an apical direction in the later phases.
由於第一階段的解剖結構明確，測量值 C 為零，B 和 D 的測量值相等; E
和 F 也相等。然而，隨著上皮附著在後期往根尖方向發展，使關係產生變化。
One hundred and twenty-six (126) specimen surfaces were analyzed in phase II. The total length of the dentogingival unit (A+B+F+) was 3.06 mm. The total attachment (B+F) was 2.45 mm. The average age for phase II was 31.4 years, and ranged from 19 to 50 years.
在第二階段中分析了一百二十六 (126) 個檢體表面。齒齦單位的總長度 (A+B+F+)為 3.06 mm。總附著 (B+F) 為 2.45 mm。 第二階段的平均年齡為 31.4 歲，範圍為 19 至 50 歲。
Phase III is a highly precise arrangement of the dentogingival apparatus, and the least number of specimens were found at this phase. In phase III eleven specimen surfaces were measured.
在第三階段中，齒齦結構呈現高度精確排列，在這個階段發現的檢體數量最少。在第三階段針對 11 個檢體表面進行測量。
There was no recorded reading for “D” since in the phase III relation, the base of the sulcus is just at the cemento-enamel junction.
沒有記錄到「D」的數據，因為在第三階段的關係中，牙齦溝底部正好位於牙骨質牙釉質交界。
TABLE II
Phase II Analysis 表二 第二階段分析
TABLE III
Phase III Analysis 表三 第三階段分析
The total length of the dentogingival unit (A+B+F) was 2.41 mm. The total attachment (B+F) was 1.80 mm. The average age for phase III was 32.3 years, and ranged from 22 to 50 years.
齒齦單位的總長度 (A+B+F) 為 2.41 mm。總附著 (B+F) 為 1.80 mm。第三階段的平均年齡為 32.3 歲，範圍為 22 至 50 歲。
One hundred and sixty-three (163) specimen surfaces were measured in phase IV. The total length of the dentogingival unit (A+B+F) was 2.53 mm. The total attachment (B+F) was 1.77 mm. The average age for phase IV was 39.7 years, and ranged from 20 to 50 years.
在第四階段測量了一百六十三 (163) 個檢體表面。齒齦單位的總長度 (A+B+F) 為 2.53 mm。總附著 (B+F) 為 1.77 mm。第四階段的平均年齡為 39.7 歲，範圍為 20 至 50 歲。
The previous analysis was a total average of all surfaces. In order to obtain the total mean average all tooth surfaces were measured for each of the distances, thus one can calculate the mean average for each of the 4 tooth surfaces. From this one can see the variance which occurs on the four different surfaces of the same tooth and for the same area measured. See Tables V to X.
先前的分析是所有表面的總平均值。為了獲得總平均值，從每個距離的所有牙齒表面進行測量，因此可以計算 4 個牙齒表面中的各個平均值，藉此觀察在同 一顆牙齒的四個不同表面上、以及在相同的測量區域上的差異。
詳見表五到表 十。
In an earlier paper by Stanley7 he states that “the type of tooth and type of tooth surface (mesial or distal) has no effect on the mean lengths of the distances.” As can obviously be seen from the present study, the tooth surface is rather variable in the total circumference, and on each of the individual teeth.
在 Stanley7 較早期的一篇論文中，他認為「牙齒的類型和牙齒表面的類型(近心或遠心)對距離的平均長度沒有影響。」從本試驗可以明顯看出，牙齒表面在周圍和每顆牙齒上的變化很大。
DISCUSSION
討論
This work has indicated that there is a somewhat definite proportional dimensional relation between the dentogingival junction and the other supporting tissues of the tooth.
本研究工作顯示，齒齦交界處和牙齒的其他支持組織之間存在某種確定的大小比例關係。
The validity of the concept of the dentogingival junction has been fortified, and the duality of its components (epithelial and fibrous connective tissue) has been identified as an orderly one.
強化驗證了齒齦交界處的觀念，其組成(上皮和纖維結締組織)的二元性及次 序也已確定。
One can no longer speak of passive exposure only being associated with the apical migration of the epithelial attachment. The correct interpretation of the gingiva and its relation to the tooth with increasing age can only be understood, if the connective tissue attachment is also considered. (See Table XI).
被動露出僅與上皮附著的根尖遷移有關的說法已失效。只有在將結締組織附著納入觀察的情況下，才能正確理解年齡增長對牙齦及其與牙齒間關係的影響。
(詳見表十一)。
TABLE IV
Phase IV Analysis
表四 第四階段分析
TABLE V
Measurement A. — Sulcus Depth
表五
A 測量 — 牙齦溝深度
The physiologic apical shift of the dentogingival junction from stage to stage during passive eruption, is responsible for the passive exposure of the tooth and is not merely due to the “peeling back” of the epithelial attachment.
在被動萌發的過程中，齒齦交界處從一個階段到另一個階段的生理根尖移動是造成牙齒被動露出的原因，而不僅僅是上皮附著的「剝離」 (peeling back) 所致。
From chart XI, one can readily see that the epithelial attachment is our most variable, while the connective tissue attachment is the most constant measurement. This observation further supports Stanley’s7 finding that the “epithelial attachment appeared to be the most variable anatomic structure within the periodontium.” Thus, during passive eruption the magnitude of the epithelial attachment diminishes. Early in phase I the amount of epithelial attachment is 1.35 mm. and decreases in phase IV to 0.71 mm., this represents a significant diminution. In correlating the epithelial attachment with age it was seen that there was less attachment with an increase in dental and physiologic age. On the other hand the connective tissue component appears to be a constant through the stages of passive eruption.
從表十一中，我們可以很容易地看出上皮附著的變化最大，而結締組織附著的測量值最為恆定。這一觀察結果進一步支持了 Stanley 的發現，即「上皮附著 似乎是牙周組織中變化最大的解剖結構」。因此，在被動萌發過程中，上皮附著 的範圍縮小。在第一階段早期，上皮附著的尺寸為 1.35 mm。在第四階段明顯 地縮小到 0.71 mm。在將上皮附著與年齡比對時，發現隨著齒齡和生理年齡的 增加，附著會縮小。另一方面，在被動萌發段，結締組織組成似乎是恆定不變的。
TABLE VI
Measurement B.- — Length of Attached Epithelium
表六
B 測量 — 附著上皮長度
Upon closer interpretation the meanings of these data indicates a need for a revision of the phases of passive eruption. A further alignment of measurements, it is seen that the four phases of eruption can rightfully be classified into two divisions. The basis for this statement is further emphasized from Table XI. It is seen that the attached epithelium is significantly greater in phase I and II, than the attached epithelium is in phase III and IV. The significant thing is that the total attachment (B+F) measures similar in phase I and II (Division A) ; and phase III and IV (Division B). Therefore it is thought that we truly have only two divisions of passive eruption.
經過詳細讀取數據的涵義，這些數據說明了，我們對被動萌發階段的理解必須修正。進一步比對測量結果，可以看出萌發的四個階段能夠明確地區分為兩個部分。表十一進一步強調了上述說明的基礎。第一階段和第二階段的附著上皮明顯大於第三階段和第四階段的附著上皮。重要的是，總附著 (B+F) 在第一階 段和第二階段(A 部分)的測量值相似，在第三和第四階段(B 部分)的測量 值也相似。因此，我們認為在被動萌發階段僅有兩部分。
TABLE VII
Measurement C. — Distance of Attached Epithelium Below Cemento Enamel Junction
表七
C 測量 — 牙骨質牙釉質交界下方的上皮附著距離
In addition it can be seen the greater amount of attached epithelium in phase I and II, and the greater amount of connective tissue attachment in phase III and IV. From this one can also see that in division A (phase I and II) the total attachment is of a greater magnitude than that of division B (phases III and IV).
此外，可以看出在第一階段和第二階段附著的上皮細胞數量較多，而在第三階段和第四階段的結締組織附著量較多。從這一點也可以看出，在 A 部分(第一 階段和第二階段)中，總附著面積比 B 部分(第三階段和第四階段)更大。
In analyzing each of the measurements for the four phases we can make some rather revealing observations. In measurement A, sulcus depth, note that under circumstances of normal physiology this remains rather constant. For measurement B, the length of the attached epithelium, note that as one progresses from phase I to IV there is less attachment of epithelium to the tooth surface. From these findings one can see that there has been approximately a 50% loss in magnitude from phase I to (1.33 mm.) to phase IV (.71 mm.). In measurement C, the most apical point of the epithelial attachment below the cemento-enamel junction, there is an increase in the clinical crown which is a normal course from phase I to IV as the epithelial attachments shifts in an apical direction. Measurement D, the distance of the bottom of the sulcus from the cemento-enamel junction, is another shift in an apical direction with a progression from phase I to IV.
在分析四個階段的各個測量值時，我們得出一些頗具啟發性的觀察結果。在 A 測量中(牙齦溝深度)，值得注意的是，在正常生理條件下，數值維持在相當恆 定的狀態;至於 B 測量(附著上皮的長度)，我們發現隨著從第一階段到第四階段的進展，上皮與牙齒表面的附著面積減少。從這些發現可以看出，從第一 階段 (1.33 mm.) 到第四階段 (0.71 mm.)，面積損失了大約 50%。在 C 測量中 (牙骨質牙釉質交界到最靠近根尖端的上皮附著)，臨床牙冠增加，這是從第一 階段到第四階段的正常現象，因為上皮附著向根尖方向遷移。而在 D 測量中 (從牙齦溝底部到牙骨質牙釉質交界的距離)，是從第一階段到第四階段發展中另一個往根尖方向移動的現象。
TABLE VIII
Measurement D. — Distance of Bottom of Sulcus from The Cemento Enamel Junction
表八
D 測量 — 從牙骨質牙釉質交界到牙齦溝底部的距離
Measurement E, distance of the cementoenamel junction from the alveolar bone, is a value which increases from phase I to IV. This is interesting in that as the tooth undergoes active eruption the alveolar bone crest doesn’t appear to keep “pace” with the cemento-enamel junction. However, this no doubt is due to the passive exposure of the tooth at the dentogingival junction which is occurring simultaneously with active eruption. Measurement F, the distance from the base of the epithelial attachment to the alveolar bone, represents the connective tissue attachment of the gingival fibers and appears to be the most constant value that the normal dentogingival junction possesses. The values were so close that 3 of the 4 phases almost duplicate each other to the hundredth of a millimeter.
E 測量(從齒槽骨到牙骨質牙釉質交界的距離)，是一個從第一階段到第四階段逐步增加的值。有趣的是，當牙齒經歷主動萌發時，齒槽骨骨脊似乎不會與牙骨質牙釉質交界保持「同步」。然而，這無疑是因為牙齒在齒齦交界處的被動露 出與主動萌發同時發生所致。F 測量(從上皮附著基底到齒槽骨的距離)，也就是牙齦纖維的結締組織附著，似乎是正常齒齦交界處中，最恆定不變的數值。 這些數值非常接近，以至於 4 個階段中有 3 個階段的差異幾乎不到 0.01 mm。
TABLE IX
Measurement E. — Distance of Cemento-Enamel Junction from Alveolar Bone
表九
E 測量 — 牙骨質牙釉質交界到齒槽骨的距離
TABLE X
Measurement F. — Distance from Base of Attached Epithelium to Aveolar Bone (Connective Tissue Attachment)
表十
F 測量 — 從附著上皮的基底到齒槽骨的距離(結締組織附著)
TABLE XI Dentogingival Junction Total Attachment (Measurement B+F )
表十一
齒齦交界處所有附著(測量 B+F)
TABLE XII
DENTOGINGIVA L JUNCTION Total Average Magnitude
Sulcus Depth (A)
Epithelial Attachment (B) and Connective Tissue Attachment (F)
表十二
齒齦交界處總平均牙齦溝深度 (A) 上皮附著 (B);以及 結締組織附著 (F)
The total magnitude, or length of the dentogingival junction is seen to decrease from phase I to IV. From this observation we can see an apparent loss of total attachment to the tooth enamel and cementum. This is evidenced by the fact that the magnitude in phase 1 is 3.23 mm. and regresses to 2.53 mm in phase IV.
從第一階段到第四階段，齒齦交界處的大小或長度會減少。第一階段的大小為 3.23 mm，第四階段則縮小到 2.53 mm。從這個觀察中，我們可以看到牙釉質 和牙骨質的完全附著明顯喪失。
While the preceding findings are of great value in themselves, one must fully realize the impetus this has upon pathology of the dentogingival junction and what the effect of surgical encroachment upon these areas has on the final dimensional proportions. This study will serve as a basis by which to understand the results obtained in osseous surgery and other approaches which denude and expose the dentogingival junction.
雖然上述發現本身具有重要價值，但我們必須充分了解這將如何推動齒齦交界 處的病理發展，以及手術侵入這些區域對最終大小比例會有什麼影響。本試驗 將作為了解在骨手術和其他剝蝕和露出齒齦交界處的方法將導致何種結果的基礎。
In an analysis of age, these findings would support the fact that about any chronologic age can be found in any of the four phases. Usually phase III and IV were absent in the chronologic ages below 21 years. In addition the average age here reported can create a false impression since only a given age range of 19 to 50 years was used.
在針對年齡的分析中，所有研究發現都支持以下結論，亦即，在四個階段中的 任何一個階段，幾乎都包含每個實際年齡的檢體。通常在 21 歲以下的實際年 齡中，找不到第三和第四階段的檢體。此外，本試驗報告的平均年齡可能會造 成錯誤印象，因為我們僅使用了 19 至 50 歲間的檢體。
SUMMARY
摘述
The prevailing concepts of the dentogingival junction are reviewed to re-emphasize the importance of this functional unit with its two component parts, 1) The connective tissue fibrous attachment and, 2) the epithelial attachment.
透過回顧齒齦交界處的普遍概念，再次強調該功能單位及其兩個組成部分:(1) 結締組織纖維附著和 (2) 上皮附著的重要性。
The dimensions of the dentogingival junction in four phases of passive eruption were ascertained from earlier studies of Orban and from thirty additional human jaws. A total of six different measurements were made on all types and surfaces of teeth. Upon comparison of all measurements we can observe that the previous four phases of eruption can be categorized in two divisions.
齒齦交界處在四個被動萌發階段的尺寸，是透過 Orban 的早期研究結果和另外 觀察 30 個人類頜骨後確定的。對各種類型和表面的牙齒進行了共六次不同的 測量。再經比較所有測量值後，我們可以觀察到萌發的前四個階段，可以進一 步分為兩個種類。
Of the measurements made, the distance from the base of the epithelial attachment to the crest of the alveolar bone (connective tissue attachment), is the most constant. It had a mean average length in all phases of 1.07 mm. The most variable part of the dentogingival junction was the length of the epithelial attachment.
在已完成的測量中發現，從上皮附著基底到齒槽骨骨脊(結締組織附著)的距 離是最不變的，在各階段的平均長度為 1.07 mm。齒齦交界處變化最大的部分 是上皮附著的長度。
This study will permit a better understanding of the alterations which occur at the dentogingival junction following osseous surgery, and surgical exposure of the dentogingival junction.
本試驗將有助於了解骨手術後齒齦交界處發生的改變，以及齒齦交界處的手術露出。
