Tooth and gingival interface
- The interface between a tooth and the surrounding gingival tissue is a dynamic structure.
- The gingival tissue forms a crevice surrounding the tooth, known as a sulcus.
- The sulcus is in a constant state of flux due to microbial invasion and immune response.
- The depth of the sulcus is approximately 2mm, consisting of junctional epithelium and gingival fiber attachment.
- The sulcus separates the surrounding epithelium from the tooth surface.

Gingival pocket
- A gingival pocket occurs when the marginal gingiva becomes edematous.
- Gingival hyperplasia can cause false pockets, with greater than normal periodontal probing measurements.
- The epithelial attachment remains at the same level, while the gingival margin migrates coronally.
- Gingivectomy may be necessary to reduce pocket depths.
- Gingival pockets are reversible when the cause of edematous reaction is eliminated.

Periodontal pocket
- Total loss of attachment (CAL) is the sum of gingival recession and probing depth.
- Periodontal pockets are lined by pocket epithelium instead of junctional epithelium.
- A probing measurement of 4mm or more clinically indicates a periodontal pocket.
- Irreversible destruction of gingival fibers occurs in periodontal pockets.
- Periodontal pockets can become infected and may require incision, drainage, and antibiotics.

Mucogingival defect
- A mucogingival defect occurs when destruction reaches the junction of attached gingiva and alveolar mucosa.
- The pocket violates the mucogingival junction.
- Mucogingival defects indicate advanced destruction of tissues.

Pocket formation
- Dental plaque is the starting point for pocket formation.
- Bacterial invasion from plaque triggers an inflammatory response.
- Continuous inflammation leads to tissue destruction and degradation of attachment and bone.
- Risk factors, such as diabetes and smoking, can worsen pocket formation.
- Proper oral hygiene measures, including interdental brushes, are essential for managing plaque levels.