ABSTRACT
Objective@#To study the effect of orthodontic traction on the roots and periodontal soft and hard tissues of buried obstructed upper incisors.@*Methods@#This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. From January 2018 to December 2022, 40 patients who underwent orthodontic traction on impacted upper incisors were selected; those whose contralateral homonymous apical foramen was not developed were placed in group A (23 cases), and those whose contralateral homonymous apical foramen was developed were placed in group B (17 cases). Software was used to measure the root length of the impacted upper incisors in groups A and B on cone beam CT (CBCT) images before and after traction and compare the changes in alveolar bone (alveolar bone width, labral bone plate thickness, and horizontal height of alveolar bone) and keratinized gingival width between each impacted upper incisor and the corresponding contralateral tooth immediately and one year after traction@*Results@#The root length of the impacted upper incisors increased after traction compared to before traction (P<0.05). The width of the alveolar bone at the completion of traction in group A was similar to that of the contralateral homonymous tooth (P>0.05), whereas the width of the alveolar bone at the completion of traction in group B did not reach that of the contralateral homonymous tooth, with a significant difference in width (P<0.05). Neither the labial bone plate height or width in group A or B reached that of the contralateral homonymous tooth after traction (P<0.05). The keratinized gingival width on the affected side was also significantly smaller than that on the contralateral side (P<0.05), but it was increased significantly in group A at the one-year follow-up visit (P<0.05).@*Conclusion@#Tooth traction is conducive to impacted upper incisor root growth, alveolar bone reconstruction and keratinized gingival growth but cannot produce complete symmetry with respect to the contralateral side.
ABSTRACT
The use of root coverage procedures to treat gingival recession defects, a common periodontal condition, is an important aspect of periodontal regenerative therapy. The synergistic relationship between vascular configuration and involved tissues is the most important factor in soft tissue graft success. The present case reports the clinical effectiveness of Gingival Unit Graft (GUG) for the management of Miller's class III gingival recession.Clinical parameters like Probing depth, recession depth, keratinized tissue width and clinical attachment level were measured at baseline and postoperative 6 months. Percentage of defect coverage was evaluated at postoperative 6 months. Healing was uneventful and 3mm root coverage was observed with 1mm residual recession and increase in keratinized gingiva after 6 months follow up. Free soft tissue autografts such as gingival unit transfers can be used along with bio-adhesives such as cyanoacrylates for predictable results in the management of recession defects.
ABSTRACT
Objective @#To explore the method of apically positioned flap technique (APFT) on buccal keratinized gingiva reconstruction around dental implants and evaluate its clinical outcomes and technical characters. @*Methods @#13 patients, who were insufficient of buccal keratinized gingiva around dental implants but sufficient with alveolar ridge crest tissue or palatal tissue at posterior maxillar, were enrolled in this study. APFT was operated during the phase Ⅱ surgery, by which some tissues were transferred from the alveolar ridge crest or palatal side to the original site of keratinized gingiva. Before APFT surgery and 1, 6 and 12 months after crown restoration, the width and thickness of transferred tissues were measured, gingival index (GI) and bleeding on probing (BOP) were also detected. The results were applied to comparative t-test statistical analysis.@*Results @# Transferred tissues by APFT showed healthy one month after crown restoration and exhibited characters of keratinized gingiva compared with the adjacent teeth at 6 and 12 months after restoration. Mean value of width of transferred tissue were respectively (3.25 ± 0.40) mm, (3.04 ± 0.34) mm and (2.97 ± 0.32) mm, meanwhile the thickness were respectively (2.05 ± 0.20) mm, (1.91 ± 0.23) mm and (1.84 ± 0.25) mm. The value of width and thickness of the adjacent teeth gingiva were (3.19 ± 0.42) mm and (1.96 ± 0.23) mm respectively. No significant differences were found between transferred tissue and adjacent teeth gingiva on width and thickness (P>0.05). Observation results of GI and positive rate of BOP of transferred tissue were also similar to which of gingiva of the adjacent teeth. @*Conclusion @#Technique of apically positioned flap is an effective measure on buccal keratinized gingiva reconstruction.
ABSTRACT
o presente artigo teve como propósito revisar a literatura sobre o papel da mucosa queratinizada na manutenção da saúde peri-implantar. Os artigos para realização dessa revisão foram extraídos de buscas às bases de dados PUBMED, MEDLlNE, SClELO e GOOGLE SCHOLAR. Foram utilizados como referências apenas artigos publicados em português ou inglês. Como resultados dessa revisão, foram encontradas evidências de que a existência de uma faixa de mucosa queratinizada pode favorecer tanto a estética na reabilitação protética sobre implantes como propiciar índices menores de sangramento à sondagem, recessão gengival e inflamação peri-implantar, o que certamente corrobora para uma maior longevidade dos implantes.
The aim of this article was to review the literature about the role of the keratinized gingiva in maintaining perimplant health. Articles for carrying out this review were extracted from searches in PUBMED, MEDLlNE, SCIELO and GOOGLE SCHOLAR databases. Only articles published in Portuguese or English were used as references. The results of this review have found that the existence of a band of keratinized tissue may favor both the aesthetics of the prosthetic rehabilitation on implants as in lower rates of bleeding on probing, gingival recession and peri-implant inflammation, which certainly supports for a higher longevity of dental implants.
Subject(s)
Dental Implants , Mouth Mucosa , Oral Health , GingivaABSTRACT
This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency(22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.
ABSTRACT
There are so many considerations for successful restorative dentistry and the periodontal consideration is one of the most important facors to consider. In modern dentistry intracrevicular margin is popular due to esthetic reason. But the marginal tissue recession after intracrevicular restoration is one of the most troublesome phenomena. The marginal tissue recession may be controlled with understanding the mechamsms. In conclusion (1) the inflammation of periodontium must be controlled before intracrevicular restorative percedure (2) the width and thicknes of keratinized gingiva must be evaluated before intracrevicular restorative procedure (3) tooth preparation must follow the natural scallop of CEJ.
Subject(s)
Dentistry , Esthetics , Gingiva , Inflammation , Pectinidae , Periodontium , Tooth Cervix , Tooth PreparationABSTRACT
The purpose of the present study was to evaluate the effect of incisor protrusion on the mucogingival parameters including the width of attached gingiva. Thirty-seven young adults with lower anterior crowding were selected for this study. From the study model, the degrees of relative and absolute protrusions were measured for each lower incisor. Clinical crown height, the width of keratinized gingiva, probing depth and the width of attached gingiva were measured with digital vernier calipers and Florida Probe System. Through comparing the difference of the above measurements between protruded and non-protruded incisors, and correlation analysis between each measurement, following results were obtained: 1. The protruded incisor showed narrow width of keratinized and attached gingiva comparing to non-protruded incisor. 2. The protruded incisor showed greater clinical crown height comparing to non-protruded side while there was no difference in the probing depth between protruded and non-protruded side. 3. The difference in the width of attached gingiva between protruded and non-protruded incisors showed higher significance in the lateral incisor than in the central incisor. 4. The degree of relative protrusion showed higher correlation with the width of attached gingiva than the degree of absolute protrusion. 5. Clinical crown height showed higher correlation with the width of attached gingiva than the degree of protrusion.
Subject(s)
Humans , Young Adult , Crowding , Crowns , Florida , Gingiva , Incisor , OverbiteABSTRACT
The purpose of this study was to investigate the width of attached gingiva of 414 subjects with healthy gingiva, or early stage of gingivitis. We compared the differences according to the tooth location, age (Yonger group : 14~30, Older group : 31~67) and gender. In addition, we compared the width of attached gingiva in the subjects with less than 2 sites of gingival recession(Re or =3) to study the relationship between the gingival recession and the width of attached gingiva. The results were as follows : 1. The width of keratinized gingiva was widest in maxillary incisors(5.3+/-1.4mm) and narrowest in mandibular right 1st bicuspid and mandibular right and left 2nd molars(3.5+/-1.1mm). 2. The width of attached gingiva was widest in maxillary right central incisor(3.8+/-1.5mm) and narrowest in mandibular right 2nd molar(1.2+/-1.0mm). 3. In the comparison between the age groups, the width of keratinized in older group was significantly(p<0.05) wider than that in younger group in maxillary right and left 1st bicuspids, mandibular right and left 1st and 2nd molars, maxillary right and left cuspids and mandibular right 1st bicuspid. There was no significant difference in the width of attached gingiva between the two groups except for maxillary right and left 1st molars and maxillary left 2nd molar. 4. In the comparison between male group and female group, in maxillary right and and left lateral incisors and cuspids, mandibular right and left cuspids and 1st bicuspids, the width of attached gingiva in female was significantly(p<0.05) wider than that in male group. 5. In the comparison between the Re 3 group and Re 2 group, there was no significant difference except for maxillary right and left 2nd molars and maxillary left 1st molar. 6. The frequency of gingival recession was in the order of mandibular right 1st bicuspid(16.6%), maxillary right 1st bicuspid(13.7%), maxillary and mandibular left 1st bicuspids(13.4%), mandibular left cuspid(10.5%), maxillary left and mandibular right cuspids(10.1%) and maxillary right cuspid(7.9%).