Gingival grafting in periodontal practice: results of 103 consecutive surgeries in 82 patients.

A consecutive series of 103 surgeries in 82 patients was studied from the normal clinical population of a periodontal specialty practice. Four different techniques were employed: free gingival grafts, free connective tissue grafts, pedicle flaps, and combined techniques. Gingival augmentation using free gingival grafts was the most predictable, with 100% of cases showing a gain of > or = 3 mm. The average root coverage was 2.47 mm overall but was most predictable with a combined technique, with 93% gaining > or = 2 mm. Miller Class 4 cases were most predictably treated with pedicle flaps and a combined technique. Smokers and patients with more complex sites showed less improvement. Mandibular central incisors and maxillary canines were the most commonly grafted teeth.

Squamous cell carcinoma of the gingiva presenting as localized periodontal disease.

Gingival squamous cell carcinoma represents less than 10% of diagnosed intraoral carcinoma. Many unique features of gingival squamous cell carcinoma clearly delineate it from oral squamous cell carcinoma arising in other sites. This article presents the clinicopathologic findings of a case. An 81-year-old woman presented for evaluation of multiple oral lesions primarily limited to the maxillary gingiva; the lesions had been present for about 2 years. Differential diagnosis included epithelial dysplasia, benign mucous membrane pemphigoid, inflammatory lesion of endodontic/periodontic origin, lichen planus, and squamous cell carcinoma. Clinical examination revealed extensive erythematous and ulcerative lesions of maxillary buccal and palatal gingiva extending into the maxillary buccal vestibule; the lesions did not respond to antibiotic therapy. Radiographic evaluation demonstrated advanced alveolar bone loss as well as displacement of the maxillary right first molar. Subsequent histology confirmed diagnosis of moderately differentiated squamous cell carcinoma. Gingival squamous cell carcinoma can mimic a multitude of oral lesions, especially those of inflammatory origin. In addition, predisposing and presenting factors are different from those of other oral squamous cell carcinomas. Careful examinations as well as routine biopsy are crucial for accurate diagnosis.

Localized periodontitis as a long-term effect of oral piercing: a case report.

Recent years have seen a dramatic increase in the number of published articles on short-term complications of oral piercing, possibly reflecting an increase in the popularity of this practice. Long-term effects of oral piercing, however, have had minimal documentation. This case report of a 28-year-old woman with piercing of the tongue and lower lip demonstrated localized severe periodontitis as a destructive long-term outcome related to oral piercing. The patient reported that she had worn 2 tongue rings and a mandibular labrette (lip piercing) in the form of a bar for 12 years. Plaque and calculus accumulation, severe inflammation, tooth mobility, severe horizontal radiographic bone loss, and deep pocketing were observed in teeth affected by the jewelry.

A comparison of the clinical and histologic crestal bone level measurements adjacent to dental implants in the baboon.

The purpose of this study was to compare clinical probing measurements with the histologic alveolar bone level in an established baboon model. Implant sites were prepared by removal of all premolars and first molars in 10 adult female baboons (Papio anubis), a total of 120 sites. The resulting edentulous ridges were allowed to heal for 6 weeks. One implant was placed in each site and allowed to heal, after which the implants were removed en bloc. The animals were not sacrificed. Clinical probing from the implant platform to the crest of the bone was performed at the buccal and lingual aspects of each implant at the time of placement and prior to section removal. All measurements were taken with a calibrated probe by a single examiner (ARV). Sections were cut in a buccolingual plane through the long axis of each implant. Histologic slides were digitized for data collection, and histologic measurements were taken at the buccal and lingual aspects from the implant platform to the crest of the bone. The results of the study showed that there were no significant differences between the clinical and histologic measurements. The authors concluded that clinical measurements around dental implants are as reliable as histologic measurements and that the tip of the probe extended to the alveolar bone every time the implant was probed in this model.