Journal of Periodontal and Implant Science

  • 제33권3호
  • /
  • Pages.519-531
  • /
  • 2003
  • /
  • 2093-2278(pISSN)
  • /
  • 2093-2286(eISSN)
대한치주과학회 (Korean Academy of Periodontology)
권호 표지

구개 및 치아 형태와 구개부 저작점막의 두께와의 연관성

Relationship between The Shape of Palatal Vault and Tooth and The Thickness of Palatal Masticatory Mucosa

  • 석화숙 (경희대학교 치과대학 치주과학교실) ;
  • 이만섭 (경희대학교 치과대학 치주과학교실) ;
  • 권영혁 (경희대학교 치과대학 치주과학교실) ;
  • 박준봉 (경희대학교 치과대학 치주과학교실)
  • Seok, Hwa-Suk (Department of Periodontology, College of Dentistry, Kyung Hee University) ;
  • Lee, Man-Sub (Department of Periodontology, College of Dentistry, Kyung Hee University) ;
  • Kwon, Young-Hyunk (Department of Periodontology, College of Dentistry, Kyung Hee University) ;
  • Park, Joon-Bong (Department of Periodontology, College of Dentistry, Kyung Hee University)
  • 발행 : 2003.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The aim of present investigation was to clinically measure the thickness of palatal masticatory mucosa in the hard palate as potential donor site for mucogingival surgery, to determine the relation to shape of palatal vault, form of tooth, gender, and to serve the clinical criteria t o choose the proper surgical technique. 84(mean age:25yrs) systemically and periodontally healthy volunteers participated in this study and 18 standard measurement points were defined in the hard palate, located on 3 lies which ran at different distances parallel to the gingival margin. 6 positions were designated on each of these 3 lines between the level of canine and 2nd molar and a bone sounding technique using a periodontal probe with minimal local anesthesia was utilized to assess the thickness of palatal masticatory mucosa. Student t-test was used to determine the difference in mucosal thickness between 2 groups gender, shape of palatal vault (high palatal vault vs. low palatal vault), tooth form (short-wide vs. long narrow) The result of this study were as follows: 1. Soft tissue thickness progressively increased in sites further away from the gingival margin (p<0.01). 2. Depending on position, in line a and line c the masticatory mucosal thickness increased from Ca to M2(p<0.01), but in line b the thickness increased from Ca to P2, and decreased to M1 and increased again to M2. 3. Gender did not influence the thickness of masticatory mucosa. 4. Palatal vault shape was associated with the thickness of masticatory mucosa. Thickness of low palatal vault group was thicker than high palatal group between P2 and M2 position. 5. Form of tooth did not influence the thickness of masticatory mucosa. In conclusion, palatal vault shape was associated with the thickness of masticatory mucosa. So, mucogingival surgery can be considered as a treatment modality in high palatal vault group. But, Gender and tooth form did not influence the thickness of masticatory mucosa.

키워드

참고문헌

  1. Muller, HP, Eger, T.: Masticatory Mucosa and Periodontal Phenotype: A Review, Int. J. Periodont Rest. Dent. 22:172-183, 2002
  2. Wara-aswapati, N., Pitiphat, W., Chandrapho, N., Rattanayatikul, C., Karimbux, N.: Thickness of Palatal Masticatory Mucosa Associated with Age., J. Periodontol., 72:1407-1412, 2001 https://doi.org/10.1902/jop.2001.72.10.1407
  3. Studer, S.P., Naef, R., and Scharer, P. : Adjustment of localized alveolar ridge defects by soft tissue transplantation to improve mucogingival esthetics : A proposal for clinical classification and evaluation of procedures, Quintessence int. 28:785-805, 1997
  4. Langer, B., and Calagna, L. J. : The Subepithelial Connective Tissue Graft A New Approach to the Enhancement of Anterior Cosmetics, Int. J. Periodont. Res. Dent. 2:23-33, 1982
  5. Seibert. JS., and Louis. JV. : Soft tissue ridge augmentation utilizing a combination Onlay-Interpositional Graft Procedure, Int. J. Periodont. Res. Dent. 16:311-321, 1996
  6. Orth, C.: A Modification of the Connective Tissue Graft Procedure for the Treatment of Type II and Type III Ridge Deformities, Int. J. Periodont. Rest. Dent. 16: 267-277, 1996
  7. Allen, EP., Gainza, C., Farthing, G and Newbold, D.: Improved technique for localized ridge aug-mentation, J. Periodontol., 195-199, 1985
  8. Rami, G., Soheir, EK., Luis, M., Raul, C. : Histological Evaluation of Healing and Re-vascu-larization of the Subepithelial Connective Tissue Graft. J. Periodontol., 72:470-478, 2001 https://doi.org/10.1902/jop.2001.72.4.470
  9. Philippe, B., Daniel, E., Jean-Pierre, O., Rolf, N.: Subepithelial Connective Tissue Grafts in the Treatment of Gingival Recession. A Comparative study of 2 Procedures., J. Periodontol., 65:929-936, 1994 https://doi.org/10.1902/jop.1994.65.10.929
  10. Langer, B. and Calagna, L.: The Subepithelial Connective Tissue Graft. J. Prosthet Dent, 44:363-371, 1980 https://doi.org/10.1016/0022-3913(80)90090-6
  11. Langer, B. and Calagna, L.: The Subepithelial Connective Tissue Graft. J. Prosthet Dent, 44:363-371, 1980 https://doi.org/10.1016/0022-3913(80)90090-6
  12. Raetzke, P. B.: Covering Localized Areas of Root Exposure Employing the 'Envelope' Technique. J. Periodontol., 56:397-402, 1985 https://doi.org/10.1902/jop.1985.56.7.397
  13. Nelson, S. W.: The Subepithelial Connective Tissue Graft. A Bilaminar Reconstructive Procedure for the Coverage of Denuded Root Surfaces. J. Periodontol., 58:95-102, 1987 https://doi.org/10.1902/jop.1987.58.2.95
  14. Jahnke, P. V., Sandifer, J. B., Gher, M. E., Gray, J. L., and Richardson, A. C.,: Thick Free Gingival and Connective Tissue Autografts for Root Coverage. J. Periodontol., 64:315-322, 1993 https://doi.org/10.1902/jop.1993.64.4.315
  15. Harris, R. J.: Human Histologic Evaluation of Root Coverage Obtained with a Connective Tissue with Partial Thickness Double Pedicle graft. :A Case Report, J. Periodontol, 70:813-821, 1999 https://doi.org/10.1902/jop.1999.70.7.813
  16. Bruno, J. F.: Connective Tissue Graft Technique Assuring Wide Root Coverage. Int. J. Periodont, Res. Dent. 2:127-138, 1994
  17. Allen, A. L,: The Use of Supraperiosteal Envelope in Soft Tissue Grafting for Root Coverage, I. Rationale and Technique. Int, J. Periodont. Res. Dent., 3: 217-228, 1994
  18. Hall, W. B., Lundergan, W. P.: Free gingival graft. Dent elin North Am 37: 227-242, 1993
  19. Azzi, R., Takei, H. H., Etienne, D., Carranza, F, A.: Root Coverage and Papilla Reconstruction Using Autogenous Osseous and Connective Tissue Grafts. Int. J. Periodont. Res, Dent. 21:141-147, 2001
  20. Maurer, A., Leone, C. W.: Use of a Serially Layered Double Connective Tissue Graft Approach to Enhance Maxillary Anterior Esthetics. Int. J. Periodont. Res. Dent. 21:497-503, 2001
  21. Nelson, S. W.: Subperiosteal Connective Tissue Grafts for Pocket Reduction and Preservation of Gingival Esthetics: A Case Report, J. Periodontol, 72:1092-1099, 2001 https://doi.org/10.1902/jop.2001.72.8.1092
  22. Novaes, A. B. Jr. and Novaes, A. B: Soft tissue management for primary closure in guided bone regeneration: Surgical technique and case report. Int. J. Oral. Maxillofac Implants 12:84-87, 1997
  23. Khoury, F., Happe, A,: The Palatal Subepithelial Connective Tissue Flap Method for Soft Tissue Management to Cover Maxillary Defects: A Clinical Report, Int J Oral Maxillofac Implants, 15:415-418, 2000
  24. Landsberg, C. J.: Socket Seal Surgery Combined with Immediate Implant Placement: A Novel Approach for Single Tooth Replacement. Int. J. Periodont. Res. Dent. 17:141-149, 1997
  25. Tai, H.: Autogenous Masticatory Mucosal Grafts in Extraction Socket Seal Procedures: A Comparison between Sockets Grafted with Demineralized Freeze-dried Bone and Deproteinized Bovine Bone Mineral. Clin, Oral. Impl, Res, 10:289-296, 1999 https://doi.org/10.1034/j.1600-0501.1999.100405.x
  26. Rosenquist B.: A comparison of methods of soft tissue management following the immediate placement of implants into extraction sockets. Int. J. Oral. Maxillofac Implants 12:43-51, 1997
  27. Lindhe, H.: Clinical Periodontology and Implant Dentistry 3rd edi.: 550-596, 1998
  28. Uchida, H., Kobayashi, K., Nagao, M.: Measurement in vivo of Masticatory Mucosal Thickness with 20 B-mode Ultrasonic Diagnostic Equipment. J. Dent. Res. 68:95-100, 1989 https://doi.org/10.1177/00220345890680021501
  29. Kydd, W. L., Daly, C. H., Wheeler, J. B. 3rd: The Thickness Measurement of Masticatory Mucosa in vivo. Int. Dent. J. 21(4): 430-441, 1971
  30. Muller, HP, Heinecke, A., Schaller, N., Eger, T.: Masticatory Mucosa in Subjects with Different Periodontal Phenotype, J Clin Periodontol, 27:621-626, 2000 https://doi.org/10.1034/j.1600-051x.2000.027009621.x
  31. Muller, H.P., Schaller, N., Eger, T., Heinecke, A.: Thickness of Masticatory Mucosa., J Clin Periodontol., 27:431-436, 2000 https://doi.org/10.1034/j.1600-051x.2000.027006431.x
  32. Muller, HP, Schaller, N., Eger, T.: Ultrasonic Determination of Thickness of masticatory Mucosa: A Methodologic Study., Oral Surg Oral Med Oral Pathol Oral Radiol Endod., 88:248-253, 1999 https://doi.org/10.1016/S1079-2104(99)70123-X
  33. Studer, SP., Allen, EP., Rees, TC., Kouba, A.: The Thickness of Masticatory Mucosa in the Human Hard Palate and Tuberosity as Potential Donor Sites for Ridge Augmentation Procedure. J. Periodontol., 68:145-151, 1997 https://doi.org/10.1902/jop.1997.68.2.145
  34. 조익현, 김현철, 박정미, 장문택, 김형섭 : 건강한 한국 성인에서 경구개와 상악결절부위 저작점막의 두께 측정, 대한치주과학회지 31(3):641-649, 2001
  35. Howell, M. M., Cassingham, R. J., Yukna, R. A.: Relationship of Maxillary Molar Root Angulation and Palatal Vault Height. J. Periodontal. 57:25-28, 1986 https://doi.org/10.1902/jop.1986.57.1.25
  36. Richardson, E. R., Dunn, G. F., Bryant, W. J., Lawrence, F.: Comparison of human palatal vault height and tooth length. Oral Surg Oral Med Oral Pathol 32(2):324-331, 1971 https://doi.org/10.1016/0030-4220(71)90234-9
  37. Muller, H. P., Eger, T.: Gingival phenotypes in young male adults. J. Clin. Periodontol. 24:65-71, 1997 https://doi.org/10.1111/j.1600-051X.1997.tb01186.x
  38. Goaslind, GD., Robertson, PB., Mahan, CJ., Morrison, WW., Olson, J V.: Thickness of Facial Gingiva, J. Periodontol., 48:768-771, 1977 https://doi.org/10.1902/jop.1977.48.12.768
  39. Olsson, M., Lindhe, J. and Marinello, C. P.: On the relationship between crown form and clinical features of the gingival in adolescents. J. Clin. Periodontol. 20:570-577, 1993 https://doi.org/10.1111/j.1600-051X.1993.tb00773.x
  40. 강철흔, 장문택, 류성훈, 김형섭 : 한국성인의 각화치은 두께측정에 관한 연구，대한치주과학회지. 30(1):179-187, 2000
  41. Renvert, S., Badersten, A., Nilveus, R., Egelberg, J.: Healing after treatment of periodontal intra osseous defects. I. Comparative study of clinical methods. J. Clin. Periodontol, 8:387-399, 1981 https://doi.org/10.1111/j.1600-051X.1981.tb00888.x
  42. Ursell, M. J.: Relationships between alveolar bone levels measured at surgery, estimated by transgingival probing and clinical attachment level measurements. J. Clin. Periodontol. 16:81-86, 1989 https://doi.org/10.1111/j.1600-051X.1989.tb01618.x
  43. Mealey, B. L., Neubauer, M. F., Butzin, C. A., Waldrop, T. C.: Use of Furcal Bone Sounding to Improve Accuracy of Furcation Diagnosis. J. Periodontol. 65:649-657, 1994 https://doi.org/10.1902/jop.1994.65.7.649
  44. Kocher, T., Immertreu, E., Plagmann, H. C.: On the relationshipbetween crown form and the outcome after periodontal treatment. : A retrospective study. J. Dent. Res. 74(3): 1731-1737, 1995 https://doi.org/10.1177/00220345950740110301
  45. Olsson, M. and Lindhe, J.: Periodontal characteristics in individuals with varying form of the upper central incisors. J. Clin. Periodontol. 18:78-82, 1991 https://doi.org/10.1111/j.1600-051X.1991.tb01124.x
  46. Eger, T., Muller, H. P., Heinecke, A.: Ultrasonic determination of gingival thickness.; Subject variation and influence of tooth type and clinical features. J. Clin. Periodontol. 23:839-845, 1996 https://doi.org/10.1111/j.1600-051X.1996.tb00621.x