• Journal of Periodontal and Implant Science
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• v.50 no.4
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• pp.226-237
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• 2020

Purpose: This study was conducted to assess the efficacy of prophylactic gingival grafting in the mandibular anterior labial area for preventing orthodontically induced gingival recession. Methods: Eight mongrel dogs received gingival graft surgery at the first (I1) and third (I3) mandibular incisors on both sides based on the following group allocation: AT group (autogenous connective tissue graft on I1), AT-control group (contralateral side in the AT group), CM group (xenogeneic cross-linked collagen matrix graft on I3) and CM-control group (contralateral side in the CM group). At 4 weeks after surgery, 6 incisors were splinted and proclined for 4 weeks, followed by 16 weeks of retention. At 24 weeks after surgery, casts were made and compared with those made before surgery, and radiographic and histomorphometric analyses were performed. Results: Despite the proclination of the incisal tip (by approximately 3 mm), labial gingival recession did not occur. The labial gingiva was thicker in the AT group (1.85±0.50 mm vs. 1.76±0.45 mm, P>0.05) and CM group (1.90±0.33 mm vs. 1.79±0.20 mm, P>0.05) than in their respective control groups. Conclusions: The level of the labial gingival margin did not change following labial proclination of incisors in dogs. Both the AT and CM groups showed enhanced gingival thickness.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.383-390
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• 2001

It is a relatively common clinical experience to see a impacted maxillary central incisor Most often, the central incisor is impacted labially. The labial impaction has been indicated as the most difficult to manage. The labial impactions have been found to be associated with mucogingival recession, reduced attached gingiva and periodontal pockets. For the successful treatment, clinicians should avoid loss of attached gingiva in surgical exposure. The most common methods of uncovering labially impacted maxillary anterior teeth are gingivectomy, apically positioned flap and closed eruption technique. If gingivectomy will not leave enough attached gingiva, then an apically positioned flap may be the treatment of choice. If the tooth is impacted in the middle of the alveolus or high in the vestibule near the nasal spine, the closed eruption technique may be the treatment of choice. Closed eruption technique was used in one case, apically positioned flap was used in two case. As the result in two cases of impacted maxillary central incisor, apically positioned flap provide the adequate width of attached gingiva. In case of impacted maxillary central incisor, through the clinical and radiologic examination to select correct surgical operation for reduce the complications.

• Journal of Oral Medicine and Pain
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• v.47 no.3
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• pp.161-166
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• 2022

Oral lichen planus (OLP) is a chronic oral mucosal disease affecting the buccal cheek, tongue, palate, lip, and gingival mucosa. Lesions in the gingiva make it difficult to control dental plaque due to pain. As a result, the disease is often accompanied by gingivitis or periodontitis. If OLP and dental plaque are not properly managed, the patient's periodontal condition will worsen. Thus, clinicians treating OLP should emphasize periodic visits and dental plaque control. Here, we report the management of a patient who struggled with OLP for 20 years and discuss the importance of periodic regular observations and active periodontal management.

• Journal of Periodontal and Implant Science
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• v.39 no.2
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• pp.111-118
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• 2009

Purpose: The integrity of interproximal hard/soft tissue has been widely accepted as the key determinant for success or degree of root coverage following the connective tissue graft. However, we reason that the gingival biotype of an individual, defined as the distance from the interproximal papilla to gingiva margin, may be the key determinant that influence the extent of root coverage regardless of traditional classification of gingival recession. Hence, the present study was performed with an aim to verify that individual gingival scalloping pattern inherent from biotype influence the level of gingival margin following the connective tissue graft for root coverage. Methods: Test group consisted of 43 single-rooted teeth from 21 patients (5 male and 16 female patients, mean age: 36.6 years) with varying degrees of gingival recession requiring connective tissue graft; 20 teeth of Miller class I and 23 teeth of Miller class III gingival recession, respectively. The control group consisted of contralateral teeth which did not demonstrate apparent gingival recession, and thus not requiring root coverage. For a biotype determination, an imaginary line connecting two adjacent papillae of a test tooth was drawn. The distance from this line to gingival margin at mid-buccal point and this distance (P-M distance) was designated as "gingival biotype" for a given individual. The distance was measured at baseline and 3 to 6 months examinations postoperatively both in test and control groups. The differences in the distance between Miller class I and III were subject to statistical analysis by using Student.s t-test while those between the test and control groups within a given patient were by using paired t-test. Results: The P-M distance at 3 to 6 months postoperatively was not significantly different between Miller class I and Miller class III. It was not significantly different between the test and control group in a given patient, either, both in Miller class I and III. Conclusions: The amount of root coverage following the connective tissue graft was not dependent on Miller's classification, but rather was dependent on P-M distance, strongly implying that the gingival biotype of a given patient may play a critical impact on the level of gingival margin following connective tissue graft.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.4
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• pp.354-359
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• 2018

In a single implant restoration of maxillary anterior teeth, it is difficult to accomplish an aesthetic restoration of the implant prosthesis in the case of gingival recession and bone defect problems. To maintain aesthetic stability in the long term, it is important to place the implant in the ideal position as well as the recovery of the soft tissue and harmony with the prosthesis. Not only ideal implant position but also the harmony with surrounding soft tissues are important to fabricate aesthetic implant prosthesis for these cases. for these cases, a 47- years -old male with lowered level of osseous crest and gingival recession on maxillary anterior tooth was treated with guided bone regeneration and gingival recontouring.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.911-923
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• 2000

A comparative clinical study on the ordinary toothbrush($Buttler^{(R)}$, America) and the silicone toothbrush($Jefe^{(R)}$, Korea) was performed. The volunteers who took part in this study were students of Dental college of Yonsei University and patients attending Dental Hospital of Yonsei University. They were classified into two group, control and experimental group. Control group brushed with nylon toothbrush and experimental group did with silicone toothbrush under the researcher's guidances. Volunteers were examined on Plaque Index(PI), Gingival Index(GI), Probing Depth(PD), Bleeding on Probing(BP) and Recession(R) at base line, 1st. week, 2nd. week and 4th. week. According to the results, both group have the tendency of improvement in the degrees of GI, PI and the improvement degree of GI of both group has the significant differences from base line statistically, and there are not statistically significant differences between the silicone and nylon group in respect of PI, GI values. So based on the present study, it could be carefully ascertained that the silicone toothbrush has similar effect with nylon toothbrush in respect of PI and GI. If it is sure that the silicone toothbrush is seldom abrasive and possibly enough to massage the gingiva, this new brush is worth to be recommended by the dentists.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.18 no.1
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• pp.27-32
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• 2009

오늘날 단일치 임플란트의 식립은 현재 시행되고 있는 가장 일반적인 임플란트 술식 중 하나이며, 상악 전치부는 이중 가장 흔하게 시행되는 식립 부위 중하나이다. 그럼에도 불구하고 상악 전치부 단일 상실치에 대한 치료 계획은 구강 내 다른 어떤 부위보다 복잡하며 고도로 심미성을 요구하는 부위로서 아무리 경험이 많고 기술이 뛰어난 치과의사라 할지라도 시술할 때마다 큰 도전으로 여겨지는 경우가 대부분일 것이다. 상악 전치부에서 임플란트 보철의 심미적 성공을 이루기 위해서는 모든 구성 요소 하나하나에서 심미적 결과를 이룩하여야 하고 이 결과들이 완벽하게 조화를 이루게 하여야 하며 이는 결코 쉬운 일이 아닐 것이다. 시술 시 교과서의 그림처럼, 모형에 식립해 본 것처럼 쉽게 되지 않는 것은 물론 구강 내 환경이 모형과 다를 리 만무한 것이 당연한 첫 번째 이유이며 뿐만 아니라 환자 대부분의 경우 모형처럼 완벽한 경 연조직이 갖추어진 상태에서 치아만 상실된 경우는 거의 찾아볼 수 없기 때문인 이유도 크다. 즉, 원하는 위치에 식립을 하고 장기간의 심미적 유지를 위해서는 경 연조직에 대한 처치가 필수적인 경우가 대부분이라는 이야기이다. 이를 간과하고 식립한 경우 추후 심각한 bone의 resorption, 그에 따르는 gingiva의 끔찍한 recession, 용납할 수 없는 비심미적 보철물의 제작은 불을 보듯 뻔한 결과가 될 것이다. 따라서 상악 전치부 식립 치료계획 시 치과의사는 성공적 결과에 영향을 미칠 수 있는 모든 요소에 촉각을 곤두세우고 이들의 완벽한 처치에 최선을 다 해야할 것이다.

• Journal of Periodontal and Implant Science
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• v.51 no.6
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• pp.398-408
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• 2021

Purpose: In this study, we aimed to evaluate the clinical validity of the modified tunneling technique using minimal soft tissue harvesting and volume-stable collagen matrix in the anterior mandible. Methods: In total, 27 anterior mandibular teeth and palatal donor sites in 17 patients with ≥1 mm of gingival recession (GR) were analyzed before and after root coverage. For the recipient sites, vertical vestibular incisions were made in the interdental area and a subperiosteal tunnel was created with an elevator. After both sides of the marginal gingiva were tied to one another, a prepared connective tissue graft and volume-stable collagen matrix were inserted through the vestibular vertical incision and were fixed with resorbable suture material. The root coverage results of the recipient site were measured at baseline (T₀), 3 weeks (T₃), 12 weeks (T₁₂), and the latest visit (T_l). For palatal donor sites, a free gingival graft from a pre-decided area avoiding the main trunk of the greater palatine artery was harvested using a prefabricated surgical template at a depth of 2 mm after de-epithelization using a rotating bur. In each patient, the clinical and volumetric changes at the donor sites between T₀ and T₃ were measured. Results: During an average follow-up of 14.5 months, teeth with denuded root lengths of 1-3 mm (n=12), 3-6 mm (n=11), and >6 mm (n=2) achieved root coverage of 97.01%±7.65%, 86.70%±5.66%, and 82.53%±1.39%, respectively. Miller classification I (n=12), II (n=10), and III (n=3) teeth showed mean coverage rates of 97.01%±7.65%, 86.91%±5.90%, and 83.19%±1.62%, respectively. At the donor sites, an average defect depth of 1.41 mm (70.5%) recovered in 3 weeks, and the wounds were epithelized completely in all cases. Conclusions: The modified tunneling technique in this study is a promising treatment modality for overcoming GR in the anterior mandible.

• The Journal of the Korean dental association
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• v.55 no.1
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• pp.30-41
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• 2017

Inadequate keratinized mucosa around dental implants can lead to more plaque accumulation, tissue inflammation, marginal recession and attachment loss. We evaluated the effects of free gingival and extracellular matrix membrane grafts performed to increase the insufficient width of keratinized tissue around dental implants in the posterior mandible. A 47-year-old female patient presented with discomfort due to swelling of the lower right second premolar area. Due to severe destruction of alveolar bone, the tooth was extracted. After 3 months, a guided bone regeneration (GBR) procedure was performed and then a dental implant was placed 6 months later. During the second-stage implant surgery, free gingival grafting was performed to increase the width of the keratinized tissue. After 12 months, a clinical evaluation was performed. A 64-year-old female patient had a missing tooth area of bilateral lower molar region with narrow zone of keratinized gingiva and horizontal alveolar bone loss. Simultaneous implant placement and GBR were performed. Five months after the first-stage implant surgery, a gingival augmentation procedure was performed with an extracellular matrix membrane graft to improve the width of the keratinized tissue in the second-stage implant surgery. After 12 months, a clinical evaluation was performed. In these two clinical cases, 12 months of follow-up, revealed that the increased width of the keratinized tissue and the deepened oral vestibule was well maintained. A patient showed a good oral hygiene status. In conclusion, increased width of keratinized tissue around dental implants could improve oral hygiene and could have positive effects on the long-term stability and survival rate of dental implants. When planning a keratinized tissue augmentation procedure, clinicians should consider patient-reported outcomes.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.3
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• pp.239-245
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• 2014

Complete denture prosthodontics includes replacement of natural teeth and associated maxillary and mandibular structures for full edentulous patients. The final objectives of prosthodontic treatment include esthetic and functional rehabilitation. Because the esthetic demand of senior patients has increased esthetic requirement should not be overlooked in denture treatment. In complete denture treatment, attempts have been made to reproduce tooth wear, arrangement, recession of cervical gingiva, staining, improved gingival shade and so on. This 61 year old female patient came to the Department of Prosthodontics with the chief complaint that dentures made 5 years ago in a local clinic were broken and did not fit well. The patient put more emphasis on fabrication of natural and esthetic dentures than recovery of masticatory function. Remake of maxillary complete denture and mandibular implant retained overdenture was planned. In order to create esthetic and natural contour, Aesthetic Color Set Easy system$^{(R)}$ (Candulor dental GmbH, Wangen, Germany) was used to make complete dentures reproducing various gingival shades. Patient's esthetic satisfaction was high. When complete denture prosthodontics treatment involves appropriate expression of individual characteristics in addition to proper selection of esthetic materials, treatment will give satisfaction to both dentist and patient.