• The Journal of the Korean dental association
• /
• v.55 no.3
• /
• pp.249-256
• /
• 2017

Gingival recession is one of the common mucogingival problems during the orthodontic treatment. The causes of the gingival recession are similar to gingival recession in patients with periodontal diseases. Accumulation of bacterial deposits around the natural teeth induces the gingival inflammation and gingival recession occurs in the teeth with the lack of the supporting bone. However, malpositioned teeth which are labially positioned teeth or rotated teeth are more risky for gingival recession. Once root is exposed to oral cavity due to gingival recession, the orthodontic tooth movement is compromised and esthetic problems appeared. In addition, excessive gingival recession over the mucogingival junction jeopardizes the oral hygiene control, which has a risk of further gingival recession and bone loss around the tooth. To cover exposed root or to prevent further gingival recession, mucogingival surgery with gingival graft is recommended for the patients under orthodontic treatment. This case report aimed to present the mucogingival treatments of gingival recession observed during orthodontic treatment. Case I had had initial slight gingival recession before the orthodontic treatment. However, during the retraction phases, the gingival recession progressed and the periodontal treatment was referred. In case II, miller Class III gingival recession was occurred after correction of rotation. Both cases were treated by coronally advanced flap with free gingival grafts and recovered to the level of adjacent teeth despite of complete root coverage was not achieved in Case II. After periodontal treatment, orthodontic treatment was successfully completed. In conclusion, mucogingival surgery during the orthodontic treatment is recommended for the successful orthodontic treatment as well as periodontal health.

• The korean journal of orthodontics
• /
• v.15 no.2
• /
• pp.291-301
• /
• 1985

Fifty subjects who were to be treated with fixed orhodontic appliances by light wire edgewise technique were selected. Bands with different marginal depth were made in first molar and direct bonding brackets were bonded in second premolar. For determining the effects of fixed orthodontic appliance on the gingival tissue, the changes of clinical crown length, periodontal pocket depth, gingival sulcus fluid were checked. The results were as follows: 1. Gingival condition was deteriorated after wearing the fixed orthodontic appliance, and the deteriorative rate was decreased gradually. 2. The greatest gingival change was occurred in the maxillary first molar among the experimental teeth. 3. The gingival change of maxillary teeth was greater than that of mandibular teeth. $(p\leq0.01)$ 4. The greater gingival change was occurred around subgingivally located band than around supragingivally located band. 5. Comparing the gingival changes of banded teeth with them of bonded teeth, the gingival tissue was more effected by oral hygiene than by type of appliances. 6. In the quantitive changes of gingival crevicular fluid, there was no exact relationship with gingival inflammation.

• The Journal of the Korean dental association
• /
• v.58 no.1
• /
• pp.8-18
• /
• 2019

This case report presents results for gingival recession coverage following gingival grafting and for gingival biotype enhancements by visualizing soft tissue volume changes using intraoral three-dimensional scanning. A 28 year old female patient with multiple gingival recessions and a 19 year old female patient with a single gingival recession on mandibular anterior area were treated. Root coverage was performed in both cases using autogenous subepithelial connective tissue harvested from palate. Intraoral 3D scan data were obatained presurgery and at 3 months, 1 year, and 2 years postsurgery. The recession areas were recovered successfully by subepithelial connective tissue graft combined with pedicle flap repositioning, and the patients showed neither further recurrence nor post-operative complication. Soft tissue biotype changes were identified by superimposing and analyzing scan data, revealing that gingival biotype was enhanced in both cases. These cases suggest that SCTG could be advantageous in terms of the gingival biotype enhancement, as well as gingival recession coverage, and intraoral 3D scanning might be suitable for assessing post-surgical gingival biotype change.

• Journal of Periodontal and Implant Science
• /
• v.39 no.1
• /
• pp.103-108
• /
• 2009

Purpose: It is well recognized that gingival enlargement is induced by unwanted effect associated with three major drugs/drug groups - phenytoin, cyclosporine, and the calcium channel blockers. The present case report describes the effect and limitation of non-surgical treatment in gingival enlargement cases. Materials and methods: Three cases included 2 drug-influenced gingival enlargement patients and a idiopathic gingival fibromatosis patient. For the drug-influenced gingival enlargement patients, the medication was replaced with other medication. And then, all the patients were treated non-surgically. Results: Drug-influenced gingival enlargements had been reduced after non-surgical treatment and the results were well-maintained. In the idiopathic gingival fibromatosis case, non-surgical treatment resulted in only limited reduction of gingival enlargement, and surgical periodontal treatment was unavoidable. Conclusion: These case reports indicated that non-surgical periodontal treatment with change in medication was effective in the treatment of drug-influenced gingival enlargements. Non-surgical approach can be considered as the primary management to reduce the gingival enlargement. If non-surgical treatment encounters a limitation, surgical treatment should be considered.

• The Journal of the Korean dental association
• /
• v.52 no.12
• /
• pp.720-725
• /
• 2014

Generalized gingival enlargement, also known as gingival hyperplasia or hypertrophy, is defined as an abnormal diffuse overgrowth of gingival tissues. There are several causes of generalized gingival enlargement and they can be grouped into four categories: hereditary gingival fibromatosis, medication-induced, inflammatory, and systemic or neoplastic causes of gingival enlargement. This paper reviews the clinical features, differential diagnosis and significance of generalized gingival enlargements.

• Journal of Periodontal and Implant Science
• /
• v.34 no.1
• /
• pp.205-221
• /
• 2004

Periodontal ligament(PDL) cells have been known as playing an important roles in periodontal regeneration and gingival fibroblasts are also important to periodontal regeneration by forming connective tissue attachment. There were rare studies about the gene expression patterns of PDL cells and gingival fibroblasts, therefore in this study, we tried cDNA microarray-based gene expression monitoring to explain the functional differences of PDL cells and gingival fibroblasts in vivo and to confirm the characteristics of PDL cells. Total RNA were extracted from PDL cells and gingival fibroblasts of same person and same passages, and mRNA were isolated from the total RNA using Oligotex mRNA midi kit(Qiagen) and then fluorescent cDNA probe were prepared. And microarray hybridization were performed. The gene expression patterns of PDL cells and gingival fibroblasts were quite different. About 400 genes were expressed more highly in the PDL cells than gingival fibroblasts and about 300 genes were more highly expressed in the gingival fibroblasts than PDL cells. Compared growth factor- and growth factor receptor-related gene expression patterns of PDL cells with gingival fibroblasts, IGF-2, IGF-2 associated protein, nerve growth factor, placental bone morphogenic protein, neuron-specific growth- associated protein, FGF receptor, EGF receptor-related gene and PDGF receptor were more highly expressed in the PDL cells than gingival fibroblasts. The results of collagen gene expression patterns showed that collagen type I, type III, type VI and type VII were more highly expressed in the PDL cells than gingival fibroblasts, and in the gingival fibroblasts collagen type V, XII were more highly expressed than PDL cells. The results of osteoblast-related gene expression patterns showed that osteoblast specific cysteine-rich protein were more highly expressed in the PDL cells than gingival fibroblasts. The results of cytoskeletal proteins gene expression patterns showed that a-smooth muscle actin, actin binding protein, smooth muscle myosin heavy chain homolog and myosin light chain were more highly expressed in the PDL cells than gingival fibrobalsts, and ${\beta}-actin$, actin-capping protein(${\beta}$ subunit), actin- related protein Arp3(ARP) and myosin class I(myh-1c) were more highly expressed in the gingival fibroblasts than PDL cells. Osteoprotegerin/osteoclastogenesis inhibitory factor(OPG/OCIF) was more highly expressed in the PDL cells than gingival fibroblasts. According to the results of this study, PDL cells and gingival fibroblasts were quite different gene expression patterns though they are the fibroblast which have similar shape. Therefore PDL cells & gingival fibroblasts are heterogeneous populations which represent distinct characteristics. If more studies about genes that were differently expressed in each PDL cells & gingival fibroblasts would be performed in the future, it would be expected that the characteristics of PDL cells would be more clear.

• Journal of Periodontal and Implant Science
• /
• v.25 no.1
• /
• pp.14-23
• /
• 1995

Cyclosporin A is a powerful immunosuppressive agent commonly used for patients receiving organ transplants. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. The purpose of this study was to compare the correlation with gingival overgrowth score and clinical indices(i.e, : plaque index, papillary bleeding index, probing depth) and correlation with gingival overgrowth score and microorganism distribution in use of phase contrast microscope. After renal tranplant, taking cyclosporin A 40 patients participating in this investigation. Post - transplatation cyclosporin medication period was average $17.53{\pm}15.75$ months. In previous study reported that gingival overgrowth is an adverse side - effects seen in about 25-81% of patient taking cyclosporin A. The results were as follows : 1. Gingival overgrowth prevalence in taking cyclosporin A patients was 77.5%. Prevalence rate of region was anterior region(26 teeth, 55.3%), molar region(14 teeth, 29.8%), premolar region(7 teeth, 14.8%) in turns. Gingival overgrowth score by Angelopoulos & Goaz method was molar region($1.56{\pm}0.81$), anterior region($1.52{\pm}0.75$), premolar region($1.14{\pm}0.90$) in turns. 2. Medication period was not correlation with gingival overgrowth score. 3. Clinical indices and gingival overgrowth score were as follows. 1) Plaque index and gingival overgrowth score was significantly correlated(p

• Journal of Korean society of Dental Hygiene
• /
• v.12 no.4
• /
• pp.733-739
• /
• 2012

Objectives : To Compare the degree of survival rate of gingival fibroblasts, which is concerned with teeth adherence based on the type of avulsed tooth's storage solution. Methods : Different media gingival fibroblasts were stored in Dulbecco's modified Eagle's medium(DMEM), Hank's balanced salt solution(HBSS), milk, saline, and green tea in for 1, 2, 3 hours. And, MTT assay was conducted to compare survival rate of human gingival fibroblasts. Results : 1. The survival rate of gingival fibroblasts in DMEM and HBSS was higher than thoes in other storage media( Milk> Saline> Green tea). 2. The survival rate of gingival fibroblasts in milk, saline and green tea decreased as time passed. 3. Because of low osmotic pressure, green tea showed decrease of survival rate of gingival fibroblasts. Conclusion : DMEM and HBSS were the most effective storage media for gingival fibroblast. Among milk, saline, green tea, milk is most effective storage media for keeping gingival fibroblasts. Milk is recommended for storage media of avulsed tooth for keeping viability of cells.

• The Journal of the Korean dental association
• /
• v.55 no.7
• /
• pp.450-456
• /
• 2017

The purpose of this case report is to present a case of free gingival graft for treatment of mandibular incisor labial gingival recession relapsed after laterally positioned flap surgery. A 22 year-old female patient with discomfort and labial gingival recession on left mandibular central incisor was treated. The patient had been treated root coverage on same site by laterally positioned flap surgery, but treated site had relapsed in one month. Exposed root surface was covered by free gingiva from left palatal area. Although gingival color did not completely match with adjacent gingiva, more than 5mm keratinized gingiva was attained. The patient showed no further recurring pain and recession on gingiva after 5 months from the surgery. In conclusion, the root coverage with gain of keratinized gingiva could be achieved through free gingival graft from palate on relapsed gingival recession.

• The Journal of Korean Academy of Prosthodontics
• /
• v.16 no.1
• /
• pp.27-31
• /
• 1978

A total of 200 patients, ranging in age from 20 to 60 years, were selected for the study. Each had at least one tooth which was restored with complete cast gold crown and a nonrestored contralateral tooth with no clinical evidence of caries and periodontal disease. The gingival tissues adjacent to the crowned and nonrestored teeth were examined to determine the evaluation of the severity of inflammation and probed to determine individual pocket depth. The findings are listed here. 1. The average sulcus bleeding index of the gingival tissues adjacent to crowned teeth was 1.99. The average sulcus bleeding index of the gingival tissues adjacent to nonrestored teeth was 0.67. 2. The average gingival sulcus depth adjacent to crowned teeth was 2.19mm. The average gingival sulcus depth adjacent to non restored teeth was 1.68mm. 3. No difference could be found between the average gingival sulcus bleeding index and average gingival sulcus depth of male and those of female. 4. The difference between sulcus bleeding index of the gingival tissues adjacent to crowned teeth and sulcus bleeding index of the gingival tissues adjacent to nonrestored teeth increased with increased age of the cast crown.