• Title/Summary/Keyword: Gingival recession

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Management of Gingival Oral Lichen Planus with Free Gingival Graft: 10-Year Follow-Up Case Report

  • Chang, HeeYung;Shim, YoungJoo
    • 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.

Evaluation of the Availability of Implant placement using Ridge Expansion Osteotomy (REO) (치조능확장골절단술을 이용한 임프란트 식립술의 유용성 평가)

  • Kim, Yeong-Gyun;Yun, Pil-Yeong;Kim, Beom-Su
    • The Journal of the Korean dental association
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    • v.46 no.4
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    • pp.243-247
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    • 2008
  • Purpose : Ridge expansion osteotomy (REO) has been introduced when it is necessary to expand narrow crestal ridge with simultaneous implant placement. This study has designed to evaluate the clinical availability of REO. Materials and methods : Subject were patients who had visited Seoul National University Bundang Hospital from July. 2003 to December, 2005 for implant placement using REO by one surgeon. Intraoperative and postoperative complication, failure of initial osseointegration and marginal bone resorption were estimated using electronic medical record and periapical radiography. Twenty?three patients, 8 males and 15 females, mean age 51, ranged 18 to 72, were treated for mean 26 months, ranged from 16 months to 46 months. Results : Mean diameter and length of implants placed at upper anterior, were 3.72mm and 13.32mm each other. Guided bone regeneration and ridge splitting were accompanied in this study. Five cases of cortical bone fracture, three cases of crestal bone loss more than 2mm, 2cases of gingival recession, and 2 cases of infection were noted, but there were no implants removed because of disintegration. Success rate of implant was 91.7%, even if survival rate of implant was 100%. In addition, there were no statistical significance between the success rate of REO and bone graft(p>0.05). Conclusion : Based on the results of the present study, it can be concluded that REO technique is reliable for implant placement at atrophic ridge with adequate height compared to bone graft and other osteotomies for ridge expansion, but care should be taken of esthetic problem such as gingival recession because of crestal bone resorption from trauma by osteotome.

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A comparative study of clinical effects following treatment of class II furcations using allograft and PR with and without bioabsorbable membrane (2급 이개부 병변을 동종골과 혈소판 농축 혈장으로 치료시 차폐막 사용에 따른 임상적 효과의 비교 연구)

  • Park, Soon-Jae;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.32 no.3
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    • pp.631-642
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    • 2002
  • The present study evaluated of regeneration effect of platelet rich plasma on the treatment of classII furcation involvement, with allograft in humans. The control was treated without bioabsorbable membrane, and the test was treated with bioabsorbable membrane. Pocket depth, clinical attachment level, and gingival recession were measured at baseline, postoperative 3, 6months. Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. The change of pocket depth and clinical attachment level in both groups was decreased significantly at 3, 6months.(p<0.05) 2. The change of gingival recession in both groups was increased significantly at 3, 6months than at baseline.(p (0.05) 3. The change of pocket depth and clinical attachment level in both groups was increased significantly at 3, 6months, but there were no statistically or clinically significant differences with both groups. 4. The change of gingival recession in both groups was increased significantly at 3, 6months, but there were no statistically or clinically significant differences with both groups. 5. The significant reduction of the pocket depth and clinical attachment level exhibited marked changes at 3 months in both groups. In conclusion, the results of this study suggest that there are no statistically or clinically significant differences between with and without bioabsorbable membrane on treatment of classII furcations using allograft and PRP

A Clinical Comparision of Nonresorbable and Resorbable Membrane in the Treatment of Human Class II Furcation Defects (II급 치근이개부병변에서 비흡수성막과 흡수성막을 이용한 조직유도재생술의 임상적 비교)

  • Jang, Chae-Yun;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.31 no.4
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    • pp.689-711
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    • 2001
  • The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.

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A comparative study of the clinical effects of PRP and non-absorbable membrane in the treatment of mandibular class II furcations (하악 2급 이개부 병변 치료시 비흡수성 차폐막과 혈소판 농축 혈장의 임상적 효과에 대한 비교 연구)

  • Kim, Chang-Ho;Lim, Sung-Bin;Chung, Chin-Hyung;Hong, Ki-Seok
    • Journal of Periodontal and Implant Science
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    • v.34 no.3
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    • pp.509-522
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    • 2004
  • This study was performed to compare the clinical effectiveness of two regenerative techniques for class II furcation involvements in human: a combination of bone grafts with PRP vs. GTR with bone grafts. The e-PTFE group was treated with non-absorbable membrane and bone grafts, the PRP group was treated with PRP and bone grafts Pocket depth, clinical attachment level, and gingival recession were measured at baseline and postoperative 6 months. Vertical and horizontal furcation depth were measured by re-entry surgeries at 6 months post-treatment Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was decreased significantly at 6 months than at baseline. (p<0.05) 2. The change of gingival recession in both groups was increased significantly at 6 months than at baseline. (p<0.05) 3. The change of alveolar crest absorption in both groups was increased at 6 months than at baseline but there were no statistically significant differences. 4. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was increased significantly at 6 months, but there were no statistically or clinically significant differences with both groups. 5. The change of gingival recession and alveolar crest absorption in both groups was increased at 6 months, but there were no statistically or clinically significant differences with both groups. In conclusion, the use of bone graft with PRP or GTR technique improved clinical index of the soft and hard tissue in mandibular class II furcation involvement but there were no statistically or clinically significant differences between bone graft with PRP and GTR technique.

Comparative Clinical Study on the Treatment Effects Following Modified Widman Flap and Modified Flap (Modified Widman Flap과 Modified Flap 후의 치료효과에 관한 임상적 비교연구)

  • Hong, Sung-Woo;Park, Young-Chae;Lee, Kwang-Soo;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.30 no.1
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    • pp.157-168
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    • 2000
  • Periodontal surgery can be directed to remove the irritants from the tooth surface and reduce the periodontal pocket. The purpose of this study is to compare the clinical effects after between modified Widman flap and modified flap in periodontal patients. Ninety six molar area teeth of 9 patients were used. One of sextants performed a modified Widman flap, while the other side performed a modified flap. After initial periodontal therapy, the following measurements prior to surgery(baseline) were taken : pocket depth, gingival recession, clinical attachment level, tooth mobility, bleeding on probing. Also these measurements were taken at 4 weeks, 8weeks, and 12 weeks after surgery. Significant decrease of pocket depth was shown in both techniques, and the degree of decrease was significant in modified flap than modified Widman flap at 12 weeks. Significant increase of gingival recession was shown in both techniques, and the degree of increase was significant in modified Widman flap than modified flap at 4 weeks, 8 weeks, and 12 weeks. Significant attachment gain was shown in both techniques, and the degree of increase was significant in modified flap than modified Widman flap at 4 weeks, 8 weeks, and 12 weeks. Significant increase of tooth mobility was shown in both techniques at 4 weeks, but the decrease of tooth mobility was shown at 12 weeks. Greater decrease of bleeding on probing was shown in both techniques at 4 weeks. Modified flap was better than modified Widman flap in the decrease of gingival recession and the attachment gain. These results indicate that modified flap operation is better than modified Widman flap operation in the effect of periodontal treatment.

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The laterally closed tunnel for the treatment of mandibular gingival recession in thin biotype patients: case report (얇은 치주 생체형 환자에서 교정 치료 후 발생한 하악 전치부 치은 퇴축에 대한 laterally closed tunnel procedure의 처치: 증례보고)

  • Kim, Hyun-Joo;Kwon, Eun-Young;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.253-259
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    • 2019
  • In this case report, gingival recession of the mandibular anterior teeth was treated with a laterally closed tunnel technique. Two patients had altered the inclination of mandibular anterior tooth during past orthodontic treatment and had periodontal thin biotype. The recipient site was formed by tunneling method, and the connective tissue graft obtained from the palatal side was placed in the tunnel, and the margins of flap were gathered at the center of the root and sutured. Despite the thin periodontal biotype, the root coverage was successfully obtained, keratinized gingiva was increased, and aesthetics were achieved by harmonizing with surrounding tissues in terms of shape and color.

Connective tissue graft for root coverage (결합조직이식을 이용한 노출된 치근피개)

  • Park, Jae-Young;Kim, Wan-Su;Yun, Woo-Hyuk;Kim, Yun-Sang;You, Hyung-Keun;Shin, Hyung-Shik;Pi, Sung-Hee
    • Journal of Periodontal and Implant Science
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    • v.38 no.2
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    • pp.231-236
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    • 2008
  • Purpose: The treatment of gingival recessions is needed to reduce root sensitivity and improve esthetical satisfaction. Several surgical techniques have been proposed to achieve these goals. The use of connective tissue grafts has made esthetic root coverage a predictable procedure. Numerous clinical studies have represented that using connective tissue grafts to cover exposed root surface showed high success rates. This is a case report which demonstrates the technique to obtain root coverage of a buccal recession defect. Materials and Methods: A 35-year-old patient with a high level of oral hygiene was selected for the study. This patient had one Class I Miller recession defect in the mandible. A coronally advanced flap in combination with the connective tissue graft was chosen for the treatment. After surgery, the patient was told to visit the hospital once a week for his oral management and professional prophylaxis. The depth of initial recession was 4.0 mm. Result: After three months, it reduced to 0.0 mm, and the average recession reduction was 4.0 mm. The average root coverage was 100%. Conclusion: The connective tissue graft is both effective and predictable way to produce root coverage in increasing the width of CAL and KT of various adjacent gingival recessions.

Clinical and patient-reported outcomes after recession coverage using modified vestibular incision subperiosteal tunnel access with a volume-stable collagen matrix as compared to a coronally advanced flap with a subepithelial connective tissue graft

  • Chun-Teh Lee;Marlena Lange;Alain Jureidini;Nurit Bittner;Ulrike Schulze-Spate
    • Journal of Periodontal and Implant Science
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    • v.52 no.6
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    • pp.466-478
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    • 2022
  • Purpose: Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. Methods: Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. Results: All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. Conclusions: The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.