• Journal of Periodontal and Implant Science
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• 제53권6호
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• pp.417-428
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• 2023

Purpose: To investigate the effect of xenogeneic collagen matrix (XCM) with polydeoxyribonucleotide (PDRN) for gingival phenotype modification compared to autogenous connective tissue graft. Methods: Five mongrel dogs were used in this study. Box-type gingival defects were surgically created bilaterally on the maxillary canines 8 weeks before gingival augmentation. A coronally positioned flap was performed with either a subepithelial connective tissue graft (SCTG) or XCM with PDRN (2.0 mg/mL). The animals were sacrificed after 12 weeks. Intraoral scanning was performed for soft tissue analysis, and histologic and histomorphometric analyses were performed. Results: One animal exhibited wound dehiscence, leaving 4 for analysis. Superimposition of STL files revealed no significant difference in the amount of gingival thickness increase (ranging from 0.69±0.25 mm to 0.80±0.31 mm in group SCTG and from 0.48±0.25 mm to 0.85±0.44 mm in group PDRN; P>0.05). Histomorphometric analysis showed no significant differences between the groups in supracrestal gingival tissue height, keratinized tissue height, tissue thickness, and rete peg density (P>0.05). Conclusions: XCM soaked with PDRN yielded comparable gingival augmentation to SCTG.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.172-181
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• 2023

Purpose: To investigate the effect of epidermal growth factor (EGF) with collagen matrix (CM) for increasing gingival thickness. Materials and Methods: In five mongrel dogs, bilateral gingival defects were surgically made on the maxillary canines. After two months, either a subepithelial connective tissue graft (group SCTG) or CM with EGF (0.1 ug/ml, group EGF) was grafted, and the flap was coronally positioned to cover the graft materials. The animals were sacrificed after three months. Intraoral scanning was performed for soft tissue analysis. Histologic and histomorphometric analyses were performed. Result: Two animals exhibited wound dehiscence during the healing phase, leaving three for analysis. No statistically significant difference was found in soft tissue changes (P>0.05). The level of gingival margin (GM) increased in both groups (1.02±0.74 mm in group SCTG vs. 1.24±0.83 mm in group EGF). Linear increases at the GM pre-augmentation in the soft tissue profile were 1.08±0.58 mm in group SCTG and 0.96±0.73 mm in group EGF. Histomorphometric parameters (keratinized tissue height, tissue thickness, and rete peg density) were not significantly different between the groups (P>0.05). Conclusion: EGF loaded onto CM led to comparable gingival phenotype enhancement to SCTG.

• Journal of Periodontal and Implant Science
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• 제11권1호
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• pp.47.1-47.1
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• 1981

• Journal of Periodontal and Implant Science
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• 제51권1호
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• pp.30-39
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• 2021

Purpose: The present study was undertaken to examine whether periodontal probe visibility (PV) accurately reflects gingival thickness (GT) and to identify factors affecting PV using cluster and multivariate analyses. Methods: The clinical characteristics of the maxillary central incisors (n=90 subjects) were examined. Clinical photographs, sex, PV, probing depth, gingival width, papilla height, GT as measured with an ultrasonic device, and the ratio of crown width to crown length were recorded. Multivariate analysis, using multinomial baseline-category logistic regression, was used to identify factors predictive of PV. Cluster analysis was used to identify gingival biotypes. Results: In the multivariate analysis, sex was the only significant predictor of PV (odds ratio, 6.48). Two clusters of subjects were created based on morphometric parameters. The mean GT among cluster A subjects was significantly lower than that among cluster B subjects (P=0.015). No significant difference was found between cluster A and B subjects in terms of PV score (P=0.583). Conclusions: Periodontal PV was not associated with GT as measured directly using an ultrasonic device. Sex was a highly significant predictor of periodontal PV. GT was found to be correlated with morphological characteristics of the periodontium.

• Journal of Periodontal and Implant Science
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• 제23권3호
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• pp.605-621
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• 1993

The gingival hyperplasia refers to an increase in the size of the gingival tissue produced by an increase in the number of its component cells. In order to investigate the cellular change in epithelium and subepithelial tissue of noninflammatory gingival hyperplasia, the gingival tissues were surgically obtained from the patients with dilantin gingival hyperplasia and idiopathic gingival hyperplasia. The excised tissue samples were fixed in neutral formalin for 6-24 hours, embedded with paraffin, sectioned at $4-6{\mu}m$ in thickness, mounted on glass slides coated with 3-aminopropyltriethoxysilane(Sigma Chemical Co., St. Louis, MO, U.S.A.) and immunocytochemically processed by Avidin-Biotin peroxidase complex method for detecting proliferating cell nuclear antigen, tenascin and collagen type IV. Monoclonal mouse anti-human PCNA antibody(Oncogene Science, Uniondale, NY, U.S.A., 1 : 250,000), monoclonal mouse anti-human tenascin antibody(Chemicon-International Inc., Temecula, CA, U.S.A., 1:5,000), and monoclonal mouse anti-human collagen type IV(Dakopatts, Glostrup, Denmark, 1: 50) were used as primary antibodies. The results were as follows: 1. In non-inflammatory gingival hyperplasia, the positive reaction to proliferating cell nuclear antigen was localized in the basal cell layer of gingival epithelium and well-developed rete pegs. 2. The positive reaction to tenascin was shown in the connective tissue subjacent to basament membrane of gingival tissue, and especially strong positive reaction was noted in the tip portion of connective tissue projections. 3. The positive reaction to collagen type IV was localized along the basement membranes of gingival epithelium and blood vessels. The results suggest that connective tissue enlargement may affect the proliferation of gingival epithelium.

• Journal of Periodontal and Implant Science
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• 제43권6호
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• pp.283-290
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• 2013

Purpose: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. Methods: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. Results: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). Conclusions: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.

• Restorative Dentistry and Endodontics
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• 제20권1호
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• pp.152-163
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• 1995

This experiment was performed to observe the adhesion pattern and microleakage in the gingival margin according to variation in the resin cement thickness which results from thickness of Die spacer. which is considered to effect the adaptability of the composite resin inlays. Clearfil CR inlays were fabricated on stone models with CR Sep applicated once and Nice fit twice, 4 times, and 6 times each. After 2nd curing within the CRC-100 oven, CR inlays were cemented with CR inlay cement. Dye(2% methylene blue) penetration and adhesion pattern were evaluated after sectioning of gingival margin into :3 pieces. The results were as follows ; 1. The thickness of resin cement showed unevenchanging pattern with that of die spacer, namely, it was increased until 4 times' application of Nice-Fit but was decreased with 6 times' application of that. 2. The degree of dye penetration wasn't affected by cement thickness within a limited value. 3. Most of dye penetration was shown through the interface between cement and enamel rather than the interface between cement and CR inlay. This shows that the affinity of resin cement for CR inlay was superior to the adhesive strength with tooth structure. 4. No gap was found at the interface between enamel and cement but some showed separation between dentin and cement. It is concidered that the contraction force of cement was less than the bond strength with the enamel. 5. Lots of voids were found in the CR inlay and resin cement. There was a pooling tendency of bonding agent and cement in the axiogingival line angle portion. 6. In some specimens, cracks were shown in enamel margin. From this it could be considered that cavity preparation and surface treatment weakened the tooth structure.

• Restorative Dentistry and Endodontics
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• 제16권2호
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• pp.43-61
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• 1991

Present - day inlay casting procedures have been developed for more than 100 years and experimentation has focused on the perfect adaptation to the cavity preparation. Marginal adaptation is considered to be an important indicator of the acceptability of the cast restotration, especially on the gingival margin. The purpose of this study was to evaluate the effects of a dissecting microscope and burnishing on vertical discrepancies, horizontal discrepancies, and cement thicknesson master die. Extracted premolars were prepared for class II gold inlays and master dies were made with conventional techniques. The experiments consisted of 4 groups. Group 1 : unaided eye, no burnishing on master die. Group 2 : unaided eye, burnishing on master die. Group 3 : microscope, no burnishing on master die. Group 4 : microscope, burnishing on master die. Cemented inlays were embedded in the hard resin and sectioned with microcutter through the gingival margins. The sectioned surfaces were polished with emery paper and finally with aluminum oxide powders. The results of the experiments were measured for vertical discrepancies, horizontal discrepancied and cement thickness under the scanning electron microscpe at the beveled gingival margin. The results of the study were summarized as follows. 1. Group 1 showed the vertical discrepancies of $81.6{\mu}m({\pm}48.6{\mu}m)$, horizontal discrepancies of $60.1{\mu}m({\pm}41.1{\mu}m)$, and cement thickness of $59.6{\mu}m({\pm}24.6{\mu}m)$. 2. Group 2 showed the vertical discrepancies of $78.6{\mu}m({\pm}30.9{\mu}m)$, horizontal discrepancies of $36.9{\mu}m({\pm}20.7{\mu}m)$, and cement thickness of $54.0{\mu}m({\pm}21.6{\mu}m)$. 3. Group 3 showed the vertical discrepancies of $57.5{\mu}m({\pm}26.4{\mu}m)$, horizontal discrepancies of $28.4{\mu}m({\pm}17.5{\mu}m)$, and cement thickness of $37.2{\mu}m({\pm}17.4{\mu}m)$. 4. Group 4 showed the vertical discrepancies of $56.7{\mu}m({\pm}35.0{\mu}m)$, horizontal discrepancies of $31.8{\mu}m({\pm}24.2{\mu}m)$, and cement thickness of $45.6{\mu}m({\pm}19.8{\mu}m)$. 5. Vertical discrepancies were not significantly different at any groups(p>.050). 6. Microscope groups(Group 3, 4) showed significantly improved horizontal marginal adaptation (p<.050). 7. Although cement thickness showed the subset of Group 3. 4, 2 and Group 4, 2, 1. Group 3 showed significantly smaller thickness than Group l(p<.050). 8. Finishing and polishing by means of a microscope produced significantly smaller discrepancies than doing so with the unaided eye(p<.050).

• Journal of Periodontal and Implant Science
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• 제35권2호
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• pp.359-369
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• 2005

It has been suggested that morphologic characteristics of the periodontium are partly related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or "biotypes". The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary anterior tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. The thickness of gingiva was measured by ultrasonic device(SDM). 100 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, gingival recession, width of keratinized gingiva, thickness of the keratinized gingiva. From maxillary study cast, the width(at the apical third-CW) and the length(CL) of the crowns of the 6 anterior teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. The 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow(group N) or a short-wide(group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long-narrow form of the central incisors displayed, compared to individuals with a short-wide crown, form (l) a narrow zone of keratinized gingiva, (2) a pronounced "scalloped" contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the keratinized gingiva. The CW/CL-ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisors and canine tooth region. The regression analyses demonstrated that the thickness of the keratinized gingiva in central, lateral incisors and canines was significantly related to the width of the keratinized gingiva.

• Journal of Periodontal and Implant Science
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• 제41권4호
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• pp.201-207
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• 2011

Purpose: The aim of this study is to compare two different gingival depigmentation techniques using an erbium:yttrium-aluminum-garnet (Er:YAG) laser and rotary instruments. Methods: Two patients with melanin pigmentation of gingiva were treated with different gingival depigmentation techniques. Ablation of the gingiva by Er:YAG laser was performed on the right side, and abrasion with a rotary round bur on the opposite side. Results: The patients were satisfied with the esthetically significant improvement with each method. However, some pigment still remained on the marginal gingival and papilla. The visual analog scale did not yield much difference between the two methods, with slightly more pain on the Er:YAG laser treated site. Conclusions: The results of these cases suggest that ablation of the gingiva by an Er:YAG laser and abrasion with a rotary round bur is good enough to achieve esthetic satisfaction and fair wound healing without infection or severe pain. Prudent care about the gingival condition, such as the gingival thickness and degree of pigmentation along with appropriate assessment is needed in ablation by the Er:YAG laser procedure.