• Journal of Periodontal and Implant Science
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• 제28권3호
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• pp.517-523
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• 1998

The purpose of this study was to investigate the width of attached gingiva of young adults with healthy gingiva. We compared the differences according to the tooth location. The width of attached gingiva of maxilla and mandible was measured by histochemical method. The results were as follows: 1. The width of buccal keratinized gingiva in maxilla was widest in incisors(5.2-5.6mm) and narrowest in first bicuspids(4.4-4.5mm). 2. The width of buccal keratinized gingiva in mandible was widest in incisors(4.3-4.5mm) and narrowest in first bicuspids(3.2-3.3mm). 3. The width of lingual keratinized gingiva in mandible was widest in first molars(5.5-5.6mm) and narrowest in incisors(2.9-3.0mm). 4. The width of buccal attached gingiva in maxilla was widest in incisors(4.1-4.4mm) and narrowest in molars (3.0mm). 5. The width of buccal attached gingiva in mandible was widest in incisors(3.2-3.4mm) and narrowest in second molars (1.7-1.8mm). 6. The width of lingual attached gingiva in mandible was widest in first molars(3.5-3.7mm) and narrowest in incisors(1.9-2.1mm).

• Journal of Periodontal and Implant Science
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• 제30권1호
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• pp.179-187
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• 2000

The objectives of this study were to measure keratinized gingival thickness in healthy Korean adults, and to correlate the keratinized gingival thickness with width of keratinized gingiva, probing pocket depth and gingival recession.Thickness measurements were performed in 37 Korean dental students using an ultrasonic device(SDM). Width of keratinized gingiva, gingival recession and probing pocket depth were measured with a Williams periodontal probe.The results showed that the keratinized gingival thickness varied from 0.83 mm(canines) to 1.16 mm(central incisors) in the maxilla and, in the mandible, from 0.68 mm(1st premolars) to 1.69 mm(2nd molars). In a stepwise multiple linear regression analysis, 23% of variation of gingival thickness could be explained by width of keratinized gingiva and probing pocket depth. It could be concluded that the keratinized gingival thickness depends on tooth type and correlates with width of keratinized gingiva and probing pocket depth.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.15-25
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• 1994

Keratinized ginigva has clinical singificance in periodontal health because it plays important roles in resistance to mechanical trauma, to penetration of bacteria, and to tensional stress by muscle attachment. In order to investigate the width change of anterior keratinized gingvial during transitional period, the width of kerainized gingiva on anterior teeth was measured annually in elementary school children with deciduous dentition until the successive anterior teeth were completely erupted. The distance from the gingival margin on mid-portion of crown to mucogingival junction was measured by Boley gauge(Hu-Friedy, U.S.A.) and was recorded as the width of keratinized gingiva. The difference of the width of keratinized gingiva according to sex and dentition was analyzed statistically by Student t-test. Following results were obtained : 1. In deciduous dentition, it was shown that the width of keratinized gingiva on maxillary central incisors($3.28{\pm}0.83mm$) was the widest(p<0.01), and that on maxillary lateral incisors, mandibular central and lateral incisors was $2.69{\pm}0.86mm$, $2.51{\pm}0.71mm$, $2.43{\pm}0.68mm$, respectively. 2. In mixed dentition, it was shown that the width of keratinized gingiva on maxillary central incisors ($5.10{\pm}0.86$) was the widest(p<0.01), and that on maxillary lateral incisors, mandibular central and lateral incisors was $4.35{\pm}0.83mm$, $3.51{\pm}0.60mm$, $3.57{\pm}0.66mm$, respectively. 3. The width of anterior keratinized gingiva was significantly increased after the successive anterior teeth were completely erupted(p<0.001). The width of keratinized gingiva on maxillary central and lateral incisors, and mandibular central and lateral incisors was increased by $1.82{\pm}0.83mm$, $1.65{\pm}0.69mm$, $0.99{\pm}0.39mm$, and $1.14{\pm}0.98mm$, respectively. 4. There was no statistical significance in the difference of the width of anterior keratinized gingiva between male and female(p>0.05).

• Journal of Periodontal and Implant Science
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• 제28권4호
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• pp.785-797
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• 1998

This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권6호
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• pp.417-421
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• 2020

Objectives: The purpose of this paper is to introduce an effective technique to easily obtain adequate amounts of keratinized gingiva and vestibular depth. Materials and Methods: Free gingiva (vertical height 10 mm) was harvested on the palatal mucosa and a partial thickness flap was elevated on the recipient site with same width as the free gingiva graft. After a conventional suture, a titanium mesh covered the graft and was fixed with miniscrews. Titanium mesh was removed 4.1±2.5 weeks after surgery. The amount of keratinized gingiva and vestibular depth was measured at the final follow-up. Results: Nine patients (males 4, females 5; 53.9±14.1 years) who underwent bone graft surgery before vestibuloplasty were included. No free gingival graft failure or complications were encountered in any of the patients. The relapse rate for vestibular depth (23.3%) was lower than that for keratinized gingiva (48.3%) after 34.4±14.4 months (P=0.010). Conclusion: Vestibuloplasty with a free gingival graft using titanium mesh could be achieved with an acceptable amount of keratinized gingiva and an appropriate vestibular depth around dental implant.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.305-318
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• 2006

This study was performed to evaluate the effect on the formation of keratinized attached gingiva when free gingival graft with strip technique was used. After the partial thickness flap was prepared, it was positioned apically more than 7mm using mucoperiosteal suture. At the donor site, strip was achieved with 2mm width, less than 1mm thickness, (mesiodistal teeth length + 6)$^{\ast}$2 mm length. Then, it was divided into 2 same pieces and located at the recipient bed apico-coronally with more or less 3mm interval. Follow-up check was made at 1,2,4,8,12 weeks after the operation. The results of this study were as follows : 1. The inter-strip space was mostly filled with keratinized attached gingiva. 2. The contraction of the graft was nigligible, and 92% of planned area was filled with keratinized attached gingiva. 3. The inconvenience of the patients at donor site was minimal. 4. The width of the strip was widened. In conclusion, free gingival graft using strip technique is useful to achieve the keratinized attached gingiva maximally with free gingival graft minimally and to minimize the inconvenience of donor palatal site of the patients.

• Journal of Periodontal and Implant Science
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• 제41권4호
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• pp.185-191
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• 2011

Purpose: The objective of this study was to compare and evaluate the inflammatory responses of three widely used suture materials in the keratinized gingiva and buccal mucosa of beagle dogs. Methods: Silk, polyglycolic acid, and nylon sutures were placed within the mandibular keratinized gingiva and maxillary buccal mucosa of four male beagle dogs. Biopsies were taken 3, 7, and 14 days after suturing. Specimens were prepared with hematoxylineosin stain for evaluation under a light microscope. Results: The suture materials placed in the oral mucosa elicited more inflammatory reactions than did those placed in the keratinized gingiva. The multifilament suture materials caused more inflammatory tissue reactions than did the monofilament suture materials in the oral mucosa. Conclusions: If oral hygiene is well maintained and suture materials are placed in the keratinized gingiva, silk, nylon, and polyglycolic acid are considered to be proper suture materials for oral surgery. However, it is advisable to use monofilament suture materials if the suture site is within the oral mucosa.

• 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.

• 대한치과의사협회지
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• 제55권3호
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• pp.240-248
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• 2017

A keratinized gingiva is important to the natural teeth and it is more essential to the health of the peri-implant mucosa of the implants. There are various surgical methods to restore a keratinized gingiva. First, a clinician could utilize apically positioned flap operation. This flap operation technique could be used as a full or partial thickness. If there is little keratinized gingival tissue available for the apically positioned flap operation, free gingival grafting should be used. Its technique sensitivity is relatively high, but using various surgical techniques and disciplines makes it simple and have the good predictability. There have been many considerations for those surgical techniques. Clinicians who treat for periodontitis or operate implant surgeries have to know the considerations and surgical methods.

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.761-776
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• 2005

The purpose of the present study was to examine the relationship between the form of the clinical crowns in the maxillary anterior segment and the clinical feature of gingiva such as morphological characteristics and the gingival thickness. Fifty periodontally healthy subjects were clinically examined regarding the probing depth, the thickness of the free gingiva, and the width of the keratinized gingiva. From study models of the maxillary anterior region, the width at cervical third(CW) and the length(CL) of the clinical crown, the papillary height, and the gingival angle of the 6 anterior teeth were measured. Each tooth was classified into 4 groups (longnarrow, NL; narrow, N; wide, W; short-wide, WS) according to CW/CL ratio and all the data were compared between groups NL and WS using independent t-test. Stepwise multiple regression analysis was performed for each tooth region with the gingival thickness at the level of sulcus bottom, the width of keratinized gingiva, and gingival angle as the dependent variables. As the results, the NL group of the upper anterior teeth displayed, higher papilla height, and narrower keratinized gingiva, more acute gingival angle resulting in pronounced "scalloped" contour of the gingival margin, compared to the WS group. There was no significant difference between groups NL and WS with respect to probing depth and the gingival thickness. The regression analyses demonstrated that the gingival thickness in central incisors was significantly associated to the mesio-distal width and bucco-lingual width of the crown, and labial probing depth. The width of keratinized gingiva was significantly associated with labial probing depth in central incisors and with proximal probing depth and gingival angle in lateral incisors, and with labial and proximal probing depth, and gingival angle in canines. The gingival angle was significantly associated with papillary height and CW/CL ratio and additionally with proximal probing depth in central incisors, with the width of keratinized gingiva in lateral incisors, and with labial probing depth and the width of keratinized gingiva in canines. These results indicate that the form of clinical crown in upper anterior region could influence the clinical feature of gingiva and the influencing factors might be different according to the tooth region.