• Title/Summary/Keyword: Keratinized gingiva

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TREATMENT OF INVERTED MAXILLARY INCISORS : CASE REPORT (역위매복된 상악 중절치의 외과적 노출과 교정력을 이용한 증례보고)

  • Kim, Jae-Yun;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.568-574
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    • 1997
  • Inverted maxillary incisor is a state in which the maxillary incisor rotates to the upward position. The present report provides two examples of correction of inverted maxillary incisors with surgical intervention & orthodontic appliance. Through surgical exposure & direct bonding of lingual button, the central incisor were brought into proper eruption path with elastic traction. The case 1 & 2 were both treated successfully. The results showed the good position of treated teeth and satisfactory esthetics and adequate width of keratinized gingiva were achieved. Careful differential diagnosis procedure is needed in order to avoid dissatisfactory results and the treatment approaches taken in this case report provided an esthetic and functional results.

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Clinical Evaluation of Passive Eruption Using Occlusal Reduction on Periodontium (교합면 삭제(occlusal reduction)를 이용한 수동적 정출 (passive eruption)이 치주조직에 미치는 영향)

  • Kim, Yoo-Jin;Kim, Sung-Jo;Choi, Jeom-Il;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.1
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    • pp.15-25
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    • 2012
  • The relationship between occlusion and periodontal health has been extensively studied. However, reports on the effects of passive eruption using occlusal reduction has not been sufficient. The purpose of the present randomized clinical trial was to assess the influence of passive eruption using occlusal reduction on the clinical periodontal parameters consisting of attachment level, pocket depth, tooth mobility, width of keratinized gingiva and osseous defect. The study was performed on 40 teeth of 16 subjects who have been treated for the moderate periodontitis at the Department of Periodontology, Pusan National University Hospital. At the baseline examination, after hygienic-phase and after 6 month from passive eruption using occlusal reduction, clinical parameters were monitored and radiographs were taken. The 20 teeth in the test group received passive eruption using occlusal reduction while the 20 control teeth did not receive any occlusal reduction. The results were as follows; 1) Degree of inflammation of periodontium was improved by initial therapy 2) Teeth received passive eruption using occlusal reduction demonstrated significantly greater reduction in pocket depth, tooth mobility and amount of bone loss, and increase in the width of keratinized gingiva, but no significant changes in the attachment level compared to the control teeth 3) There was significantly greater reduction in pocket depth, mobility, amount of bone loss and attachment level in the test teeth after initial hygienic phase when compared with baseline data. Taken together, these results suggest that the passive eruption using occlusal reduction would be helpful to improve periodontal health.

Root coverage using subepithelial connective tissue graft (상피하 결합조직 이식편을 이용한 치근 피개술)

  • Kim, Jeong-Hyun;Herr, Yeek;Kwon, Young-Hyuk;Park, Joon-Bong;Chung, Jong-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.38 no.1
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    • pp.91-96
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    • 2008
  • Purpose: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. and Aestheic concerns are usually the reason to perform root coverage procedure. This case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft(SCTG) on Miller's Class I marginal tissue recession. Materials and Methods: One patient, with two Miller's class I marginal tissue recession on both maxiallay canines, was treated with root coverage using SCTG (modified Nelson's technique). At baseline, the following measurements were recorded: 1) recession depth; 2) width of keratinized giniga. At 9, 10 months post-surgery, all clinical measurements were repeated. Result: 1) The mean root coverage from baseline to 9, 10 months post-surgery was 92.3%. 2) The mean recession depth decreased from 6.5 mm to 0.5 mm. 3) The mean width of keratinized gingiva increased from 1.25 mm to 3.5 mm. Conclusion: Within the above results, root coverage using SCTG is an effective procedure to cover Miller's class I marginal tissue recession defect. Also, patient with aesthetic concern could be satisfied with this result.

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.

Case report of esthetic maxillary anterior crown lengthening (상악 전치부에서 심미적 치관 연장술의 치유 양상 보고)

  • Kim, Sun-Ha;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.39 no.2
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    • pp.199-204
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    • 2009
  • Purpose: Excessive gingival display and short clinical crowns due to altered passive eruptions are major concerns for a considerable number of patients visiting dental clinics. Altered passive eruptions could be corrected through various types of periodontal surgery conformable to a classification. 3 cases are reported here on the esthetic correction of altered passive eruption to evaluate results of crown lengthening procedure. Methods: Three patients whose major complaints were excessive gingival display and short teeth were picked out for this case study. Before treatment, clinical and radiological exam was performed to choose type of surgery. Thickness and width of keratinized gingiva was measured in all three patients then they were treated by surgical methods including flap operation and depigmentation under subsequent diagnosis. Results: Uneventful healing and stable gingival margin were observed in all three patients except recurrence of gingival pigmentation of one patient. Conclusions: The treatment of altered passive eruption requires precise diagnostic procedure and could achieve better esthetic outcomes when it is accompanied by other orthodontic and orthognathic treatment.

GUIDANCE OF ROOT FORMATION BY FORCED ERUPTION FOR INVERTED MAXILLARY CENTRAL INCISOR (역위 매복된 상악 중절치의 교정적 처치를 통한 치근 형성유도)

  • Jang, Eun-Young;Lim, Kwang-Ho;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.644-651
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    • 1999
  • It is a relatively common clinical experience to see an unerupted maxillary central incisor. This phenomenon is apparent at the dental age of almost eight years and over. Among the possible cause for failure of eruption, ectopic development of the tooth germ is mentioned. This is not fully understood but trauma or periapical imflammation of primary predecessors is accepted. The case with no history of trauma may be impacted by the periapical imflammation of primary predecessors. For bringing into the tooth eruption and the continued normal root developement by the Hertwig's epithelial root sheath, there are early considered of surgical invention and orthodontic traction with removable appliance. We reported successful treatment for inverted maxillary central incisor with proper eruption and normal root developement by forced eruption using removable appliance. But further observation will be required to evaluate the final root developement state and amount of keratinized attachment gingiva.

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ORTHODONTIC TRACTION OF HORIZONTALLY IMPACTED MAXILLARY CANINE (수평 매복된 상악 견치의 교정적 견인)

  • Choi, Hyung-Jun;Lee, Jong-Eun;Lee, Jae-Ho;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.4
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    • pp.600-604
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    • 2003
  • Tooth impaction is defined as a cessation of the eruption of a tooth at the level of the oral mucosa or alveolar bone. Maxillary canines are the most frequently impacted teeth next to the third molar. Maxillary canine impaction is associated with congenital missing of lateral incisors, peg lateralis and genetic factors such as ectopic positioning of a tooth germ. The clinicians have an important role in early detection of tooth impaction for prevention of esthetic and functional problems. There are specific methods to treat impacted tooth for different conditions. In this case, an 11-year-old girl with a horizontally impacted maxillary right canine in a palatal position was treated through orthodontic traction along with surgical button attachment procedure. On regaining of eruption space, canine traction was performed. At the completion of treatment, the canine was positioned fairly within the arch with proper keratinized gingiva and complications such as root resorption were not observed.

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Maxillary complete denture and mandibular All-on-4 implant restoration considering maintenance: a case report (유지 관리를 고려한 상악 총의치와 하악 All-on-4 임플란트 보철 수복 증례)

  • Kim, So-Yeun;Kwon, Eun-Young;Jung, Kyoung-Hwa;Jeon, Hye-Mi;Kang, Eun-Sook;Yun, Mi-Jung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.1
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    • pp.37-45
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    • 2019
  • In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.

Histological analysis on tissues around orthodontically intruded maxillary molars using temporary anchorage devices: A case report

  • Hui-Chen Tsai;Julia Yu-Fong Chang;Chia-Chun Tu;Chung-Chen Jane Yao
    • The korean journal of orthodontics
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    • v.53 no.2
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    • pp.125-136
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    • 2023
  • Before progress was recently made in the application of temporary anchorage devices (TADs) in bio-mechanical design, orthodontists were rarely able to intrude molars to reduce upper posterior dental height (UPDH). However, TADs are now widely used to intrude molars to flatten the occlusal plane or induce counterclockwise rotation of the mandible. Previous studies involving clinical or animal histological evaluation on changes in periodontal conditions after molar intrusion have been reported, however, studies involving human histology are scarce. This case was a Class I malocclusion with a high mandibular plane angle. Upper molar intrusion with TADs was performed to reduce UPDH, which led to counterclockwise rotation of the mandible. After 5 months of upper molar intrusion, shortened clinical crowns were noticed, which caused difficulties in oral hygiene and hindered orthodontic tooth movement. The mid-treatment cone-beam computed tomography revealed redundant bone physically interfering with buccal attachment and osseous resective surgeries were followed. During the surgeries, bilateral mini screws were removed and bulging alveolar bone and gingiva were harvested for biopsy. Histological examination revealed bacterial colonies at the bottom of the sulcus. Infiltration of chronic inflammatory cells underneath the non-keratinized sulcular epithelium was noted, with abundant capillaries being filled with red blood cells. Proximal alveolar bone facing the bottom of the gingival sulcus exhibited active bone remodeling and woven bone formation with plump osteocytes in the lacunae. On the other hand, buccal alveolar bone exhibited lamination, indicating slow bone turnover in the lateral region.

Regeneration of emergence profile with soft tissue graft and wide computer aided design/computer aided mamufacturing abutments: a clinical report (연조직 이식술과 넓은 computer aided design/computer aided mamufacturing 지대주를 이용한 임플란트 고정성 보철물의 출현윤곽 재현)

  • Kim, Min-Kyung;Lee, Ji-Hun;Ahn, Seung-Geun;Kim, Kyung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.4
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    • pp.364-370
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    • 2015
  • Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.