• 제목/요약/키워드: Mucogingival surgery

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교정 치료 중인 환자의 치주수술 (Mucogingival surgery for patients under orthodontic treatment)

  • 박신영
    • 대한치과의사협회지
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    • 제55권3호
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    • pp.249-256
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    • 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.

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A combined approach to non-carious cervical lesions associated with gingival recession

  • Yang, SungEun;Lee, HyeJin;Jin, Sung-Ho
    • Restorative Dentistry and Endodontics
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    • 제41권3호
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    • pp.218-224
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    • 2016
  • Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs.

Clinical evaluation of root coverage in Miller class III/RT2 labial gingival recession treated with interdisciplinary periodontal-orthodontic therapy: a randomized controlled clinical trial

  • Sakshi Malhotra;Shikha Tewari;Rekha Sharma;Rajinder Kumar Sharma;Nishi Tanwar;Ritika Arora
    • Journal of Periodontal and Implant Science
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    • 제54권4호
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    • pp.265-279
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    • 2024
  • Purpose: The aim of current study was to evaluate percentage root coverage (RC%) in isolated Miller class III/RT2 labial gingival recession (GR) associated with malaligned mandibular anteriors, using interdisciplinary periodontal-orthodontic treatment as compared to mucogingival surgery alone. Methods: Thirty-six systemically healthy patients having isolated Miller class III/RT2 GR with respect to malaligned mandibular anteriors, were randomly divided into test group: mucogingival surgery using subepithelial connective tissue graft followed by orthodontic treatment and control group: mucogingival surgery alone. Primary clinical parameters included (RC%), recession depth, keratinized tissue width, mid-labial clinical attachment level, interdental clinical attachment level (iCAL), periodontal phenotype (PP), gingival thickness (GT), root coverage esthetics score (RES) and hypersensitivity. Total duration of follow up was 12 months. Results: Mean RC% was significantly more achieved in test group (66.67%±40.82%) in comparison to control group (39.93%±31.41%) at the end of study (P=0.049). Further, complete root coverage was attained in 5/8 cases of test group versus 1/2 cases of control group after 3/12 months respectively. RES and hypersensitivity, showed statistically significant improvement after complete follow up period in both the groups. An ideal RES score of 10 was achieved in 4/7 cases of test group while in 1/2 cases of control group after 3/12 months respectively. Correlation analysis revealed significant negative correlation between RC% and iCAL. Correlation of RC% with GT and PP was non-significant. Conclusions: Interdisciplinary periodontal-orthodontic approach may be more beneficial in terms of achieving improved RC%, esthetic and resolution of hypersensitivity in the management of Miller class III/RT2 GR in malaligned mandibular anteriors.

항암제 Cyclophosphamide가 구강창상 치유에 미치는 영향에 관한 실험적 연구 (EXPERIMENTAL STUDY ON THE EFFECTS OF CYCLOPHOSPHAMIDE ON THE HEALING OF THE ORAL INCISED WOUND)

  • 김성수
    • 대한치과의사협회지
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    • 제15권2호
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    • pp.153-158
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    • 1977
  • To assure that cyclophosphamide has been considered something that must be effective to retard wound healing, the Author has studied clinically and histopathologically. All rabbits were incised on the mucogingival junction of anterior teeth in mandible about 1 Cm. in length with mucosa and periosteum layer. The 21 rabbits within 6 months old, weighing about 1.5-1.8 kg were divided into a experimental group and a control group. 1) Group 1 (Experimental group)-After 14 rabbits dieted as the control group were injected with Endoxan (=Cyclophosphamide) in dosage of 30mg per 1kg-body weight intramuscularly, the surgery was performed. 2) Group 2 (Control group)-the surgery in this group was performed without Endoxan. The rabbits were sacrificed on the 1st, 3rd, 5th, 7th, 10the, 14th day after surgery and microscopic slides were made with H-E stain. The results might be summarized as follows; 1) Cyclophosphamide effected to retard healing process on the incised wound of oral mucosa and connective tissue. 2) Control wounds were healed by the 7th day after surgery. 3) Comparison between control and experimental wound did not show significant differences 14th day after surgery.

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Clinical evaluation of a collagen matrix to enhance the width of keratinized gingiva around dental implants

  • Lee, Kang-Ho;Kim, Byung-Ock;Jang, Hyun-Seon
    • Journal of Periodontal and Implant Science
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    • 제40권2호
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    • pp.96-101
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    • 2010
  • Purpose: The purpose of this study was to evaluate the effect of collagen matrix with apically positioned flap (APF) on the width of keratinized gingiva, comparing to the results of APF only and APF combined with free gingival graft (FGG) at the second implant surgery. Methods: Nine patients were selected from those who had received treatments at the Department of Periodontics, Chosun University Dental Hospital, Gwangju, Korea. We performed APF, APF combined with FGG, and APF combined with collagen matrix coverage respectively. Clinical evaluation of keratinized gingival was performed by measuring the distance from the gingival crest to the mucogingival junction at the mid-buccal point, using a periodontal probe before and after the surgery. Results: The ratio of an increase was 0.3, 0.6, and 0.6 for the three subjects in the APF cases, 3, 5, and 7 for the three in the APF combined with FGG case, and 1.5, 0.5, and 3 for the three in the APF combined with collagen matrix coverage case. Conclusions: This study suggests that the collagen matrix when used as a soft tissue substitute with the aim of increasing the width of keratinized tissue or mucosa, was as effective and predictable as the FGG.

임상가를 위한 특집 3 - 치주판막 절개의 기본원리 (Basic Rules of Incision in Periodontal Flap Preparation)

  • 신승일
    • 대한치과의사협회지
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    • 제50권8호
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    • pp.474-481
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    • 2012
  • The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.