• Journal of Periodontal and Implant Science
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• v.28 no.3
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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 the korean academy of Pediatric Dentistry
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• v.5 no.1
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• pp.27-32
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• 1978

To corroborate that the width of attached gingiva should be changed according to ages, and what relationships between the changes and the results of Glickman's clinical tension test would be, The author measured the width of attached gingiva of 85 Korean children in male, 94 Korean children in female from 8 to 11 ages and performed clinical tension test. The results were as followings; 1) At midline region of each evaluated teeth, Width of attached gingiva was the narrowest at midline region of deciduous canine, and nearly same at midline region of central incisor and lateral incisor. 2) At interproximal region of each evaluated teeth, Width of attached gingiva between left and right central incisors was the narrowest, that of between deciduous canine and lateral incisor, and between lateral incisor and cental incisor were the widest at maxilla and All were nearly same at mandible. 3) In general, width of attached gingiva of interproximal region was wider than that of midline region. 4) In this study, width of attached gingiva tended to be increasing according to ages both at maxilla and at mandible. 5) Compared maxilla with mandible, Width of attached gingiva of maxilla was wider than that of mandible. 6) The results of tension test were it that Over-all incidence was the highest in 8 year old children who had the narrowest width of attached gingiva at frenum attached region and tended to be decreasing according to ages from 8 to 11 years.

• Journal of Periodontal and Implant Science
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• v.27 no.1
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• pp.235-248
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• 1997

The purpose of this study was to investigate the width of attached gingiva of 414 subjects with healthy gingiva, or early stage of gingivitis. We compared the differences according to the tooth location, age (Yonger group : $14{\sim}30$, Older group : $31{\sim}67$) and gender. In addition, we compared the width of attached gingiva in the subjects with less than 2 sites of gingival recession($Re{\leq}2$) and the subjects with more than 3 sites of gingival recession($Re{\geq}3$) to study the relationship between the gingival recession and the width of attached gingiva. The results were as follows : 1. The width of keratinized gingiva was widest in maxillary incisors($5.3{\pm}1.4mm$) and narrowest in mandibular right 1st bicuspid and mandibular right and left 2nd molars($3.5{\pm}1.1mm$). 2. The width of attached gingiva was widest in maxillary right central incisor($3.8{\pm}1.5mm$) and narrowest in mandibular right 2nd molar($1.2{\pm}1.0mm$). 3. In the comparison between the age groups, the width of keratinized in older group was significantly (p<0.05) wider than that in younger group in maxillary right and left 1st bicuspids, mandibular right and left 1st and 2nd molars, maxillary right and left cuspids and mandibular right 1st bicuspid. There was no significant difference in the width of attached gingiva between the two groups except for maxillary right and left 1st molars and maxillary left 2nd molar. 4. In the comparison between male group and female group, in maxillary right and and left lateral incisors and cuspids, mandibular right and left cuspids and 1st bicuspids, the width of attached gingiva in female was significantly(p<0.05) wider than that in male group. 5. In the comparison between the Re 3 group and Re 2 group, there was no significant difference except for maxillary right and left 2nd molars and maxillary left 1st molar. 6. The frequency of gingival recession was m the order of mandibular right 1st bicuspid(16.6%), maxillary right 1st bicuspid(13.7%), maxillary and mandibular left 1st bicuspids (13.4%), mandibular left cuspid (10.5%), maxillary left and mandibular right cuspids(10.1%) and maxillary right cuspid(7.9%).

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.4
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• pp.678-685
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• 2006

A certain width of attached gingiva is required to maintain gingival health The purpose of this study was to examine the dimensional changes in the width of attached gingiva and the depth of gingival sulcus among the deciduous, mixed and permanent dentitions and establish baseline information on the width of attached gingiva in Korean children. Eighty-eight children aged 4 to 14, who visited the Department of Pediatric Dentistry at Samsung Medical Center, were selected and divided into 3 groups according to the periods of dentition: deciduous, mixed and permanent dentitions. The width of keratinized gingiva and the depth of gingival sulcus were measured in each group with a periodontal probe and the width of attached gingiva was determined. The width of attached gingiva in maxillary and mandibular first molars increased significantly with age after eruption in the permanent dentition (p<0.05). The sulcus depth significantly increased in newly erupted permanent teeth with narrower width of attached gingiva (p<0.05) in all of the experimented teeth with the exception of the mandibular central incisor during the transition period. The results suggest that the mean width of attached gingiva does not increase steadily from the deciduous to the permanent dentition.

• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.135-142
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• 1998

The purpose of the present study was to evaluate the effect of incisor protrusion on the mucogingival parameters including the width of attached gingiva. Thirty-seven young adults with lower anterior crowding were selected for this study. From the study model, the degrees of relative and absolute protrusions were measured for each lower incisor. Clinical non height, the width of keratinized gingiva, probing depth and the width of attached gingiva were measured with digital vernier calipers and Florida Probe System. Through comparing the difference of the above measurements between protruded and non-protruded incisors, and correlation analysis between each measurement, following results were obtained: 1. The protruded incisor showed narrow width of keratinized and attached gingiva comparing to non-protruded incisor. 2. The protruded incisor showed greater clinical crown height comparing to non-protruded side while there was no difference in the probing depth between protruded and non-protruded side. 3. The difference in the width of attached gingiva between protruded and non-protruded incisors showed higher significance in the lateral incisor than in the central incisor. 4. The degree of relative protrusion showed higher correlation with the width of attached gingiva than the degree of absolute protrusion. 5. Clinical crown height showed higher correlation with the width of attached gingiva than the degree of protrusion.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.533-539
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• 1994

The mandibular buccal frenum is a fold of mucous membrane at the posterior labial vestibule, that attaches the lips and the cheeks to the alveolar mucosa, gingiva, and underlying periosteum. The buccal frenum becomes a problem if its attachment is too close to the marginal gingiva. It may then pull on healthy gingiva, encourge plaque formation and interfere with tooth brushing. Heavy buccal frenum mucogingivally results in insufficient attached gingiva, inadequate vestibular depth and high frenum attachment and also difficulty in eruption of mandibular second premolar. Frenectomy in various forms has been used for many years to remove the influence of the frenum. Unfortunately, the results are not always ideal and there is often postoperative relapse because of muscle pull. In this treatment, frenotomy was used in conjuction with autogenous free gingival graft with the object of removing the influence of the buccal frenum and creating an adequate and stable width of attached gingiva. We observed decrease in muscle pull, adequate width of attached gingiva and increased vestibular depth in addition to progressive eruption of second premolar. Periodic follow-up is needed for evaluation of relapse, grafting gingiva and also space regaining for second premolar.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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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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• v.31 no.1
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• pp.243-258
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• 2001

Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Threrfore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingival, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1. The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. the average periodontal pocket depth is 2.0mm and 47% of frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2. With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3. With statistical significance(p<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (p>0.05). 4. The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (p<0.05). 5. With statistical significance(p<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (p>0.05).

• The Journal of the Korean dental association
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• v.54 no.4
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• pp.296-305
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• 2016

Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.122-134
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• 2000

The aim of this study is (1) to establish the baseline information concerning the width of keratinized gingiva, depth of gingival sulcus and width of attached gingiva on the buccal surface of the teeth: and (2) to determine the relationship between the above values and tooth eruption: and (3) to estimate the frequency of mucogingival problems. The results were as follows; 1. The mean width of attached gingiva of the children aged $6\sim12$ proved to be wider in the maxilla than in the mandible. Of the primary teeth, the widest width was found in the areas of maxillary primary lateral incisors and maxillary primary canines(3.50mm and 3.55mm). The narrowest was noted in the area of mandibular first primary molars(1.34mm) In the permanent dentition, the greatest width was found in the areas of maxillary permanent lateral incisors (3.00mm). The narrowest was noted in the area of mandibular first premolars(0.55mm). 2. In the primary dentition, the width of attached gingiva of primary canines and first and second primary molars became wider from the age of six as the age increased. In the permanent dentition of the boys, only mandibular central incisors and maxillary first molars showed the tendency towards increase in the width of attached gingiva with increasing age. In the permanent dentition of girls, central and lateral incisors of both jaws and maxillary first molars showed statistically significant increase in the width of attached gingiva with increasing age(p<0.05). 3. At the age of tooth change, the attached gingiva of primary teeth were almost wider than those of successive permanent teeth (p<0.05). 4. During the period of 6 to 12 years of age, the width of keratinized gingiva and the depth of gingival sulcus of permanent tooth at the age of twelve were larger than those of primary tooth at the age of six (p<0.05). 5. The maximum in the frequency of mucogingival problems was found in the areas of upper and lower first primary molars of primary dentition, and in the upper and lower first premolars of permanent dentition regardless of sex. The frequency was higher in primary teeth than in the corresponding successive permanent teeth These teeth showed tendency towards increase in mucogingival problems with age.