• 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).

• 대한소아치과학회지
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• 제5권1호
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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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• 제27권1호
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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%).

• 대한소아치과학회지
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• 제33권4호
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• pp.678-685
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• 2006

건강한 치주조직을 유지하기 위해서는 적절한 폭경의 부착치은이 필요하다. 이러한 부착치은의 폭경은 연령에 따라서 변화한다는 보고가 있다. 그러나 그 정상치에 대한 보고는 저자들마다 차이를 보이며 또한 한국인에서의 정상 평균값에 대한 연구는 미흡한 실정이다. 본 연구의 목적은 악골의 발육 및 치아의 맹출과 관련하여 유치열기로부터 초기영구치열기까지의 부착치은의 폭경 및 치은열구 깊이의 변화 양상을 조사하고, 한국인 아동의 정상치를 구하는 것이다. 삼성서울병원 소아치과에 내원한 4세에서 14세 사이의 유치열기, 혼합치열기 및 영구치열기 아동88명을 대상으로 유치열기($4{\sim}6$세)에서는 유중절치와 제1유구치, 혼합치열기($7{\sim}10$세)에서는 중절치, 제1유구치 및 제1대구치, 영구치열기($10{\sim}14$세)에서는 중절치, 제1소구치 및 제1대구치에서 협측 부착치은의 폭경과 치은열구 깊이를 치주탐침으로 측정하여 비교하였다. 상하악 제1대구치 부착치은의 폭경은 치아맹출 후 연령에 따라서 증가하였다(p<0.05). 하악유전치을 제외한 모든 실험 치아에서 맹출 직후 치은열구 깊이가 증가하는 것을 보였으며 부착치은의 폭경은 상대적으로 줄어들었다(p<0.05). 이러한 결과는 부착치은의 폭경이 유치열기부터 영구치열까지 연령에 비례하여 일정하게 증가하지 않는다는 것을 의미한다.

• 대한치과교정학회지
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• 제28권1호
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• pp.135-142
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• 1998

치아돌출정도가 부착치은 폭경에 미치는 영향을 살펴보기 위하여 치주상태가 양호한 성인 중 하악 전치부에 다소의 총생이 있는 37명을 대상으로 하악의 인상채득 후 석고모형을 제작한 다음 각 하악 절치의 상대적 및 절대적 돌출정도를 측정하고 임상치관 고경, 치주낭 깊이, 각화 및 부착치은 폭경과 비교 분석하여 다음과 같은 결론을 얻었다. 1. 비돌출측에 비하여 돌출측의 각화치은 및 부착치은 폭경이 작게 나타났다. 2. 돌출측의 임상치관 고경은 비돌출측보다 유의하게 크게 나타났으나 치주낭 깊이는 돌출측과 비돌출측간의 유의한 차이를 보이지 않았다. 3. 돌출측과 비돌출측간의 부착치은 폭경차이는 중절치보다 측절치에서 더욱 뚜렷이 나타났다. 4. 절대적 돌출도보다 상대적 돌출도가 부착치은 폭경과 더 높은 상관관계를 나타내었다. 5. 돌출도보다 임상치관고경이 부착치은 폭경과 더 높은 상관관계를 나타내었다.

• 대한소아치과학회지
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• 제21권2호
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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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• 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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• 제31권1호
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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).

• 대한치과의사협회지
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• 제54권4호
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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.

• 대한소아치과학회지
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• 제27권1호
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• pp.122-134
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• 2000

각화치은, 부착치은의 폭경, 치은열구의 깊이에 대해 성인에서는 많은 연구가 있었으나 아동에서의 연구는 드물었기 때문에, 유치열기, 혼합치열기 및 영구치열기의 모든 치아에 대하여 아동의 협측 각화치은 및 부착치은의 폭경과 치은열구 깊이에 대한 정상치를 구하고, 악골의 발육 및 치아의 맹출과의 관련성을 고찰하며, 점막치은 문제의 발현빈도를 조사하고자 하였다. 결론은 다음과 같다. 1. 유치열의 부착치은 폭경은 상악 유측절치 및 유견치에서 각각 3.50mm, 3.55mm로 최대값을, 하악 제1유구치에서 1.34mm로 최소값을 나타내었다. 영구치열의 경우에는 상악 측절치에서 3.00mm로 최대값을, 하악 제1소구치에서 0.55mm로 최소값을 나타내었다. 상하악 동명치아 비교시 상악 치아가 하악 치아보다 더 큰 값을 나타내었고, 남녀간 차이에는 특별한 규칙이 발견되지는 않았다. 2. 연령증가에 따른 부착치은 폭경의 변화 양상은 유치열의 경우 유견치, 제1유구치, 제2유구치에서 6세부터 증가하였다. 영구치의 경우 남자에서는 하악 중절치와 상악 제 1대구치의 측정값만이 연령에 따른 증가 추세를 나타냈으나(p<0.05), 여자에서는 상하악 중절치 측절치 및 상악 제1대구치에서 통계적으로 유의성 있는 각화치은 폭경의 증가 추세를 관찰할 수 있었다(p<0.05). 3. 치아교대기에서 부착치은 폭경의 차이는 남자 상악 중절치를 제외한 모든 경우에 유치에서의 측정값이 영구치에서의 측정값보다 큰 것으로 나타났다(p<0.05). 4. 6제부터 12세까지는 각화치은의 폭경과 치은열구의 깊이는 대부분 유치 초기값보다 그 계승영구치 최종값이 더 높은 값을 나타냈으나(p<0.05), 부착치은의 폭경에서는 유치 초기와 그 계승영구치 최종값사이에 통계적으로 유의성 있는 차이가 나타나지 않았다. 5. 점막치은 문제 발현 빈도는 남녀에 상관없이 유치열은 상하악 제 1유구치가, 영구치열은 상하악 모두 제 1소구치가 최고치를 나타냈으며 유치에서보다 그 대응 계승영구치에서 그 빈도가 더욱 높게 나타났다. 연령증가에 따라 점막치은 문제의 발현 빈도는 유치열, 영구치열에서 모두 감소하였으나, 하악 제1유구치, 하악 영구 견치, 제1, 제2소구치의 경우 연령의 증가와 상관없이 비슷하게 유지되거나 증가하는 경향을 보였다.