• Title/Summary/Keyword: attached gingiva

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Upper lip tie wrapping into the hard palate and anterior premaxilla causing alveolar hypoplasia

  • Heo, Woong;Ahn, Hee Chang
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.48-50
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    • 2018
  • Bony anomaly caused by lip tie is not many reported yet. There was a case of upper lip tie wrapping into the anterior premaxilla. We represent a case of severe upper lip tie of limited lip motion, upper lips curling inside, and alveolar hypoplasia. Male patient was born on June 3, 2016. He had a deep philtral sulcus, low vermilion border and deep cupid's bow of upper lip due to tension of short, stout and very tight frenulum. His upper lip motion was severely restricted in particular lip eversion. There was anterior alveolar hypoplasia with deep sulcus in anterior maxilla. Resection of frenulum cord with Z-plasty was performed at anterior premaxilla and upper lip sulcus. Frenulum was tightly attached to gingiva through gum and into hard palate. Width of frenulum cord was about 1 cm, and length was about 3 cm. He gained upper lip contour including cupid's bow and normal vermilion border after the surgery. This case is severe upper lip tie showing the premaxillary hypoplasia, abnormal lip motion and contour for child. Although there is mild limitation of feeding with upper lip tie child, early detection and treatment are needed to correct bony growth.

Forced orthodontic eruption for augmentation of soft tissue prior to implant placement (임플란트 식립 전 연조직 증대를 위한 교정적 정출술)

  • Park, Chul-Wan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.1
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    • pp.54-61
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    • 2020
  • Forced orthodontic eruption(FOE) is a non-surgical treatment approach that allows augmenting both soft- and hard-tissue profiles of potential implant sites, by forced orthodontic extrusion of "hopeless" teeth and their periodontal apparatus. By stretching the gingival and periodontal ligament fibers during extrusion, tension is imparted to the entire alveolar socket, stimulating osseous apposition at the alveolar crest. FOE increases the width of the attached gingiva, and the mucogingival junction remains stable when the gingival margin migrates coronally. Based on these effects, FOE of non-restorable teeth prior to implant placement is a viable alternative to conventional surgical augmentative procedures in implant site development. The aim of this case report is to describes coronal soft-tissue augmentation around fractured teeth, which was achieved by FOE before implant placement.

Long-term Management of a Gingival Fibromatosis Patient with the Primary Dentition (유치열기에서 나타난 치은섬유종증 환자의 장기간 관리)

  • Kang, Chungmin;Lee, Jaeho;Choi, Hyungjun;Song, Jeseon;Kim, Seongoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.328-334
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    • 2014
  • Gingival fibromatosis is a rare oral condition that is characterized by proliferative fibrous overgrowth of the attached gingiva, the marginal gingiva, and the interdental papilla, typically presenting in the growth period. A case of a 27-month-old girl with a generalized severe gingival overgrowth is described herein. The patient had no known systemic disease, but enlarged gingival tissue had gradually covered her teeth. The excess gingival tissue was removed by conventional gingivectomy, which involved extraction of the retentive primary teeth under general anesthesia when she was 5 years old. Post surgical follow-up at 18 months after the surgery demonstrated no recurrence. Resectional surgery of the enlarged gingival tissue is the treatment choice for gingival fibromatosis, although there is a high risk of recurrence. More frequent professional follow-ups and oral hygiene instruction might be required. A delay in the surgical treatment may have significant consequences for the patient, such as primary dentition retention and consequent delay in the eruption of the permanent teeth, difficulties in mastication and phonation, malpositioning of the teeth, and psychological problems. Early surgical treatment should be performed according to the severity of enlargement.

A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases

  • Park, Jung-Chul;Yang, Ki-Bin;Choi, You-Na;Kim, Yong-Tae;Jung, Ui-Won;Kim, Chang-Sung;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.40 no.4
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    • pp.194-200
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    • 2010
  • Purpose: There is no consensus regarding the relationship between the width of keratinized mucosa and the health of periimplant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone. Methods: During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days. Results: A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients. Conclusions: The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants.

TREATMENT OF CAPILLARY HEMANGIOMA ON MAXILLARY BUCCAL MUCOSA : A CASE REPORT (상악 협측 치은에 발생한 모세혈관종 치험례)

  • Kang, Keun-Young;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.680-684
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    • 2004
  • The hemangioma, a benign proliferation of blood vessel, is the most common tumor of infancy and childhood. In many instances, the lesion probably represents a hamartoma or malformation rather than a true neoplasm. In the oral cavity, common sites are lips, followed by tongue, buccal mucosa and palate. Clinical characteristics appear as a flat or raised reddish-blue lesion and are generally solitary. They are classified on the basis of their histological appearance into capillary, mixed, cavernous or a sclerosing variety. A 6-year-old male of this case was referred to the Department of Pediatric Dentistry, Chonnam National University with a chief complaint of swelling lesion on gingiva. The strawberry appearance mass was detected by clinical examination on attached gingiva at the upper left primary lateral incisor and canine. Surgical excision and biopsy were carried out for histological examination and the lesion was diagnosed with a capillary hemangioma. The risk of recurrence after this therapy is rare, and there is no malignant transformation. Despite their benign origins and behaviour, hemangiomas in the region of oral cavity are always clinically important to the dental profession because of bleeding tendency.

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Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement

  • Sohn, Joo-Yeon;Park, Jung-Chul;Cho, Kyoo-Sung;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • v.44 no.2
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    • pp.94-99
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    • 2014
  • Purpose: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the longterm outcome of this grafted gingiva. Methods: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. Results: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. Conclusions: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.

Prosthetic restoration of a partially edentulous patient using double crowns: a clinical report (이중관을 이용한 부분 무치악 환자의 수복 증례)

  • Park, Minseo;Kim, Hyeong-Seob;Kwon, Kung-Rock;Woo, Yi-Hyung;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.21-27
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    • 2016
  • In removable dental prostheses, it is important to minimize impairment of residual tissue caused by wearing dentures. There are two factors that harm residual tissue. The first is functional load bearing of remaining teeth and alveolar ridges and the second is the effect of poor oral hygiene. Double crown retained removable dental prostheses provide rigid support, and it may reduce impairment caused by load bearing of alveolar ridges. Also, dental plaque and oral deposits, which are attached to outer crowns and dentures, can be easily managed extra-orally. In addition, it is beneficial to the health of the marginal gingiva because inner crowns have easy access for oral hygiene. In this case, double crown retained removable dental prostheses were used for the partially edentulous patient with severe residual alveolar bone resorption and poor oral hygiene, and the result was clinically satisfactory in terms of functional, esthetical, and oral hygiene aspects.

GINGIVAL FIBROMATOSIS IN MIXED DENTITION (혼합 치열기 어린이의 치은 섬유종증)

  • Han, Hyo-Jeong;Kim, Jin;Kim, Seong-Oh;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.696-700
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    • 2004
  • Gingival fibromatosis is a non-inflammatory oral disease, characterized by slowly progress enlargement of the free and attached gingiva. Gingival fibromatosis may have familial tendency. Gingival enlargement usually begins with the eruption of the permanent dentition but can also develop with the eruption of the primary dentition. In this case, a 6-year-old female had gingival enlargement at birth. There was no familial, medical and pharmacologic history of gingival overgrowth. Treatment is gingivectomy with a rigorous program of oral hygiene. Recurrence of gingival fibromatosis may well be inevitable. Therefore there is no general aggrement as to the timing of surgical intervention. Generally the best time is when all the permanent teeth have erupted. However early intervention can improve oral function and esthetic and psychologic effect.

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Treatment of Multiple Gingival Recessions Using Vestibular Incision Subperiosteal Tunnel Access with Platelet-rich Fibrin: Two Cases Reports

  • Sung-Min Hwang;Jo-Young Suh
    • Journal of Korean Dental Science
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    • v.16 no.2
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    • pp.218-226
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    • 2023
  • Treatment of multiple gingival recession defects is usually more challenging than that of single gingival recession. Various techniques for the treatment of multiple gingival recession have been established. Recently, vestibular incision subperiosteal tunnel access (VISTA) technique has been considered to exhibit high predictive ability. Connective tissue graft (CTG) has also been considered a gold standard technique owing to its high predictability of root coverage. However, this technique requires a suitable donor site and has clinical disadvantages, such as additional pain. Thus, in this case presentation, platelet-rich fibrin (PRF) was used as an alternative material for CTG along with VISTA. We herein report cases of two patients with Miller's class I and III multiple gingival recession defects, respectively. These patients underwent VISTA along with the use of a PRF membrane. They were followed up for 12 months postoperatively, and their clinical parameters, including probing depth, depth of gingival recession, clinical attachment level, and width of attached gingiva at baseline and at 2, 6, and 12 months postoperatively, were assessed. The patient with class 1 recession defects exhibited a significant amount of root coverage, which remained stable during the follow-up period. Whereas the patient with class 3 recession defects had lesser amount of coverage compared to class 1 patient. The partial coverage observed may be attributed to not only anatomical factors but also the technique-sensitive nature of the procedure. Considering these results, the use of VISTA along with PRF is a viable option for treating gingival recession, as it does not cause discomfort to patients. However, various factors need to be considered during the surgical procedure.

A study on the bone thickness of midpalatal suture area for miniscrew insertion (미니스크류 식립 부위로서 정중 구개봉합부 골의 두께에 관한 연구)

  • Kyung, Seung-Hyun
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.63-70
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    • 2004
  • The midpalatal suture area has some advantages for supporting miniscrews : it has no specific anatomical structure, it is composed of thick cortical bone, and covered with attached gingiva. So it is suitable area for inserting miniscrews. However, the midpalatal suture area appears thinner when seen in ceph. As a result, Clinicians can misunderstand that inserting miniscrews cause the problem, both the risk of perforation and the decrease of stability. The purpose of this article is measuring the vertical bone thickness of the midpalatal suture area for inserting miniscrews. The total of 25patient (male : 13, female : 12), who are in their twenties, were taken CT. The vertical bone thickness of the midpalatal suture area was measures from the transverse section of CT. As a result, We reached a conclusion from the differences of each area. It is as follows: 1. There is no significant difference between the thickness of male group and that of female group. 2. In coronal section, Bone thickness becomes thinner from the midpalatal suture to Left & Right side, in sagittal section, Bone thickness becomes thinner from incisive foramen to PNS. 3. The area that is within 3mm of left and right from the midpalatal suture area transversely and within 25mm backward from the incisive foramen sagittaly is enough for inserting miniscrews.