• 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.25 no.2
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• pp.253-266
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• 1995

Recently, available interests concerning the biologic significance of the extracellular matrix and proliferating cells associated with periodontal disease has been increased. The distribution or expression of cellular proliferation by PCNA, macrophage detection by ${\alpha}$-l-antichymotrypsin, fibronectin playing a important role in host defence mechanisms indirectly, and transglutaminase that cross linked to fibronectin and stimulate fibrin stabilization were studied in inflammed and healthy gingiva. The excised tissue samples were fixed neutral formalin for 24 hours, embedded with paraffin, sectioned at 4-61lffi in thickness, and immunohistochemically processed by LSAB method. The positive reaction to PCNA was localized in the suprabasal and basal layer of inflammed gingiva and an increasing reactivity was observed than healthy gingiva. ${\alpha}$-I-antichymotrypsin positive cells were localized in the basal layer of inflammed gingiva, and there was no or rare positive cells in healthy gingiva. The positive reaction to fibronectin in inflammed gingiva was more than healthy gingiva,"and shown in the connective tissue subjacent to basement membrane of epithelium and in the periphery of the collagen fiber bundles. The positive cells by transglutaminase in inflammed gingiva were noted in suprabasal, spinous, and keratin layer of epithelium, and slightly increased in the capillaries of connective tissues. But the results of this study demonstrated in vitro reaction. Therefore, the role of PCNA,${\alpha}$-l-antichyrnotrypsin, transglutaminase, fibronectin and coefficient with other growth factor and extracellular matrix were further investigated in vivo.

• 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.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 Periodontal and Implant Science
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• v.28 no.4
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• pp.785-797
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• 1998

This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.

• Journal of Periodontal and Implant Science
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• v.26 no.3
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• pp.655-668
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• 1996

The change in vascular adhesion molecule expression and number of infiltrating leukocytes were investigated irnmunohistochemically in clinically healthy and inflammed gingiva. Monoclonal antibodies to ICAM-1, VCAM-1 and E-cadherin were used to identify positive vessels and leukocyte within gingival biopsies. 10 healthy gingiva and 30 inflammed gingiva was resected by clinical crown lengthening and modified Widman flap operation, respectively. Leukocyte entry into tissues at sites of inflammation is controlled by the interaction between adhesion molecule and endothelium. Because of rapid and severe destructive periodontal disease that is remarkable leukocyte adhesion deficiency, it is very important to unerdstand the mechanism of host defence against periodontal disease. The purpose of this investigation was the characterization of the presence and distribution of the adhesion molecule(ICAM-1, VCAM-1 and Evcadherin) in inflammatory gingival tissues compared to clinically healthy gingiva. The results were as followed; 1. ICAM-1 was distributed on basal layer, endothelium and mononuclear cells 10 healthy gingiva but inflammed gingiva was observed stronger stain than healthy gingiva. 2. Rare expression was observed in both group but few positive VCAM-1 cells were investigated in inflammatory gingival tissues 3. E-cadherin was expressed in only epithelium and reduced expression was observed in inflammatory gingival tissues. ICAM-1, VCAM-1 showed more expression in inflammatory tissues compared to healthy gingiva. Conversely, E-cadherin revealed a opposite result. These finding demonstrate a characteristic distribution and degree of adhesion molecule in healthy and inflammatory gingival tissues. But it is suggested that more detail study be progressive associated with leukocyte adhesion molecule to determine characterization of periodontal disease.

• The Journal of Advanced Prosthodontics
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• v.3 no.3
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• pp.166-171
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• 2011

PURPOSE. The purpose of this study is to evaluate and compare the shear bond strength of the gingiva-colored composite resin and the tooth-colored composite resin to porcelain, metal and zirconia. MATERIALS AND METHODS. Sixty cylindrical specimens were fabricated and divided into the following 6 groups (Group 1-W: tooth-colored composite bonded to porcelain, Group 1-P: gingiva-colored composite bonded to porcelain, Group 2-W: tooth-colored composite bonded to base metal, Group 2-P: gingiva-colored composite bonded to base metal, Group 3-W: tooth-colored composite bonded to zirconia, Group 3-P: gingiva-colored composite bonded to zirconia). The shear bond strength was measured with a universal testing machine after thermocycling and the failure mode was noted. All data were analyzed using the two-way analysis of variance test and the Bonferroni post-hoc test at a significance level of 0.05. RESULTS. The mean shear bond strength values in MPa were 12.39, 13.42, 8.78, 7.98, 4.64 and 3.74 for Group 1-W, 1-P, 2-W, 2-P, 3-W and 3-P, respectively. The difference between the two kinds of composite resin was not significant. The shear bond strength of Group 1 was the highest and that of Group 3 was the lowest. The differences among Group 1, 2 and 3 were all significant (P<.05). CONCLUSION. The shear bond strength of the gingiva-colored composite was not less than that of the tooth-colored composite. Thus, repairing or fabricating ceramic restorations using the gingiva-colored composite resin can be regarded as a practical method. Especially, the prognosis would be fine when applied on porcelain surfaces.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.132-136
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• 2000

The cell surface glycoprotein CD44 is a kind of adhesion molecule, which binds hyaluronic acid, type I collagen and fibronectin. Although there have been numerous reports on the expression and the function of CD44 in lymphocytes and macrophages, very little is known about its distribution and definite role in epithelial tissue, especially in oral epithelial one. The present study was performed to investigate the distribution and expression of the CD44 in human gingiva and squamous cell carcinoma(SCC) arising in human gingiva. And the authors compared CD44 expression with histopathologic grade of SCC. The results were as follows: 1. The CD44 was strongly expressed in granular, spinous and basal layers of normal marginal and attached gingiva, in spinous and basal layers of normal sulcular gingiva, and in all epithelial layers of normal junctional gingiva. 2. In SCC of gingiva, the CD44 was expressed in all but one case. In most of the cases the CD44 was expressed at cell membrane and the degree of expression was relatively strong. 3. In low-grade SCC of gingiva, the CD44 was strongly expressed, especially at the basal and spinous layers of abundantly keratinized cancer nests. In high-grade SCC of gingiva, the CD44 expression tended to be weak but was strong at cells showing individual keratinization. This study suggest that the CD44 expression of normal and cancerous gingival epithelium is associated with the degree of proliferation and differentiation of epithelial cells.

• The Journal of the Korean dental association
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• v.52 no.12
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• pp.726-733
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• 2014

The gingiva consists of an epithelial layer and an underlying connective tissue layer. The oral epithelium is a keratinized, stratified, squamous epithelium. The epithelium can be divided into the following cell layer: basal layer, prickle cell layer, granular cell layer and keratinized cell layer. The desquamative disease of gingiva means exfoliative diseases of epithelial layer on the gingiva. The chronic desqumative gingivitis is usually related to the dematologic disorders that produce cutaneous and mucous membrane blisters. The cicatricial pemphigoid and lichen planus are representative diseases of the dermatologic cases. Patients may be asymptomatic or symptomatic. When symptomatic, their complaints range from a mild burning sentation to an severe pain. The clinical examination must be considered with a thorough history, and routine histologic and immunofluorescence studies. A systemic approach needs to achieve accurate diagnosis and treatment of the gingival desquamative diseases.