• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.26 no.1
• /
• pp.4-16
• /
• 2017

In dental esthetics, soft tissue plays an important part, probably very large portion of it. A clear understanding of the periodontal tissues and its management around teeth and implants help us to develop concepts for a modern dental treatment that addresses the needs of demanding patients in regard of esthetics and durability. When we talk about esthetic, we can say that one of the most important element is a harmonization with gingiva (soft tissue) called 'Pink Esthetic' As for the pink esthetics, gingival line(contour) takes most of the influence on esthetic result; it consists of labial gingival level, interproximal papilla height, and a line that connects them. In the gingival recession, labial gingival level and gingival contour move to the apical portion, and the root area is exposed. It leads to the unesthetic result. Root coverage technique is classically used to treat gingival recession (marginal tissue recession) of natural teeth. It is an essential technique on periodontal plastic surgery part. It is also a very useful technique to recover soft tissue problems in implant dentistry. So, root coverage technique must be mastered for a good implant esthetic result. The general overview of root coverage procedures will be discussed with step by step explanation to get more esthetic result.

• The Journal of the Korean dental association
• /
• v.48 no.9
• /
• pp.670-679
• /
• 2010

Esthetic demands for dental treatment are increasing every day. The interdisciplinary relationship of the restorative treatment, periodontal therapy and other treatments such as endodontics, orthodontics and so on is more emphasized nowadays to reconstruct the hard and soft tissue foundation for the esthetic restorative treatment. This article will focus on the periodontal plastic surgery for esthetic restorative treatment. These followings will be discussed. 1. Understand the relationship between teeth and gingival scaffold for esthetics 2. Discuss the classification and treatment of gummy smile 3. Recognize the gingival margin irregularities by gingival recession and how to achieve the harmonic soft tissue margins 4. describe the hard and soft tissue augmentation for ridge augmentation.

• Journal of Periodontal and Implant Science
• /
• v.35 no.3
• /
• pp.703-718
• /
• 2005

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polvlactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

• 대한치주과학회:학술대회논문집
• /
• 2005.11a
• /
• pp.17-18
• /
• 2005

• Journal of Periodontal and Implant Science
• /
• v.51 no.2
• /
• pp.77-87
• /
• 2021

Purpose: The aim of this study was to compare the efficacy of the tunnel technique for root coverage using a new xenogeneic acellular dermal matrix vs. connective tissue grafting (CTG) for the treatment of multiple maxillary adjacent recessions (recession type 1) at 12 months postoperatively. Methods: This study enrolled 12 patients with at least 3 contiguous, bilateral, symmetrical maxillary gingival recessions (i.e., at least 6 recessions per patient). In total, 74 recessions were treated using the modified coronally advanced tunnel (MCAT) technique combined with a novel porcine-derived acellular dermal matrix (PADM) at 37 test sites or CTG at 37 control sites. The following clinical parameters were measured: recession height, clinical attachment level, width of keratinized tissue, probing depth, recession width, gingival thickness, mean root coverage (MRC), and complete root coverage (CRC). Comparisons between test and control groups were made for pain visual analog scale scores at 14 days. Results: At 12 months, the MCAT with PADM (test) yielded a statistically significant improvement in all clinical parameters studied. MRC was significantly higher on the control sides (80.6%±23.7%) than on the test sides (68.8%±23.4%). Similarly, CRC was 48.7%±6.8% on the control sides (CTG), in contrast to 24.3%±8.2% on the test sides (PADM). Statistically significant differences were observed in favor of the control sides for all clinical parameters studied. Nevertheless, the MCAT in adjunction with PADM was clearly superior at reducing mean and maximum patient-reported postoperative pain intensity and pain duration in the first week after surgery. Conclusions: The use of PADM to treat multiple recessions improved clinical parameters at 12 months, but these outcomes were nevertheless poorer than those observed for CTG. However, PADM reduced morbidity, particularly the pain experienced by patients.

• Journal of Periodontal and Implant Science
• /
• v.41 no.1
• /
• pp.44-50
• /
• 2011

Purpose: Pathologic tooth migration (PTM) is a tooth displacement which is derived from imbalance of tooth retention force and is dominantly found out in maxillary anterior area. PTM in maxillary anterior area was tried to corrected with periodontal treatment and a clear aligner in this study and the result was evaluated clinically and radiographically. Methods: For the treatment of a patient with chronic periodontal disease accompanied by maxillary anterior pathologic tooth migration, clear aligner was applied to move teeth after a series of case-related periodontal therapy. Clinically, probing depth, gingival recession, clinical attachment level and mobility were measured pre- and post-treatment, and radiographic examination was performed as well. Results: Clinically, we found the decrease of the probing depth, gingival recession, clinical attachment level and mobility. And we could also acknowledge the reduction of vertical and horizontal dimension on infrabony defect radiographically. However, it is still controversial if there was an actual bone filling. Conclusions: Clear aligner is an effective appliance to move teeth since it costs little in terms of expense and time. In addition, it wraps whole crowns, providing advantages to deal with crowding, spacing, and size of arch. In short, clear aligner could be a useful treatment option for PTM patient, since it provides decreased probing depth, gingival recession, clinical attachment level, mobility and esthetical restoration.

• The Journal of the Korean dental association
• /
• v.56 no.4
• /
• pp.208-216
• /
• 2018

Patients with malocclusion may present with preexisting mucogingival problems susceptible to attachment loss during or after orthodontic treatment. Lower anterior teeth especially show a high prevalence of gingival recession following orthodontic treatment. This case report demonstrates hard tissue augmentation of labially thin or deficient alveolar bone (dehiscences and fenestrations) to prevent attachment loss during or after orthodontic treatment. Three patients presented clinically prominent root surfaces and dehiscences and fenestrations on cone-beam computed tomography (CBCT) in lower anterior teeth. Labial hard tissue augmentation of lower anterior teeth was performed with deproteinized bovine bone mineral and collagen membrane. Six months later, hard tissue augmentation reduced root prominence and created a greater volume of hard tissue on lower anterior area in clinical and radiographic findings. Hard tissue augmentation using xenograft could prevent attachment loss associated with orthodontic treatment and maintain stability of healthy periodontium.

• Restorative Dentistry and Endodontics
• /
• v.16 no.1
• /
• pp.216-225
• /
• 1991

The purpose of this study was to evaluate the desensitizing effect of potassium oxalate(Group I), sodium fluoride (Group II), and control group (Group III). The 120 teeth of 26 patients who had been complained dentinal hypersensitivity were divided into three groups by applicating agent. The observation was done before and immediately after treatment. The data were statistically analyzed and the results were as followed. 1. Potassium oxalate showed the best desensitizing effect to the stimuli, followed by sodium fluoride, control group, and there was a significant difference (p<0.05) in desensitizing effect among the groups. 2. Potassium oxalate showed the best desensitizing effect to the stimuli, followed by sodium fluride, control group on both cervical abrasion and gingival recession, and there was a significant difference (p<0.05) in desensitizing effect among the groups on both cervical abrasion and gingival recession. 3. There was no significant difference (p<0.05) in effect of the desensitization between cervical abrasion and gingival recession. 4. The scratch and air blast I were more effective in desensitiziation than other stimuli with significant difference (p<0.05). In view of the results mentioned above, it can be conceived that potassium oxalate is more effective than sodium fluoride on the reduction of dentinal hypersensitivity.

• Journal of Periodontal and Implant Science
• /
• v.23 no.1
• /
• pp.183-192
• /
• 1993

The purpose of this epidermiological analysis was to evaluate the periodontal status of Korean young adults(twenties) in order to provide detail & baseline data for frequence of periodontal disease. Two hundred and fifty young adults, aged 20-29 years, were selected by random sampling. Dental visity, scaling treatment, education, income, toothbrushing frequence & method were checked, and plaque index(Loe and silness), calculus index(Ramfjord), gingival index(Loe and silness), attached gingival width, perio probing depth, gingival recession were measured. The obtained results were as follows. 1. Average plaque index(1.96), calculus index(1.43), gingival index(1.7) were higher in mandible than maxillar. It was most prevalent in lst molar. 2. Average attached gingival width(4.0mm) was wider in maxillar than mandible. It was most prominent in lateral incisor. 3. Pocket depth(>4mm) was distributed in 42% subject, it was higher in mandible than maxilla and most prevalent in 1st molar. 4. Gingival recession(>1mm) was distributed in 94% subject, it was higher in mandible than maxilla, and most prevalant in canine. 5. According to unpaired t-test, palque index, calculus index, gingival index were not statistically significant in history of scaling treatment, level of eduction and account of income, but were showed statistically significant in histrory of dental clinic.(PB0.05) 6. According to ANOVA test, correlation between tooth-brushing(frequence, method) and gingival index was showed statistically significant.(P<0.05) 7. There was gingival recessionof 87% subject in only one time brushing, 80% subject in two time, and 68% subject in three times. There was gingival recessionof 68% subject in leftright direction tooth brushing, 73% subject in upper-low method and 77% subject in combination method.

• Journal of Periodontal and Implant Science
• /
• v.33 no.2
• /
• pp.139-147
• /
• 2003

The roots of teeth exposed by gingival recession, may be successfully covered by various type of gingival grafting procedures. Vascularization of the recipient site is an essential determinant of the grafts' survival during the first healing stages. It has been suggested that a procedure by which they stimulate the periosteum presurgically will induce the proliferation of neo-endothelium in the site to be operated. The purpose of this study is to evaluate the variations in the gingival blood flow during 4weeks after periosteal stimulation in patient scheduled to receive gingival grafts and to compare variations in the gingival blood flow between smoker and non-smoker. Laser Doppler Flowmetry(floLAB(R), Moor Instruments Ltd, England ; wave length = 780mm. Max. power =l.6mW) was used to measure the gingival blood flow. 112 sites of 68 male patients (32 smokers and 36 non-smoker), aged between 23 and 48 years (smoker : 24-44 years. mean=32.6, non-smoker : 23-48 years, mean=28.5) were monitored for the blood flow. Gingival blood flow measured at before periosteal stimulation, 1-, 2-, 3-, and 4-weeks after periosteal stimulation from 10 a.m. to 2 p.m. The difference of blood flow in each measuring time, each measuring site and between smokers and non-smokers were statistically analyzed by MANOVA. The results were as follows : (1) Blood flow stayed increased for 2 weeks, and then, it was a tendency to decrease(p<0.05). (2) There was no statistically significant difference of blood flow change between smokers and non-smokers. (3)The blood flow at middle site had lower than mesial and distal site during the measuring periods(p<0.05). The present study suggested that blood flow change following periosteal stimulation was significant difference, thus periosteal stimulation before gingival graft might induce favorable results in gingival recession patient.