• Title/Summary/Keyword: periodontal biotype

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The laterally closed tunnel for the treatment of mandibular gingival recession in thin biotype patients: case report (얇은 치주 생체형 환자에서 교정 치료 후 발생한 하악 전치부 치은 퇴축에 대한 laterally closed tunnel procedure의 처치: 증례보고)

  • Kim, Hyun-Joo;Kwon, Eun-Young;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.4
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    • pp.253-259
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    • 2019
  • In this case report, gingival recession of the mandibular anterior teeth was treated with a laterally closed tunnel technique. Two patients had altered the inclination of mandibular anterior tooth during past orthodontic treatment and had periodontal thin biotype. The recipient site was formed by tunneling method, and the connective tissue graft obtained from the palatal side was placed in the tunnel, and the margins of flap were gathered at the center of the root and sutured. Despite the thin periodontal biotype, the root coverage was successfully obtained, keratinized gingiva was increased, and aesthetics were achieved by harmonizing with surrounding tissues in terms of shape and color.

Influence of gingival biotype on the amount of root coverage following the connective tissue graft (치은의 biotype이 결합조직이식 후 치근피개도에 미치는 영향)

  • Joo, Ji-Young;Lee, Ju-Youn;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.39 no.2
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    • pp.111-118
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    • 2009
  • Purpose: The integrity of interproximal hard/soft tissue has been widely accepted as the key determinant for success or degree of root coverage following the connective tissue graft. However, we reason that the gingival biotype of an individual, defined as the distance from the interproximal papilla to gingiva margin, may be the key determinant that influence the extent of root coverage regardless of traditional classification of gingival recession. Hence, the present study was performed with an aim to verify that individual gingival scalloping pattern inherent from biotype influence the level of gingival margin following the connective tissue graft for root coverage. Methods: Test group consisted of 43 single-rooted teeth from 21 patients (5 male and 16 female patients, mean age: 36.6 years) with varying degrees of gingival recession requiring connective tissue graft; 20 teeth of Miller class I and 23 teeth of Miller class III gingival recession, respectively. The control group consisted of contralateral teeth which did not demonstrate apparent gingival recession, and thus not requiring root coverage. For a biotype determination, an imaginary line connecting two adjacent papillae of a test tooth was drawn. The distance from this line to gingival margin at mid-buccal point and this distance (P-M distance) was designated as "gingival biotype" for a given individual. The distance was measured at baseline and 3 to 6 months examinations postoperatively both in test and control groups. The differences in the distance between Miller class I and III were subject to statistical analysis by using Student.s t-test while those between the test and control groups within a given patient were by using paired t-test. Results: The P-M distance at 3 to 6 months postoperatively was not significantly different between Miller class I and Miller class III. It was not significantly different between the test and control group in a given patient, either, both in Miller class I and III. Conclusions: The amount of root coverage following the connective tissue graft was not dependent on Miller's classification, but rather was dependent on P-M distance, strongly implying that the gingival biotype of a given patient may play a critical impact on the level of gingival margin following connective tissue graft.

Relationship between the facial bone thickness and gingival biotype of the anterior maxilla in Koreans (한국인의 상악 전치부 순측골 두께와 치은 생체형(gingival biotype)의 상관관계)

  • Park, Ji-Hun;Kim, Yeun-Kang;Kim, Hyoung-Min;Joo, Ji-Young;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.3
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    • pp.169-177
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    • 2015
  • Purpose: The objects of this study were to examine the thickness of labial plate of anterior maxillary teeth and the gingival biotype in Koreans and to evaluate whether there is a correlation between the gingival biotype and the thickness of labial plate. Materials and Methods: This study was performed on 335 teeth of 57 subjects at the Pusan National University Dental Hospital. Cone Beam Computed Tomography (CBCT) was used to measure the thickness of labial plate at 4 mm, 6 mm, 8 mm from the cementoenamel junction and the gingival biotype was determined by the visibility of periodontal probe. Results: Thin facial bone less than 1 mm was observed in 87% at 4 mm, 88% at 6 mm and 90% at 8 mm. In 21% of total objects, thin gingival biotype was observed. There is no correlation between the thickness of labial plate and gingival biotype. Conclusion: Additional thorough radiographic examination such as CBCT was mandatory for aesthetic dental implant in the anterior dentition besides clinical oral examination.

Free gingival graft in combination with apically positioned flap for establishment of keratinized gingiva around the implants: Report of two cases (근단변위판막술과 함께 유리치은이식술을 사용하여 임플란트 주변 각화치은을 증대시킨 2건의 증례 보고)

  • Baek, Won-Sun;Cha, Jae Kook;Lee, Jae-Hong;Lee, Jung-Seok;Jung, Ui-Won
    • 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.

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Labial and lingual/palatal bone thickness of maxillary and mandibular anteriors in human cadavers in Koreans

  • Han, Ji-Young;Jung, Gyu-Un
    • Journal of Periodontal and Implant Science
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    • v.41 no.2
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    • pp.60-66
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    • 2011
  • Purpose: The aim of this study is to evaluate the buccal and lingual bone thickness in the anterior teeth and the relationship between bone thickness and the tissue biotype. Methods: Three male and two female human cadaver heads (mean age, 55.4 years) were used in this study. First, the biotype of periodontium was evaluated and categorized into a thick or a thin group. Next, full thickness reflections of the mandible and the maxilla to expose the underlying bone for accurate measurements in the anterior regions were performed. After the removal of the half of the alveolar bone, the probe with a stopper was used to measure the thickness of bone plate at the alveolar crest (AC), 3 mm apical to the alveolar crest (AC-3), 6 mm apical to the alveolar crest (AC-6), and 9 mm apical to the alveolar crest (AC-9). The thickness of the buccal plates at the alveolar crest were $0.97{\pm}0.18\;mm$,$0.78{\pm}0.21\;mm$, and $0.95{\pm}0.35\;mm$ in the maxillary central incisors, lateral incisors, and canines, respectively. The thickness of the labial plates at the alveolar crest were $0.86{\pm}0.59\;mm$, $0.88{\pm}0.70\;mm$, and $1.17{\pm}0.70\;mm$ in the mandibular central incisors, lateral incisors and canines, respectively. Conclusions: The thickness of the labial plate in the maxillary anteriors is very thin that great caution is needed for placing an implant. The present study showed the bone thickness of maxillary and mandibular anteriors at different positions. Therefore, these data can be useful for the understanding of the bone thickness of the anteriors and a successful implant placement.

An analysis on the factors responsible for relative position of interproximal papilla in healthy subjects

  • Kim, Joo-Hee;Cho, Yun-Jung;Lee, Ju-Youn;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.43 no.4
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    • pp.160-167
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    • 2013
  • Purpose: This study examined the factors that can be associated with the appearance of the interproximal papilla. Methods: One hundred and forty-seven healthy interproximal papillae between the maxillary central incisors were examined. For each subject, a digital photograph and periapical radiograph of the interdental embrasure were taken using a 1-mm grid metal piece. The following parameters were recorded: the amount of recession of the interproximal papilla, contact point-bone crest distance, contact point-cemento-enamel junction (CEJ) distance, CEJ-bone crest distance, inter-radicular distance, tooth shape, embrasure space size, interproximal contact area, gingival biotype, papilla height, and papilla tip form. Results: The amount of recession of the interproximal papilla was associated with the following: 1) increase in contact point-bone crest, contact point-CEJ, and CEJ-bone crest distance; 2) increase in the inter-radicular distance; 3) triangular tooth shape; 4) decrease in the interproximal contact area length; 5) increase in the embrasure space size; and 6) flat papilla tip form. On the other hand, the amount of gingival recession was not associated with the gingival biotype or papilla height. In the triangular tooth shape, the contact point-bone crest distance and inter-radicular distance were longer, the interproximal contact area length was shorter, and the embrasure space size was larger. The papilla tip form became flatter with increasing inter-radicular distance and CEJ-bone crest distance. Conclusions: The relative position of the interproximal papilla in healthy subjects was associated with the multiple factors and each factor was related to the others. A triangular tooth shape carries a higher risk of recession of the interproximal papilla because the proximal contact point is positioned more incisally and the bone crest is positioned more apically. This results in an increase in recession of the interproximal papilla and flat papilla tip form.

Clinical features of the gingiva according to maxillary anterior teeth form in adult (성인 상악 전치 형태에 따른 치은의 임상적 소견)

  • An, Chi-Hyun;Heo, Soo-Rye;Cho, Ik-Hyun;Kim, Hyung-Seop
    • Journal of Periodontal and Implant Science
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    • v.35 no.2
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    • pp.359-369
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    • 2005
  • It has been suggested that morphologic characteristics of the periodontium are partly related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or "biotypes". The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary anterior tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. The thickness of gingiva was measured by ultrasonic device(SDM). 100 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, gingival recession, width of keratinized gingiva, thickness of the keratinized gingiva. From maxillary study cast, the width(at the apical third-CW) and the length(CL) of the crowns of the 6 anterior teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. The 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow(group N) or a short-wide(group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long-narrow form of the central incisors displayed, compared to individuals with a short-wide crown, form (l) a narrow zone of keratinized gingiva, (2) a pronounced "scalloped" contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the keratinized gingiva. The CW/CL-ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisors and canine tooth region. The regression analyses demonstrated that the thickness of the keratinized gingiva in central, lateral incisors and canines was significantly related to the width of the keratinized gingiva.