bromochloroacetic-acid and Gingival-Pocket

One of the success factors in periodontal plastic surgery is the synergistic relationship between involved tissues and vascular supply. Gingiva as a functional unit is unique with a specific vascular configuration and contains the supracrestal portion naturally created to survive over avascular root surfaces. The aim of this randomized controlled trial is to clinically evaluate the treatment of localized gingival recessions by using gingival unit grafts (palatal tissue involving marginal gingiva and papillae) compared with conventional palatal grafts.. Seventeen patients with Class I to II recession defects on mandibular anterior teeth were included and randomly divided into two groups. Recessions were treated with gingival unit grafts in group 1 (n = 8) and with palatal grafts in group 2 (n = 9). Clinical parameters including vertical recession (VR), probing depth, keratinized tissue (KT), and attachment level were recorded at baseline and 8 months after surgery.. Both treatments produced significant clinical improvements within the groups. Intergroup comparison revealed significantly higher VR reduction, attachment, and KT gain in group 1 than in group 2; mean percentages of the defect coverage were 91.62% ± 9.74% and 68.97% ± 13.67%, respectively (P <0.05). Healing of the gingival unit donor site was uneventful.. Within its limits, this study demonstrates the possibility of treating buccal recessions with gingival unit grafts as an alternative technique using gingival donor graft of site-specific vascular configuration, with better defect coverage, clinical, and esthetic improvements compared with palatal grafts.

Topics: Adolescent; Adult; Dental Plaque Index; Epithelial Attachment; Female; Follow-Up Studies; Gingiva; Gingival Pocket; Gingival Recession; Humans; Keratins; Male; Middle Aged; Patient Satisfaction; Tooth Cervix; Transplant Donor Site; Treatment Outcome; Young Adult

The aim of this retrospective long-term split-mouth study was to compare the periodontal conditions of sites treated with gingival-augmentation procedures to untreated homologous contralateral sites over a long period of time (10 to 27 years).. Fifty-five subjects with 73 sites (test group) lacking attached gingiva associated with recessions were treated by means of submarginal free gingival grafts (SMFGGs) and marginal free gingival grafts (MFGGs). The 73 contralateral homologous sites (control group), with or without recession and with or without attached gingiva, were not treated. Patients were recalled every 4 months during the follow-up period (10 to 27 years). Clinical variables, including recession depth, amount of keratinized tissue (KT), and probing depth (PD), were measured in treated and untreated sites at baseline, at 1 year, and at the end of the follow-up period.. At the end of the follow-up period, recession was reduced in all treated sites (1.5 +/- 1.0 mm for SMFGG and 1.3 +/- 0.9 mm for MFGG), whereas it was increased in the untreated sites (-0.7 +/- 0.7 mm for SMFGG and -1.0 +/- 0.5 mm for MFGG). In the treated sites, the increased KT remained quite stable during the follow-up period. PD remained stable (1 mm) in the treated and untreated sites.. The sites treated with gingival-augmentation surgery showed a tendency for coronal displacement of the gingival margin with a reduction in recession. The contralateral untreated sites showed a tendency for apical displacement of the gingival margin with an increase in the existing recessions.

Topics: Adolescent; Adult; Case-Control Studies; Cohort Studies; Dentin Sensitivity; Disease Progression; Female; Follow-Up Studies; Gingiva; Gingival Pocket; Gingival Recession; Gingivoplasty; Humans; Keratins; Longitudinal Studies; Male; Middle Aged; Periodontal Index; Periodontal Pocket; Retrospective Studies; Tooth Root; Young Adult

Evaluation of the treatment of gingival recessions with coronally positioned flap with or without acellular dermal matrix allograft (ADM) after a period of 24 months.. Thirteen patients with bilateral gingival recessions were included. The defects were randomly assigned to one of the treatments: coronally positioned flap plus ADM or coronally positioned flap alone. The clinical measurements were taken before the surgeries and after 6, 12 and 24 months.. At baseline, the mean values for recession height were 3.46 and 3.58 mm for the defects treated with and without the graft, respectively (p>0.05). No significant differences between the groups were observed after 6 and 12 months in this parameter. However, after 24 months, the group treated with coronally positioned flap alone showed a greater recession height when compared with the group treated with ADM (1.62 and 1.15 mm, respectively--p<0.05). A significant increase in the thickness of keratinized tissue was observed in the group treated with ADM as compared with coronally positioned flap alone (p<0.05).. ADM may reduce the residual gingival recession observed after 24 months in defects treated with coronally positioned flap. In addition, a greater gingival thickness may be achieved when the graft is used.

Topics: Adult; Biocompatible Materials; Collagen; Female; Follow-Up Studies; Gingiva; Gingival Pocket; Gingival Recession; Gingivoplasty; Humans; Keratins; Male; Periodontal Attachment Loss; Prospective Studies; Surgical Flaps; Treatment Outcome

The aim of this study was to evaluate whether there is a positive correlation between the width of the zone of gingival keratinized tissue and its thickness. Maxillary right canines, lateral incisors, and central incisors of 60 patients (30 men, 30 women) between the ages of 20 and 35 years were examined. Using an endodontic spacer with a rubber cursor and a digital caliper of 0.01-mm resolution, the values of the width of the zone of gingival keratinized tissue and gingival thickness were obtained. It was observed that the lateral incisor has the largest mean zone of gingival keratinized tissue (5.54 ± 1.09 mm), followed by the central incisor (4.62 ± 1.02 mm) and canine (4.32 ± 1.33 mm). The mean gingival thickness was greater in the central incisor (1.17 ± 0.20 mm), followed by the lateral incisor (1.04 ± 0.24 mm) and canine (0.87 ± 0.27 mm). No statistically significant difference was verified for the mean width of the zone of gingival keratinized tissue and gingival thickness between men and women. A positive correlation between gingival thickness and width of the zone of gingival keratinized tissue was observed in the maxillary canine (Pearson r = 0.398, P < .05), lateral incisor (Pearson r = 0.369, P < .05), and central incisor (Pearson r = 0.492, P < .05). In patients 20 to 35 years of age, there was a positive correlation between gingival thickness and width of the zone of gingival keratinized tissue for the maxillary right canine, lateral incisor, and central incisor.

Topics: Adult; Cuspid; Female; Gingiva; Gingival Pocket; Humans; Incisor; Keratins; Male; Maxilla; Mouth Mucosa; Single-Blind Method; Young Adult

Finding biocompatible matrix materials capable of enhancing the procedures of gingival augmentation is a major concern in periodontal research. This has prompted the investigation of a safe grafting technique by means of synthetic or natural polymers. The objective of this study is to examine the effect of a gingival fibroblast cultured on a naturally derived (i.e., chitosan-based) scaffold on the width of keratinized gingiva in dogs.. Gingival fibroblasts were cultured from a small portion of hard palates of five dogs. A bilayered chitosan scaffold was seeded with the gingival fibroblasts and transferred to dogs. Surgery was performed bilaterally, and the regions were randomly divided into two groups: chitosan only (control site) and chitosan + fibroblast (test site). Periodontal parameters, including probing depth and width of keratinized and attached gingiva, were measured at baseline and 3 months after surgery. A histologic evaluation was also performed on the healed grafted sites.. Comparison of width of keratinized and attached gingiva in control and test sites showed that the mean width of keratinized and attached gingiva increased in each group after surgery. However, the difference between control and test groups was not statistically significant. Concerning the existence of the keratinized epithelium, exocytosis, and epithelium thickness, no significant difference was observed in test and control sites. The difference was significant in relation to rete ridge formation.. The tissue-engineered graft consisting of chitosan + fibroblast was applied to gingival augmentation procedures and generated keratinized tissue without any complications usually associated with donor-site surgery.

Topics: Animals; Biocompatible Materials; Biopsy; Cell Culture Techniques; Chitosan; Collagen; Connective Tissue; Dogs; Epithelium; Exocytosis; Fibroblasts; Gingiva; Gingival Pocket; Gingivoplasty; Keratins; Random Allocation; Surgical Flaps; Suture Techniques; Time Factors; Tissue Engineering; Tissue Scaffolds

The occurrence of creeping attachment has been documented with epithelialized autogenous masticatory mucosa grafts (free gingival grafts) and suggested in other root coverage techniques. The purpose of this study was to examine whether or not creeping attachment occurred after a connective tissue with partial-thickness double pedicle graft had been performed. This study examined 22 defects, in 19 patients, treated where less than complete root coverage was obtained at 4 weeks postoperative. Creeping attachment occurred in 21 of the 22 defects (95.5%), in 18 of the 19 patients (94.7%). Complete root coverage occurred in 17 of the 22 defects (77.3%), in 15 of 19 patients (78.9%). The mean creeping attachment obtained was 0.8 mm. Additionally, it was the goal of this study to see if any factor could be associated with creeping attachment. This study did not find any factors that could be associated with the amount of creeping attachment seen. Creeping attachment seems to occur commonly, but complete root coverage is not predictable.

Topics: Adult; Age Factors; Anti-Bacterial Agents; Bucrylate; Connective Tissue; Dental Plaque; Dentin Sensitivity; Epithelial Attachment; Female; Follow-Up Studies; Forecasting; Gingiva; Gingival Pocket; Gingival Recession; Humans; Keratins; Labial Frenum; Male; Periodontal Dressings; Root Planing; Smoking; Surgical Flaps; Tetracycline; Tissue Adhesives; Tooth Cervix; Tooth Root; Transplantation, Autologous; Wound Healing

The increased use of implants in orthodontics has stimulated interest in augmenting bone in patients who have deficient alveolar ridges that preclude ideal implant placement. A nonsurgical technique for increasing the amount of available bone for implant site development and fixture placement is orthodontic extrusion, or forced eruption. The concept of a tooth moving coronally by orthodontic means and the clinical alterations in the soft tissue architecture of the periodontium demonstrated during orthodontic extrusive movement of periodontally compromised teeth have demonstrated a direct relationship of pocket depth reduction, accompanied with an immature appearing tissue, "the red patch." This article will describe the periodontium during eruptive tooth movement.

Topics: Alveolar Bone Loss; Color; Dental Implantation, Endosseous; Dental Implants; Gingiva; Gingival Pocket; Humans; Incisor; Keratins; Maxilla; Periodontal Diseases; Periodontal Pocket; Periodontitis; Periodontium; Radiography; Root Canal Therapy; Tooth Eruption; Tooth Movement Techniques; Wound Healing

The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary front tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. 108 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, thickness of the free gingiva, width of the keratinized gingiva and the contour of the marginal gingiva. From clinical photographs of the maxillary front tooth region, the width (at the apical third--CW) and the length (CL) of the crowns of the 6 front 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. After correction for incisal attrition, 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.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Cuspid; Dental Arch; Dental Cementum; Dental Enamel; Epithelial Attachment; Gingiva; Gingival Pocket; Gingivitis; Humans; Incisor; Keratins; Maxilla; Models, Dental; Odontometry; Tooth Abrasion

Miniature swine exhibit naturally-occurring, progressive recession on facial surfaces of the permanent mandibular incisors. The purpose of this study was to determine whether placing a free gingival graft to augment the width of keratinized gingiva of mandibular incisors in miniature swine would prevent or retard recession at the grafted site compared to an untreated contralateral control site. In 8 litter-mate miniature swine, free gingival grafts were placed on the facial surface of the permanent central and lateral incisors on one side of the mandible. The contralateral mandibular incisors did not receive any treatment and served as controls. Clinical measurements, including eruption, recession, pocket depth, attachment level, and keratinized gingival width were obtained preoperatively, 2 to 3 weeks after surgery to assess the success of gingival augmentation, and 3, 6, and 9 months postoperatively. Eight grafted sites were successful and showed significant augmentation of the keratinized gingival width, with a mean increase of 5.8 +/- 0.7 mm, while 6 grafts failed and showed a slight decrease in the mean width of -0.4 +/- 0.5 from the preoperative to postoperative examination. All sites showed significant recession during the experimental period. Successful sites showed no statistically significant or clinically major difference in the rate or amount of recession than contralateral control sites. By 9 months, the average increase in recession from the baseline examination was 2.8 +/- 1.5 mm for successfully grafted sites and 2.6 +/- 1.3 mm for contralateral controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Gingiva; Gingival Pocket; Gingival Recession; Gingivitis; Keratins; Swine; Swine, Miniature; Time Factors; Wound Healing

A study was conducted to observe the changes in areas with untreated mucogingival defects over a 4-year period. Upon entering dental school, a group of freshman students were assessed for Plaque Index, Gingival Index, probing depth, and width of keratinized gingiva. These same students were reassessed for the same parameters at the end of their senior year. Of the 112 sites in 39 individuals, 33 sites revealed a slight increase in keratinized gingiva, 69 sites were unchanged, and 10 sites showed a slight decrease. These changes were minimal and not statistically significant. The Plaque Index, Gingival Index, and probing depth mean values showed a small but statistically significant improvement. In this group of students with a high degree of oral hygiene, areas with inadequate zones of attached gingiva were able to be maintained without further recession and without surgery.

Topics: Dental Plaque Index; Double-Blind Method; Gingiva; Gingival Diseases; Gingival Pocket; Gingival Recession; Humans; Keratins; Longitudinal Studies; Periodontal Index

Topics: Animals; Cats; Cell Differentiation; Cells, Cultured; Epithelial Cells; Epithelium; Gingiva; Gingival Pocket; Keratins; Phenotype

Topics: Adolescent; Adult; Blood Vessels; Chromium Alloys; Collagen; Denture Bases; Denture, Partial, Removable; Female; Gingiva; Gingival Diseases; Gingival Pocket; Gingivitis; Humans; Keratins; Lymphocytes; Male; Methylmethacrylates; Middle Aged; Plasma Cells; Stomatitis; Stomatitis, Denture

Topics: Adult; Gingiva; Gingival Pocket; Humans; Keratins; Middle Aged; Periodontitis; Transplantation, Autologous