• Journal of Periodontal and Implant Science
• /
• v.27 no.1
• /
• pp.235-248
• /
• 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 the korean academy of Pediatric Dentistry
• /
• v.33 no.4
• /
• pp.678-685
• /
• 2006

A certain width of attached gingiva is required to maintain gingival health The purpose of this study was to examine the dimensional changes in the width of attached gingiva and the depth of gingival sulcus among the deciduous, mixed and permanent dentitions and establish baseline information on the width of attached gingiva in Korean children. Eighty-eight children aged 4 to 14, who visited the Department of Pediatric Dentistry at Samsung Medical Center, were selected and divided into 3 groups according to the periods of dentition: deciduous, mixed and permanent dentitions. The width of keratinized gingiva and the depth of gingival sulcus were measured in each group with a periodontal probe and the width of attached gingiva was determined. The width of attached gingiva in maxillary and mandibular first molars increased significantly with age after eruption in the permanent dentition (p<0.05). The sulcus depth significantly increased in newly erupted permanent teeth with narrower width of attached gingiva (p<0.05) in all of the experimented teeth with the exception of the mandibular central incisor during the transition period. The results suggest that the mean width of attached gingiva does not increase steadily from the deciduous to the permanent dentition.

• Journal of Periodontal and Implant Science
• /
• v.27 no.3
• /
• pp.549-559
• /
• 1997

The purpose of this study was to evaluate clinical changes in graft size after treatment with strip gingival autograft in human. 57 premolar teeth in 27 patients having the following mucogingival problems were selected. The width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth were measured at the initial examination, 2, 12 and 24 weeks following the strip gingival autograft and free gingival autograft. The change of width of extension, attached gingiva including free marginal gingiva, width of transplant and clinical sulcus depth according to healing process in both graft procedures was statistically analyzed by repeated measure ANOVA test and independent t-test using SPSS program. The results were as follows : 1. The change of keratinized gingiva in both graft procedures was increased significantly at 24 weeks post-op. 2. The clinical sulcus depth exhibited no marked changes throughout the entire investigation in both graft procedures. 3. No dimensional variation was seen in graft size in both graft procedures. 4. Shrinkage did not differ significantly in both graft procedures. From the day of grafting to 24 weeks after surgery the percentages of shrinkage were : strip gingival autograft 28% and free gingival autograft 29%.

• The Journal of the Korean dental association
• /
• v.48 no.9
• /
• pp.664-669
• /
• 2010

All prosthetic and restorative therapies require a healthy periodontium as a prerequisite for success. Understanding of the concepts of periodontal-restrorative interaction, especially with regard to interactions at the gingival margin is important. The aim of this article gives the information about the essential considering factor for successful prosthesis; biologic width, periodontal biotype, width of attached gingiva, margin of restoration. If a restorative margin must be extended below the gingival margin, it is critical that adequate band of attached gingiva is present, the margin does not violate the biologic width, the margin is closed and properly finished.

• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.305-318
• /
• 2006

This study was performed to evaluate the effect on the formation of keratinized attached gingiva when free gingival graft with strip technique was used. After the partial thickness flap was prepared, it was positioned apically more than 7mm using mucoperiosteal suture. At the donor site, strip was achieved with 2mm width, less than 1mm thickness, (mesiodistal teeth length + 6)$^{\ast}$2 mm length. Then, it was divided into 2 same pieces and located at the recipient bed apico-coronally with more or less 3mm interval. Follow-up check was made at 1,2,4,8,12 weeks after the operation. The results of this study were as follows : 1. The inter-strip space was mostly filled with keratinized attached gingiva. 2. The contraction of the graft was nigligible, and 92% of planned area was filled with keratinized attached gingiva. 3. The inconvenience of the patients at donor site was minimal. 4. The width of the strip was widened. In conclusion, free gingival graft using strip technique is useful to achieve the keratinized attached gingiva maximally with free gingival graft minimally and to minimize the inconvenience of donor palatal site of the patients.

• Journal of Periodontal and Implant Science
• /
• v.31 no.1
• /
• pp.243-258
• /
• 2001

Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Threrfore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingival, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1. The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. the average periodontal pocket depth is 2.0mm and 47% of frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2. With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3. With statistical significance(p<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (p>0.05). 4. The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (p<0.05). 5. With statistical significance(p<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (p>0.05).

• Journal of Periodontal and Implant Science
• /
• v.29 no.3
• /
• pp.635-645
• /
• 1999

The present study examines the effects of orthodontic treatment of surgically exposed impacted upper canines or ectopically erupted upper canines to periodontal condition and whether various opening procedures have significant difference in postoperative periodontal status. The subjects included 23 orthodontic patients(7 men, 16 women) with unilateral upper canine impaction treated either with closed eruption technique(group I), with apically positioned flap procedure (group II), and those with canines ectopically erupted through keratinized gingiva (group III). In each subject, the ectopic canine was orthodontically aligned, and changes in periodontal tissue were assessed by measuring keratinized gingival width, attached gingival width, probing depth and bone probing depth. In all three groups, the width of keratinized gingiva was preserved while showed no signs of detrimental periodontal condition such as gingival recession. In all three groups, no significant difference in periodontal pocket depth from control was observed. The width of attached gingiva was significantly greater in patients treated with apically positioned flap procedure(group II) than in patients on other groups.

• 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.

• The Journal of the Korean dental association
• /
• v.54 no.4
• /
• pp.296-305
• /
• 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.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.23 no.4
• /
• pp.893-898
• /
• 1996

The occlusal disharmonies resulted from labially protruded or malpositioned teeth can damage the periodontium and induce the non-inflammatory gingival recession. For these cases, a conservative approach was performed by improving oral hygiene and correcting the axial and positional status of the gingivally recessed teeth and removing the prematurely contacted areas. In some cases, rapid remission of tooth mobility and gradual decrease of gingival recession was observed just after start of treatment. In cases of gingival recession in permanent lower incisors of the children with mixed dentition, the treatment of choice is non-surgical conservative approaches. In cases when the gingival inflammation can be controlled through reinforcing the oral hygiene, when attached gingiva have a potential to increase in width through growth (not more than 1 year after eruption or not yet arrived at adult level), and when the recession can be corrected by moving the teeth from labial cortical plate through orthodontic treatment, the conservative measures would be the first choice. On the contrary, when recession has exceeded beyond the level of CEJ, when the gingival inflammation existed with the cause of poor oral hygiene, when the attached gingiva have little potential to increase (for example, more than 8 years after eruption), and when the conservative measures yielded no benefit after 4-8 weeks of treatment, the surgical approaches should be sought.