• The Journal of the Korean dental association
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• v.58 no.1
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• pp.8-18
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• 2019

This case report presents results for gingival recession coverage following gingival grafting and for gingival biotype enhancements by visualizing soft tissue volume changes using intraoral three-dimensional scanning. A 28 year old female patient with multiple gingival recessions and a 19 year old female patient with a single gingival recession on mandibular anterior area were treated. Root coverage was performed in both cases using autogenous subepithelial connective tissue harvested from palate. Intraoral 3D scan data were obatained presurgery and at 3 months, 1 year, and 2 years postsurgery. The recession areas were recovered successfully by subepithelial connective tissue graft combined with pedicle flap repositioning, and the patients showed neither further recurrence nor post-operative complication. Soft tissue biotype changes were identified by superimposing and analyzing scan data, revealing that gingival biotype was enhanced in both cases. These cases suggest that SCTG could be advantageous in terms of the gingival biotype enhancement, as well as gingival recession coverage, and intraoral 3D scanning might be suitable for assessing post-surgical gingival biotype change.

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.2-13
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• 2020

Purpose: Subepithelial connective tissue grafts (SCTGs) are commonly performed for the treatment of gingival recession due to their high predictability. This study evaluated and histologically compared connective tissue grafts in terms of the presence of epithelial remnants and composition of the tissue types that were present (epithelium, lamina propria, and submucosa). Methods: Ten patients underwent epithelium removal using 2 different techniques: the use of a blade (group B) and through abrasion (group A). Twenty samples were collected and each tissue type was analyzed histologically in terms of its area, thickness, and proportion of the total area of the graft. Results: In 4 samples (40%) from group B (n=10) and 2 samples (20%) from group A (n=10), the presence of an epithelial remnant was observed, but the difference between the groups was not statistically significant (P>0.05). Likewise, no statistically significant differences were observed between the groups regarding the area, mean thickness, or proportion of the total area for any of the tissue types (P>0.05). Conclusions: Histologically, SCTGs did not show statistically significant differences in terms of their tissue composition depending on whether they were separated from the epithelial tissue by abrasion or by using a blade.

• Archives of Reconstructive Microsurgery
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• v.22 no.2
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• pp.69-73
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• 2013

Facial esthetics and smiling are key components in nonverbal communication and have an important role in determination of the first impression of a person. The various components of the smile in dental esthetics include Gingival scaffold, lip framework, and Teeth. The periodontist creates a smile by performing various periodontal plastic microsurgery procedures for management of mucogingival problems. A 25-year-old patient reported to the Department of Periodontology at Teerthanker Mahaveer Dental College and Research Center, Moradabad, Northern India, with the chief complaint of long looking teeth in the upper jaw, making him conscious while smiling. Miller class I gingival recession with Maxillary left canine (23) was diagnosed. Periodontal plastic microsurgery employing double papilla grafting with connective tissue graft harvested from the palate in order to cover denuded root was performed using microsurgical instruments and microsuturing with 6-0 suturing material under magnification. Healing was uneventful, with achievement of 100% root coverage of denuded root after three months. The patient was highly impressed and satisfied with his enhanced smile.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.237-249
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• 2007

This study was performed to evaluate the effect of membrane exposure on new bone formation when guided bone regeneration with perforated titanium membrane on atrophic alveolar ridge. The present study attempted to establish a GBR model for four adult beagle dog premolar. Intra-marrow penetration defects were created on the alveolar ridge(twelve weeks after extraction) on the mandibular premolar teeth in the beagle dogs. Space providing perforated titanium membrane with various graft material were implanted to provide for GBR. The graft material were demineralized bovine bone(DBB), Irradiated cancellous bone(ICB) and demineralized human bone powder(DFDB). The gingival flap were advanced to cover the membranes and sutured. Seven sites experienced wound failure within 2-3weeks postsurgery resulting in membrane exposure. The animals were euthanized at 4 weeks postsurgery for histologic and histometric analysis. The results of this study were as follows: 1. There was little new bone formation at 4 weeks postsurgery. irrespectively of membrane exposure. 2. There was significant relationship between membrane exposure and bone graft resorption(P<0.05), but no relation between membrane exposure and infiltrated connective tissue. 3. There was much bone graft resorption on DFDB than ICB and DBB. 4. The less exposure was on the perforated titanium membrane, the more dense infiltrated connective tissue was filled under the membrane when grafted with ICB and DBB. but there was no relationship between the rate of membrane exposure and the percentage of infiltrated connective tissue area and no relationship between the percentage of the area in the infiltrated connective tissue and in the residual bone graft. Within the above results, bone formation may be inhibited when membrane was exposed and ICB and DBB were more effective than DFDB as a bone graft material when guided bone regeneration.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.30 no.2
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• pp.102-111
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• 2021

Implant placement in the anterior region is performed in several stages, and harmonization of both hard and soft tissues is essential. In addition, adequate esthetic and functional evaluations are necessary in the process of transitioning from the provisional to the final prosthesis to attain patient satisfaction. Although gingiva can be molded in the anterior region, depression in the occlusal view can yield good results through the augmentation procedure. However, the harvesting of connective tissue from the palate is not suitable for various reasons, such as postoperative discomfort and intraoperative bleeding. Compared to the palatal area, the harvesting of connective tissue from the maxillary tuberosity can easily result in relatively thick tissue and quick healing of the donor site, thus proving to be a good modality for graft procedures. The purpose of this report is to examine the relevant evidence from previous studies and evaluate the process of soft tissue augmentation through a case presentation.

• Journal of Periodontal and Implant Science
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• v.44 no.6
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• pp.300-306
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• 2014

Purpose: A laterally positioned flap (LPF) combined with a subepithelial connective tissue graft (SCTG) is one of the conventional approaches for resolving gingival recession defects, with the advantages of flap flexibility and extended coverage of the tissue graft. However, thus far, evidence is lacking for the use of this technique for the treatment of advanced gingival recession defects. This report discusses three Miller class III cases with interproximal bone loss and wide and deep defects treated with a combination procedure of a modified laterally positioned flap (mLPF) and SCTG. Methods: mLPF combined with SCTG was performed for each case. The defect size and the degree of hypersensitivity at baseline and the final appointment in each case were documented. Results: The three cases had a mean initial defect of $7.7{\pm}1.5mm$ and a mean residual defect of $1.7{\pm}1mm$ at the 6-, 3-, and 36-month follow-up, respectively, after the root coverage surgery. The symptom of hypersensitivity was improved, and the patients were satisfied with the clinical outcomes. Conclusions: The results demonstrated that the combination of mLPF with SCTG is promising for treating these advanced cases with respect to obtaining the expected root coverage with the gingival tissue.

• 대한치주과학회:학술대회논문집
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• 1997.11a
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• pp.71-71
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• 1997

• 대한치주과학회:학술대회논문집
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• 1998.11a
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• pp.65-65
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• 1998

• 대한치주과학회:학술대회논문집
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• 2009.05a
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• pp.34-34
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• 2009

• 대한치주과학회:학술대회논문집
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• 2002.05a
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• pp.14-14
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• 2002