• Title/Summary/Keyword: Gingival Recession

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Comparative study of two collagen membranes for guided tissue regeneration therapy in periodontal intrabony defects: a randomized clinical trial

  • Chung, Young-Mi;Lee, Jue-Yeon;Jeong, Seong-Nyum
    • Journal of Periodontal and Implant Science
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    • v.44 no.4
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    • pp.194-200
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    • 2014
  • Purpose: The purpose of this study was to assess and compare the clinical and radiographic outcomes of guided tissue regeneration therapy for human periodontal intrabony defects using two different collagen membranes: a porous nonchemical cross-linking collagen membrane (NC) and a bilayer collagen membrane (BC). Methods: Thirty subjects were randomly assigned and divided into the following 3 groups: a test group (NC+BM), in which a NC was used with xenograft bone mineral (BM), a positive control group (BC+BM), in which a BC was used with xenograft BM, and a negative control group (BM), in which only xenograft BM was used. The following clinical measurements were taken at baseline and 3 months after surgery: plaque index, gingival index, probing pocket depth, gingival recession, and clinical attachment level. Radiographic analysis was performed at baseline, 1 week and 3 months after surgery. Results: Membrane exposure was not observed in any cases. Significant probing depth reduction, attachment-level gain and bone fill were observed for both test and control groups compared to baseline at 3 months after surgery (P<0.05). However, there were no statistically significant differences in clinical improvement and radiographic bone fill between treatment protocols (P>0.05). Conclusions: Within the limitations of this study, the results suggest that both NC and BC were comparable in terms of clinical and radiographic outcomes for the treatment of periodontal intrabony defects in human subjects.

Bacterial Adhesion And Penetration To e-PTFE Membrane Used For The Guided Tissue Regeneration (치주조직재생유도술용 비흡수성 차폐막 (e-PTFE membrane)에의 세균부착 및 침투)

  • Chung, Hyun-Ju;Lee, Sung-Mi;Lee, Ho-Jae;Kim, Ok-Soo
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.103-116
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    • 1996
  • This study was performed to observe the bacterial adhesion and penetration to e-PTFE membrane following guided tissue regeneration(GTR) procedure and to evaluate the association of the membrane exposure and bacterial contamination with the clinical outcome. For the study, ten infrabony defects in 9 patient were treated by mucoperiosteal flap operation including placement of the e-PTFE membrane. The treated teeth were monitored weekly for the membrane exposure, gingival recession and gingival inflammation. The membranes were retrieved after 4 to 6 weeks, examined by SEM for bacterial contamination and adherent connective tisue elements, and observed under LM for the bacterial penetration into membrane. Three months postsurgery, the defect sites were clinically reexamined for the changes in attachment level and probing depth. Comparison of the ultrastuctural findings and clinical outcome revealed that extent of membrane exposure and bacterial contamination of the membrane was inversely associated with clinical attachment gain. From this finding, the extent of membrane exposure and the bacterial contamination on the apical portion of the e-PTFE membrane at the time of removal seemed to be a critical determinant on the clinical outcome of GTR and the membrane exposure needs to be controlled for optimal results.

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Subepithelial connective tissue graft with and without the use of plasma rich in growth factors for treating root exposure

  • Lafzi, Ardeshir;Faramarzi, Masoumeh;Shirmohammadi, Adileh;Behrozian, Ahmad;Kashefimehr, Atabak;Khashabi, Ehsan
    • Journal of Periodontal and Implant Science
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    • v.42 no.6
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    • pp.196-203
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    • 2012
  • Purpose: The aim of this study was to evaluate the clinical efficiency of the subepithelial connective tissue graft (SCTG) with and without plasma rich in growth factor (PRGF) in the treatment of gingival recessions. Methods: Twenty bilateral buccal gingival Miller's Class I and II recessions were selected. Ten of the recessions were treated with SCTG and PRGF (test group). The rest ten of the recessions were treated with SCTG (control group). The clinical parameters including recession depth (RD), percentage of root coverage (RC), mucogingival junction (MGJ) position, clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, and 1 and 3 months later. The data were analyzed using the Wilcoxon signed rank and Mann-Whitney U tests. Results: After 3 months, both groups showed a significant improvement in all of the mentioned criteria except PD. Although the amount of improvement was better in the SCTG+PRGF group than the SCTG only group, this difference was not statistically significant. The mean RC was $70.85{\pm}12.57$ in the test group and $75.83{\pm}24.68$ in the control group. Conclusions: Both SCTG+PRGF and SCTG only result in favorable clinical outcomes, but the added benefit of PRGF is not evident.

The influence of Advanced Adult Periodontitis on the pulp (진행성 치주염이 지수 조직에 미치는 영향)

  • Lee, Kang-Woon;Lee, Chel-Woo;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.29 no.1
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    • pp.95-102
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    • 1999
  • The purpose of this study was to observe histopathologically the influence of advanced periodontitis on pulp tissue, and to conclude the correlation between the results with clinical manifestations. The samples were teeth with over 7mm pocket depth and over 50% radiographic bone loss. These were diagnosed to have very poor prognosis and thus planned to be extracted. Those with any of following conditions were excluded from the samples, loss of vitality, periapical pathology, restoration or prosthesis, dental caries, and attrition or abrasion. It was because these conditions could affect pulp without any correlation with periodontal disease. For the experiment, 17 teeth from 11 patients were selected. Average age of patient was 47. Each tooth was examined for following categoris; pocket depth, gingival recession, electric pulp test, mobility, percussion test, sensitivity test. The extracted teeth were fixed buffered neutral formalin solution. It was decalcified using 4% nitric acid. Sliced histological samples observed using light microscope, for pulp status, and severeity of inflammation. 4 samples were excluded due to histologic sample discrepency. Thus 13 samples were subject to observation. 4 showed normal conditions. Focal reversable pulpitis was shown in 5 samples. Chronic pulpitis was observed 1 sample. Pulpal abscess was observed in 3 samples.

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Socket Preservation Utilizing Modified Free Connective Tissue Graft for Primary Closure : Wing Graft (발치와 보전술식시 변형 유리 결체조직 이식술을 이용한 일차 페쇄술식 : 익이식술)

  • Min, Kyoung-Man;Han, Soo-Boo;Lee, Chul-Woo;Kim, Dong-Kyun;Leem, Sang-Hoon
    • Journal of Periodontal and Implant Science
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    • v.28 no.3
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    • pp.409-418
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    • 1998
  • The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.

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Single-flap versus double-flap approach for periodontal pocket reduction in supraosseous defects: a comparative study

  • Mathala, Venkata Lakshmi;Konathala, Santosh Venkata Ramesh;Gottumukkala, Naga Venkata Satya Sruthima;Pasupuleti, Mohan Kumar;Bypalli, Vivek;Korukonda, Radharani
    • Journal of Periodontal and Implant Science
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    • v.51 no.4
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    • pp.239-253
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    • 2021
  • Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.

Esthetically improved complete denture by gingival shade alteration: a case report (무치악 환자에서 치은의 색조 개선을 통해 심미성을 향상 시킨 총의치 수복 증례)

  • Yim, Soo-Hyun;Kim, Jee-Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.3
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    • pp.239-245
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    • 2014
  • Complete denture prosthodontics includes replacement of natural teeth and associated maxillary and mandibular structures for full edentulous patients. The final objectives of prosthodontic treatment include esthetic and functional rehabilitation. Because the esthetic demand of senior patients has increased esthetic requirement should not be overlooked in denture treatment. In complete denture treatment, attempts have been made to reproduce tooth wear, arrangement, recession of cervical gingiva, staining, improved gingival shade and so on. This 61 year old female patient came to the Department of Prosthodontics with the chief complaint that dentures made 5 years ago in a local clinic were broken and did not fit well. The patient put more emphasis on fabrication of natural and esthetic dentures than recovery of masticatory function. Remake of maxillary complete denture and mandibular implant retained overdenture was planned. In order to create esthetic and natural contour, Aesthetic Color Set Easy system$^{(R)}$ (Candulor dental GmbH, Wangen, Germany) was used to make complete dentures reproducing various gingival shades. Patient's esthetic satisfaction was high. When complete denture prosthodontics treatment involves appropriate expression of individual characteristics in addition to proper selection of esthetic materials, treatment will give satisfaction to both dentist and patient.

Clinical effect of Vitamin C, Vitamin E, lysozyme, carbazochrome complex medicine($IGATAN^{(R)}$) in periodontal disease : Double blind, randomized control study (중등도 치주질환에 대한 Vitamin C, Vitamin E, lysozyme, carbazochrome (이가탄$^{(R)}$) 복합제제의 임상 효과)

  • Chang, Yun-Young;Jang, Yong-Ju;Jung, Im-Hee;Um, Yoo-Jung;Jung, Ui-Won;Kim, Chang-Sung;Kim, Baek-Il;Choi, Seong-Ho
    • The Journal of the Korean dental association
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    • v.47 no.12
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    • pp.830-837
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    • 2009
  • Purpose : The purpose of this study was to evaluate the clinical effect of Vitamin C, Vitamin E, lysozyme, carbazochrome complex medicine($IGATAN^{(R)}$) for periodontal disease. Material and Methods : The study was performed by double blinded, ramdomized method. Forty two subjects diagnosed as chronic incipient or moderate periodontitis at department of periodontology, Yonsei Dental Hospital were included in the study. This study was approved by Institutional Review Board, Yonsei University Hospital. All subjects received scaling at their first examination and second examination was scheduled after 2 weeks. At second examination, periodontal parameters such as plaque index(PI), gingival index(GI), probing depth(PD), bleeding on probing(BOP), gingival recession(GR) and clinical attachment level(CAL) were recorded(Baseline) with prescription of Vitamin C, Vitamin E, lysozyme, carbazochrome complex($IGATAN^{(R)}$) (Experimental group 23 subjects) or placebo medicine(Control group; 19 subjects). The subjects were recalled after 4 weeks for periodontal parameters measurement. Results : In the experimental groups, PI, GI, CAL and BOP scores were significantly reduced at 4 weeks compared to baseline. A statistically significant decrease in or and BOP scores were observed in the experimental group compared to the control group. Conclusion : It can be concluded that Vitamin C, Vitamin E, lysozyme, carbazochrome complex medicine($IGATAN^{(R)}$) have an effect in reducing gingival bleeding and improving periodontal inflammatory condition inchronic incipient- moderate periodontitis.

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Efficacy of glycine powder air-polishing in supportive periodontal therapy: a systematic review and meta-analysis

  • Zhu, Mengyuan;Zhao, Meilin;Hu, Bo;Wang, Yunji;Li, Yao;Song, Jinlin
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.147-162
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    • 2021
  • Purpose: This systematic review and meta-analysis was conducted to assess the effects of glycine powder air-polishing (GPAP) in patients during supportive periodontal therapy (SPT) compared to hand instrumentation and ultrasonic scaling. Methods: The authors searched for randomized clinical trials in 8 electronic databases for relevant studies through November 15, 2019. The eligibility criteria were as follows: population, patients with chronic periodontitis undergoing SPT; intervention and comparison, patients treated by GPAP with a standard/nozzle type jet or mechanical instrumentation; and outcomes, bleeding on probing (BOP), patient discomfort/pain (assessed by a visual analogue scale [VAS]), probing depth (PD), gingival recession (Rec), plaque index (PI), clinical attachment level (CAL), gingival epithelium score, and subgingival bacteria count. After extracting the data and assessing the risk of bias, the authors performed the meta-analysis. Results: In total, 17 studies were included in this study. The difference of means for BOP in patients who received GPAP was lower (difference of means: -8.02%; 95% confidence interval [CI], -12.10% to -3.95%; P<0.00001; I2=10%) than that in patients treated with hand instrumentation. The results of patient discomfort/pain measured by a VAS (difference of means: -1.48, 95% CI, -1.90 to -1.06; P<0.001; I2=83%) indicated that treatment with GPAP might be less painful than ultrasonic scaling. The results of PD, Rec, PI, and CAL showed that GPAP had no advantage over hand instrumentation or ultrasonic scaling. Conclusions: The findings of this study suggest that GPAP may alleviate gingival inflammation more effectively and be less painful than traditional methods, which makes it a promising alternative for dental clinical use. With regards to PD, Rec, PI, and CAL, there was insufficient evidence to support a difference among GPAP, hand instrumentation, and ultrasonic scaling. Higher-quality studies are still needed to assess the effects of GPAP.

CLINICAL AND RADIOGRAPHICAL EVALUATION OF IMPLANT-SUPPORTED FIXED PARTIAL PROSTHESES (임플랜트 지지 고정성 국소의치의 임상적, 방사선학적 평가)

  • Seo Ji-Young;Shim June-Sung;Lee Jae-Hoon;Lee Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.44 no.4
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    • pp.394-404
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    • 2006
  • Statement of problem: A conventional 3-unit fixed partial denture design with a pontic between two retainers is the most commonly used. However in cases where the mental nerve is in close proximity to the second premolar, a cantilever design can be considered. As such, logical and scientific evidence is lacking for the number and position of implants to be placed for partially edentulous patients, and no clear-cut set of treatment principles currently exist. Purpose : The purpose of this study was to evaluate prognosis of implant-supported fixed partial dentures and to compare changes in bone level which may rise due to the different factors. Material and method : The present study examined radiographical marginal bone loss in patients treated with implant-supported fixed partial dentures (87 prostheses supported by 227 implants) and evaluated the influence of the span of the pontic, type of the opposing dentition. Clinical complications were studied using a retrospective method. Within the limitation of this study. the following result were drawn Result, 1. Seven of a total of 227 implants restored with fixed prostheses failed, resulting in a 96.9% success rate. 2. Complications encountered during recall appointments included dissolution of temporary luting agent (17 cases), porcelain fracture (8 cases), loosened screws (5 cases), gingival recession (4 cases), and gingival enlargement (1 case). 3. Marginal bone loss, 1 year after prosthesis placement, was significant(P<0.05) in the group that underwent bone grafting, however no difference in annual resorption rate was observed afterwards. 4. Marginal bono loss, 1 year post-placement, was greater in cantilever-type prostheses than in centric pontic protheses (P<0.05). 5. Marginal bone loss was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. The degree of marginal bone loss was proportional to the length of the pontic (P<0.05). Conclusion: The success rate of implant-supported fixed partial dentures, including marginal bone loss, was satisfactory in the present study. Factors influencing marginal bone loss included whether bone graft was performed, location of the pontic (s), location of the surgical area in the arch pontic span. Long-term evaluation is necessary for implant-supported fixed partial dentures, as are further studies on the relationship between functional load and the number of implants to be placed.