• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.91-96
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• 2008

Purpose: One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. and Aestheic concerns are usually the reason to perform root coverage procedure. This case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft(SCTG) on Miller's Class I marginal tissue recession. Materials and Methods: One patient, with two Miller's class I marginal tissue recession on both maxiallay canines, was treated with root coverage using SCTG (modified Nelson's technique). At baseline, the following measurements were recorded: 1) recession depth; 2) width of keratinized giniga. At 9, 10 months post-surgery, all clinical measurements were repeated. Result: 1) The mean root coverage from baseline to 9, 10 months post-surgery was 92.3%. 2) The mean recession depth decreased from 6.5 mm to 0.5 mm. 3) The mean width of keratinized gingiva increased from 1.25 mm to 3.5 mm. Conclusion: Within the above results, root coverage using SCTG is an effective procedure to cover Miller's class I marginal tissue recession defect. Also, patient with aesthetic concern could be satisfied with this result.

• Journal of Periodontal and Implant Science
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• 제39권2호
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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.

• Journal of Periodontal and Implant Science
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• 제38권4호
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• pp.717-722
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• 2008

Purpose: The subepithelial connective tissue graft(SCTG) has been proven to be a highly predictable treatment modality for coverage of gingival recession. This case report was performed to evaluate the effect of various root coverage procedures using SCTG on gingival recession. Materials and Methods: Three patients presents with Miller's class I recession defect on the maxillary canine. Each other SCTG(coronally advanced flap, Bruno's Tech., envelope Tech.) were performed for root coverage. Clinical parameters assessed included recession depth, recession width, and keratinized gingival width. Measurements were taken at baseline and 2 months and follow up end. Results: The average of root coverage was 4 mm(100% of the pre-operative recession depth) at the 2, 5 months examination. The average increase of keratinized tissue between the baseline and the 2 months amounted to 3.2mm. Conclusion: Within the above results, various root coverage using SCTG is an effective procedure to Miller's class I recession defect and patient could be satisfied aesthetic requirement.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.625-636
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• 2007

Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.

• 대한치과의사협회지
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• 제54권5호
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Journal of Periodontal and Implant Science
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• 제38권3호
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• pp.483-492
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• 2008

Purpose: The purpose of this study was to compare clinical effect of the Langer & Langer technique, the modified Langer & Langer technique and Bruno technique. Material and Methods: 30 patients who have gingiva recession(Miller class I or class II) were carried root coverage. Langer & Langer technique(14 patients/32 tooth), modified Langer & Langer technique(5 patients/10 tooth) and Bruno technique(11 patients/18 tooth) was carried. At baseline and average 3 months after operation, it was estimated clinical index(Pocket depth, gingiva recession, clinical attachment level, keratinized gingiva, scar tissue, root coverage rate) by Williams style probe. Result: Root coverage rate is indicated Langer & Langer technique(8S%), Modified Langer & Langer technique(86%) and Bruno technique(90%). Conclusion: All three of the procedures were effective in gingival recession and improved clinical parameters.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.218-226
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• 2023

Treatment of multiple gingival recession defects is usually more challenging than that of single gingival recession. Various techniques for the treatment of multiple gingival recession have been established. Recently, vestibular incision subperiosteal tunnel access (VISTA) technique has been considered to exhibit high predictive ability. Connective tissue graft (CTG) has also been considered a gold standard technique owing to its high predictability of root coverage. However, this technique requires a suitable donor site and has clinical disadvantages, such as additional pain. Thus, in this case presentation, platelet-rich fibrin (PRF) was used as an alternative material for CTG along with VISTA. We herein report cases of two patients with Miller's class I and III multiple gingival recession defects, respectively. These patients underwent VISTA along with the use of a PRF membrane. They were followed up for 12 months postoperatively, and their clinical parameters, including probing depth, depth of gingival recession, clinical attachment level, and width of attached gingiva at baseline and at 2, 6, and 12 months postoperatively, were assessed. The patient with class 1 recession defects exhibited a significant amount of root coverage, which remained stable during the follow-up period. Whereas the patient with class 3 recession defects had lesser amount of coverage compared to class 1 patient. The partial coverage observed may be attributed to not only anatomical factors but also the technique-sensitive nature of the procedure. Considering these results, the use of VISTA along with PRF is a viable option for treating gingival recession, as it does not cause discomfort to patients. However, various factors need to be considered during the surgical procedure.

• Journal of Periodontal and Implant Science
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• 제42권6호
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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.

• 철학연구
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• 제123호
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• pp.137-185
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• 2018

여성혐오를 넘어서기 위해서는 여성이라는 존재론적 차원의 물질성과 현실성을 기각시키거나 저항의 단위소를 무화시키는 것이 아닌, 성별 불평등구조에서 지배계급성을 구성하고 있는 남성성의 작동 메커니즘에 대한 치밀한 분석과 해체로 나아가야 한다. 이를 위해 필자는 첫 번째로 남근질서라는 아버지의 법질서에서 팔루스와 페니스 간의 유착성-팔루스가 초월적이며 절대적 심급이 아닌 스스로 축소되고 사라져버리는 페니스의 유약성에 참조점을 두고 있는 내재적 결핍성의 지점임을 이론적으로 추적해나감으로써 남근질서의 해체가능성을 모색해보고자 한다. 두 번째로 남성지배의 축 중 하나인 페니스 나르시시즘이라는 개인적 정체성화의 작동방식을 분석해보고자 한다. 여기서 페니스는 해부학적 기관에 그치는 것이 아니라 자기애의 온전성을 담지받는 장소이자 아버지의 법질서의 사회문화적 권위와 권력의 계승점을 나타내는 것이다. 즉 남성은 자신의 페니스를 중심으로 페니스 나르시시즘이라는 개인으로서의 남성의 정체성화 양식을 구성해나가고 있으며, 사회문화적으로는 방기하는 몸이라는 권력적 몸, 특권적 몸을 양산하는 것이다. 세 번째로 남성지배의 또 다른 축인 페니스 카르텔이라는 집단적 정체성화의 메커니즘은 남성들의 본래적 우월성의 상호확인에서만이 아니라, 남성들의 자기 완결성의 결여, 무능력함과 형편없음, 비리 축적을 상호 묵인함으로써 더욱 더 강력하게 작동하는 것이다. 왜냐하면 남성 특권구조란 특정한 남성 개개인에게 독점되는 양태가 아니라, 남성이라는 성별 계급으로 범주화된 이들이 의식적, 무의식적으로 나눠가지는 지배적 집합성에서 기인하는 것이기 때문이다. 이러한 페니스 나르시시즘과 페니스 카르텔을 해체하기 위해서 페니스가 자기완결적이며 불침투적인 닫힌 몸이 아님을 드러내어야 한다. 즉 페니스는 사정기관과 배설 기관이라는 다공성의 일체화 구조를 통해 구멍 지어진 몸이자 숭고와 비천, 깨끗함과 더러움 등의 분열적 지점이라 할 수 있다. 또한 우뚝 솟은 불변의 공격성과 능동성, 힘과 권위의 기관이 아닌, 시시각각 형태가 변하는 유동적 살로서의 페니스와 팔루스-기관의 유약성을 연동시켜 사유해봄으로써 페니스 카르텔의 남근다발이 한데 묶일 수조차 없는 결핍성의 지대임을 논증하고자 한다. 남근 이데올로기론이 갖는 임계점을 이론적으로 살펴봄으로써, 폭압적 남성성의 재생산 고리를 끊어내어 여성혐오를 극복해보고자 한다.