• 제목/요약/키워드: Mucogingival surgery

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교정 치료 중인 환자의 치주수술 (Mucogingival surgery for patients under orthodontic treatment)

  • 박신영
    • 대한치과의사협회지
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    • 제55권3호
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    • pp.249-256
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    • 2017
  • Gingival recession is one of the common mucogingival problems during the orthodontic treatment. The causes of the gingival recession are similar to gingival recession in patients with periodontal diseases. Accumulation of bacterial deposits around the natural teeth induces the gingival inflammation and gingival recession occurs in the teeth with the lack of the supporting bone. However, malpositioned teeth which are labially positioned teeth or rotated teeth are more risky for gingival recession. Once root is exposed to oral cavity due to gingival recession, the orthodontic tooth movement is compromised and esthetic problems appeared. In addition, excessive gingival recession over the mucogingival junction jeopardizes the oral hygiene control, which has a risk of further gingival recession and bone loss around the tooth. To cover exposed root or to prevent further gingival recession, mucogingival surgery with gingival graft is recommended for the patients under orthodontic treatment. This case report aimed to present the mucogingival treatments of gingival recession observed during orthodontic treatment. Case I had had initial slight gingival recession before the orthodontic treatment. However, during the retraction phases, the gingival recession progressed and the periodontal treatment was referred. In case II, miller Class III gingival recession was occurred after correction of rotation. Both cases were treated by coronally advanced flap with free gingival grafts and recovered to the level of adjacent teeth despite of complete root coverage was not achieved in Case II. After periodontal treatment, orthodontic treatment was successfully completed. In conclusion, mucogingival surgery during the orthodontic treatment is recommended for the successful orthodontic treatment as well as periodontal health.

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A combined approach to non-carious cervical lesions associated with gingival recession

  • Yang, SungEun;Lee, HyeJin;Jin, Sung-Ho
    • Restorative Dentistry and Endodontics
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    • 제41권3호
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    • pp.218-224
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    • 2016
  • Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs.

항암제 Cyclophosphamide가 구강창상 치유에 미치는 영향에 관한 실험적 연구 (EXPERIMENTAL STUDY ON THE EFFECTS OF CYCLOPHOSPHAMIDE ON THE HEALING OF THE ORAL INCISED WOUND)

  • 김성수
    • 대한치과의사협회지
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    • 제15권2호
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    • pp.153-158
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    • 1977
  • To assure that cyclophosphamide has been considered something that must be effective to retard wound healing, the Author has studied clinically and histopathologically. All rabbits were incised on the mucogingival junction of anterior teeth in mandible about 1 Cm. in length with mucosa and periosteum layer. The 21 rabbits within 6 months old, weighing about 1.5-1.8 kg were divided into a experimental group and a control group. 1) Group 1 (Experimental group)-After 14 rabbits dieted as the control group were injected with Endoxan (=Cyclophosphamide) in dosage of 30mg per 1kg-body weight intramuscularly, the surgery was performed. 2) Group 2 (Control group)-the surgery in this group was performed without Endoxan. The rabbits were sacrificed on the 1st, 3rd, 5th, 7th, 10the, 14th day after surgery and microscopic slides were made with H-E stain. The results might be summarized as follows; 1) Cyclophosphamide effected to retard healing process on the incised wound of oral mucosa and connective tissue. 2) Control wounds were healed by the 7th day after surgery. 3) Comparison between control and experimental wound did not show significant differences 14th day after surgery.

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Clinical evaluation of a collagen matrix to enhance the width of keratinized gingiva around dental implants

  • Lee, Kang-Ho;Kim, Byung-Ock;Jang, Hyun-Seon
    • Journal of Periodontal and Implant Science
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    • 제40권2호
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    • pp.96-101
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    • 2010
  • Purpose: The purpose of this study was to evaluate the effect of collagen matrix with apically positioned flap (APF) on the width of keratinized gingiva, comparing to the results of APF only and APF combined with free gingival graft (FGG) at the second implant surgery. Methods: Nine patients were selected from those who had received treatments at the Department of Periodontics, Chosun University Dental Hospital, Gwangju, Korea. We performed APF, APF combined with FGG, and APF combined with collagen matrix coverage respectively. Clinical evaluation of keratinized gingival was performed by measuring the distance from the gingival crest to the mucogingival junction at the mid-buccal point, using a periodontal probe before and after the surgery. Results: The ratio of an increase was 0.3, 0.6, and 0.6 for the three subjects in the APF cases, 3, 5, and 7 for the three in the APF combined with FGG case, and 1.5, 0.5, and 3 for the three in the APF combined with collagen matrix coverage case. Conclusions: This study suggests that the collagen matrix when used as a soft tissue substitute with the aim of increasing the width of keratinized tissue or mucosa, was as effective and predictable as the FGG.

임상가를 위한 특집 3 - 치주판막 절개의 기본원리 (Basic Rules of Incision in Periodontal Flap Preparation)

  • 신승일
    • 대한치과의사협회지
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    • 제50권8호
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    • pp.474-481
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    • 2012
  • The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.

구개 및 치아 형태와 구개부 저작점막의 두께와의 연관성 (Relationship between The Shape of Palatal Vault and Tooth and The Thickness of Palatal Masticatory Mucosa)

  • 석화숙;이만섭;권영혁;박준봉
    • Journal of Periodontal and Implant Science
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    • 제33권3호
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    • pp.519-531
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    • 2003
  • The aim of present investigation was to clinically measure the thickness of palatal masticatory mucosa in the hard palate as potential donor site for mucogingival surgery, to determine the relation to shape of palatal vault, form of tooth, gender, and to serve the clinical criteria t o choose the proper surgical technique. 84(mean age:25yrs) systemically and periodontally healthy volunteers participated in this study and 18 standard measurement points were defined in the hard palate, located on 3 lies which ran at different distances parallel to the gingival margin. 6 positions were designated on each of these 3 lines between the level of canine and 2nd molar and a bone sounding technique using a periodontal probe with minimal local anesthesia was utilized to assess the thickness of palatal masticatory mucosa. Student t-test was used to determine the difference in mucosal thickness between 2 groups gender, shape of palatal vault (high palatal vault vs. low palatal vault), tooth form (short-wide vs. long narrow) The result of this study were as follows: 1. Soft tissue thickness progressively increased in sites further away from the gingival margin (p<0.01). 2. Depending on position, in line a and line c the masticatory mucosal thickness increased from Ca to M2(p<0.01), but in line b the thickness increased from Ca to P2, and decreased to M1 and increased again to M2. 3. Gender did not influence the thickness of masticatory mucosa. 4. Palatal vault shape was associated with the thickness of masticatory mucosa. Thickness of low palatal vault group was thicker than high palatal group between P2 and M2 position. 5. Form of tooth did not influence the thickness of masticatory mucosa. In conclusion, palatal vault shape was associated with the thickness of masticatory mucosa. So, mucogingival surgery can be considered as a treatment modality in high palatal vault group. But, Gender and tooth form did not influence the thickness of masticatory mucosa.