• 대한치과의사협회지
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• 제48권9호
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• pp.664-669
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• 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.

• 대한심미치과학회지
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• 제11권2호
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• pp.9-13
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• 2002

In the last decade, the replacement of old PFM restorations has been a common dental procedure, especially on the anterior regions. Gingiva conditions in most re-treatment cases are not healthy with the old restorations due to ill-fitting margin, improper tooth reduction and poor oral hygiene. Practitioners must carefully evaluate and manage periabutmental gingiva for final restorations. The role of provisional restoration became a major clinical concern at this point. Well-fabricated provisional restorations with precise-fit margin and proper anatomy are critical for achieving good gingival health. Thus, the key of success in replacing old PFM crown depends on the proper tissue management by precise provisional restorations.

• Journal of Periodontal and Implant Science
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• 제26권1호
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• pp.309-316
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• 1996

Squamous cell carcinoma is the most common malignant tumor of the gingiva. Oral cancer accounts for 5 percent of all malignant tumors in the body, and 6 percent of these occur in the gingiva. We present one case of squamous cell carcinoma of the gingiva in 23-year-old female. She complained of gingival swelling and pain during mastication between left maxillary first molar and second molar. Since she had received scaling 2 years ago, food impaction occurred frequently in this site and an ulcerative lesion recurred several times. When she was referred from local clinic, she had a large, irregularly ulcerated lesion of palatal gingiva between left maxillary first molar and second molar, accompanying induration in center and slight elevation around ulcerative margin. The etiology could not be defined but we could diagnose by careful history taking and excisional biopsy of the recurrent ulcerative lesion. In addition, computed tomography and nuclear medicine imaging were undertaken. As a result, we finally diagnosed as moderately differentiated squamous cell carcinoma without metastases. It is concluded that if ulcerations do not respond to therapy in the usual manner, it should be biopsed and histologically evaluated for the definitive diagnosis and treatment.

• 대한치과보철학회지
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• 제14권1호
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• pp.17-21
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• 1976

The author studied the gingival responses to some dental cements in the gingival sulcus around artificial crowns. Abutment preparation for full veneer crown was performed in the canines of the two dogs. The location of cervical margins was about 0.5mm. below the gingival crest. Niranium metal crowns were constructed for the teeth, and cemented with zinc phosphate cement or polycarboxy late cement. In the experimental groups the retained cements in the gingival sulucus were not removed, and in the control groups the cements were removed completely after cementation. The dogs were sacrificed at 3 weeks and 5 weeks respectively after cementation. The gingival responses to these cements were examined histologically. The findings were as follows. 1. There was severe inflammation in the gingiva where the cements had been retained in the gingival sulcus around artificial crowns. 2. There was more severe inflammation in the gingiva which had contacted with zinc phosphate cement than in the gingiva with polycarboxylate cement. 3. There was mild inflammation in the gingiva around the margins of Niranium crowns. 4. The retained cement around the margin of restoration should be completely removed after cementation.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.817-827
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• 2006

Purpose : This study was designed 1) to compare the perception of dental professionals and lay people with respect to minor variations in maxillary anterior tooth size and alignment and their relation to the surrounding soft tissues, and 2) to evaluate the normal tooth-gingiva topographical relationships in periodontally healthy young subjects, Materials and methods : Maxillary anterior teeth were intentionally diagrammed in varying degree of deviation with respect to one of three common anterior esthetic discrepancies including variations in crown length, shape of gingival margin, and length of interproximal contact, 17 images were generated to be preferentially selected by 2 groups consisting of dental professionals and lay people (total of 740). Smiling photographs of 120 dental students who had healthy periodontium were taken and the photographic images were analyzed to be classified as 17 kinds of altered image groups. Results : The results demonstrated noticeable difference between the varying levels of discrepancy. Both group preferred gingival margin of lateral incisor to be 0.5mm lower than that of central incisor. Lay people preferred the gingival margin shape that has 2/9 horizontal component of the crown width, while dental professionals preferred the gingival margin shape that has 1/9 horizontal component of the crown width. Lay people preferred longer length of the interproximal contact (two thirds of the crown length), whereas dental professionals preferred shorter length of the interproximal contact (half of the crown length). Photographic analysis of normal esthetic gingival topography revealed 2/9 horizontal component and short length of the interproximal contact which was of the hybrid nature of the preferences shared by lay people and dental professionals. Conclusion: The results of this study show that dental professionals and lay people demonstrated significant difference in their preference of dental esthetic components, which may then influence the decision making process by dental professionals with respect to designing the anterior esthetic gingival line.

• Journal of Periodontal and Implant Science
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• 제28권4호
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• pp.785-797
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• 1998

This study has been done to prove that keratinized gingiva is required for the periodontal health and to analyse the adequate width that is necessary. Until now, the study on frenum has been documented on changing its location. But the location or the formation of the frenum has not been reported. This experiment has used 173 patients from the department of periodontology of Dankook University to investigate the width of keratinized gingiva, the formation of the frenum and its location for the frequency. This study also looks into the relationship between the gingival recession and the structure of the frenum, and affects they have on periodontal health. The width of the keratinized gingiva in the mandible has been found to be highest in the lateral incisor than in the central incisor. The width decreased from the canine to the first premolar until it reached the molar. The interproximal area of the mandibular frenum was 77.9%, which was greater than the frequency (22.1%) from the midline of the teeth. The highest frequency of frenum was at 30.6% in between the both central incisor then second greatest at 20.6% in between the right canine and the right first premolar. Frenum was not found in between the second premolar and the distal area. In the morphology of the frenum, it was found that 43.4% out of 551 parts were found to be a single narrow frenum, and the double or triple ligamented form of the complex frenum were found in similar frequency of 237 parts, but the broad frenum was rarely frequent. The incisal area was popular mostly with the single narrow frenum, the left premolar area frequented 57.4%, and the right premolar frequented 64.7%. Because the distance between the frenum apex and the gingival margin measured to be about 5mm or greater, the frenum apex started in the mucogingival junction and not just below the keratinized gingiva. In the 551 area investigated, 48.3% of gingiva showed recession, incisal area had recession the least at 44.9%, right buccal side at 47.4%, and right buccal side frequented the highest at 52.1%. The teeth that showed recession recessed at the average of 2.151.0.mm and the left canine showed the greatest amount of gingival recession. In the investigation to find out if the keratinized gingiva and the gingiva recession had mutually related somehow, the width of keratinized gingiva showed no affect on the probing depth, but had affected in the gingiva recession. This investigation showed that the gingival recession and the morphology of the frenum related in that, the single narrow frenum had recessed the least and the broad frenum recessed the most. With this analysis, a conclusion was drawn that the morphology of the frenum had affected in the gingical recession.

• Journal of Periodontal and Implant Science
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• 제35권2호
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• pp.359-369
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• 2005

It has been suggested that morphologic characteristics of the periodontium are partly related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or "biotypes". The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary anterior tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. The thickness of gingiva was measured by ultrasonic device(SDM). 100 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, gingival recession, width of keratinized gingiva, thickness of the keratinized gingiva. From maxillary study cast, the width(at the apical third-CW) and the length(CL) of the crowns of the 6 anterior teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. The 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow(group N) or a short-wide(group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long-narrow form of the central incisors displayed, compared to individuals with a short-wide crown, form (l) a narrow zone of keratinized gingiva, (2) a pronounced "scalloped" contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the keratinized gingiva. The CW/CL-ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisors and canine tooth region. The regression analyses demonstrated that the thickness of the keratinized gingiva in central, lateral incisors and canines was significantly related to the width of the keratinized gingiva.

• Journal of Periodontal and Implant Science
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• 제24권1호
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• pp.15-25
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• 1994

Keratinized ginigva has clinical singificance in periodontal health because it plays important roles in resistance to mechanical trauma, to penetration of bacteria, and to tensional stress by muscle attachment. In order to investigate the width change of anterior keratinized gingvial during transitional period, the width of kerainized gingiva on anterior teeth was measured annually in elementary school children with deciduous dentition until the successive anterior teeth were completely erupted. The distance from the gingival margin on mid-portion of crown to mucogingival junction was measured by Boley gauge(Hu-Friedy, U.S.A.) and was recorded as the width of keratinized gingiva. The difference of the width of keratinized gingiva according to sex and dentition was analyzed statistically by Student t-test. Following results were obtained : 1. In deciduous dentition, it was shown that the width of keratinized gingiva on maxillary central incisors($3.28{\pm}0.83mm$) was the widest(p<0.01), and that on maxillary lateral incisors, mandibular central and lateral incisors was $2.69{\pm}0.86mm$, $2.51{\pm}0.71mm$, $2.43{\pm}0.68mm$, respectively. 2. In mixed dentition, it was shown that the width of keratinized gingiva on maxillary central incisors ($5.10{\pm}0.86$) was the widest(p<0.01), and that on maxillary lateral incisors, mandibular central and lateral incisors was $4.35{\pm}0.83mm$, $3.51{\pm}0.60mm$, $3.57{\pm}0.66mm$, respectively. 3. The width of anterior keratinized gingiva was significantly increased after the successive anterior teeth were completely erupted(p<0.001). The width of keratinized gingiva on maxillary central and lateral incisors, and mandibular central and lateral incisors was increased by $1.82{\pm}0.83mm$, $1.65{\pm}0.69mm$, $0.99{\pm}0.39mm$, and $1.14{\pm}0.98mm$, respectively. 4. There was no statistical significance in the difference of the width of anterior keratinized gingiva between male and female(p>0.05).

• Journal of Periodontal and Implant Science
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• 제35권3호
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• pp.761-776
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• 2005

The purpose of the present study was to examine the relationship between the form of the clinical crowns in the maxillary anterior segment and the clinical feature of gingiva such as morphological characteristics and the gingival thickness. Fifty periodontally healthy subjects were clinically examined regarding the probing depth, the thickness of the free gingiva, and the width of the keratinized gingiva. From study models of the maxillary anterior region, the width at cervical third(CW) and the length(CL) of the clinical crown, the papillary height, and the gingival angle of the 6 anterior teeth were measured. Each tooth was classified into 4 groups (longnarrow, NL; narrow, N; wide, W; short-wide, WS) according to CW/CL ratio and all the data were compared between groups NL and WS using independent t-test. Stepwise multiple regression analysis was performed for each tooth region with the gingival thickness at the level of sulcus bottom, the width of keratinized gingiva, and gingival angle as the dependent variables. As the results, the NL group of the upper anterior teeth displayed, higher papilla height, and narrower keratinized gingiva, more acute gingival angle resulting in pronounced "scalloped" contour of the gingival margin, compared to the WS group. There was no significant difference between groups NL and WS with respect to probing depth and the gingival thickness. The regression analyses demonstrated that the gingival thickness in central incisors was significantly associated to the mesio-distal width and bucco-lingual width of the crown, and labial probing depth. The width of keratinized gingiva was significantly associated with labial probing depth in central incisors and with proximal probing depth and gingival angle in lateral incisors, and with labial and proximal probing depth, and gingival angle in canines. The gingival angle was significantly associated with papillary height and CW/CL ratio and additionally with proximal probing depth in central incisors, with the width of keratinized gingiva in lateral incisors, and with labial probing depth and the width of keratinized gingiva in canines. These results indicate that the form of clinical crown in upper anterior region could influence the clinical feature of gingiva and the influencing factors might be different according to the tooth region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.299-303
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• 2009

Introduction: Maxillary malignant tumors are primary tumors of the maxillary gingiva, sinus, and palate. The purpose of this study was to research the prognosis and treatment modalities of maxillary malignant tumors. Materials & Methods: For this study, 52 patients, who were treated after being diagnosed for maxillary malignant tumors at the department of OMFS at Yonsei University college of Dentistry from January 1997 till April 2008, were classified, then the prognoses of these patients were evaluated depending on their primary site, histopathology and treatment modalities. The results of this study showed that the most common primary site for maxillary malignant tumors was the gingiva and for histopathology, squamous cell carcinoma. Result & Conclusion: The average follow up period was 32.7 months. In determining prognosis, the most important factors were the control of local site and metastasis of cervical lymph nodes. Therefore, for a better prognosis, a tumor free margin during surgery and a periodic follow up to examine for metastasis to cervical lymph nodes and other organs are necessary.