• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.247-252
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• 2008

Purpose: Passive eruption is characterized by the apical shift of the dentogingival junction. As this occurs, the length of the clinical crown increases as the epithelial attachment migrates apically. Altered passive eruption occurs when the margin of gingiva is malpositioned incisally on the anatomic crown in adulthood and results in excessive gingiva. The purpose of this article is to evaluate esthetic results of crown lengthening procedure in altered passive eruption.s. Materials and Methods: Three patients who complained "My front teeth look too short" were included. Bone sounding with periodontal probe revealed that alveolar bone crest was close to CEJ. Based on the diagnostic information, a diagnosis of altered passive eruption was made. They were performed apically positioned flap procedure with osseous resection. Results: Six months later, all patients achieved favorable esthetic results and gingival margins were healthy and stable. Conclusion: When the diagnostic procedures reveal alveolar bone crest levels approximating the CEJ, apically positioned flap procedure with osseous resection is indicated.

• The korean journal of orthodontics
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• v.47 no.3
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• pp.176-185
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• 2017

Objective: To evaluate the relationship of gingival thickness (GT) and the width of keratinized gingiva (WKG) with different malocclusion groups and the level of crowding. Methods: A total of 187 periodontally healthy subjects (121 females and 66 males) who presented at the Faculty of Dentistry in $Y{\ddot{u}}z{\ddot{u}}nc{\ddot{u}}$ Yil University for orthodontic treatment were enrolled in the study. The individuals involved in the study were divided into three groups; Angle Class I malocclusion, Angle Class II malocclusion, and Angle Class III malocclusion. Each group was classified as mild, moderate, or severe according to the level of crowding. WKG was determined as the distance between the mucogingival junction and the free gingival margin. GT was determined by the transgingival probing technique. Factorial variance analysis and the Duncan multiple comparison test were employed to identify the extent to which a difference was apparent between the groups according to these parameters. Results: It was determined that teeth in the mandibular anterior region display the thin gingival biotype. WKG and GT were observed as being higher at the mandibular incisor teeth in the severe crowding group and at the mandibular canine teeth in the mild crowding group. The GT of the mandibular right central and lateral incisors was found to be thinner in the Angle Class III group. Conclusions: Within the limits of this study, the results demonstrate that, there is no significant relationship of WKG and the mean GT in the mandibular anterior region according to the Angle classification.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.8-15
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• 2016

Purpose: The purpose of this research is to determine whether pontic metal substructures, which are currently used in clinical surgeries, are designed appropriately and identify the problems that can occur due to their shape, size, and position. Then it aimed to emphasize the importance of making and designing pontic metal substructures based on basic principles. Materials and Methods: This research measured pontic basal surface (P1) used sample metal substructures in this study, gingiva margin (P2), and the porcelain thickness of maximum infrabulge of labial surface around 1/3 of cervix dentis (P3). One-way ANOVA analysis was carried out to test the differences among groups, Tukey Honestly Significant Difference Test was conducted for statistical analysis among groups. Results: For porcelain thickness and SD value, the P1 part was $1.2-1.8({\pm}0.17)mm$ for experimental group 1, $1.2-1.7({\pm}0.17)mm$ for experimental group 2, and $0.4-2.8({\pm}0.92)mm$ for experimental group 3. Next, the P2 part was $1.4-1.6({\pm}0.07)mm$ for experimental group 1, $1.3-1.8({\pm}0.07)mm$ for experimental group 2, and $0.5-2.7({\pm}0.67)mm$ for experimental group 3. The P3 part was $1.4-1.7({\pm}0.10)mm$ for experimental group 1, $1.5-2({\pm}0.10)mm$ for experimental group 2, and $0.9-3.1mm({\pm}0.90)$ for experimental group 3. There was no significance when One-way ANOVA analysis/Tukey Honestly Significant Difference Test was conducted for statistical analysis among groups (P > 0.05). Conclusion: The suggested metal substructures can be used clinically as they meet the requirements that pontic must have.

• Journal of Periodontal and Implant Science
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• v.50 no.3
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• pp.146-158
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• 2020

Purpose: The aim of this study was to investigate and identify the main causes of periodontal tissue change associated with labial gingival recession by examining the anterior region of patients who underwent orthodontic treatment. Methods: In total, 45 patients who had undergone orthodontic treatment from January 2010 to December 2015 were included. Before and after the orthodontic treatment, sectioned images from 3-dimensional digital model scanning and cone-beam computed tomography images in the same region were superimposed to measure periodontal parameters. The initial labial gingival thickness (IGT) and the initial labial alveolar bone thickness (IBT) were measured at 4 mm below the cementoenamel junction (CEJ), and the change of the labial gingival margin was defined as the change of the distance from the CEJ to the gingival margin. Additionally, the jaw, tooth position, tooth inclination, tooth rotation, and history of orthognathic surgery were investigated to determine the various factors that could have affected anterior periodontal tissue changes. Results: The mean IGT and IBT were 0.77±0.29 mm and 0.77±0.32 mm, respectively. The mean gingival recession was 0.14±0.57 mm. Tooth inclination had a significant association with gingival recession, and as tooth inclination increased labially, gingival recession increased by approximately 0.2 mm per 1°. Conclusions: In conclusion, the IGT, IBT, tooth position, tooth rotation, and history of orthognathic surgery did not affect labial gingival recession. However, tooth inclination showed a significant association with labial gingival recession of the anterior teeth after orthodontic treatment.

• Journal of Periodontal and Implant Science
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• v.39 no.2
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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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• v.39 no.2
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• pp.199-204
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• 2009

Purpose: Excessive gingival display and short clinical crowns due to altered passive eruptions are major concerns for a considerable number of patients visiting dental clinics. Altered passive eruptions could be corrected through various types of periodontal surgery conformable to a classification. 3 cases are reported here on the esthetic correction of altered passive eruption to evaluate results of crown lengthening procedure. Methods: Three patients whose major complaints were excessive gingival display and short teeth were picked out for this case study. Before treatment, clinical and radiological exam was performed to choose type of surgery. Thickness and width of keratinized gingiva was measured in all three patients then they were treated by surgical methods including flap operation and depigmentation under subsequent diagnosis. Results: Uneventful healing and stable gingival margin were observed in all three patients except recurrence of gingival pigmentation of one patient. Conclusions: The treatment of altered passive eruption requires precise diagnostic procedure and could achieve better esthetic outcomes when it is accompanied by other orthodontic and orthognathic treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.16 no.1
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• pp.27-31
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• 1978

A total of 200 patients, ranging in age from 20 to 60 years, were selected for the study. Each had at least one tooth which was restored with complete cast gold crown and a nonrestored contralateral tooth with no clinical evidence of caries and periodontal disease. The gingival tissues adjacent to the crowned and nonrestored teeth were examined to determine the evaluation of the severity of inflammation and probed to determine individual pocket depth. The findings are listed here. 1. The average sulcus bleeding index of the gingival tissues adjacent to crowned teeth was 1.99. The average sulcus bleeding index of the gingival tissues adjacent to nonrestored teeth was 0.67. 2. The average gingival sulcus depth adjacent to crowned teeth was 2.19mm. The average gingival sulcus depth adjacent to non restored teeth was 1.68mm. 3. No difference could be found between the average gingival sulcus bleeding index and average gingival sulcus depth of male and those of female. 4. The difference between sulcus bleeding index of the gingival tissues adjacent to crowned teeth and sulcus bleeding index of the gingival tissues adjacent to nonrestored teeth increased with increased age of the cast crown.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.29 no.1
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• pp.54-61
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• 2020

Forced orthodontic eruption(FOE) is a non-surgical treatment approach that allows augmenting both soft- and hard-tissue profiles of potential implant sites, by forced orthodontic extrusion of "hopeless" teeth and their periodontal apparatus. By stretching the gingival and periodontal ligament fibers during extrusion, tension is imparted to the entire alveolar socket, stimulating osseous apposition at the alveolar crest. FOE increases the width of the attached gingiva, and the mucogingival junction remains stable when the gingival margin migrates coronally. Based on these effects, FOE of non-restorable teeth prior to implant placement is a viable alternative to conventional surgical augmentative procedures in implant site development. The aim of this case report is to describes coronal soft-tissue augmentation around fractured teeth, which was achieved by FOE before implant placement.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.438-444
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• 2016

To enhance the esthetic appearance, the maxillary anterior area is important. It is possible to improve the esthetic appearance through the treatment of maxillary anterior area, which includes altering the color, form, and arrangement of teeth. When planning these treatments, clinicians should individualize personal demands, by using the information obtained from facial, dento-labial, dental, and gingival analysis. It is essential to properly prepare the gingival structure, which includes the height of gingival margin, the location of zenith, reconstruction of the interdental papillae, emergence profile, and symmetry. Clinicians often face unfavorable condition of the gingiva and the edentulous ridge, and appropriate management of the gingival structure is needed. In this case report, the patients were treated to improve the gingival conditions surrounding maxillary anterior teeth. By using conservative treatment without surgical intervention, such as application of pink porcelain, subgingival contour modelling and modification of pontic base, satisfactory esthetic results were gained.

• Journal of Periodontal and Implant Science
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• v.31 no.3
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• pp.641-649
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• 2001

The aim of present study was to assess the thickness of masticatory mucosa on the hard palate and tuberosity as a potential donor site for mucogingival surgery. Thickness measurement was performed in 30 dental college students who are periodontally healthy, with a recently developed, ultrasonic device(SDM). The mean age of study subjects was 23.7(range 21-29) years old and the subjects were composed of 18 males and 12 females. Eighteen standard measurement points were defined on the hard palate, located on 3 lines which ran at different distances parallel to the gingival margin. Six positions were designated on each of these 3 lines between the level of the canine and the second molar. On the tuberosity, 6 standard measurement points were defined, located on 2 lines running parallel to the gingival margin at different distances. Data were analyzed to determine differences in gender, between different positions, and between lines, by an analysis of variance. The results showed that the mucosa of the tuberosity was significantly thicker than that of the hard palate region. Gender did not influence the thickness of masticatory mucosa, either on the hard palate or the tuberosity. On the hard palate, mucosa thickness increased as the distance from the marginal gingiva increased. The mucosa over the palatal root of the maxillary first molar was significantly thinner than that at all other positions on the hard palate. Measurement error at palate was 0.25mm, at tuberosity 0.51mm. No difference in the thickness of masticatory mucosa on palate and tuberosity was found between men and women. On the hard palate, soft tissue thickness progressively increased in sites further from the gingival margin. Therefore, we may harvest more thicker graft on the tuberosity that has more masticatory mucosa thickness than hard palate, however the width may not be sufficient for using.