• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.6
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• pp.369-373
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• 2019

This paper describes a patient with an insufficient vestibular depth for a removable partial denture who underwent vestibuloplasty with a free gingival graft using a titanium mesh in the anterior mandible. Free gingiva was harvested from the palatal mucosa, and a partial thickness flap was elevated at the recipient site. After minimal suturing for the graft, a titanium mesh was fixed over the graft. The mesh was removed four weeks after surgery. The patient obtained an adequate vestibular depth and keratinized gingiva eight weeks after surgery without any complications. In this case, an appropriate vestibular depth and keratinized gingiva were easily obtained by vestibuloplasty using a titanium mesh.

• The Journal of the Korean dental association
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• v.55 no.7
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• pp.450-456
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• 2017

The purpose of this case report is to present a case of free gingival graft for treatment of mandibular incisor labial gingival recession relapsed after laterally positioned flap surgery. A 22 year-old female patient with discomfort and labial gingival recession on left mandibular central incisor was treated. The patient had been treated root coverage on same site by laterally positioned flap surgery, but treated site had relapsed in one month. Exposed root surface was covered by free gingiva from left palatal area. Although gingival color did not completely match with adjacent gingiva, more than 5mm keratinized gingiva was attained. The patient showed no further recurring pain and recession on gingiva after 5 months from the surgery. In conclusion, the root coverage with gain of keratinized gingiva could be achieved through free gingival graft from palate on relapsed gingival recession.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.417-421
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• 2020

Objectives: The purpose of this paper is to introduce an effective technique to easily obtain adequate amounts of keratinized gingiva and vestibular depth. Materials and Methods: Free gingiva (vertical height 10 mm) was harvested on the palatal mucosa and a partial thickness flap was elevated on the recipient site with same width as the free gingiva graft. After a conventional suture, a titanium mesh covered the graft and was fixed with miniscrews. Titanium mesh was removed 4.1±2.5 weeks after surgery. The amount of keratinized gingiva and vestibular depth was measured at the final follow-up. Results: Nine patients (males 4, females 5; 53.9±14.1 years) who underwent bone graft surgery before vestibuloplasty were included. No free gingival graft failure or complications were encountered in any of the patients. The relapse rate for vestibular depth (23.3%) was lower than that for keratinized gingiva (48.3%) after 34.4±14.4 months (P=0.010). Conclusion: Vestibuloplasty with a free gingival graft using titanium mesh could be achieved with an acceptable amount of keratinized gingiva and an appropriate vestibular depth around dental implant.

• Archives of Craniofacial Surgery
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• v.21 no.2
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• pp.132-136
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• 2020

Oral mucosal melanoma is a very rare type of malignant melanoma, the characteristics of which differ from those of cutaneous melanoma. Primary amelanotic melanoma of the mandibular gingiva, which can invade the mandibular bone, is very rare worldwide. Here, we report a case in which we performed a reconstruction of the mandible and gingiva using the fibula osteocutaneous free flap procedure to treat a patient diagnosed with a primary amelanotic melanoma of the mandibular gingiva. The procedure was successful, and no recurrence was observed 10 months after surgery. Oral mucosal melanoma has a much poorer prognosis and a lower 5-year survival rate than cutaneous melanoma. However, recently, immunomodulatory therapies for mutations in melanocytic lesions have been used effectively to treat the increasing number of patients developing this type of melanoma, thus improving the prognosis of patients with oral mucosal melanoma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.132-136
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• 2000

The cell surface glycoprotein CD44 is a kind of adhesion molecule, which binds hyaluronic acid, type I collagen and fibronectin. Although there have been numerous reports on the expression and the function of CD44 in lymphocytes and macrophages, very little is known about its distribution and definite role in epithelial tissue, especially in oral epithelial one. The present study was performed to investigate the distribution and expression of the CD44 in human gingiva and squamous cell carcinoma(SCC) arising in human gingiva. And the authors compared CD44 expression with histopathologic grade of SCC. The results were as follows: 1. The CD44 was strongly expressed in granular, spinous and basal layers of normal marginal and attached gingiva, in spinous and basal layers of normal sulcular gingiva, and in all epithelial layers of normal junctional gingiva. 2. In SCC of gingiva, the CD44 was expressed in all but one case. In most of the cases the CD44 was expressed at cell membrane and the degree of expression was relatively strong. 3. In low-grade SCC of gingiva, the CD44 was strongly expressed, especially at the basal and spinous layers of abundantly keratinized cancer nests. In high-grade SCC of gingiva, the CD44 expression tended to be weak but was strong at cells showing individual keratinization. This study suggest that the CD44 expression of normal and cancerous gingival epithelium is associated with the degree of proliferation and differentiation of epithelial cells.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.109-114
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• 1996

Plasmacytoma is one of the malignant neoplasm that originate in immunoglobulin-producing plasma cell, and occurrence in gingiva is known to be rare. About 7% of all patients with plasma cell malignancies present with solitary lesions in bone or soft tissues. In 30% to 40% of patients, the disease progresses to mulitiple myeloma on long-term follow-up. the incidence of progression to multiple myeloma is higher in patients with a bone lesion as compared with an extramedullary lesion. Several studies have shown a relatively favorable course for both these groups of patients, but many long-term studies have demonstrated the distinct difference in ultimate prognosis between patients with solitary lesions in bone and those with extramedullary lesions. The primary objective in the past has been to suppress the immune system to permit allotransplantation. But immunosuppressant also increases the incidence of malignant neoplasms in patients after allograft transplantation. We treated a 15-year patient with plasmacytoma on gingiva who had received kindny transplantation & immunosuppressant therapy. We excised this lesion & performed radiotherapy and had a favorable result.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.346-349
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• 2005

Metastatic tumours to oral soft tissue are uncommon and accounts for approximately 1% of malignant oral neoplasms. Because of its rarity and clinical appearance of benign nature, the diagnosis of a metastatic lesion in the oral soft tissue may be challenging, both to clinicians and pathologists. We analyzed the clinical data of 9 patients who had metastatic carcinoma to oral soft tissues. The metastatic site to oral soft tissue was the gingiva in all cases. The most common primary site was lung (6 cases) followed by liver (2 cases) and breast (1 case). The clinical appearance resembled gingiva hyperplasia, pyogenic granuloma or gingival swelling. In one case, the metastatic gingiva lesion was found before detection of primary cancer. The mean survival time after diagnosis of metastatic lesion was 3 months. Although this metastatic lesion is rare, oral and maxillofacial surgeon should recognized that benign inflammatory lesion may be the metastatic malignant lesion or the first sign of undiagnosed underlying malignancy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.362-366
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• 2001

Leiomyosarcoma(LMS) is a malignant tumor from smooth muscle origin that arises most commonly in the gastrointestinal tract and uterus, but rarely in the oral and maxillofacial area which lacks smooth muscles. 63 cases of oral LMS have been reported, especially LMS that occurred in the mandibular gingiva is only 2 cases. Major symptom of oral LMS is painful or painless swelling. Besides it, oral LMS has no specific characteristics. So it is difficult to diagnose the case as LMS of the oral cavity. Certain cases report that LMS of the oral cavity was misdiagnosed as periodontitis and the patients were treated with unnecessary procedures. Conventional treatment of LMS is the radical surgical excision. LMS that is infiltrative and very malignant has poor prognosis despite of well-circumscribed boundary. LMS of the oral cavity is often recurred, has high rate of distant metastasis and 5-year-survival rate is as low as 23%. This article reports LMS of the mandibular gingiva that treated with surgical intervention, had local recurrence and metastasis to the lymph node after 16-month's follow-up examination.

• The Journal of the Korean dental association
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• v.54 no.4
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• pp.296-305
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• 2016

Narrow zone of attached gingiva and shallow vestibule around the implants might contribute to difficulty of cleasing, periimplant mucositis caused by incomplete cleansing and further peri-implantitis. The aim of this case report is to present modification of soft tissue biotype around the implants by free gingival grafts according to timing of surgical intervention and shape of free gingiva. A 44 year-old male patient had a missing area on lower right second molar area with 1 to 2 mm of narrow attached gingiva zone and wanted to be treated by implant placement. In radiographic analysis, there was enough alveolar bone to install an implant, free gingiva from hard palate was grafted following implant placement using double layer flap. The width of attached gingival was increased to 4 to 5mm and well maintained during 5 months of follow up. A 69 year-old female patient also had a missing area on lower right first and second molar area with 1 to 2 mm narrow attached gingiva. Since she had systematically angina pectoris and dental phobia, minimal invasive free gingival graft after implants placement was planned. After 2 months of implant surgery, free gingival graft surgery was performed with healing abutments connection. The grafted gingiva was composed of two strip shaped free gingiva, and they were immobilized by periodontal pack. The width of attached gingival was increased to 4 to 5mm and well maintained during 10 months of follow up. With prosthesis delivery, the patients recovered ideal periodontal environment around implants and masticatory function. In conclusion, periodontal health and masticatory function could be achieved through implant placement and free gingival graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.276-279
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• 2012

The development of multiple primary tumors is a problem leading to the treatment of patients diagnosed with gingival squamous cell carcinoma (SCC). The occurrence of multiple primary cancers in patients with SCC of the head and neck is uncommon. Thyroid carcinomas have been found incidentally in the cervical lymph nodes after histopathologic examination. A 72-year-old male with SCC of the lower gingiva at the clinical stage T2N0M0 was treated with partial mandibulectomy and selective neck dissection. Histopathologic examination showed the foci of papillary thyroid carcinoma metastasis. The patient subsequently underwent total thyroidectomy. We report a case of papillary thyroid carcinoma associated with SCC of the oral gingiva along with a review of literatures.