• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.199-206
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• 2008

Purpose: Variation in the morphology of gingival papilla may be determined by the shape and position of anatomic crown as well as contact area and embrasure form of individual teeth. However, periodontal biotype classification is regarded to be subjective because of the lack of definite criteria. In this study, we defined the objective parameters which constitute the periodontal biotype and measured their relationship. Materials and Methods: 109 of dental casts were prepared using three dimensional scanner and specialized reconstruction software, then acquiredvirtual models were sent to the 20 professional dentists to define the specific periodontal biotypes. Several parameters around periodontal structures were measured from the virtual models; facial surface area of the anterior tooth (AT), anterior papillary area (AP), proportion of the dento-papillary complex, clinical papillary length (PL), and clinical papillary angle (PA). Statistical analysis was performed to confirm the relationship among parameters. Results: Coincidence rate of periodontal biotype within observers was $63.77{\pm}16.05%$. Coincidence rate between observers was $76.15{\pm}16.43%$. Among the parameters measured, PL showed the most positive correlations and PA presented the most negative correlations. The parameter of the AP and PL of six maxillary anterior teeth showed significant correlation coefficient. Conclusion: Anterior papillary area and clinical papillary length would be objective parameters for determining the consistent periodontal biotypes.

• Journal of Periodontal and Implant Science
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• 제43권6호
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• pp.283-290
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• 2013

Purpose: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. Methods: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. Results: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). Conclusions: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.

• 대한치과의사협회지
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• 제58권1호
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• pp.8-18
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• 2019

This case report presents results for gingival recession coverage following gingival grafting and for gingival biotype enhancements by visualizing soft tissue volume changes using intraoral three-dimensional scanning. A 28 year old female patient with multiple gingival recessions and a 19 year old female patient with a single gingival recession on mandibular anterior area were treated. Root coverage was performed in both cases using autogenous subepithelial connective tissue harvested from palate. Intraoral 3D scan data were obatained presurgery and at 3 months, 1 year, and 2 years postsurgery. The recession areas were recovered successfully by subepithelial connective tissue graft combined with pedicle flap repositioning, and the patients showed neither further recurrence nor post-operative complication. Soft tissue biotype changes were identified by superimposing and analyzing scan data, revealing that gingival biotype was enhanced in both cases. These cases suggest that SCTG could be advantageous in terms of the gingival biotype enhancement, as well as gingival recession coverage, and intraoral 3D scanning might be suitable for assessing post-surgical gingival biotype change.

• Journal of Korean Dental Science
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• 제9권2호
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• pp.49-54
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• 2016

Purpose: The purpose of this study was to assess the relationship between gingival biotype and underlying crestal bone morphology in the maxillary anterior region. Materials and Methods: The maxillary anterior teeth from 40 subjects (20 thin biotype, 20 thick biotype) with ages from 20 to 50 years were included in this study. All subjects had healthy gingiva in the maxillary anterior region and had no history of orthodontic treatment, periodontal treatment, or hyperplastic medication. Using the probe transparency method, the scalloped distance (SCD) between the contact point-bone crest and the midface-bone crest was measured for each maxillary anterior teeth of two groups. Result: The mean SCD was $3.00{\pm}0.21mm$ in thin biotype and $2.81{\pm}0.20mm$ in thick biotype. The SCD value in the thin biotype was statistically significantly greater than in the thick biotype (t=2.982, P<0.01). Comparing the degree of crestal bone scallop in each maxillary anterior teeth in the two groups, all six teeth in the thin biotype showed higher bone scallop than in the thick biotype. Conclusion: A simple procedure using a probe could to determine gingival biotype and to predict the underlying crestal bone morphology was introduced. This may be useful for effective treatment planning.

• 대한치주과학회:학술대회논문집
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• 대한치주과학회 2003년도 춘계학술대회
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• pp.21-22
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• 2003

• 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.

• Journal of Periodontal and Implant Science
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• 제48권6호
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• pp.395-404
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• 2018

Purpose: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. Methods: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1-3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1-3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. Results: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1-3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. Conclusions: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.

• 대한치과의사협회지
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• 제57권12호
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• pp.758-767
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• 2019

The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.117-130
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• 1999

All contours of the restoration not directly related to occlusion are related to the gingival tissues only.And proper contour of restoration is essential for the health of the periodontal tissues.But there are so many controversies about the contour of the restoration, and there is no uniform agreement in the literature as to which contour of restoration is best for periodontium. In general, the contour of restoration means the supragingival contour only but in the case of the intracrevicular restorative procedure the subgingival contour of restoration must be considered. Because a portion of the restoration is placed in a gingival sulcus which is extremely vulnerable to periodontal disease. In this article the concepts or theories of the supragingival contour, the subgingival contour, and the emergence profile were discussed.The contour of the restoration and the biotype of the periodontium must be considered in intracrevicular restorative procedure.And sufficient tooth preparation is important factor to develop the proper contour of restoration which is kind to periodontium.

• 대한치과의사협회지
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• 제48권9호
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• pp.654-663
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• 2010

The success in periodontal-prosthetic therapy lies in patient satisfaction with subjective and customized treatment regimen that has been refined for individual needs. To fulfill these requirements, multiple predictors may have to be taken into consideration in the comprehensive treatment planning. Incorporation of complex factors that guarantee the evidence-based therapy would include, but not limited to, osseous morphology, biotype of gingival around abutment, bone morphology of interdental bone and those around furcation area, abutment or bridge mobility. The periodontal-restorative interface should be of mutually protective. Also strategic and esthetic value of abutment teeth to be restored should also be taken into consideration. Taken together, all these should work in concert to enhance the predictability and longevity of abutment teeth in periodontal-prosthetic therapy.