Gingival recession is exposure of the root surface with apical shift in the position of gingiva. The incidence of gingival recession is 8% in children and 100% after the age of 50. Recession tends to be found in patients with healthy gingiva, but more frequentely found in patients with periodontal disease, and it often causes mucogingival defects. Buccal surface of premolar is the area not only for severe gingival recession and cervical abrasion, but also the area of numbers of buccal frenum and less keratinized gingiva. Therefore, the goal of this study was to observe the patients with periodontitis and examine whether there are clinical relations between gingival recession and cervical abrasion of premolar and other factors related with the condition of periodontal health. Generally healthy 218 patients who had periodontal disease such as gingivitis and periodontitis, aged between 18 and 78, were examined for depth of periodontal poket, width of attached gingiva, gingival recession, cervical abrasion, and frenum of mid-buccal surface of premolar at the Department of Periodontics in Dankook University Dental Hospital and following is the result. 1.The average gingival recession and cervical abrasion of premolar with periodontal disease was 0.76mm and 0.29mm and each has 43% and 14% of incidence. Also the width of attached gingiva of mid-buccal surface was 1.77mm. The average periodontal pocket depth is 2.0mm and 47% of frenum were related. The frenum more frequently seen was narrow single shaped frenum, and the interdistance of the frenum was mostly over 4mm. 2.With statistical significance(P<0.05), the incidence of gingival recession increased with age and was related much more with female than male, the first premolar than the second premolar, and with narrow attached gingiva and frenum. 3.With statistical significance(P<0.05), the incidence of cervical abrasion increased with age and was related with the area of the first premolar and narrow attached gingiva, but the sexual and frenum differences were not statistically significant (P>0.05). 4.The severity of gingival recession increased with age and was more related with female than male, the first premolar than the second premolar. And the area of narrow attached gingiva and frenum showed more gingival recession and the distance of frenum was more highly related than shape, and they were statistically significant (P<0.05). 5. With statistical significance(P<0.05), the severity of cervical abrasion increase with age and was observed at the first premolar and narrow attached gingiva. But the sexual and frenum differences were not statistically significant (P>0.05).
Bicuspid ; Child ; Female ; Gingiva ; Gingival Recession* ; Gingivitis ; Humans ; Incidence ; Male ; Periodontal Diseases ; Periodontal Pocket ; Periodontics ; Periodontitis

The congenital epulis is a rare benign lesion which has an uncertain histogenesis. But, recently it is suggested that it derives either from histiocytic/mesenchymal cells or myofibroblasts which based on many immunohistochemical study. Neumann first described congenital granular cell tumor which developed from the gingiva as congenital epulis in 1871. Epulis means "on the gum" or "gumboil" in Greek word. Congenital epulis is located exclusively on the anterior or lateral alveoiar ridge with marked predilection for female infants. The mass was covered with a nonpapillated stratified squamous epithelium of uniform thickness. There was no pseudoepitheliomatous hyperplasia. Granular cells have abundant cytoplasm with distinct borders and mitotic figures were rarely found. Six days old female neonate who had 2 x3 cm sized mass with 2 x2 cm neck in the gingival and anterior alveolar ridge of mandible was operated by simple excision and coverage by local mucosal flap. After two years she had normal teeth eruption and no recurrence.
Alveolar Process ; Cytoplasm ; Epithelium ; Female ; Gingiva ; Gingival Diseases ; Gingival Neoplasms* ; Granular Cell Tumor* ; Humans ; Hyperplasia ; Infant ; Infant, Newborn ; Mandible ; Myofibroblasts ; Neck ; Recurrence ; Tooth

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there has been many attempts to develop a method to achieve this goal, but none of them was completely successful. This study was designed to compare the effects of treatment using resorbable barrier membrane(Biomesh?) in combination with autogenous bone graft material with control treated by only modified Widman flap. 22 infrabony defecs from 10 patients with chronic periodontitis were used for this study, 10 sites of them were treated with resorbable barrier membrane and autogenous bone graft material as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6-8 months later, and the significance of the changes was statistically analyzed. The results are as follows : 1. Probing depth of the two group was reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(P<0.05), but not in experimental group, and initial values of the two group were in statistically significant difference(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(P<0.05), but not in control group, and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using resorbable barrier membrane in combination with autogenous bone graft material improve the probing depth, bone probing depth and loss of attachment in infrabony defects.
Chronic Periodontitis ; Gingival Recession ; Humans ; Membranes* ; Periodontal Diseases ; Regeneration ; Transplants*

The ultimate goal of periodontal disease therapy is to promote the regeneration of lost periodontal tissue, there have been many attempts to develop a method to achieve this goal, but none of them was completely successful. The purpose of this study was to compare the effects of treatment using BBP(R) with control treated by only modified Widman flap. 22 intrabony defects from 12 patients with chronic periodontitis were used for this study, 10 sites of them were treated with BBP(R) as experimental group and 12 site were treated by only modified Widman flap as control group. Clinical parameters including probing depth, gingival recession, bone probing depth and loss of attachment were recorded at 6 months later, and the significance of the changes was statistically analyzed. The results are as follows: 1. Probing depth of control(delta2.7+/-1.3mm) and experimental group(delta3.6+/-1.8mm) weres reduced with statistically significance(P<0.05), but this changes were not different between the two experiment, control group with statistically significance. 2. Gingival recession showed statistically significant increase in control group(delta2.1+/-1.2mm)(P<0.05), but not in experimental group(delta0.5+/-0.7mm), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 3. Bone probing depth showed statistically significant decrease in experimental group(delta2.9+/-1.0mm)(P<0.05), but not in control group(delta1.1+/-1.4mm), and this changes were different between the two experiment, control group with statistically significance(P<0.05). 4. Loss of attachment showed statistically significant decrease in experimental group(delta3.1+/-1.7mm), but not in control group(delta0.6+/-1.2mm), and this changes were different between the two experiment, control group with statistically significance(P<0.05) On the basis of these results, treatment using BBP(R) improves the probing depth, bone probing depth and loss of attachment in intrabony defects.
Chronic Periodontitis ; Gingival Recession ; Humans ; Periodontal Diseases ; Regeneration

Periodontal surgery can be directed to remove the irritants from the tooth surface and reduce the periodontal pocket. The purpose of this study is to compare the clinical effects after between modified Widman flap and modified flap in periodontal patients. Ninety six molar area teeth of 9 patients were used. One of sextants performed a modified Widman flap, while the other side performed a modified flap. After initial periodontal therapy, the following measurements prior to surgery(baseline) were taken : pocket depth, gingival recession, clinical attachment level, tooth mobility, bleeding on probing. Also these measurements were taken at 4 weeks, 8weeks, and 12 weeks after surgery. Significant decrease of pocket depth was shown in both techniques, and the degree of decrease was significant in modified flap than modified Widman flap at 12 weeks. Significant increase of gingival recession was shown in both techniques, and the degree of increase was significant in modified Widman flap than modified flap at 4 weeks, 8 weeks, and 12 weeks. Significant attachment gain was shown in both techniques, and the degree of increase was significant in modified flap than modified Widman flap at 4 weeks, 8 weeks, and 12 weeks. Significant increase of tooth mobility was shown in both techniques at 4 weeks, but the decrease of tooth mobility was shown at 12 weeks. Greater decrease of bleeding on probing was shown in both techniques at 4 weeks. Modified flap was better than modified Widman flap in the decrease of gingival recession and the attachment gain. These results indicate that modified flap operation is better than modified Widman flap operation in the effect of periodontal treatment.
Gingival Recession ; Hemorrhage ; Humans ; Irritants ; Molar ; Periodontal Pocket ; Tooth ; Tooth Mobility

Root surfaces affected by periodontal disease undergo various forms of changes. Cementum exposure from gingival recession may result in absorption of calcium, phosphorus, and fluoride and subsequent hypermineralization and increased radiodensity. Although some reports have suggested that inorganic content with root cementum might show various changes depending upon age or extent of periodontal disease, but no consensus can be reached regarding the the distribution of various elements. The present study examines the difference in mineral content between healthy and periodontal diseased roots by analyzing three areas per tooth along the root surface in cervico-apical direction using electron probe and scanning electron microscope. Healthy tooth that was extracted for orthodontic purpose was used as control. Experimental teeth include those with periodontal pocket depth exceeding 6mm and those with gingival recession and periodontal pocket depth of 2-4mm. Levels of Ca, P, Mg and Na were measured using wavelength dispersive x-ray spectrometer at three areas per tooth. The examined areas were located apical to cemento-enamel junction in control and periodontal ligament-depleted areas in experimental teeth. The corresponding areas were also examined with scanning electron microscope(x70) The results are as follows. 1. Minerals were detected in order of Ca, P, Mg and Na. In all root surfaces, levels of Ca and P were higher in dentin than in cementum. 2. Level of Mg was twice as high in dentin than in cementum. There was no significant difference in the level of Mg and Na between normal and periodontal diseased roots or between the various locations in the same root. 3. Level of Ca and P in the surface cementum showed no difference between normal and periodontal diseased root, although the areas in dentin with high level of either ion also showed high level of corresponding ion incementum. 4. Difference in the Ca and P content between various locations within the same root was noted, although no coherent pattern existed. These results suggest that although the mineral content of the root cementum in periodontitis-affected tooth is affected by exogenous ions from saliva and food, but there was no difference in the mineral contents between normal and periodontally diseased root.
Absorption ; Calcium ; Consensus ; Dental Cementum ; Dentin ; Electron Probe Microanalysis* ; Fluorides ; Gingival Recession ; Ions ; Minerals ; Periodontal Diseases ; Periodontal Pocket ; Phosphorus ; Saliva ; Tooth

Gingival Diseases/surgery* ; Gingival Neoplasms/surgery* ; Humans

PURPOSE: The purpose of this study was to evaluate the clinical effects of erythritol powder air polishing device (EPAP) in addition to scaling and root planing (SRP) in non-surgical periodontal treatment in moderate chronic periodontitis patients. MATERIALS AND METHODS: Clinical evaluation was performed at 21 sites treated with SRP (control) and 21 sites treated with the addition of SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Depth of the periodontal pocket, gingival recession, clinical attachment level, plaque index, and bleeding of probing were measured as clinical parameters. RESULTS: In both test and control groups, there was a significant decrease in the depth of the periodontal pocket, plaque index, bleeding of probing, increased gingival recession, and gain of clinical attachment level at 1 month and 3 months after treatment. However, there was no significant clinical difference between the test group and the control group. Clinical result was improved after 1 month compared to the baseline; in contrast, results at 3 months after treatment were worse than at 1 month after treatment. CONCLUSION: In this study, we cannot suggest that SRP + EPAP is clinically more effective than SRP alone as non-surgical periodontal treatments. Periodic periodontal therapy, at intervals of at least every three months, is important for sustaining effects of this treatment.
Chronic Periodontitis ; Clinical Study ; Dental Scaling ; Erythritol ; Gingival Recession ; Hemorrhage ; Humans ; Periodontal Pocket ; Periodontitis ; Root Planing ; Treatment Outcome

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 (1) 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.
Adult* ; Crowns ; Cuspid ; Gingiva* ; Gingival Recession ; Humans ; Incisor ; Periodontal Diseases ; Periodontium ; Tooth* ; Ultrasonics

Biological Dressings ; Dermis ; cytology ; transplantation ; Extracellular Matrix ; transplantation ; Gingival Recession ; surgery ; Humans ; Mouth Diseases ; surgery