OBJECTIVES: This study aimed to evaluate the efficacy and long-term stability of tunnel technique (TUN) and coronally advanced flap (CAF) combined with connective tissue graft (CTG) in treating gingival recession. METHODS: Databases including PubMed, Web of Science, Embase, and CNKI were electronically searched to collect randomized controlled trial (RCT) of CAF+CTG compared to TUN+CTG in the treatment of Miller class Ⅰ or Ⅱ gingival recession on September 1, 2022. RESULTS: There were 8 RCTs with 305 patients (454 recession sites) participating. The results of the Meta-analysis revealed that, in terms of mean root coverage (MRC) of main indicators, no significant difference was found between the CAF group and the TUN group in both short- and long-term results, which were [MD: 1.45%, 95%CI (-2.93%, 5.82%), P=0.52] and [MD: -0.70%, 95%CI (-6.41%, 5.00%), P=0.81]. However, the CAF group outperformed the TUN group in the long term [MD: 5.69%, 95%CI (0.87%, 10.50%), P=0.02], and the results of complete root coverage (CRC) analysis were similar to those of MRC. In the short term, the TUN group grew keratinized gingiva significantly faster than the CAF group [MD: -0.38 mm, 95%CI (-0.67 mm, -0.10 mm), P=0.008]. Long-term findings revealed no significant difference between the two groups [MD: -0.26 mm, 95%CI (-0.94 mm, 0.43 mm), P=0.46]. The TUN group's secondary index root coverage esthetic score (RES) was statistically significantly higher than the CAF group's [MD: 0.62, 95%CI (0.28, 0.96), P=0.000 3]. Given that there were few results included in the literature and the heterogeneity was too great, no significant difference was observed in the postoperative VAS pain index score [MD: 0.53, 95%CI (-1.96, 3.03), P=0.68]. CONCLUSIONS This study discovered that both CAF+CTG and TUN+CTG can achieve good root coverage in treating gingival recession, with CAF outperforming TUN and both groups achie-ving good long-term stability. After the operation, the TUN group had a higher RES than the CAF group. Given the limitations of this study, more high-quality studies are needed in the future to demonstrate the efficacy of TUN in gingival retraction surgery.
Humans ; Gingival Recession/surgery* ; Treatment Outcome ; Tooth Root ; Esthetics, Dental ; Gingiva/surgery*

Humans ; Gingival Recession/surgery* ; Gingivoplasty/methods* ; Connective Tissue/transplantation* ; Treatment Outcome ; Gingiva/transplantation* ; Tooth Root

Mucogingival surgery is a general term for periodontal surgeries that correct aberrant periodontal soft tissues. Conventional mucogingival surgeries with pedicle flap or autologous soft tissue graft for treatment of gingival recession and insufficient keratinized tissues are always related to disadvantages such as need for a second surgery site, limited supplies, and complaints for postoperative discomfort. In this regard, research and application of soft tissue substitutes have gained increasing attention. Various kinds of soft tissue substitutes, including acellular dermal matrix and xenogeneic collagen matrix, have been developed and applied to clinical treatment. This review aims to summarize advances in research of the characteristics and clinical effectiveness of several soft tissue substitutes and provide references for clinical application.
Gingiva ; Gingival Recession ; surgery ; Humans ; Tooth Root

OBJECTIVES: The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required.MATERIALS AND METHODS: Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage.RESULTS: The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001).CONCLUSION: A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.
Anticoagulants ; Electrocoagulation ; Emergency Service, Hospital ; Emergency Treatment ; Fibrinolytic Agents ; Gingiva ; Hemorrhage ; Humans ; Liver Cirrhosis ; Male ; Methods ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Surgery, Oral ; Sutures ; Tooth Extraction ; Tranexamic Acid

OBJECTIVE: This study aimed to evaluate the clinical effect of periodontal microscopic surgery on the augmentation of attached gingiva and determined the clinical principle on how to use minimally invasive surgery to improve the surgery success rate. METHODS: Twenty patients with insufficient attached gingiva around implants were selected. Periodontal microscopic surgery for free gingival graft was performed to increase the width of the attached gingiva around the implants. The survival state of the free gingiva was observed after surgery, and the width of the attached gingiva around the implants was recorded before and after surgery and 1 year after surgery. The shrinkage rate of the free gingival flap 1 year after surgery was analyzed to evaluate the stability of the flap. RESULTS: The flaps of the 20 cases all survived. One year after the operation, the width of the attached gingiva was (3.05±0.44) mm, which increased compared with that of preoperation (2.56±0.31) mm
and decreased compared with that of postoperative day (2.13±0.28) mm. The shrinkage rate of the attached gingiva was 41.22%±5.04%. CONCLUSIONS The application of microscopic surgery on the augmentation surgery of attached gingiva can increase the success rate and improve the quality and quantity of attached gingiva around implants.
Dental Implants ; Gingiva ; surgery ; Humans ; Microsurgery ; Oral Surgical Procedures ; Surgical Flaps

Miniscrews offer a reliable alternative for anchorage during orthodontic treatment, particularly for non-cooperative patients or periodontal patients with alveolar bone loss. The study aims at assessing the correlation of various clinical indicators with the success or failure of miniscrews used for anchorage during orthodontic treatment. Thirty-four consecutive patients with a cumulative total of 82 miniscrews implanted participated in the study. Generalized Estimating Equations were used to assess the correlation of various factors with success rates. The miniscrew was considered the unit of analysis clustered within site and within patient. The overall success rate of miniscrews was 90.2%. For every additional miniscrew used in a patient's oral cavity, the success rate was reduced by 67%. Retromandibular triangle and palatal placement and in movable mucosa resulted in lower success rate. The miniscrew length and diameter were found to correlate with success rates. Orthodontic force applied on miniscrews for uprighting purposes showed a lower success rate than that used for retraction. This study revealed that miniscrews present high success rates. The number of miniscrews used per patient, the miniscrew site placement, the soft tissue type of placement, the miniscrew length and diameter as well as the orthodontic force applied on the miniscrew showed significant correlation with success rates.
Adolescent ; Adult ; Alveolar Process ; surgery ; Bone Screws ; Dental Stress Analysis ; Female ; Gingiva ; surgery ; Humans ; Linear Models ; Logistic Models ; Male ; Mandible ; surgery ; Middle Aged ; Mouth Mucosa ; surgery ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design ; Palate, Hard ; surgery ; Retrospective Studies ; Statistics, Nonparametric ; Treatment Outcome ; Young Adult

PURPOSE: The objective of this study was to compare and evaluate the inflammatory responses of three widely used suture materials in the keratinized gingiva and buccal mucosa of beagle dogs. METHODS: Silk, polyglycolic acid, and nylon sutures were placed within the mandibular keratinized gingiva and maxillary buccal mucosa of four male beagle dogs. Biopsies were taken 3, 7, and 14 days after suturing. Specimens were prepared with hematoxylin-eosin stain for evaluation under a light microscope. RESULTS: The suture materials placed in the oral mucosa elicited more inflammatory reactions than did those placed in the keratinized gingiva. The multifilament suture materials caused more inflammatory tissue reactions than did the monofilament suture materials in the oral mucosa. CONCLUSIONS: If oral hygiene is well maintained and suture materials are placed in the keratinized gingiva, silk, nylon, and polyglycolic acid are considered to be proper suture materials for oral surgery. However, it is advisable to use monofilament suture materials if the suture site is within the oral mucosa.
Animals ; Biopsy ; Dogs ; Gingiva ; Humans ; Keratins ; Light ; Male ; Mouth Mucosa ; Nylons ; Oral Hygiene ; Polyglycolic Acid ; Silk ; Surgery, Oral ; Sutures

Recently, the population of patients who refuse transfusion has increased for both religious and non-religious reasons, even in life threatening emergency situations. Their refusal has highlighted the need to develop nonblood transfusion surgery techniques to decrease the risk from blood transfusions. A 57-year woman with an ulcerative lesion on the gingiva of the right upper molar area visited the department of oral and maxillofacial surgery in Dankook University Dental Hospital. After a preliminary evaluation, the patient was diagnosed with squamous cell carcinoma. As she refused blood transfusion during surgery for religious reasons, surgery was planned using recombinant human erythropoietin (rHuEPO) without a blood transfusion. The patient underwent a partial maxillectomy, supraomohyoid neck dissection, free radial forearm flap and split thickness skin graft under general anesthesia. rHuEPO and iron were used before and after surgery. The hemoglobin/hematocrit (Hb/Hct) level, iron (Fe) and total iron-binding capacity (TIBC) were assessed. The patient recovered completely without any blood transfusions. rHuEPO is a viable alternative for patients with religious objections to receiving blood transfusions.
Anesthesia, General ; Blood Transfusion ; Carcinoma, Squamous Cell ; Disulfiram ; Emergencies ; Erythropoietin ; Female ; Forearm ; Gingiva ; Humans ; Iron ; Molar ; Mouth Neoplasms ; Neck Dissection ; Skin ; Surgery, Oral ; Transplants ; Ulcer

PURPOSE: The purpose of this study was to examine the effects of using gauze frozen with normal saline or ice on thirst-relief and oral condition of laparoscopic cholecystectomy patients. METHODS: A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=53) received either gauze frozen with normal saline (n=17), ice (n=18) or wet gauze (n=18) for thirst-relief. The subjective thirst level and oral condition of the participants were assessed before the intervention, 15 min after the first intervention and 15 min after the second intervention. RESULTS: After oral care was provided twice, there were significant differences in thirst level among the groups. When oral care was provided twice, the oral condition of tongue, saliva, mucosal membrane, and gingiva was improved in patients receiving gauze frozen with normal saline or ice. CONCLUSION: Gauze frozen with normal saline and ice can be effective for oral care in reducing the thirst level and improving the condition of the oral cavity.
Adult ; Aged ; *Cholecystectomy, Laparoscopic ; Female ; Freezing ; Gallbladder Diseases/*surgery ; Gingiva/drug effects ; Humans ; *Ice ; Male ; Middle Aged ; Mouth Mucosa/drug effects ; Pilot Projects ; Saline Solution, Hypertonic ; Saliva/physiology ; *Thirst/drug effects ; Tongue/drug effects

Adult ; Chromium Alloys ; adverse effects ; Crowns ; adverse effects ; Female ; Foreign Bodies ; etiology ; Foreign-Body Reaction ; Gingiva ; surgery ; Gingival Hyperplasia ; etiology ; surgery ; Gingivectomy ; Humans ; Metal Ceramic Alloys ; adverse effects