DOCSLIB.ORG

Use of Mucograft Collagen Matrix® Versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: a Randomized Controlled Clinical Trial

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Use of Mucograft Collagen Matrix® Versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: a Randomized Controlled Clinical Trial Frontiers in Dentistry Use of Mucograft Collagen Matrix® versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: A Randomized Controlled Clinical Trial Amirreza Rokn1,2, Hadi Zare3, Pardis Haddadi3* 1. Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran 3. Department of Periodontics, Faculty of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran Article Info A B S T R A C T Article type: Objectives: This study aimed to evaluate the mucograft collagen matrix (CM) to Original Article increase keratinized tissue around teeth compared to free gingival graft (FGG). Materials and Methods: The present double-blind, randomized, controlled clinical trial studied 12 patients who had 2 mm or less keratinized gingiva bilaterally around mandibular premolars. The 6-month width of keratinized tissue, periodontal Article History: parameters (preoperatively and 1, 3, and 6 months postoperatively), color match, Received: 16 Jul 2019 pain, and total surgical time were measured. Accepted: 17 Dec 2019 Published: 8 Mar 2020 Results: The mean dimensional change of keratinized gingiva 6 months postoperatively was 4.1±0.7 mm for FGG and 8±1.7 mm for CM. Periodontal parameters were not affected in the two groups. The CM group had a significantly lower pain, experienced less surgery time, and gained better aesthetics compared to * Corresponding author: the FGG group. Department of Periodontics, Faculty of Dentistry, Lorestan University of Medical Conclusion: CM appears to be a suitable substitute for FGG in procedures designed Sciences, Khorramabad, Iran to increase keratinized tissue around teeth. It has remarkable benefits, such as acceptable keratinized tissue gain, less pain, less surgical chair time, and better Email: [email protected] aesthetics. Keywords: Gingiva; Mucograft; Tissue Transplantation Cite this article as: Rokn AR, Zare H, Haddadi P. Use of Mucograft Collagen Matrix® Versus Free Gingival Graft to Augment Keratinized Tissue Around Teeth: A Randomized Controlled Clinical Trial. Front Dent. 2020;17:5. doi: 10.18502/fid.v17i1.3965 INTRODUCTION gingival augmentation procedures may be The width of keratinized gingiva differs in indicated when patients experience different individuals and even in different discomfort during tooth brushing and/or teeth [1]. The rationale of mucogingival chewing due to interference from a lining therapy has been primarily based on the fact mucosa or when orthodontic tooth that a minimum width of gingiva is critical for movement is planned and the buccal position maintaining gingival health and preventing of teeth can result in alveolar bone gingival recession [2]. However, today, it is dehiscence. An increase of the gingiva may believed that gingival health can be also be considered when subgingival maintained independently of its dimensions restorations are placed in areas with a thin [3,4]. As a result, narrow gingiva alone cannot marginal tissue [5]. justify surgical intervention. However, Various techniques have been invented for Copyright © 2020 The Authors. Published by Tehran University of Medical Sciences. This work is published as an open access article distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by-nc/4). Non-commercial uses of the work are permitted, provided the original work is properly cited. Mucograft for Keratinized Tissue Augmentation increasing the width of keratinized gingiva. The present double-blind, randomized, Since the late 1960s, clinicians have controlled clinical trial (IRCT registration corrected insufficient keratinized tissue and number: IRCT2013052813501N1) was insufficient vestibules by placing autogenous conducted according to the guidelines of the free gingival grafts (FGGs), free connective Helsinki Declaration of 1975 (revised, 2000). tissue grafts, and surgically releasing the The Ethics Committee of the Dental Research vestibular area (vestibuloplasty) [6]. One of Center of Tehran University of Medical the earliest and most common gingival Sciences approved the research protocol augmentation procedures involves FGG in (Ethical code: 91-04-10-18791-78324). which the graft is harvested from the The study population consisted of patients patient’s palate. This technique has more referring to the Department of Periodontics, predictable results but it has some School of Dentistry, Tehran University of disadvantages. First, the palate is healed by Medical Sciences, Tehran, Iran, who had less secondary intention and requires a dressing than 2mm of attached keratinized gingiva for 10 to 14 days, which is uncomfortable for bilaterally on the buccal aspect of the most patients [7]. Other disadvantages mandibular premolar teeth. include the inability to harvest large grafts, The inclusion criteria were: 1) age over 18 high morbidity rates after surgery, and poor years, 2) good oral hygiene; O'Leary oral aesthetics due to differences in texture and plaque index < 15%, 3) no bleeding on probing color from adjacent areas [8]. In patients with (BOP) based on the Ainamo and Bay index difficult-to-control bleeding at the graft (1976), 4) the presence of an identifiable donor site, treatment of multiple sites would cementoenamel junction (CEJ), and 5) teeth in be a challenge [9]. need of prosthetic or orthodontic treatment. Possible alternatives to FGGs are xenografts Exclusion criteria were: 1) active carious and allografts [10]. The Mucograft® Collagen lesions or restorations or crowns at the CEJ, 2) Matrix (CM; Geistlich Pharma AG, Wolhusen, smoking, 3) systemic conditions precluding Switzerland) is a resorbable, three- periodontal surgery, 4) systemic conditions dimensional (3D) matrix that is designed affecting the periodontium; 5) high frenum specifically for soft tissue regeneration in the pull, 6) history of mucogingival surgery in the oral cavity. It is fabricated as a matrix of pure area, and 7) pathologic movement of the type I and III porcine collagen obtained with involved teeth. The sample size was standardized and controlled manufacturing predicated based on obtaining 80% power for processes without cross-linking or chemical testing the primary study endpoint, which treatment [8]. evaluated whether or not mucograft was Some previous studies have investigated the inferior to FGG in the generation of keratinized clinical outcome of CM for augmentation of tissue from the baseline to 6 months insufficient keratinized tissue [11-13]. These postoperatively. studies have shown favorable clinical results; This assumed a paired t-test of non-inferiority however, most of them have been conducted with a non-inferiority margin of 1.0 mm, a around dental implants and not around teeth. within-patient standard deviation (SD) of 1.0 In most cases, the design of the studies was mm, and a one-sided alpha of 0.05. Under not split-mouth; therefore, patient-related these assumptions and according to the below factors were not the same in the control and formula, a sample size of 10 was required to test groups. As a result, we decided to power the primary endpoint [13]. To account compare CM and FGG for the augmentation of for potential loss to follow-up, 12 patients keratinized gingiva around teeth in a split- were enrolled in the trial. The investigator mouth study. blinded to the details of the study and surgical protocols carried out randomization of the MATERIALS AND METHODS patients and their assignment to intervention Study design and participants: groups. Volume 17 | Article 5 | Mar 2020 2 / 8 Rokn AR, et al. Fig. 1. Gingival augmentation by free gingival graft (FGG) on the right side (a and b) and mucograft on the left side (c and d) The patients were numbered according to adjacent teeth. Recipient sites were slightly when they had presented to the department. larger than the CM and FGG grafts. The CM and After the patients' eligibility for enrollment in FGG grafts were 10×20 mm2. Vertical the study was confirmed, all the surgeries incisions were made on the mesial and distal were done according to the patients' numbers. aspects of the CM and FGG sites, extending Concealed allocation was performed by using apically as far as the vestibules allowed. The sealed, coded envelopes that were opened just mesial and distal incisions were then before surgery to determine the test connected apically. Muscle fibers were (Mucograft®) and control (FGG) groups. To removed with scissors, creating a clean allow for possible dropouts, 12 patients were periosteal bed. recruited. One experienced surgeon, who was The CM was placed dry (not pre-wet), and blinded to the randomization sequences, blood was allowed to soak into the matrix to performed all surgeries. form an initial stable clot. The FGG was Periodontal parameters: harvested from the randomly assigned palate Patients received oral hygiene instructions for donor site. The CM and FGG test and control two weeks before surgery, and professional materials were placed in direct contact with scaling and root planing (SRP) was carried out. the appropriate randomly assigned recipient A calibrated postgraduate student, who was bed and sutured in place with non-resorbable blinded to the study protocol, measured all 4-0 Cytoplast™ PTFE suture’s monofilament clinical parameters before and after surgery. construction that does not allow bacterial All measurements were made using a wicking
Load more

Recommended publications
  • Download Article (PDF)
    Advances in Health Science Research, volume 8 International Dental Conference of Sumatera Utara 2017 (IDCSU 2017) Black Triangle, Etiology and Treatment Approaches: Literature Review Putri Masraini Lubis Rini Octavia Nasution Resident Lecturer Department of Periodontology Department of Periodontology Faculty of Dentistry, University of Sumatera Utara Faculty of Dentistry, University of Sumatera Utara [email protected] Zulkarnain Lecturer Department of Periodontology Faculty of Dentistry, University of Sumatera Utara Abstract–Currently, beauty and physical appearance is Loss of the interdental papillae results in a condition of a major concern for many people, along with the known as the black triangle. Various factors may affect greater demands of aesthetics in the field of dentistry. in the case of interdental papilla loss, including alveolar Aesthetics of the gingival is one of the most important crest height, interproximal spacing, soft tissue, buccal factors in the success of restorative dental care. The loss of thickness, and extent of contact areas. With the current the interdental papillae results in a condition known as the black triangle. Interdental papilla is one of the most adult population which mostly has periodontal important factors that clinicians should pay attention to, abnormalities, open gingival embrasures are a common especially in terms of aesthetic. The Black triangle can thing. Open gingival embrasures also known as black cause major complaints by the patients such as: aesthetic triangles occur in more than one-third of the adult problems, phonetic problems, food impaction, oral population; black triangle is a state of disappearance of hygiene maintenance problems. The etiology of black the interdental papillae and is a disorder that should be triangle is multi factorial, including loss of periodontal discussed first with the patient before starting treatment.
    [Show full text]
  • The Consumer's Guide to Safe, Anxiety-Free Dental Surgery
    The Consumer’s Guide to Safe, Anxiety-Free Dental Surgery Jeffrey V. Anzalone, DDS 1 2 About The Author 7 Meet The Anzalones 9 Acknowledgments 11 Overview of the BIG PICTURE 13 The 9 Most Important Dental Surgery Secrets 13 Chapter 2 Selecting the Right Dental Surgeon 17 What Are the Dental Specialties That Perform Surgery? 19 What Is a Periodontist? 20 Chapter 3 The Consultation 23 The Initial Consultation: Examining the Doctor 25 Am I a candidate for surgery? 26 14 Questions to Ask Your Prospective Periodontist 27 Chapter 4 Gum Disease (Periodontitis) 29 Gum Disease Symptoms 30 Pocket Recording 32 Is gum disease contagious? 32 Gum Disease and the Human Body 33 Gum Disease and Cardiovascular Disease 33 Gum Disease and Other Systemic Diseases 34 Gum Disease and Women 35 Gum Disease and Children 37 Signs of Periodontal Disease 38 Advice for Parents 39 Gum Disease Risk Factors 41 Non-Surgical Periodontal Treatment 42 Regenerative Procedures 43 Pocket Reduction Procedures 44 Follow-Up Care 45 Chapter 5 The Photo Gallery 47 Free Gingival Graft 47 Connective Tissue Graft 49 Dental Implants 51 Sinus Lift With Dental Implant Placement 53 Classification of Implant Sites 53 Implants placed after sinus has been elevated 54 3 4 Sinus Lift as a Separate Procedure 55 Sinus Perforation 55 Bone Grafting 57 Esthetic Crown Lengthening 59 Crown Lengthening for a Restoration 60 Tooth Extraction and Socket Grafting 61 More Photos of Procedures 62 Connective Tissue Graft 62 Connective Tissue Graft + Crowns 64 Free Gingival Graft 64 Esthetic Crown Lengthening
    [Show full text]
  • Free Gingival Autograft for Augmen- Tation of Keratinized Tissue and Stabili- Zation of Gingival Recessions
    Journal of IMAB - Annual Proceeding (Scientific Papers) 2008, book 2 FREE GINGIVAL AUTOGRAFT FOR AUGMEN- TATION OF KERATINIZED TISSUE AND STABILI- ZATION OF GINGIVAL RECESSIONS Chr. Popova, Tsv. Boyarova Department of Periodontology Faculty of Dental Medicine, Medical University - Sofia, Bulgaria SUMMARY: formation and periodontal disease can cause progressive Background: The presence of gingival recession loss of attachment and displacement of gingival margin associated with an insufficient amount of keratinized tissue apically reducing vestibular depth. Proper oral hygiene is may indicate gingival augmentation procedure. The most impossible in such cases with minimal vestibular depth and common technique for gingival augmentation procedure is lack of attached gingiva (2, 15). the free gingival autograft. There are several evidences that persons who The aim of this study was to evaluate the changes practice optimal oral hygiene may maintain periodontal in the amount of keratinized tissue and in the position of health with minimal amount of keratinized gingiva (18). gingival margin in sites treated with free gingival autograft However, a number of authors suggest that sufficient apical to the area of Miller’s class I, class II and class III amount of keratinized tissue is considered essential to gingival recessions. preserve the healthy periodontal status and to support the Methods: Twenty three subjects with 56 gingival dentogingival unit more resistant during the masticatory recessions associated with an insufficient amount of function and oral hygiene procedure (9). Therefore the keratinized gingiva were treated with gingival augmentation presence of gingival recession associated with a minimal procedure (free gingival graft). The grafts were positioned amount or lack of keratinized gingiva may indicate need of apical to the area of recession at the level of mucogingival gingival augmentation procedure to prevent additional junction.
    [Show full text]
  • Free Gingival Graft As a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects
    12 Gingival graft in mandibular defect Original Article Free Gingival Graft as a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects Lata Goyal1*, Narender Dev Gupta2, Namita Gupta2, Kirti Chawla3 1. Department of Dentistry, All India ABSTRACT Institute of Medical Sciences, Rishikesh, India; BACKGROUND 2. Department of Periodontics and Gingival recession is a frequent issue encountered by both Community Dentistry, Dr. Ziauddin Ahmad Dental College, Aligarh Muslim the clinician and the patient. This study was aimed to University, Aligarh India; assess the predictability of the free gingival graft as a single 3. Department of Periodontology, Jamia Millia Islamia, New Delhi, India step procedure in terms of root coverage and aesthetics in Miller Class I and II mandibular gingival recession. METHODS Ten patients (4 males, 6 females) aged 25-30 years with a total of 12 mandibular sites having Miller class I and II recession were selected. All recession sites were treated with single step free gingival graft procedure. Clinical parameters like recession depth, recession width, width of attached gingiva, probing depth and clinical attachment level were recorded at baseline, 6 and 9 months. Visual analog score at 1, 6 and 9 months postoperatively was provided. RESULTS There was a reduction in mean recession depth from 3.66±1.20 to 0.91±0.99 mm suggesting coverage of 82% over a period of 9 months. There was statistically significant gain in clinical attachment level and width of attached gingiva. Aesthetically, it was acceptable by patients as measured by visual analog scores. CONCLUSION Free gingival graft as a single step procedure is acceptable in terms of root coverage and aesthetics.
    [Show full text]
  • Treatment Concepts for Soft Tissue Regeneration with Geistlich Mucograft
    Treatment concepts for soft tissue regeneration with Geistlich Mucograft® 600526/1907/en © 2017 Geistlich Pharma AG – Subject to modifi cations – Subject to modifi © 2017 Geistlich Pharma AG 600526/1907/en Acknowledgements Geistlich Biomaterials is grateful to Dr. D. S. Thoma, PD Dr. R.E. Jung, Dr. Prof. Dr. mult. R. A. Sader, Dr. S. Ghanaati, Dr. I. Zabalegui, Dr. M. K. McGuire, Dr. R. Abundo, and Dr. G. Corrente for kindly sup- plying the images used in this brochure. We acknowledge the authors of the clinical cases and the participants of the Geistlich Mucograft® Seal Advisory Board Meeting for their valuable contribution and eff orts: Dr. A. Guerrero, Prof. Dr. M. Sanz, Dr. R. Lorenzo, Dr. D. Panaite, Dr. A. Charles, Dr. E. Vaia, Dr. U. Konter, Dr. H. Antoun, PD Dr. R.E. Jung, Dr. M. K. McGuire, Dr. E. T. Scheyer, Dr. D. Cardarop- oli, Prof. Dr. G. Zucchelli, Dr. P. Lindkvist, Dr. H. De Vree, Prof. Dr. H. De Bruyn, Dr. C. Romagna, Dr. O. Brendel, Dr. S. Aroca, Prof. Dr. A. Sculean, Dr. I. Sanz, PD Dr. S. Fickl, Dr. B. Wallkamm, Dr. A. Laskus, Dr. J. Sola, Dr. L. Ramaglia, Dr. R. Cavalcanti, PD Dr. D.S. Thoma, Dr. M. Bechtold, Prof. Dr. N. Donos. Geistlich Biomaterials thanks ACME Publishing for the copyright permission. Why are soft tissue graft alternatives needed? In recent years there has been a change in the direction of the treatment concept for edentulous patients towards an increasing awareness of the significance of dental aesthetics. Although bone is the supporting framework, the quantity and quality of the soft tissue around teeth and implants gain progressively in importance.
    [Show full text]
  • Soft Tissue Reconstruction with Free Gingival Graft Technique Following Excision of a Fibroma
    Hindawi Publishing Corporation Case Reports in Dentistry Volume 2015, Article ID 248363, 4 pages http://dx.doi.org/10.1155/2015/248363 Case Report Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma Nurcan Tezci,1 Suleyman Emre Meseli,1 Burcu Karaduman,1 Serap Dogan,2 and Sabri Hasan Meric1 1 Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, 34295 Istanbul, Turkey 2Department of Pathology, Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey Correspondence should be addressed to Suleyman Emre Meseli; [email protected] Received 25 June 2015; Revised 7 August 2015; Accepted 13 August 2015 Academic Editor: Adriano Loyola Copyright © 2015 Nurcan Tezci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone.
    [Show full text]
  • TO GRAFT OR NOT to GRAFT? an UPDATE on GINGIVAL GRAFTING DIAGNOSIS and TREATMENT MODALITIES Richard J
    October 2018 Gingival Recession Autogenous Soft Tissue Grafting Tissue Engineering JournaCALIFORNIA DENTAL ASSOCIATION TO GRAFT OR NOT TO GRAFT? AN UPDATE ON GINGIVAL GRAFTING DIAGNOSIS AND TREATMENT MODALITIES Richard J. Nagy, DDS Ready to save 20%? Let’s go! Discover The Dentists Supply Company’s online shopping experience that delivers CDA members the supplies they need at discounts that make a difference. Price compare and save at tdsc.com. Price comparisons are made to the manufacturer’s list price. Actual savings on tdsc.com will vary on a product-by-product basis. Oct. 2018 CDA JOURNAL, VOL 46, Nº10 DEPARTMENTS 605 The Editor/Nothing but the Tooth 607 Letter to the Editor 609 Impressions 663 RM Matters/Are Your Patients Who They Say They Are? Preventing Medical Identity Theft 667 Regulatory Compliance/OSHA Regulations: Fire Extinguishers, Eyewash, Exit Signs 609 674 Tech Trends FEATURES 615 To Graft or Not To Graft? An Update on Gingival Grafting Diagnosis and Treatment Modalities An introduction to the issue. Richard J. Nagy, DDS 617 Gingival Recession: What Is It All About? This article reviews factors that enhance the risk for gingival recession, describes at what stage interceptive treatment should be recommended and expected outcomes. Debra S. Finney, DDS, MS, and Richard T. Kao, DDS, PhD 625 Autogenous Soft Tissue Grafting for the Treatment of Gingival Recession This article reviews the use of autogenous soft tissue grafting for root coverage. Advantages and disadvantages of techniques are discussed. Case types provide indications for selection and treatment. Elissa Green, DMD; Soma Esmailian Lari, DMD; and Perry R.
    [Show full text]
  • Free Gingival Grafts: a Histological Evaluation in Humans
    Loyola University Chicago Loyola eCommons Master's Theses Theses and Dissertations 1970 Free Gingival Grafts: A Histological Evaluation in Humans Robert Cannon Bracket Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_theses Part of the Dentistry Commons Recommended Citation Bracket, Robert Cannon, "Free Gingival Grafts: A Histological Evaluation in Humans" (1970). Master's Theses. 2432. https://ecommons.luc.edu/luc_theses/2432 This Thesis is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Master's Theses by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © Robert Cannon Bracket FREE GINGIV AL GRAFTS: A HISTOLOGICAL BV ALUA TION IN HUMANS BY Robert Cannon Brackett. o. o. s. A THESIS SUBMITIBO TO nlB FACULTY OF THE GRADUATE SCHOOL OP LOYOLA UNIVERSITY IN PARTIAL FULFILLMENT OP THE REQUIREMENTS OP THE DBGRBB OF MASTER OF SCIENCE. May, 1970 t: :, Rt,~;2.. ~f LOYOLA UNIVERSitY MEDICAL CENTER AUTOBIOGRAPHY The author was born on July 16, 1939 in Fort Worth, Texas. A rather nomadic life makes the schools attended for primary education too numerous to mention here. His public education was completed in 1957 at Lubbock Senior High, Lubbock, Texas. Athletics were limited to football and boxing. After completing one semester attending Texas Techno­ logical College, he volunteered for the draft. He was inducted into the Army and while ftniahing a European tour, decided on dentistry as ht• future course d.
    [Show full text]
  • Soft Tissue Reconstruction with Free Gingival Graft Technique Following Excision of a Fibroma
    Hindawi Publishing Corporation Case Reports in Dentistry Volume 2015, Article ID 248363, 4 pages http://dx.doi.org/10.1155/2015/248363 Case Report Soft Tissue Reconstruction with Free Gingival Graft Technique following Excision of a Fibroma Nurcan Tezci,1 Suleyman Emre Meseli,1 Burcu Karaduman,1 Serap Dogan,2 and Sabri Hasan Meric1 1 Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, 34295 Istanbul, Turkey 2Department of Pathology, Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey Correspondence should be addressed to Suleyman Emre Meseli; [email protected] Received 25 June 2015; Revised 7 August 2015; Accepted 13 August 2015 Academic Editor: Adriano Loyola Copyright © 2015 Nurcan Tezci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Oral fibromas are benign, asymptomatic, smooth surfaced, firm structured tumoral lesions that originate from gingival connective tissue or periodontal ligament. Histologically, they are nodular masses characterized by a dense connective tissue, surrounded by stratified squamous epithelium. Case Report. This case report includes the clinical, radiographical, and histological findings and periodontal treatment of a 38-year-old female patient having painless swelling on the gingiva. Intraoral examination revealed a fibrotic, sessile, smooth surfaced gingival overgrowth interdentally between the teeth #13 and #14. Radiographical findings were normal. Initial periodontal treatment (IPT) was applied including oral hygiene instructions, scaling, and root planing. Following IPT, the lesion (0.7 × 0.6 × 0.4 cm) was excised and examined histopathologically. Subsequently, flap operation was performed to have an access to alveolar bone.
    [Show full text]
  • Redalyc.Aesthetic Improvements in Free Gingival Graft Due to Its
    RSBO Revista Sul-Brasileira de Odontologia ISSN: 1806-7727 [email protected] Universidade da Região de Joinville Brasil Lopes, Tertuliano Ricardo; Machado, Cassiana Nathalie; Camargo Rogacheski, Mariana; Verbicaro, Thalyta; Giovanini, Allan Fernando; Miranda Deliberador, Tatiana Aesthetic improvements in free gingival graft due to its association with frenectomy RSBO Revista Sul-Brasileira de Odontologia, vol. 10, núm. 2, abril-junio, 2013, pp. 135-142 Universidade da Região de Joinville Joinville, Brasil Available in: http://www.redalyc.org/articulo.oa?id=153027495006 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ISSN: Electronic version: 1984-5685 RSBO. 2013 Apr-Jun;10(2):135-42 Original Research Article Aesthetic improvements in free gingival graft due to its association with frenectomy Tertuliano Ricardo Lopes1 Cassiana Nathalie Machado1 Mariana Camargo Rogacheski1 Thalyta Verbicaro1 Allan Fernando Giovanini1 Tatiana Miranda Deliberador1 Corresponding author: Tatiana Miranda Deliberador Mestrado Profissional em Odontologia Clínica, Universidade Positivo Rua Professor Pedro Viriato Parigot de Souza, n. 5.300 – Campo Comprido CEP 81280-330 – Curitiba – PR – Brasil E-mail: [email protected] 1 Department of Dentistry, Positivo University – Curitiba – PR – Brazil. Received for publication: November 11, 2012. Accepted for publication: December 1, 2012. Abstract Keywords: Introduction: The insufficient amount of attached gingiva and the Periodontics; labial abnormal insertion of the labial frenulum may be related. When this frenulum; gingiva; occurs, it is common to associate frenectomy techniques with free histology; clinical gingival graft (FGG).
    [Show full text]
  • Alloplastic Bone Grafting System
    WESTERN SOCIETY OF PERIODONTOLOGY “Synergy For Success: Innovations in Periodontology” 66TH ANNUAL SCIENTIFIC SESSION San Diego 2018 THE COLLABORATIVE EVENT OF THE YEAR! PERIODONTOLOGY • RESTORATIVE • HYGIENE NEW FOR 2018 Improved Schedules More CE Courses Corporate Forums Manchester Grand Hyatt, San Diego HOTEL APRIL 6 - 8 PROGRAM • FRANK SCHWARTZ, PROF. DR. MED. DENT. • DHAVAL PATEL, DDS - Clinical Excellence with In-Office CadCam Treatment Concepts For The Management Of Peri-Implantitis *Hands-On: Soft-Tissue Augmentation and Corrections for the • BEN MIRAGLIA, DDS - Better Periodontal Health with Clear Aligner Therapy Prevention and Management of Peri-Implant Diseases • BOBBY BIRDI, DMD, MS - Surgical-Prosthetic Synergy in Today’s Implant Treatment • DENNIS TARNOW, DDS • GEORGIOS E. ROMANOS, DDS, PHD, PROF. DR. MED. DENT. Interdisciplinary Approach To Difficult Aesthetic Cases Implant Diameter as a Key for Long-Term Success in Implant Dentistry • RODRIGO NEIVA, DDS, MS • BALDWIN MARCHACK, DDS, MBA Current Trends in Periodontics and Implant Dentistry Esthetics & Implant Prosthetics: Avoiding Failures And Complications • STANLEY MALAMED, DDS • SANDA MOLDOVAN, DDS 10 Minutes to Save a Life: Emergency Medicine in Dentistry Increase the success of your dental implant practice with your hygiene protocol • SALAH HUWAIS, DDS • DIANE MILLAR, RDH, MA *Hands-On: Osseodensification: Optimize the Site-Optimize the Outcome State of the Art Hygiene: A Virtual Reality Trip Through Cutting Edge Scaling Techniques • EARNEST CHOLAKIS, DMD, MBA *Hands-On:
    [Show full text]
  • Veterinary Periodontal Disease
    Veterinary Periodontal Disease Introduction Periodontal disease is the most common infectious disease of adult dogs. It is a progressive, cyclical inflammatory disease of the supporting structures of the teeth and is the main cause of dental disease and early tooth loss in dogs and cats. It affects over 87% of dogs and 70% of cats over three years of age. By the end of this chapter you should be able to: ü Understand the aetiopathogenesis of periodontal disease ü Know the significance of untreated periodontal disease on both the mouth and body organs ü Treat and prevent common periodontal problems ü Understand the different pocket types that may present and select appropriate treatment for them. Periodontal Tissues Periodontal tissues include four defined structures: gingiva, cementum, alveolar bone, and the periodontal ligament. The following landmarks are crucial to the understanding of the support structures of the tooth and the aetiopathogenesis of periodontal disease. Gingiva The gingiva is the only one of the four periodontal tissues normally seen in the mouth. Attached Gingiva The attached gingiva is keratinised to withstand the stress of ripping and tearing food. It tightly adheres to the underlying connective tissue with rete pegs. Free Gingiva The free gingiva surrounds the crown of the tooth. Cementum The cementum covers the dentin of the root surface of the tooth. It is histologically similar in structure to bone. It is thicker apically than coronally and is capable of both necrosis and some regeneration by cementoblasts. Both the periodontal ligament and gingiva anchor fibres into the cementum. Alveolar Bone The roots are encased in alveolar processes.
    [Show full text]