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Alireza Torabi, Babak Najafi, Howard J Drew, Emil G Cappetta
Improvement of smile esthetics is a major goal of modern dentistry. Various treatment modalities have been proposed to correct excessive gingival display (EGD), depending on the identified etiologies. This study reports on the clinical and patient-centered outcomes of a novel lip repositioning technique with vestibular shallowing approach in the treatment of three types of EGD with varying etiologies. Periosteal fenestration with cicatrization (scarification) was performed at the mucogingival junction to ensure the stability of esthetic outcomes...
March 7, 2018: International Journal of Periodontics & Restorative Dentistry
George A Mandelaris, Bradley S DeGroot, Robert Relle, Brian Shah, Iwei Huang, Brian S Vence
Comorbidities that negatively impact orthodontic (malocclusion), periodontal (periodontitis, deficient dentoalveolar bone volume, mucogingival), and prosthetic (structural integrity compromise from caries, attrition, and erosion) conditions can affect the general health of the patient. In addition, emerging data highlights the importance of undiagnosed airway volume deficiencies and sleep-disordered breathing conditions in the adult and pediatric population. Deficiencies in dentoalveolar bone and discrepancies in skeletal relationships can impact the volume of hard- and soft-tissue structures of the periodontium and decrease oral cavity volume...
March 2018: Compendium of Continuing Education in Dentistry
Matteo Marzadori, Martina Stefanini, Claudio Mazzotti, Sabrina Ganz, Praveen Sharma, Giovanni Zucchelli
Loss of dentition leads to functional and esthetic challenges that are determined by the anatomic features of the edentulous area. These features can complicate the prosthetic rehabilitation of such patients, especially in situations where optimal esthetic outcomes are desired. For these reasons, reconstructive plastic surgery procedures, aimed at restoring the alveolar ridge to its former dimensions, have become of great clinical interest. These reconstructive plastic surgery procedures frequently involve soft-tissue augmentation, performed to improve the quality and quantity of mucogingival tissue with the aim to achieve an ideal esthetic result...
March 1, 2018: Periodontology 2000
Anamika Sharma, Shatakshi Sharma, Harshita Garg, Vineeta Singhal, Pooja Mishra
This clinical report describes the successful use of lip repositioning technique for the reduction of excessive gingival display. The lip repositioning technique was performed with the main objective of reducing gummy smile by limiting the retraction of elevator muscles (e.g., zygomaticus minor, levator anguli, orbicularis oris, and levator labii superioris). This technique includes removing a strip of mucosa from the maxillary buccal vestibule, creating a partial-thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display...
October 2017: Journal of Cutaneous and Aesthetic Surgery
Joe Iwanaga, Koichi Watanabe, Jingo Kusukawa, Rod J Oskouian, R Shane Tubbs
Mimetic muscles contract and pull the overlying skin toward the muscle's bony attachment. Numerous books and articles have shown the mimetic muscles via cadaveric dissection. However, for dentistry and oral surgery, the mimetic muscles have not been detailed from intraoral dissection. Recently, several papers have addressed various mimetic muscles in relation to intraoral dissection. However, to our knowledge, there has been no overview of these muscles beneath the oral mucosa. Here, we review the literature concerning the mimetic muscles as revealed during intraoral dissection, create novel illustrations, and discuss the relationship of these muscles with general dentistry and oral surgery...
December 13, 2017: Curēus
Ashu Bhardwaj, Zeba Jafri, Nishat Sultan, Madhuri Sawai, Anika Daing
Background: Chronic periodontitis in lower anterior teeth results in rapidly progressive gingival recession (GR), loss of alveolar bone, decreased vestibular depth (VD) with consequential tooth mobility, and tooth loss. Treatment option for such cases in this esthetically important area of the oral cavity includes extraction followed by implants for which sufficient bone height and mucogingival complex are a prerequisite. Henceforth, an attempt was made to prolong the life of lower anterior teeth and postpone the need for implants by the treatment of chronic periodontitis with periodontal flap surgery followed by vestibular deepening in single surgical procedure...
January 2018: Journal of Natural Science, Biology, and Medicine
Reza Fekrazad, Nasim Chiniforush, Katayoun Kalhori
AIM: This case series study evaluated the application of Er;Cr:YSGG laser for a free gingival graft procedure and the effect of low level laser therapy on post surgical pain and wound healing. CASES: 6 cases with mucogingival problems needing free gingival grafts were selected. First, the recipient site was anesthetized and de-epithelialization was done with a Er;Cr:YSGG laser. After tracing the palatal donor site with the laser, the graft was harvested. For root modification of the recipient tooth, conditioning of the dentin was done by the same laser...
February 16, 2018: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Avita Rath, Bennete Aloysius Fernandes, Preena Sidhu, Priyadarshini Ramamurthy
New and innovative surgical techniques are necessary to help the clinician ensure the best results and satisfy patient's expectations. One such periodontal problem that has been challenging to the dental practitioners and impacts the oral health quality of life of patients has been gingival recession. When present anteriorly where esthetics is a major concern, patient centric parameters too become paramount. Root coverage esthetic score (RES) evaluation helps to keep the patient outcomes in mind. This case reports the successful treatment of a wide anterior mucogingival defect using epithelial embossed connective tissue graft which was evaluated for the first time using RES...
May 2017: Journal of Indian Society of Periodontology
Manoela Moura De Bartoli, Luis Felipe Oliveira Maciel, Marília Gabriela Mendes de Alencar, Thiago Coelho Gomes da Silva, Ricardo José Holanda Vasconcellos
Osteoma is an uncommon benign osteogenic tumor characterized by the proliferation of compact and cancellous bone. The objective of this study was to report a case of osteoma in the basilar region of the mandible. The patient reported no pain, but the affected area was tender to touch and there was esthetic concern because of the apparent swelling. The mass measured approximately 5 cm in diameter and extended to the lingual area of the mandible. A vestibular approach was used for surgical treatment. After infiltration of a local anesthetic and vasoconstrictor, to expose the mandibular ramus, an incision was made with an electric scalpel along the external oblique ridge through the mucosa, submucosa and muscle, fascia and periosteum until the lower second molar, 3 to 5 mm inferior to the mucogingival junction...
February 7, 2018: Journal of Craniofacial Surgery
Sana Farista, Ramreddy Yeltiwar, Butchibabu Kalakonda, Kaustubh Suresh Thakare
Excessive gingival display (EGD) resulting in a "gummy smile" is a major esthetic concern with ramifications in an individual's personal and social life. Numerous treatment modalities have been used for the correction of EGD. The present case report describes the successful treatment of a young woman with an excess gingival display caused by a hyperactive upper lip and a mild vertical maxillary excess that was treated with a laser-assisted lip repositioning surgical technique accompanied by gingival recontouring...
March 2017: Journal of Indian Society of Periodontology
Monika Puzio, Artur Błaszczyszyn, Jakub Hadzik, Marzena Dominiak
PURPOSE: A comparative, ultrasound evaluation of the thickness of keratinized mucosa (TKT) around implants one year after gingival augmentation (GA) by means of a connective tissue graft (CTG) and the xenogeneic collagen matrix (CMX). MATERIALS AND METHODS: A total of 75 bone level tapered implants (Conelog® Camlog) were inserted in 57 patients in the aesthetic area of both jaws. The patients were divided into 3 groups: control group I- without GA; group II- GA 3 months before implantation, and group III- GA 3 months after implantation...
December 14, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Martina Stefanini, Giovanni Zucchelli, Matteo Marzadori, Massimo de Sanctis
The aim of this study was to evaluate the short- (1 year) and longer-term (3 years) effectiveness of a surgical procedure combining coronally advanced flap (CAF) with site-specific application of connective tissue graft (CTG) in the treatment of multiple gingival recessions (MGR). A total of 60 periodontally healthy subjects with esthetic complaints due to excessive tooth length presenting multiple (at least three) Miller Class I and II gingival recession defects (≥ 1 mm) affecting adjacent teeth in the maxilla and mandible were enrolled in the study...
January 2018: International Journal of Periodontics & Restorative Dentistry
Marco Veneziani
Complex cases with high esthetic needs represent a challenge for clinicians. A multidisciplinary approach is vital to achieve the planned result. New technological devices are needed to facilitate the collaboration between the clinical team members and to develop a fluent and effective diagnostic and therapeutic pathway. This article describes a well-defined protocol for the treatment of complex esthetic cases with the use of ceramic laminate veneers. The protocol involves different branches of dentistry: periodontal therapy, mucogingival surgery, restorative dentistry, orthodontics, and prosthodontics...
2017: International Journal of Esthetic Dentistry
Beata Wyrębek, Dorota Cudziło, Paweł Plakwicz
AIM: To evaluate the periodontal status, mucogingival parameters and oral hygiene in growing patients with bilateral cleft lip and palate. MATERIAL AND METHODS: Assessment was performed in 15 patients aged 6 to 18 years with a bilateral cleft. Records included probing pocket depth, clinical attachment level, keratinized gingiva, recession, vestibule depth, biotype, type of fraena, dental plaque and bleeding. RESULTS: The mean scores of pocket depth were: 1...
2017: Developmental Period Medicine
Ann M Decker, Fernando Suárez-López Del Amo, Istvan A Urban, Preston D Miller, Hom-Lay Wang
PURPOSE: The etiology and progression of periimplant mucogingival defects are multifactorial. As such, the aim of this study was to discern and discuss the key long-term prognostic factors that change the balance of homeostasis/regeneration in periimplant mucogingival and recession defects. MATERIALS AND METHODS: This report provides cases and a discussion of anatomical factors that affect the long-term maintenance of periimplant soft tissue. RESULTS: The factors guiding long-term maintenance of the periimplant soft tissue apparatus are increasingly complex due to the additive combination of patient-related factors, anatomical variations, and unique material-host interactions...
December 2017: Implant Dentistry
Ramzi V Abou-Arraj, Maninder Kaur, Philip J Vassilopoulos, Nicolaas C Geurs
Acellular dermal matrix allografts (ADMs) have been hypothesized to create a zone of immobile connective tissue (ICT) extending apical to the mucogingival junction (MGJ). This 12-month prospective randomized trial investigated the presence of ICT after the use of two commercially available ADMs with coronally advanced flaps in the treatment of Miller Class I and II recession defects. This study demonstrated that the use of either type of ADM resulted in predictable root coverage and a zone of ICT extending apical to the MGJ by 1...
July 2017: International Journal of Periodontics & Restorative Dentistry
Yeşim Kaya, Özer Alkan, Sıddık Keskin
OBJECTIVE: To evaluate the relationship of gingival thickness (GT) and the width of keratinized gingiva (WKG) with different malocclusion groups and the level of crowding. METHODS: A total of 187 periodontally healthy subjects (121 females and 66 males) who presented at the Faculty of Dentistry in Yüzüncü Yıl University for orthodontic treatment were enrolled in the study. The individuals involved in the study were divided into three groups; Angle Class I malocclusion, Angle Class II malocclusion, and Angle Class III malocclusion...
May 2017: Korean Journal of Orthodontics
Yun-Jin Koo, Sung-Hwan Choi, Byeong-Tak Keum, Hyung-Seog Yu, Chung-Ju Hwang, Birte Melsen, Kee-Joon Lee
OBJECTIVE: To evaluate the differences in maxillomandibular transverse measurements at either the crown or the estimated center of resistance (CR), and to compare values between normal occlusion and Class III malocclusion groups. METHODS: Dental casts and computed tomography (CT) data from 30 individuals with normal occlusion and 30 with skeletal Class III malocclusions were evaluated. Using the casts, dental arch widths (DAWs) were measured from the cusp tips, and basal arch widths (BAWs-cast) were measured as the distance between the points at the mucogingival junction adjacent to the respective cusp tips...
May 2017: Korean Journal of Orthodontics
John K Brooks, Justin W Kleinman, John R Basile
The gingival cyst of the adult is a relatively rare, benign odontogenic cyst that maintains an insidious growth rate. This article describes a case of a diminutive fibrotic overgrowth arising on the labial interproximal gingiva between the mandibular right canine and first premolar in a 68-year-old woman. Within 1 year, the lesion had increased in size and appeared vesicular. The morphologic changes warranted surgical excision and histopathologic review. The lesion was diagnosed as a gingival cyst. At a 4.5-month recall appointment, there was no evidence of recurrence...
May 2017: General Dentistry
Ed Madeley, Brett Duane
Data sourcesMedline, The Cochrane Database Trials Register, Embase, supplemented by handsearching of five prominent periodontal journals, references from reviewed papers and contact with experts in the field of mucogingival surgery.Study selectionRandomised controlled trials (RCTs) with or without a split-mouth design, on human patients. RCTs had to compare at least two different surgical interventions on clearly specified recession defects, be over six months in duration and have clearly specified clinical measurements regarding root coverage...
March 2017: Evidence-based Dentistry
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