A clinical study of the width of the attached gingiva in the deciduous, transitional and permanent dentitions tenenbaum 1986 journal of clinical periodontology wiley online library. The width of keratinized gingiva during orthodontic. The importance of keratinized gingiva surrounding dental. I n recent years, much attention has been focused on the width of attached gingiva. Various techniques to increase keratinized tissue for implant. The relationship between the width of keratinized gingiva and gingival health. Eighteight per cent of the mandibular permanent central incisors with 1 mm or more of attached gingiva at the first examination showed a. T his study was performed to evaluate the effects of orthodontic therapy on the width of the zone of keratinized gingiva. Increasing the width of periodontal attached gingiva using an nd. On basis of observation it seems justified to assume that the anatomical width of the attached gingiva is in direct proportion to the amount of past tooth eruption. Innovative use of increasing the width of attached gingiva using. Pdf the width of attached gingiva varies from tooth to tooth and also among individuals with mixed opinions regarding an adequate or. A distinct pattern of the width of healthy lingual attached gingiva was found. Assessment of the width of attached gingiva using different methods.
Using the mucogingival junction as the boundary demarcating the apical border of the attached gingiva, a periodontal probe is inserted into the gingival sulcus to measure how much. The width of the attached gingiva during orthodontic. Orthopantomographic assessment of the width of attached. Adjustment of the occlusal plane of natural teeth opposed by a complete or partial denture should be completed major connectors of a cast maxillary partial denture are beaded at the periphery in order to a line angle not present on a class i cavity preparation on tooth 1. The size of the fgg applied was 4 mm wide, with the length dictated by the number of teeth being treated.
The achieved increase of attached gingiva and the vestibule depth led to improvement of the effectiveness of the. Attached gingiva plays a promising role in maintaining periodontal health. The position of mgj relative to lower border of mandible did not increase with age. The width of the attached gingiva ag is an important clinical parameter. Techniques for increasing attached gingiva periodontal.
On attached gingiva lies between the free gum and mucous alveolar ridge fig. The assessment of width of attached gingiva in different age groups by vm revealed that the width of gingiva increases with age as suggested by authors like ainamo and talari and vincent et. In case of inadequate width of attached gingiva, the gingival augmentation procedure has been performed classically using the patients own masticatory mucosa and more recently, using an acellular dermal allograft as the donor material. The factors that impact the width of attached and keratinized gingiva during this period of life are. Among various techniques for augmenting width of attached gingiva, modified apically repositioned flap marf is a simple and easy procedure that does not require a second surgical. The intracrevicular restorative margin,the biologic width, and the maintenance of gingival margin. A baseline examination carried out 6 months after treatment revealed that the sites to be monitored were lacking or had only a minimal zone attached gingiva. The width of attached gingiva on the facial aspect varies in differ ent areas of the mouth. The purpose of the study was to determine the variation with age of the width of attached gingiva and the location of the mucogingival junction. Digital assessment of gingival dimensions of healthy periodontium. Pdf evaluation of color and width of attached gingiva gain in. The clinical width of attached gingiva is determined by.
Then, the facial gingiva and mucosa of both jaws were digitally scanned using an. Increasing the width of attached gingiva by using modified. The opinions or assertions contained in this article are the private ones of the writer and are not to be construed as official or reflecting the views of the department of the navy or the navy dental corps. Various techniques to increase keratinized tissue for. Pdf a study of the width of attached gingiva giovanna. Gingival sulcus depth gsd, attached gingiva width agw, and gingival thickness gt were measured archwise and toothwise in. Longitudinal changes in the width of attached gingiva in. Although the need for a socalled adequate amount of keratinized tissue for maintenance of periodontal health is questionable, the mucogingival junction serves as an important clinical landmark in periodontal. The increase with age of the width of attached gingiva. View the article pdf and any associated supplements and figures for a period of 48 hours. Pdf width of keratinized gingiva and the health status of. Assessment of the width of attached gingiva using different.
Living cellular construct for increasing the width of. The subcrevicular physiologic space is analogous to the biologic width described gargiuloetal 1961. The width of attached gingiva varies from tooth to tooth and also among individuals with mixed opinions regarding an adequate or sufficient dimension of the gingiva. The function of attached gingiva to keep free of gum from broke away from the teeth and protect the gums from injury.
The width of the attached gingiva during orthodontic treatment. When the width of the attached gingiva in the mandibular permanent central incisors was less than 1. The keratinized gingiva extends from the marginal gingiva to the mucogingival junction and include both free and attached gingiva. Assessment of gingival sulcus depth, width of attached gingiva, and. Pdf assessment of the width of attached gingiva using different. Dec 17, 2020 another technique consists of outlining the recipient site with two vertical incisions from the cut gingival margin into the alveolar mucosa tig. Mean values were reported using descriptive statistics. Although the need for a socalled adequate amount of keratinized tissue for maintenance of periodontal health is questionable, the mucogingival junction serves as an important clinical landmark in periodontal evaluation. Summary of a thesis submitted to the faculty of the ohio state university college of dentistry in partial fulfillment of the requirements for the degree of master of.
In man the keratinized gingiva includes the free and the attached gingiva and extends from the gingival mar gin to the mucogingival. Orthopantomographic assessment of the width of attached gingiva. Pdf width of keratinized gingiva and the health status. Jul 01, 2010 the width of attached gingival increased with age. Increasing width of attached gingiva by envelope technique with trap door technique for subepithelial connective tissue graft. In patients with inadequate width of attached gingiva mucogingival surgeries like connective. Nov 24, 2020 width of attached gingiva plays an important role in maintaining periodontal health, provides stabilization of the gingival margin against frictional forces and aids in dissipating physiological forces exerted by the muscular fibers of the alveolar mucosa on the gingival tissues. Lack of association between width of attached gingiva and. Width of attached gingiva is not measured to taste, because it is impossible to determine where attached gingiva ends and the soft palate mucosa begins. Width of attached gingiva plays an important role in maintaining periodontal health, provides stabilization of the gingival margin against. Attached gingiva is an important factor affecting periodontal health which enhances the plaque removal around the gingival. A study of the width of attached gingiva bowers 1963 the. However, thin gingival tissues around teeth with restorations or undergoing labial orthodontic tooth movement may be more susceptible to recession.
The width of gingiva varies from 19mm, being greatest at the incisor region especially in the lateral incisor and smallest in the canine and first premolar region. The achieved increase of attached gingiva and the vestibule depth led to improvement of the effectiveness of the oral hygiene and to better control of the gingival inflammation. Apr 10, 2017 bower measured the width of facial attached gingiva in both primary and permanent dentition. Longitudinal changes in the width of attached gingiva in children. A clinical study of the width of the attached gingiva in. Techniques for increasing attached gingiva periodontal disease. The attached gingiva was numerically determined by subtracting the probing. Provide attachment or a solid base for the movable alveolar mucosa for the action of the cheeks, lips, and tongue. The width of attached gingiva is not significant to maintain periodontal health in the presence of adequate oral hygiene. This was followed by the third molar 3mm second bicuspid 2. Clinical features that require calculations foundations of.
The smallest width was usually seen in the area of the anterior teeth, and the widest gingiva. The importance of keratinized gingiva surrounding dental implants. Pdf correlation of width of attached gingiva on oral. The width of the attached gingiva wag central incisors, the width of the attached gingiva did not increase significantly from 5. Pdf correlation of width of attached gingiva, depth of the. Review the width of the attached gingivamuch ado about nothing. An adequate width of attached gingiva prevents plaque formation and softtissue recession. Comparative evaluation of free gingival graft and alloderm. The width of the keratinized gingiva and the depth of the gingival sulcus were measured on.
The orthopantomographic width of the attached gingiva was measured to the nearest millimeter by determination of the distance between the mucogingival and cementoenamel junctions along the long axis of each tooth. The labial surfaces of 966 teeth in a sample of 100 orthodontic patients were studied. On attached gingiva is part of the desna river, which is closely linked with cement cervical third root and periosteum connective tissue cover alveolar bone. Width of attached gingival varies in different areas of the mouth and also increases with age with no significant difference in the method of its assessment. The width of the attached gingivamuch ado about nothing. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. Pdf width of attached gingiva in an indian population. Fortyeight periodontally healthy volunteers 38 males and 10 females, mean age. Free gingival graft for increasing the width of attached gingiva a.
The width of attached gingiva can vary dramatically between patients and within an individuals mouth, from as little as 1 mm to over 10 mm. Biologic width and its importance in periodontal and. A clinical study comparing the width of attached gingiva and the prevalence of gingival recessions. Apical repositioned flap with osseous reduction this technique is used when there is no adequate zone of attached gingiva and the biologic width is less than 3 mm. Width of attached gingiva on attached gingiva is the largest in the incisors and indigenous areas ranging from 3. This study aimed to compare the color and width of tissue grafted by two surgical techniques of keratinized gingival augmentation, namely free gingival. The gingiva regenerated with the lcc matched the color and texture of the adjacent gingiva. There was a significant association p gingival recession and width of attached gingiva, tooth malposition, type of frenal attachments, simplified oral hygiene index, type of brush. Increasing width of attached gingiva by envelope technique with. An increase in attached gingiva width is required in cases of inadequate attached 3 gingiva, especially in orthodontic or prosthetic treatments, better plaque removal from the gingival margin, and. Innovative use of increasing the width of attached gingiva. Mgj position is stays constant but width of attached gingiva increases as the teeth erupt passively. Free gingival graft to increase the width of attached gingiva for oral. The relationship between the width of keratinized gingiva.
It is the distance between the mucogingival junction mgj and the projection on the external surface of the bottom of the gingival sulcus or the periodontal pocket. According to abrahamsson in 1996, a certain width of keratinized gingiva is required to promote an adequate epithelial and connective tissue attachment. Inadequate width of attached gingiva leads to attachment loss, soft tissue recession, and impedes oral hygiene. Digital assessment of gingival dimensions of healthy. The study included 40 subjects 22 males and 18 females with 480 sites of an age range 425 years. Pdf measurement of the width of attached gingiva in an. The mean width of the attached gingiva did not show an increase from the deciduous to the permanent dentition. Demonstrate a new technique to increase the width of keratinized gingiva using a biological mem brane material in place of donor tissue. A clinical study of the width of the attached gingiva in the. Assessment of gingival sulcus depth, width of attached. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on youtube. Here is a basic method to determine the amount of attached, keratinized gingiva that you have on a toothregion the roll technique.
The relationship between the width of keratinized gingiva and. A study of the width of attached gingiva bowers 1963. Studies of the influence of orthodontic movement on the width of the attached gingiva gave conflicting results. This procedure is done when there is no adequate width of attached gingiva, and there is a biologic width of more than 3 mm on multiple teeth. Significance of the width of keratinized gingiva on the periodontal. A baseline examination comprised assessments of dental plaque, gingival conditions, attachment level, position of the gingival margin and width of the keratinized and the attached gingiva. The presence of an adequate width of keratinized tissue is important to maintain a healthy dentogingival junction. Pdf the width of the attached gingiva during orthodontic.
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