Measurement of attached gingiva width the width of keratinized gingiva was measured in midfacial area for six anterior teeth in the maxillary and mandibular regions from the gingival margin to the mucogingival junction using unc15 periodontal probe. The assessment of width of attached gingiva in different age groups by vm revealed that the width of gingiva increases with age wherein the mean width in maxillary teeth in width of attached gingiva using. On attached gingiva in the narrow premolar regions 1. Similar to the variations seen in bowers study, the widest zone of attached gingiva was found in the incisors and the least in the premolar region irrespective of the. 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. Ughabharathy r, balu p, muthu j, saravanakumar r, vineela k, karthikeyan i. Shallow vestibule along with the inadequate width of attached gingiva is a common cause of the gingival recession. 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. The aim of this study was to determine normal values of the width of attached gingiva in an indian subpopulation. Clinical features that require calculations foundations.
This technique is important for maintaining an adequate zone of keratinized tissue, as opposed to the gingivectomy technique, where soft tissue is resected. Wiley online library, proceedings from the state of the art workshop on surgical therapy for periodontitis, journal of periodontology, 53, 8, 475501, 1982. The width of the attached gingiva during orthodontic. A study of the width of attached gingiva bowers 1963. This question of assigning a value to the width has been explored from a different perspective. The mean width of the attached gingiva did not show an increase from the deciduous to the permanent dentition. 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. In case 2, the width of the attached gingiva increased from 3 mm to 6 mm on tooth 2431 and from 1 mm to 6. The intracrevicular restorative margin,the biologic width, and the maintenance of gingival margin. Adequate width of attached gingiva is required for resistance against functional stresses and providing periodontal health 1,2,3,4. Aug 21, 2012 the most coronal part towards the tooth reforms as attached gingiva keratinized tissue from the gingiva surrounding the adjacent teeth. 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.
Upon intra oral examination the sound tooth structure was deep below the gum tissue and not accessible, very narrow zone of attached gingiva was also noticed. No significant correlation was shown between width of attached gingiva or vestibular depth and gingival inflammation and oral hygiene maintenance. Vestibuloplasty is a preprosthetic surgical technique that has been developed to rebuild a sufficient vestibular depth by reducing the high muscle tensions that are streching to the maxillary or mandibular sides 3,4. The width of attached gingiva is not significant to maintain periodontal health in the presence of adequate oral hygiene. Clinical evaluation of increase in the width of attached gingiva using modified apically repositioned flap.
Pdf width of keratinized gingiva and the health status. Henri tenenbaum and monique tenenbaum, a clinical study of the width of the attached gingiva in the deciduous, transitional and permanent dentitions, journal of clinical periodontology, , 4, 270275. On attached gingiva does not include any part of the desna river, which is separated from tooth to the crevice, grooves or periodontal pocket. However, the width of the attached gingiva in the case of newly erupted permanent teeth was narrower than in the corresponding primary teeth. May 02, 2014 the assessment of width of attached gingiva in different age groups by vm revealed that the width of gingiva increases with age wherein the mean width in maxillary teeth in width of attached gingiva and the prevalence of gingival recessions, journal of clinical periodontology, 9, 1, 8692, 2011. The width of attached gingiva varies in different areas of the mouth and have been given a range of 19 mm, 14 mm, 0g5 mm.
The mucogingival junction was determined using a jiggle method because of movable the alveolar mucosa and firmly attached gingiva. The relationship between the width of keratinized gingiva prosites. The treatment procedure led to significant improvements in width of gingiva. Feb 01, 2017 width of attached gingiva maxilla incisor region. Students ttest for paired samples was used to compare the means of the clinical measurements at all experimental periods. The width of the attached gingiva can be accurately measured if scaling has not been done gingival inflammation in the area has been eliminated the pocket depth is not beyond 3mm. Longitudinal changes in the width of attached gingiva in. An adequate width of attached gingiva is essential to maintain oral hygiene. Orthopantomographic assessment of the width of attached. In 100% of teeth with less than 2mm of keratinized tissue, inflammation and exudates was present. Pdf correlation of width of attached gingiva, depth of the. Adam bear discusses the advantages this procedure has for surgical crownlengthening procedures. The width of the attached gingiva can be accurately measured if a pontic replacing a mandibular first molar should be designed so that itits 1.
The 20 patients were pleased with this new technique using the nd. A free gingival graft 12, was obtained from the right and left side portions of the palate, approximately 2 mm below the gingival margin. Subsequent studies38 demonstrated that it is possible to maintain the periodontal attachment level through the control of gingival in. Pdf a study of the width of attached gingiva giovanna saldana. Width of attached gingiva on attached gingiva is the largest in the incisors and indigenous areas ranging from 3. Using the mucogingival junction as the boundary demarcating the apical border of the attached gingiva, a periodontal probe in inserted into the gingival sulcus to measure how much. A clinical study of the width of the attached gingiva in the. Each measurement was made from the gingival margin to the mucogingival junction. The width of the attached gingiva can be accurately.
Pdf correlation of width of attached gingiva, depth of. Lang and loe 5 reported a study on the relationship between the gingival width and inflammation, in an effort to determine the adequate amount. Clinical evaluation of a dermic allograft in procedures to. Hall 1982 said that the width of attached gingiva is determined by subtracting the sulcus or pocket depth from total width of gingiva. Although the need for a socalled adequate amount of keratinized tissue for maintenance of periodontal health is questionable, the mucogingival junction serves as. The width of keratinized gingiva the distance between gingival margin and mucogingival line was measured to.
However, in the present study the widths varied from 0 to 5 mm. They concluded that 2mm of keratinized gingiva, with less than 1mm of attached gingiva. Soft tissue sealing around dental implants based on. Pdf free gingival graft for increasing the width of. In case 1, the width of the attached gingiva increased from 3 mm to 7 mm on teeth 2431 and 2541 and from 2 mm to 6 mm on teeth 2332 and 2642.
Brownstein, recognition of periodontal disease in children, pediatric clinics of north america, 29, 3, 457. The width of attached gingiva in the labial or buccal surface at edentulous area was measured before surgical procedures and after the completion of superstructures. Assessment of gingival sulcus depth, width of attached. Attached gingiva 4 555 3 4,5 gain of attached gingiva 2,5 5 5 4 3 2,5 fig. Assessment of the width of attached gingiva using different. None introduction the width of the attached gingiva ag is an important clinical parameter. Double lateral sliding bridge flap for the coverage of. The width of the attached gingiva during orthodontic treatment. Pdf width of keratinized gingiva and the health status of. The width of the attached gingiva can be accurately measured. P of keratinized attached gingiva and nonkeratinized alveolar mucosa shows that attached gingiva is keratinized with thin, prominent epithelial ridges, and is firmly attached to the underlying bone and tooth allowing it be more protective and making it better able to withstand mechanical irritation bouri, 2008. Width of keratinized gingiva and the health status of the. The procedure involves adjusting the levels if the gum tissue and bone around the tooth in question, to.
Pdf width of attached gingiva in an indian population. The free gingival graft fgg is predictable surgical techniques often employed to increase the zone of attached gingiva. Therefore, the current consensus9 is that, provided with adequate oral hygiene, periodontal stability. The recipient area was prepared with a split thickness flap which was fixed apical with periosteal. The smallest width was usually seen in the area of the anterior teeth, and the widest gingiva was found. 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. The apically positioned flap is a commonly used surgical approach to achieve pocket elimination. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. However, thin gingival tissues around teeth with restorations or undergoing labial orthodontic tooth movement may be more susceptible to recession.
Attached gingiva definition of attached gingiva by. View the article pdf and any associated supplements and figures for a period of 48 hours. Clinical evaluation of increase in the width of attached. The widest zone of attached gingiva was found over the central and lateral incisors. The significance of keratinized mucosa on implant health. Attached gingiva augmentation is classically recommended to control the microbial plaque accumulation and prevention of more recession 3,5, and attachment loss 3. Significance of the width of keratinized mucosa on the.
Pdf assessment of the width of attached gingiva using. The loss of the attached gingiva affects the oral health as well as the aesthetics and in addition compromises the natural support of the teeth or the dentures 1,2. With performing tension test 16, gingival margin was mobile because of high attachment of buccal frenum, so we decided to augment attached gingiva. The width of keratinized gingiva was measured in midfacial area for six anterior teeth in the maxillary and mandibular regions from the gingival margin to the. 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. Measurement of the width of attached gingiva in an indian. The relationship between the width of keratinized gingiva. Living cellular construct for increasing the width of. The width of the attached gingivamuch ado about nothing. Longitudinal changes in the width of attached gingiva in children. It may be concluded that the new procedure provides significant increase of keratinized gingiva with the advantage of minimal morbidity and pleasing cosmetic results.
A free gingival graft with strip technique was chosen to obtain augmentation of the gingiva and increase of the vestibule depth on the whole frontal area. Assessment of the width of attached gingiva using different methods in various age groups. The free gingival grafts have been used in periodontics to primarily augment the width of attached gingiva and to a lesser extent cover denuded root surfaces. Proper mucogingival therapy should lead to gingival augmentation and create a vestibule with adequate depth in the regions with insufficient attached gingival tissues 1, 14, 18. It is the distance between the mucogingival junction mgj and the projection on the external surface of the.
The apical part towards the vestibule would be expected to be movable, but frequently i find it to be a scar kind of tissue, pretty stable. The width of attached gingiva increases with age and in supraerupted teeth 7,15. Clinical dental advantages of the apically positioned flap. Broadening of the attached gingiva indication matrix. The width of attached gingiva varies in different areas of the mouth and have been given a range of 19 mm, 14 mm, 05 mm. 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. There are various periodontal plastic surgical techniques available till date to treat these defects in order to increase the width of the attached gingiva and to improve the aesthetics. Singlestage surgical procedure for increasing depth of. Henri tenenbaum, a clinical study comparing the width of attached gingiva and the prevalence of gingival recessions, journal of clinical periodontology, 9, 1, 8692, 2011. The width of the attached gingiva can be accurately measured if scaling has not been done. Attached gingiva and dental implants perioimplant advisory. Attached gingiva and its significance linkedin slideshare. However, the present findings failed to demonstrate the hypothesis that the width of the attached gingiva at the manditable 1.
The attached gingiva increased on all experimental teeth. In man the keratinized gingiva includes the free and the attached gingiva and extends from the gingival mar gin to the mucogingival. In the present study, the range of the mean width of attached gingiva varied from 1 mm to 4 mm. The relationship between the width of keratinized gingiva and. Assessment of the width of attached gingiva using different methods. Attached gingiva, esthetics, inadequate width, modified apically repositioned flap, mucogingival surgery how to cite this article. The gingiva regenerated with the lcc matched the color and texture of the adjacent gingiva.
The width of attached gingiva on the facial aspect varies in differ ent areas of the mouth. Dorfman determined the changes in the width of keratinized gingiva of fully treated orthodontic patients. On attached gingiva lies between the free gum and mucous alveolar ridge fig. Attached gingiva is an important factor affecting periodontal health which enhances the plaque removal around the gingival. The free gingival margin covers the cementoenamel junction cej and the gingival papillae fill the embrasures. Multiple techniques have been developed, separately, to increase the depth of vestibule and the width of attached gingival but this case report present a single stage surgical procedure for increasing both depth of vestibule and the width of attached gingiva by vestibular. Gingiva, gingival recession, periodontal attachment loss. The width of the attached gingiva can be accurately measured if scaling has not been done gingival inflammation in the area has been eliminated the pocket depth is. The mucogingival junction was identified by the rolling technique, wherein the mucosa was rolled until the nonmovable portion of the attached. The objective of this in vivo study was to evaluate sulcus depth width and thickness of facial attached gingiva in primary, mixed, and permanent dentition. A total of 240 subjects were selected with healthy gingival tissue. The anatomy and physiology of the healthy periodontium 7 when a periodontal probe is placed into this space, a measure may be recorded which is very useful for diagnosis.
Biologic width and its importance in periodontal and. Bayesian hierarchical model of width of keratinized gingiva. Attached gingiva then and now cods journal of dentistry. Free gingival graft to increase keratinized mucosa after. Bouri and nabil bissada and mohammad alzahrani and fady fouad faddoul and imad e nouneh, journalthe international. Free gingival graft to increase the width of attached. The importance of keratinized gingiva surrounding dental.
In patients with inadequate width of attached gingiva mucogingival surgeries like connective tissue grafts, free gingival grafts, apically displaced flap etc. The width of attached tissue is critical, because the more there is available provides a greater sense of protection against the aforementioned insults to the tissue. According to abrahamsson in 1996, a certain width of keratinized gingiva is required to promote an adequate epithelial and connective tissue attachment. A study of the width of attached gingiva by g e r a l d m. Width of attached gingiva wag is an important marker for diagnosis of periodontal disease. To widen zone of attached gingiva for prosthetic abutment teeth to increase vestibular depth to allow proper oral hygiene techniques gingival clefting areas with less than 2 mm of attached gingiva ridge augmentation free soft tissue graft procedure is not indicated for. 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. A study of the width of attached gingiva wiley online library.
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