The document discusses attached gingiva and procedures for gingival augmentation. It defines attached gingiva and explains its clinical significance as a barrier against microbes and irritants. The width and thickness of attached gingiva can be measured using various methods and are influenced by factors like age, tooth position, and frenal attachments. Adequate attached gingiva is important for periodontal health and limiting recession, though its width alone does not prevent recession. In restorative dentistry, at least 2mm of attached gingiva is recommended when crowns are placed close to or below the gingival margin to avoid inflammation and recession.
1. The junctional epithelium is a specialized non-keratinized stratified squamous epithelium that attaches to the tooth surface and forms a collar around the cervical portion.
2. It develops from the reduced enamel epithelium during tooth eruption. The reduced enamel epithelium fuses with the oral epithelium and transforms into the junctional epithelium.
3. The junctional epithelium attaches firmly to the tooth surface through hemidesmosomes of the basal cells (called DAT cells) and an internal basal lamina. This structure is called the epithelial attachment apparatus.
This document discusses various suturing techniques used in periodontal flap surgery. It begins with an introduction on the purpose of suturing flaps, which is to maintain the flap in position until desired healing. Resorbable sutures are preferred for patient comfort and elimination of removal appointments. The document then describes different suturing techniques like horizontal mattress suture, continuous independent sling suture, anchor suture, closed anchor suture, and periosteal suture. It provides details on their specific uses and how to perform each technique. A variety of suture materials, both resorbable and non-resorbable, are also listed.
This document discusses various flap techniques used in periodontal surgery. It defines flaps as sections of gingiva and mucosa surgically separated from underlying tissues to provide access to bone and roots. Full and partial thickness flaps are classified based on the depth of tissue reflection. Techniques include the modified Widman flap, undisplaced flap, apically displaced flap, papilla preservation flap, and techniques for distal molar surgery. Healing after flap surgery is described in stages from initial clot formation to establishment of new connective tissue attachment after 4 weeks.
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
Gingival crevicular fluid (GCF) is a serum transudate that forms in the gingival sulcus. It contains cells, bacteria, serum components, and host mediators that make it useful for periodontal monitoring and diagnosis. GCF forms through increased permeability of blood vessels in the sulcus or through an osmotic gradient. Its composition varies in health and disease, making biomarkers of host enzymes, tissue breakdown products, and inflammatory mediators clinically significant. While non-invasive collection methods exist, contamination and variable recovery pose challenges. Further research on GCF components may aid in diagnosis and monitoring of periodontal disease progression and treatment outcomes.
Wound healing [including healing after periodontal therapy]Jignesh Patel
The document discusses wound healing and periodontal wound healing in particular. It describes the processes of regeneration and repair. Regeneration involves renewal of tissues through growth of same tissue type, while repair involves replacement of tissues through scar formation. The molecular biology of wound healing is explained, including roles of fibrin clot, growth factors, matrix degradation and connective tissue formation. Healing by primary and secondary intention is also defined. Healing processes following various periodontal procedures like scaling, root planing, flap surgery and implant placement are outlined. Factors influencing wound healing and potential complications are briefly mentioned.
This document discusses crown lengthening procedures and biological width. It defines biological width as the natural distance between the base of the gingival sulcus and alveolar bone, which is typically 2mm. Crown lengthening surgically exposes more tooth structure above the bone to avoid violating the biological width and prevent inflammation. The document outlines different types of crown lengthening procedures based on the available soft and hard tissue dimensions, as well as factors to consider like gingival biotype and restoration design. Maintaining at least 3mm of tooth structure above bone is recommended to allow for proper restorative margins and healing.
1. The junctional epithelium is a specialized non-keratinized stratified squamous epithelium that attaches to the tooth surface and forms a collar around the cervical portion.
2. It develops from the reduced enamel epithelium during tooth eruption. The reduced enamel epithelium fuses with the oral epithelium and transforms into the junctional epithelium.
3. The junctional epithelium attaches firmly to the tooth surface through hemidesmosomes of the basal cells (called DAT cells) and an internal basal lamina. This structure is called the epithelial attachment apparatus.
This document discusses various suturing techniques used in periodontal flap surgery. It begins with an introduction on the purpose of suturing flaps, which is to maintain the flap in position until desired healing. Resorbable sutures are preferred for patient comfort and elimination of removal appointments. The document then describes different suturing techniques like horizontal mattress suture, continuous independent sling suture, anchor suture, closed anchor suture, and periosteal suture. It provides details on their specific uses and how to perform each technique. A variety of suture materials, both resorbable and non-resorbable, are also listed.
This document discusses various flap techniques used in periodontal surgery. It defines flaps as sections of gingiva and mucosa surgically separated from underlying tissues to provide access to bone and roots. Full and partial thickness flaps are classified based on the depth of tissue reflection. Techniques include the modified Widman flap, undisplaced flap, apically displaced flap, papilla preservation flap, and techniques for distal molar surgery. Healing after flap surgery is described in stages from initial clot formation to establishment of new connective tissue attachment after 4 weeks.
Coronal advanced flap in combination with a connective tissue graft. Is the t...MD Abdul Haleem
Coronal advanced flap in combination with a connective tissue graft. Is the thickness of the flap a predictor for root coverage? - A prospective clinical study.
Department of Periodontology and Oral Implantology.
"A Journal Club Presentation"
Gingival crevicular fluid (GCF) is a serum transudate that forms in the gingival sulcus. It contains cells, bacteria, serum components, and host mediators that make it useful for periodontal monitoring and diagnosis. GCF forms through increased permeability of blood vessels in the sulcus or through an osmotic gradient. Its composition varies in health and disease, making biomarkers of host enzymes, tissue breakdown products, and inflammatory mediators clinically significant. While non-invasive collection methods exist, contamination and variable recovery pose challenges. Further research on GCF components may aid in diagnosis and monitoring of periodontal disease progression and treatment outcomes.
Wound healing [including healing after periodontal therapy]Jignesh Patel
The document discusses wound healing and periodontal wound healing in particular. It describes the processes of regeneration and repair. Regeneration involves renewal of tissues through growth of same tissue type, while repair involves replacement of tissues through scar formation. The molecular biology of wound healing is explained, including roles of fibrin clot, growth factors, matrix degradation and connective tissue formation. Healing by primary and secondary intention is also defined. Healing processes following various periodontal procedures like scaling, root planing, flap surgery and implant placement are outlined. Factors influencing wound healing and potential complications are briefly mentioned.
This document discusses crown lengthening procedures and biological width. It defines biological width as the natural distance between the base of the gingival sulcus and alveolar bone, which is typically 2mm. Crown lengthening surgically exposes more tooth structure above the bone to avoid violating the biological width and prevent inflammation. The document outlines different types of crown lengthening procedures based on the available soft and hard tissue dimensions, as well as factors to consider like gingival biotype and restoration design. Maintaining at least 3mm of tooth structure above bone is recommended to allow for proper restorative margins and healing.
- Attached gingiva is the portion of gingiva firmly bound to bone or tooth, which helps resist forces from muscles and plaque accumulation.
- The width of attached gingiva is measured from the mucogingival junction to the bottom of the sulcus.
- With good oral hygiene, adequate width of attached gingiva may not be necessary to maintain gingival health, but a minimum of 1mm is recommended to prevent recession after treatment.
- The thickness of gingival tissue, rather than just the width, plays a larger role in determining soft tissue health and susceptibility to recession.
This document discusses the anatomy, measurement, and clinical significance of the attached gingiva. It notes that the attached gingiva extends from the base of the gingival sulcus to the mucogingival junction. The normal width is 3-4.5mm in the maxillary anterior region but narrower in other areas. Inadequate width can facilitate subgingival plaque formation. Methods to measure width and increase width through surgery are described. The importance of keratinized, attached tissue for resisting mechanical irritation and stabilizing the gingival margin is emphasized.
This presentation describes the gingival recession, its classifications and theories of pathogenesis and different etiological factors in its progression.
The defense mechanism of gingiva includes GCF, Saliva, epithelial barrier and connective tissue cells. All these protect the periodontium from bacterial invasion.
The document discusses age-related changes in the periodontium and their effects. It notes that with age, the gingival epithelium thins and becomes less keratinized. The gingival connective tissue becomes coarser and denser. The periodontal ligament has fewer fibroblasts and a more irregular structure. Cementum increases in width, especially apically and lingually. The alveolar bone surface becomes more irregular and collagen fiber insertion less regular. Aging may increase the inflammatory response to plaque and the progression of periodontal disease if plaque is not controlled. Response to periodontal treatment can be successful if patients maintain meticulous plaque control and thorough debridement is performed.
This document provides an overview of the gingiva. It begins with definitions of gingiva from various sources. It then discusses the development, macroscopic anatomy including the different regions of gingiva, and microscopic anatomy. The latter covers the histology of the epithelial layers and cell types present. It also describes the different types of gingival epithelium and concludes with the dentogingival unit.
Aberrant Frenum !!
No worries... When Frenectomy is here.
Hello Periodontists,
Here's the entire process of Frenectomy in a nutshell and various ways to encounter the same.
Lets Shoot ...
The gingival connective tissue consists of collagen fibers, fibroblasts, macrophages, mast cells, and other cells within a ground substance. Collagen types I and III are predominant and provide strength and flexibility. Fibroblasts synthesize collagen and other proteins that make up the extracellular matrix. Mast cells, macrophages, and other immune cells are also present and help defend against pathogens. The connective tissue provides structure, nutrition, and immune function to support the overlying epithelium.
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
Guided tissue regeneration (GTR) involves placing barriers over defects to separate gingival tissues and allow regeneration of periodontal ligament and bone. Animal and human studies show that excluding epithelium and allowing repopulation of defects by periodontal ligament cells leads to new attachment. Both resorbable and non-resorbable membrane barriers have been used for GTR with the goal of preventing epithelial migration and promoting regeneration. GTR has been shown to be predictable for treating intra-bony defects and grade II furcations.
1. Gingival recession is the exposure of root surface caused by an apical shift in gingival position. It can be classified as visible, hidden, localized, or generalized.
2. Miller and Atkin & Sullivan classified gingival recession defects based on their location and amount of bone loss. Common causes of recession include age, faulty brushing technique, tooth malposition, gingival inflammation, abnormal frenal attachment, and masochistic habits.
3. Recession can be treated non-surgically through modifying risks or surgically through pedicle or free soft tissue grafts to cover exposed root surfaces and reduce sensitivity.
Pathologic tooth migration (PTM) refers to tooth displacement resulting from a disturbance in factors that maintain normal tooth position. PTM is common in periodontal patients, with prevalence studies finding rates of 30-55%. The primary factor in PTM is periodontal bone loss resulting from periodontal disease. Other factors include occlusal changes from tooth loss, soft tissue pressures, oral habits, and periapical or gingival inflammation. Treatment involves periodontal therapy, sometimes with adjunctive orthodontics or prosthodontics, while prevention focuses on periodontal disease control and management of predisposing occlusal and habit factors.
The periodontal ligament is a connective tissue that connects the tooth to the alveolar bone. It contains collagen fibers, fibroblasts, cementoblasts, osteoblasts and other cells. The principal collagen fibers of the periodontal ligament originate on the cementum and insert into the alveolar bone in different orientations to provide structural support to the tooth and resist various forces. The periodontal ligament is essential for functions such as tooth eruption and maintains the space between the tooth and bone.
The document discusses attached gingiva, defining it as the portion of gingiva that extends from the base of the gingival crevice to the mucogingival junction. It describes the width and thickness of attached gingiva, noting it varies between 1-9mm wide and has an average thickness of 1.25mm. Microscopically, attached gingiva has a keratinized, cellular epithelium and dense connective tissue. It functions to act as a buffer zone, bear trauma and forces from occlusion, and prevent attachment loss and recession.
This document discusses the history and techniques of free gingival grafts (FGG), a periodontal plastic surgery procedure used to widen attached gingiva. It describes the classic FGG technique which involves preparing the recipient site, obtaining a partial-thickness graft from the palate donor site, suturing the graft into place, and protecting the donor site. Variant techniques like the accordion, strip, and combination methods are also outlined. The healing process of FGG grafts is explained, noting revascularization begins after 2-3 days and integration is largely complete by 10-17 days, though thicker grafts may take longer. FGG procedures aim to enhance plaque removal, improve tooth stability, and provide tissue
This document provides information on periodontal diagnosis and examination. It discusses the importance of a thorough history and clinical examination in making an accurate diagnosis. The stages of clinical diagnosis are outlined as history recording, clinical examination, provisional diagnosis, investigations, and final diagnosis. Clinical examination parameters for soft tissues, hard tissues, furcations, mobility, and recession are defined. Common periodontal diseases like gingivitis, periodontitis, and necrotizing periodontal diseases are introduced. The Basic Periodontal Examination code system and indices for bleeding, recession, furcations, and mobility are explained as screening and assessment tools. The importance of a problem-focused examination and treatment based on a problem-based approach are emphasized
Diabetes and periodontal disease ,at two way relationshipLobna El Khatib
The document discusses the bidirectional relationship between diabetes and periodontal disease. It begins by providing overviews of diabetes and periodontal disease. It then explains how diabetes can increase the risk and severity of periodontal disease by altering oral microorganisms, the host immune response, blood vessels, and wound healing. Conversely, periodontal disease can negatively impact blood sugar control in diabetes by increasing systemic inflammation. Maintaining good oral hygiene and treating periodontal disease may help manage diabetes and reduce complications.
This document outlines the phases of periodontal therapy, including:
1) Preliminary phase focusing on emergencies and extractions.
2) Nonsurgical phase involving plaque control, non-surgical treatments like scaling and root planing.
3) Surgical phase using various periodontal surgeries and other treatments like implants and endodontics.
4) Restorative phase for final restorations and prosthodontics.
5) Maintenance phase for long-term supportive periodontal therapy.
Surgical periodontal therapy aims to eliminate pathologic changes, create a stable periodontium, and promote regeneration through techniques like pocket reduction surgeries and correction of anatomic defects
ROS is a substractive method of having positive bone architecture. it includes osteotomy and ostectomy procedures. osteotomy is to remove non supporting bone and ostectomy is to remove supporting bone for having positive bony architecture. there is definitive osseous surgery and compromise osseous surgery. transgingival probing is a method of determining osseous topography. various hand and rotary instruments are use for this procedure.
This document provides information on periodontal plastic and aesthetic surgery procedures. It discusses the objectives of these procedures which include creating an adequate zone of attached gingiva and eliminating muscle pulls. It describes various gingival augmentation techniques used to widen attached gingiva including pedicle flaps and free soft tissue grafts. The document also discusses that while a minimal width of gingiva can maintain health, gingival augmentation may be indicated in situations involving planned orthodontic treatment, subgingival restorations, or patient discomfort.
Role of iatrogenic factors in the etiology of periodontal diseasePeriowiki.com
The document discusses various dental procedures that can potentially cause iatrogenic injury to periodontal structures, including restorations, endodontic therapy, prosthetics, orthodontics, surgery, implants, and periodontal treatment. It provides definitions of iatrogenic factors and reviews the history. For restorations specifically, it examines how cavity preparation, violation of biologic width, overhanging margins, subgingival margins, contours can negatively impact the periodontium. Studies have demonstrated links between overhangs and increased pocket depth and bone loss. Contours that limit access for oral hygiene or retain plaque and irritants can also increase inflammation.
- Attached gingiva is the portion of gingiva firmly bound to bone or tooth, which helps resist forces from muscles and plaque accumulation.
- The width of attached gingiva is measured from the mucogingival junction to the bottom of the sulcus.
- With good oral hygiene, adequate width of attached gingiva may not be necessary to maintain gingival health, but a minimum of 1mm is recommended to prevent recession after treatment.
- The thickness of gingival tissue, rather than just the width, plays a larger role in determining soft tissue health and susceptibility to recession.
This document discusses the anatomy, measurement, and clinical significance of the attached gingiva. It notes that the attached gingiva extends from the base of the gingival sulcus to the mucogingival junction. The normal width is 3-4.5mm in the maxillary anterior region but narrower in other areas. Inadequate width can facilitate subgingival plaque formation. Methods to measure width and increase width through surgery are described. The importance of keratinized, attached tissue for resisting mechanical irritation and stabilizing the gingival margin is emphasized.
This presentation describes the gingival recession, its classifications and theories of pathogenesis and different etiological factors in its progression.
The defense mechanism of gingiva includes GCF, Saliva, epithelial barrier and connective tissue cells. All these protect the periodontium from bacterial invasion.
The document discusses age-related changes in the periodontium and their effects. It notes that with age, the gingival epithelium thins and becomes less keratinized. The gingival connective tissue becomes coarser and denser. The periodontal ligament has fewer fibroblasts and a more irregular structure. Cementum increases in width, especially apically and lingually. The alveolar bone surface becomes more irregular and collagen fiber insertion less regular. Aging may increase the inflammatory response to plaque and the progression of periodontal disease if plaque is not controlled. Response to periodontal treatment can be successful if patients maintain meticulous plaque control and thorough debridement is performed.
This document provides an overview of the gingiva. It begins with definitions of gingiva from various sources. It then discusses the development, macroscopic anatomy including the different regions of gingiva, and microscopic anatomy. The latter covers the histology of the epithelial layers and cell types present. It also describes the different types of gingival epithelium and concludes with the dentogingival unit.
Aberrant Frenum !!
No worries... When Frenectomy is here.
Hello Periodontists,
Here's the entire process of Frenectomy in a nutshell and various ways to encounter the same.
Lets Shoot ...
The gingival connective tissue consists of collagen fibers, fibroblasts, macrophages, mast cells, and other cells within a ground substance. Collagen types I and III are predominant and provide strength and flexibility. Fibroblasts synthesize collagen and other proteins that make up the extracellular matrix. Mast cells, macrophages, and other immune cells are also present and help defend against pathogens. The connective tissue provides structure, nutrition, and immune function to support the overlying epithelium.
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
Guided tissue regeneration (GTR) involves placing barriers over defects to separate gingival tissues and allow regeneration of periodontal ligament and bone. Animal and human studies show that excluding epithelium and allowing repopulation of defects by periodontal ligament cells leads to new attachment. Both resorbable and non-resorbable membrane barriers have been used for GTR with the goal of preventing epithelial migration and promoting regeneration. GTR has been shown to be predictable for treating intra-bony defects and grade II furcations.
1. Gingival recession is the exposure of root surface caused by an apical shift in gingival position. It can be classified as visible, hidden, localized, or generalized.
2. Miller and Atkin & Sullivan classified gingival recession defects based on their location and amount of bone loss. Common causes of recession include age, faulty brushing technique, tooth malposition, gingival inflammation, abnormal frenal attachment, and masochistic habits.
3. Recession can be treated non-surgically through modifying risks or surgically through pedicle or free soft tissue grafts to cover exposed root surfaces and reduce sensitivity.
Pathologic tooth migration (PTM) refers to tooth displacement resulting from a disturbance in factors that maintain normal tooth position. PTM is common in periodontal patients, with prevalence studies finding rates of 30-55%. The primary factor in PTM is periodontal bone loss resulting from periodontal disease. Other factors include occlusal changes from tooth loss, soft tissue pressures, oral habits, and periapical or gingival inflammation. Treatment involves periodontal therapy, sometimes with adjunctive orthodontics or prosthodontics, while prevention focuses on periodontal disease control and management of predisposing occlusal and habit factors.
The periodontal ligament is a connective tissue that connects the tooth to the alveolar bone. It contains collagen fibers, fibroblasts, cementoblasts, osteoblasts and other cells. The principal collagen fibers of the periodontal ligament originate on the cementum and insert into the alveolar bone in different orientations to provide structural support to the tooth and resist various forces. The periodontal ligament is essential for functions such as tooth eruption and maintains the space between the tooth and bone.
The document discusses attached gingiva, defining it as the portion of gingiva that extends from the base of the gingival crevice to the mucogingival junction. It describes the width and thickness of attached gingiva, noting it varies between 1-9mm wide and has an average thickness of 1.25mm. Microscopically, attached gingiva has a keratinized, cellular epithelium and dense connective tissue. It functions to act as a buffer zone, bear trauma and forces from occlusion, and prevent attachment loss and recession.
This document discusses the history and techniques of free gingival grafts (FGG), a periodontal plastic surgery procedure used to widen attached gingiva. It describes the classic FGG technique which involves preparing the recipient site, obtaining a partial-thickness graft from the palate donor site, suturing the graft into place, and protecting the donor site. Variant techniques like the accordion, strip, and combination methods are also outlined. The healing process of FGG grafts is explained, noting revascularization begins after 2-3 days and integration is largely complete by 10-17 days, though thicker grafts may take longer. FGG procedures aim to enhance plaque removal, improve tooth stability, and provide tissue
This document provides information on periodontal diagnosis and examination. It discusses the importance of a thorough history and clinical examination in making an accurate diagnosis. The stages of clinical diagnosis are outlined as history recording, clinical examination, provisional diagnosis, investigations, and final diagnosis. Clinical examination parameters for soft tissues, hard tissues, furcations, mobility, and recession are defined. Common periodontal diseases like gingivitis, periodontitis, and necrotizing periodontal diseases are introduced. The Basic Periodontal Examination code system and indices for bleeding, recession, furcations, and mobility are explained as screening and assessment tools. The importance of a problem-focused examination and treatment based on a problem-based approach are emphasized
Diabetes and periodontal disease ,at two way relationshipLobna El Khatib
The document discusses the bidirectional relationship between diabetes and periodontal disease. It begins by providing overviews of diabetes and periodontal disease. It then explains how diabetes can increase the risk and severity of periodontal disease by altering oral microorganisms, the host immune response, blood vessels, and wound healing. Conversely, periodontal disease can negatively impact blood sugar control in diabetes by increasing systemic inflammation. Maintaining good oral hygiene and treating periodontal disease may help manage diabetes and reduce complications.
This document outlines the phases of periodontal therapy, including:
1) Preliminary phase focusing on emergencies and extractions.
2) Nonsurgical phase involving plaque control, non-surgical treatments like scaling and root planing.
3) Surgical phase using various periodontal surgeries and other treatments like implants and endodontics.
4) Restorative phase for final restorations and prosthodontics.
5) Maintenance phase for long-term supportive periodontal therapy.
Surgical periodontal therapy aims to eliminate pathologic changes, create a stable periodontium, and promote regeneration through techniques like pocket reduction surgeries and correction of anatomic defects
ROS is a substractive method of having positive bone architecture. it includes osteotomy and ostectomy procedures. osteotomy is to remove non supporting bone and ostectomy is to remove supporting bone for having positive bony architecture. there is definitive osseous surgery and compromise osseous surgery. transgingival probing is a method of determining osseous topography. various hand and rotary instruments are use for this procedure.
This document provides information on periodontal plastic and aesthetic surgery procedures. It discusses the objectives of these procedures which include creating an adequate zone of attached gingiva and eliminating muscle pulls. It describes various gingival augmentation techniques used to widen attached gingiva including pedicle flaps and free soft tissue grafts. The document also discusses that while a minimal width of gingiva can maintain health, gingival augmentation may be indicated in situations involving planned orthodontic treatment, subgingival restorations, or patient discomfort.
Role of iatrogenic factors in the etiology of periodontal diseasePeriowiki.com
The document discusses various dental procedures that can potentially cause iatrogenic injury to periodontal structures, including restorations, endodontic therapy, prosthetics, orthodontics, surgery, implants, and periodontal treatment. It provides definitions of iatrogenic factors and reviews the history. For restorations specifically, it examines how cavity preparation, violation of biologic width, overhanging margins, subgingival margins, contours can negatively impact the periodontium. Studies have demonstrated links between overhangs and increased pocket depth and bone loss. Contours that limit access for oral hygiene or retain plaque and irritants can also increase inflammation.
This document discusses various biological considerations related to dental restorations and periodontal health. It covers topics such as biologic width, margin placement, overhangs, and correcting biologic width violations. Key points include that supragingival margins have the least impact on the periodontium, biologic width violations can lead to inflammation and bone loss, and overhangs increase plaque and pathogens if placed subgingivally. The document provides guidelines for proper margin placement based on sulcular depth to avoid future recession. It also discusses procedures for tissue retraction and electrosurgery when placing subgingival margins.
Biologic width understanding and its preservationSah Oman
This document discusses the biologic width, which refers to the dimensions of the dentogingival junction including the epithelial attachment and underlying connective tissue. It was first described as being on average 2.04mm, consisting of 0.97mm of epithelial attachment and 1.07mm of connective tissue. Placing restorative margins within the biologic width can lead to gingival inflammation, clinical attachment loss, bone loss, and gingival recession. The document discusses different options for margin placement and how to evaluate whether the biologic width has been violated.
This document discusses biologic width, which refers to the combined width of connective tissue and epithelial attachment above the alveolar bone crest. It provides definitions, a brief history of the concept, and an overview of the significance of maintaining biologic width to preserve periodontal health. Violations of the biologic width can lead to inflammation, attachment loss, bone loss, and recession. The document outlines methods for evaluating biologic width violations and categorizing biologic widths, and reviews surgical and orthodontic techniques for correcting violations. It also discusses considerations for margin placement in relation to biologic width for restorations.
This document discusses various iatrogenic factors in dentistry that can affect the periodontium. Careless procedures, improper use of instruments and chemicals, and negligent treatment planning by dentists can cause traumatic injuries to supporting periodontal tissues. Violations of the biological width, poor restoration margins, overhangs, and improper contouring of restorations can lead to plaque retention and inflammation, resulting in gingivitis, periodontal pocket formation, attachment loss, and bone loss. To prevent iatrogenic periodontal disease, dentists must have thorough knowledge and expertise to avoid harming the patient during treatment.
Luận Văn Surgical Research Applications Using Subepithelial Connective Tissue...tcoco3199
Luận Văn Surgical Research Applications Using Subepithelial Connective Tissue Graft For Recovering Exposed Tooth Root Surface., các bạn tham khảo thêm tại tài liệu, bài mẫu điểm cao tại luanvantot.com
Luận Văn Surgical Research Applications Using Subepithelial Connective Tissue...mokoboo56
Luận Văn Surgical Research Applications Using Subepithelial Connective Tissue Graft For Recovering Exposed Tooth Root Surface.doc
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Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
The document discusses the biologic width, which refers to the dimensions of the soft tissue attached to the tooth coronal to the alveolar bone crest. It consists of the junctional epithelium, connective tissue attachment, and the sulcular depth, totaling approximately 2-3 mm. Violation of the biologic width by placing restorative margins too far subgingivally can lead to bone resorption, gingival recession, or hyperplasia. The document outlines techniques for assessing biologic width dimensions and various surgical or orthodontic procedures to correct violations. Maintaining at least 3 mm of distance from the restorative margin to alveolar bone is important for periodontal health.
This document discusses mucogingival surgery and periodontal plastic surgery procedures. It begins with definitions and terminology related to these procedures. The main objectives are to correct issues with attached gingiva, shallow vestibule, and aberrant frenum. Common procedures discussed include gingival augmentation using free gingival grafts to increase the width and thickness of gingiva. Free gingival grafts involve obtaining a partial thickness graft from the palate donor site and suturing it to the recipient site to increase the zone of attached gingiva. Variations on this technique include accordion and strip methods. The healing process of free gingival grafts is also summarized.
The biological width is defined as the dimension of soft tissue attached to the tooth coronal to the alveolar bone crest, including the sulcus depth, epithelial attachment, and connective tissue attachment. It typically measures around 2.04 mm. Violation of the biological width can occur when restorations are placed too far subgingivally and can lead to inflammation and bone loss. Surgical crown lengthening and orthodontic extrusion are techniques used to correct biological width violations. Maintaining the biological width is important for peri-implant health as well.
mucogingival surgery or plastic surgery of muco-gingival tissue is a surgical procedure targeted to correct and eliminate anatomic, developmental and traumatic alterations of gingiva.
Effects of restorative procedure on periodontiumParth Thakkar
The document discusses several factors related to restoring teeth and maintaining periodontal health. Restorative procedures should aim to place margins in a supragingival location to avoid biological width violations that can cause inflammation and bone loss. Crown contours and materials should facilitate plaque removal. Esthetic considerations include maintaining ideal embrasure forms between teeth. Occlusion should distribute forces across all teeth to prevent trauma from excessive forces.
The document discusses several factors related to restoring teeth and maintaining periodontal health. Restorative procedures should aim to place margins in a supragingival location to avoid biological width violations. Overhanging restorations and poor marginal fit can promote plaque retention and inflammation. Proper crown contours are also important to allow for adequate cleaning. Esthetic considerations include maintaining ideal embrasure forms between teeth.
Width of attached gingiva and its significance Hudson Jonathan
This document discusses the width of attached gingiva and its significance. It begins by defining the different parts of the gingiva and describing the microscopic and macroscopic features of attached gingiva. It then discusses the normal width of attached gingiva in different regions of the mouth, how it is measured, and what constitutes an inadequate width. The document also covers the indications for increasing the width of attached gingiva, its significance around implants, and methods for measuring and augmenting the width.
1) The document reviews gingival augmentation procedures and aims to answer 5 common clinical questions through a systematic review of literature.
2) It finds a lack of in-depth comparative studies and randomized clinical trials to draw strong conclusions but makes recommendations based on case reports and series.
3) For question 1, it finds that maintaining adequate gingiva, such as 2mm, is important for restorations with intracrevicular margins based on clinical observations.
Gingival prosthesis: an efficient solution to severe gingival recessions in a...Premier Publishers
Clinical attachment loss in periodontal disease may lead to gingival recessions, elongation of the crowns, black triangles and unaesthetic appearance of maxillary anterior. For these problems surgical procedures may not have acceptable results in case of severe gingival recessions. Thus, non-surgical methods, like gingival prostheses/veneers, should be considered as an alternative treatment approach in such cases. It is an easy constructed and practical device to optimize the esthetic and functional outcome after the control of periodontal disease. This case report of young female patient illustrates treatment for an advanced tissue loss in a maxillary anterior area using a removable gingival prosthesis/veneers. This treatment modality offered a good optional solution and optimum esthetic patient satisfaction with a 2-year follow-up.
Similar to Attached gingiva and procedures for gingival augmentation (20)
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Radiographic aids in periodontal disease diagnosis part IPeriowiki.com
This document discusses the use of radiographs in diagnosing periodontal disease. It provides a brief history of using radiographs in dentistry and periodontics. Radiographs can reveal bone loss and destruction patterns but not current soft tissue changes. Standardized techniques are needed for accurate assessment over time. Early periodontitis may show fuzziness of the lamina dura or widening of the periodontal ligament space. More advanced disease appears as severe bone loss, fingerlike projections into the bone, or interdental bone craters. However, radiographs have limitations in depicting the full extent and morphology of bone defects.
The alveolar process forms the tooth sockets and supports the teeth. It consists of external cortical plates and internal cancellous trabeculae. Osteoblasts, osteocytes, and osteoclasts maintain the alveolar bone through remodeling. The alveolar bone develops with tooth eruption and is resorbed after tooth loss. It undergoes constant remodeling to withstand forces while maintaining form. The document provides detailed descriptions of the anatomical structures and cellular processes that comprise and maintain the alveolar bone.
Smoking has various negative effects on the immune system's response to periodontal disease. It reduces the phagocytic activity and respiratory burst of neutrophils, impairs their migration and apoptosis. Smokers have increased T cell levels but reduced IgG2 and B cell antibody production. Natural killer cell activity and numbers are also lower in smokers. Regarding cytokines, smokers have higher TNF-alpha but lower IL-1 levels in gingival crevicular fluid. Overall, smoking causes both quantitative and qualitative defects in immune cells that compromise periodontal defense mechanisms.
Technological advances in dental implant surgeryPeriowiki.com
This document discusses recent technological advances in dental implant surgery, including computer-aided design/computer-aided manufacturing (CAD/CAM) technology and computer-guided implant surgery techniques. It describes computerized tomography (CT) imaging and how CT data can be used for virtual surgical planning and fabrication of surgical guides. The document compares computer-guided implant surgery (CGIS), which uses static surgical guides, to computer-navigated implant surgery (CNIS), which allows for intraoperative modification of the surgical plan. Both techniques aim to increase the accuracy and predictability of dental implant placement.
The document discusses aggressive periodontitis, specifically localized aggressive periodontitis (LAP). It provides:
1) A historical background on LAP, formerly known as localized juvenile periodontitis, describing its identification and classification over time.
2) Key diagnostic criteria for LAP including an early age of onset typically around puberty, involvement of first molars and incisors, and a rapid rate of attachment loss and bone destruction.
3) Typical clinical characteristics of LAP such as minimal visible inflammation despite deep pockets and bone loss out of proportion to plaque levels. Radiographs often show vertical bone loss around first molars and incisors. Prevalence is typically below 1% with some studies finding higher rates in black males
The document discusses splinting, including its history, definitions, aims, principles, indications, classifications, advantages, and disadvantages. Some key points:
- Splinting aims to immobilize and stabilize loose or mobile teeth by redistributing forces across multiple teeth.
- It has been used since ancient Egypt to stabilize teeth and fractures. Modern classifications include temporary, provisional, and permanent splints made of various materials.
- Indications include reducing tooth mobility from trauma, occlusal adjustment, or periodontal disease. Contraindications include active periodontal inflammation.
- Advantages are stabilizing teeth and tissues, but disadvantages include increased risk of decay and difficulties with oral hygiene.
Guided tissue regeneration (GTR) aims to regenerate lost periodontal tissues by using barrier membranes to selectively prevent the migration of epithelial and gingival connective tissue cells to the root surface, allowing periodontal ligament cells to repopulate the area. The document discusses the history and development of GTR, the biological basis and concept behind using barrier membranes, characteristics of ideal GTR membranes, indications and contraindications for GTR, and outcomes from studies applying GTR in treating periodontal defects.
Furcation the problem and its managementPeriowiki.com
The document discusses furcation involvement, which occurs when periodontal disease causes attachment loss that affects the bifurcation or trifurcation of multi-rooted teeth. It presents Glickman's classification of furcation defects into four grades based on the extent of bone loss and visibility of the furcation opening. Grade I is the earliest stage where only soft tissues are affected. Grade IV is the most advanced where bone is destroyed between roots, making the furcation opening visible. The classification schemes of Karthikeyan et al. (2015) and Pilloni and Rojas (2018) are also presented, which provide additional assessment criteria for furcation defects.
Classification of diseases and conditions affecting the periodontiumPeriowiki.com
The document discusses the historical development of classification systems for periodontal diseases from the 1870s to present. It describes the three dominant paradigms that influenced classification: the clinical characteristics paradigm from 1870-1920 which based classifications on observable symptoms; the classical pathology paradigm from 1920-1970 which considered the pathological changes; and the current infection/host response paradigm since 1970 which considers the roles of infection and the body's response. It provides details on influential classification systems under each paradigm.
The document discusses the anatomy and histology of the gingiva. It describes the different types of gingiva - marginal, attached, and interdental gingiva - and their clinical and microscopic features. Microscopically, the gingiva consists of stratified squamous epithelium and connective tissue. The gingival epithelium undergoes proliferation and differentiation, including keratinization in some areas. Keratin proteins and other proteins important for epithelial maturation are also discussed.
Reactive oxygen species and anti-oxidantsPeriowiki.com
This document discusses reactive oxygen species (ROS) and antioxidants. It begins with a brief history of the discovery of oxygen, free radicals, and their role in biology. ROS are classified and sources both endogenous and exogenous are described. The document outlines the origins and formation of ROS, as well as their beneficial roles in physiological functions and microbial destruction. However, excessive ROS can also cause tissue damage through lipid peroxidation and DNA damage. The body's antioxidant defense systems and how ROS levels impact periodontal health are examined. The conclusion discusses measuring ROS and antioxidants.
The document discusses the development, composition, and function of the four main tissues that make up the periodontium - gingiva, periodontal ligament, cementum, and alveolar bone. It describes how each tissue develops during tooth formation and eruption. It also provides details on the biochemical components of the normal connective tissues in the periodontium, including the cells, fibers, and ground substance present in the gingiva, periodontal ligament, cementum and alveolar bone. The document concludes by discussing how diseases can affect the periodontal connective tissues.
Molecular mediators in periodontal pathologyPeriowiki.com
This document provides an overview of inflammatory mediators involved in the pathogenesis of periodontitis. It begins by introducing inflammation and how acute inflammation can become chronic. It then classifies inflammatory mediators as exogenous (bacterial products) or endogenous (produced internally). Key endogenous mediators discussed include cytokines like tumor necrosis factor (TNF)-α, colony stimulating factors, and interferons. The document explains the roles of these mediators in periodontal tissue destruction and bone resorption.
Local anesthesia involves the loss of sensation, especially pain, in one part of the body through the use of local anesthetic drugs. The document discusses the historical background of local anesthesia beginning in the 1880s with cocaine. It defines local anesthesia and related terms and outlines the ideal properties of local anesthetic drugs. The document describes the composition of local anesthetic solutions, classifications of drugs, and their mechanism of action in blocking nerve conduction. It explores theories of pain and the pain pathway, which local anesthetics are able to interrupt.
This document provides an overview of general microbiology. It discusses the history of microbiology, including early pioneers like Hooke, van Leeuwenhoek, Pasteur, and Koch. It also covers the basic classification of microorganisms into domains, including bacteria, archaea, protists, fungi and viruses. Specific sections are dedicated to bacteria, including their structures, growth patterns, shapes, and gram-positive and gram-negative examples. The document aims to introduce the key topics within general microbiology.
Collagen is the most abundant protein in mammals and provides structural integrity to tissues. There are over 30 types of collagen that can be classified based on structure and function. Collagen forms fibrils, networks, membranes, and other structures essential for tissue morphology and function. Disorders of collagen synthesis and structure can lead to a variety of associated pathologies.
This document provides an overview of antimicrobial agents (AMAs), including a brief history, classifications, characteristics of ideal antibiotics, factors to consider when choosing an AMA, indications, contraindications, problems associated with AMA use, and mechanisms of antibiotic resistance. It covers topics such as the distinction between bacteriostatic and bactericidal mechanisms, advantages and disadvantages of each, and common causes of AMA treatment failure.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
24. Role of attached gingiva in :
1. Periodontics:
Adequacy of
attached
gingiva various
concepts
Correlation
between attached
gingiva & gingival
recession
27. Correlation between attached gingiva & gingival
recession
.
Stoner and Masdyasna (1981) found no
association between calculus and gingival
recession but found that it was closely
related to the width of keratinized
gingiva.
28. Dorfman et al in 1982 - In a 4 yr follow up study of pts with bilateral gingival
recession with inadequate width of attached gingiva – No further recession in
areas with inadequate width of attached gingiva
Concluded that, recession sites with lack of attached gingiva will not develop
further attachment loss & recession , if the inflammation is controlled.
2) In a controlled animal study Gould et al in 1992, evaluated whether a gingival graft
to augment the attached gingiva would prevent development of gingival recession
Concluded that recession continued to develop to a similar degree as in a non
grafted sites & augmenting the width of AG does not prevent or retard the
marginal recession.
29. gingival width.
But the evidence from the prospective
longitudinal studies show that the attached
gingival width is not a critical factor for the
prevention of marginal tissue recession, but
that the development of a recession will
result in loss of gingival width.
Thus it can be concluded that,
-the evidence from the prospective longitudinal
studies show that the attached gingival width is not
a critical factor for the prevention of marginal tissue
recession, but that the development of a recession
will result in loss of gingival width
But the evidence from the prospective longitudinal studies
show that the attached gingival width is not a critical factor
for the prevention of marginal tissue recession, but that the
development of a recession will result in loss of attached
gingiva.
63. -The main advantages of this procedure are that the pedicle flap
taken from the palatal area provides for a large amount of donor
mucosa with a blood supply, flap tissue which closely matches the
color of the surrounding tissue, and the potential to treat multiple
teeth.
-The exposed palatal wounds heal via secondary intention with
minimal postoperative discomfort, and the buccally positioned
pedicle palatal flap also heal well.
- However, the procedure is time-consuming, and only useful in the
maxillary area with adequate interdental spaces.
Buccally positioned pedicle flap