Papillary Gingiva Research Articles

Intra-Oral Photograph Analysis for Gingivitis Screening in Orthodontic Patients.

This study aimed to confirm the presence of gingival inflammation through image analysis of the papillary gingiva using intra-oral photographs (IOPs) before and after orthodontic treatment and to confirm the possibility of using gingival image analysis for gingivitis screening. Five hundred and eighty-eight (n = 588) gingival sites from the IOPs of 98 patients were included. Twenty-five participants who had completed their orthodontic treatments and were aged between 20 and 37 were included. Six points on the papillary gingiva were selected in the maxillary and mandibular anterior incisors. The red/green (R/G) ratio values were obtained for the selected gingival images and the modified gingival index (GI) was compared. The change in the R/G values during the orthodontic treatment period appeared in the order of before orthodontic treatment (BO), mid-point of orthodontic treatment (MO), three-quarters of the way through orthodontic treatment (TO), and immediately after debonding (IDO), confirming that it was similar to the change in the GI. The R/G value of the gingiva in the image correlated with the GI. Therefore, it could be used as a major index for gingivitis diagnosis using images.

Use of beta-tricalcium phosphate bone graft in dental implants for bone regeneration

Objective: to avoid alveolar bone loss and prevent bone resorption and implant failure through the use of beta-tricalcium phosphate bone graft. Case Report: 43-year-old patient who underwent dental extraction of the upper right canine due to root fracture; subsequently, a Bicon® dental implant was placed accompanied by a bone regeneration process in the peri-implant space with beta-tricalcium phosphate substitute and collagen plug, preserving the alveolar bone and papillary gingiva. Results: adequate healing was observed, without gingival retraction. When evaluating the final tomography, an increase in bone tissue was observed at the intervention site with greater measurements than the initial ones and without bone resorption. A fixed temporary crown was made on a temporary abutment which allows the soft tissues to be conditioned, improving the emergence profile for the final crown.

Analysis of gingival recession risk factors

Relevance. In most cases, modern dentistry can successfully treat gingival recessions, thus achieving both aesthetic and functional goals. Conservative, surgical, orthodontic, instrumental, injection procedures and methods, which help adequately manage the position of the gingival margin according to the cementum-enamel junction and keep the smile beautiful and healthy, primarily preserve teeth. Meanwhile, timely identification of risk factors associated with gingival recession is no less of a priority in the individualized preventive approach to supporting patients at the dentist appointment.Materials and methods. The research was conducted at the Department of Operative Dentistry and Introduction to Dental Diseases of the Ural State Medical University and the Department of Control Systems Modeling of the Ural Federal University in Yekaterinburg. The study examined 60 young adults: 20 men (33.3%) and 40 women (66.7%) who presented to the dentist. The patients were allocated into two groups according to their age. Each group consisted of 30 patients: the first group contained 20 to 24-year -olds and the second group comprised 35 to 44-year -old patients.Results. The analysis of gingival recession risk factors revealed aggressive tooth brushing in 19% subjects of the first group (р ≥ 0.05), poor oral hygiene in 17% cases (vs 19% in the second group (р ≥ 0,05); overhanging restorations – 12% cases (р ≥ 0.05); thin gingival biotype –14% (р ≥ 0,05).Conclusion. Effective customized control of gingival recession risk factors primarily allows normalizing oral hygiene, timely arresting inflammation in the marginal and papillary gingiva, eliminating trauma from tooth brushing and interdental cleaning devices, as well it provides an interdisciplinary approach to patient management at the dental appointment.

Idiopathic linear leukoplakia of gingiva: A rare case report

White lesions of the oral cavity are not uncommon though majority of them are benign. This case report documents a rare case of idiopathic linear leukoplakia of gingiva with no apparent etiology. Initial examination revealed a non-scrapable linear white lesion on the marginal and papillary gingiva of upper right teeth region. Incisional biopsy was taken for pathologic evaluation. Patient was treated with routine oral hygiene procedures and excision of the lesions. The histopathological results demonstrated hyperparakeratinized/orthokeratinized hyperplastic oral epithelium with orthokeratin-filled clefts and with no dysplasia. Clinical results demonstrated no recurrence after electrosurgical intervention. This paper reports a rare case of idiopathic linear leukoplakia of gingiva which was non-dysplastic in nature. Electrosurgical treatment proved to be successful compared to surgical technique as there was no recurrence even after two years of follow-up.

Ultrasonic determination of thickness of masticatory mucosa: A methodologic study

Objective. The aim of the present study was to assess the reliability and validity of ultrasonic measurements of thickness of the masticatory mucosa. Study design. Eleven periodontally healthy subjects took part. Thickness of the buccal gingiva was assessed midbuccally and interdentally. In the maxilla, the palatal mucosa was measured at every tooth midpalatally, between the first and second molars, and between the second and third molars at each of 3 defined locations 4 mm apart. In the mandible, thickness of the lingual gingiva was measured midlingually as well as interdentally between the first and second molars and between the second and third molars. Thickness of the retromolar mucosa was also assessed. All 1,293 measurements were repeated after 24 hours. Validity of measurements was tested in a porcine model. Results. Mean (± standard deviation) thickness of the midbuccal and midlingual gingiva was 0.99 ± 0.52 mm; the measurement error was 0.26 mm. Measurements were well correlated (Pearson’s r = .74, P < .001). Mean thickness of the papillary gingiva was 1.19 ± 0.53 mm; the measurement error was 0.37 mm ( r = .58, P < .001). A lower reliability was observed for palatal measurements of mucosal thickness; mean thickness was 2.36 ± 0.87 mm, and measurement error was 0.54 mm ( r = .64, P < .001). The validity of measurements was excellent in the 0.5-4.5 mm range. Conclusions. Differences in reliability of ultrasonic assessments of mucosal thickness in different parts of the oral cavity may depend on the difficulties of repeatedly measuring at the same location, on varying thickness of the tissues, and on expression of palatal rugae. These problems might be resolved by averaging multiple measurements. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:248-53)

Gingival microcirculation response to tooth brushing measured by laser Doppler flowmetry.

This study quantified changes in blood flow following tooth brushing, using laser Doppler flowmetry (LDF). Twenty subjects had polysiloxane stents fabricated with openings to permit placement of the LDF probe on the mesial papillae of 6 teeth. Probing depth, plaque index, and gingival index were recorded and subjects instructed in brushing. LDF initially recorded a 30 second baseline blood flow. The stent was removed and subjects brushed the site for either 3 or 10 seconds. The stent was repositioned and recordings again taken, followed by a control reading. The process was repeated 4 weeks later. Correlations between baseline and control readings were 0.585 (P < 0.001) at the first visit, and 0.654 (P < 0.001) at the return visit. The mean control blood flow was 156.4 perfusion units. The 3 and 10 second brushing increased the mean value 22.6 units and 21.2 units respectively (both P < 0.001). Tooth brushing for both 3 and 10 seconds significantly increased gingival blood flow in the papillary gingiva of healthy individuals.

反射スペクトル解析法による歯肉微小循環機能の測定 特に，プローブと歯肉との接触条件および測定部位の影響

The purpose of this study was to examine the effect of contact between the probe and gingiva, and to compare the parameters between arches, regions, and surfaces in measurement of gingival microvascular function by tissue reflectance spectrophotometry (TRS). The index of hemoglobin concentration (Hb index) and the index of oxygen saturation (SO2 index) in papillary gingiva were assessed with TRS in a standardized manner. Gingival spectra were measured immediately before and during contact between the optical probe and gingival tissue. The Hb index showed a maximum value during the procedure when the probe was in the first contact with gingiva. The SO2 index showed lower values before the contact and higher values after the first contact. When the probe/gingiva surface angle increased, the Hb index decreased but the SO2 index showed little change. These results indicate that good reliability of the measurement could be obtained by selection of a representative spectrum showing the maximum Hb index among several spectra measured at the same site. Reflectance spectra were also measured at various locations of the upper and lower arches in subjects with clinically healthy gingiva. Coefficients of variation of both indices in lingual/palatal surfaces and in molar teeth were higher than those in facial surfaces and incisor teeth, respectively. Analysis of variances indicated significant differences in both indices between facial and lingual/palatal surfaces and among the teeth but no difference between the sides and between the arches. Significant interactions were observed in both indices between arch and surface, and in Hb index between arch and tooth. Thus, the application of TRS measurements in periodontal practice should consider differences in TRS parameters at a given location in the mouth.

発赤歯肉の反射光スペクトルによる健康時歯肉色の線形予測について

This study was made to examine if original gingival color of an individual patient in healthy condition can be presumed from the observed data on the color of his gingiva having presented pericoronal gingival redness. The subjects were 50 males (aged 23-31) whose gingivae have been identified as clinically healthy. X, y, V, Bl and f values were determined from raw data obtained by the color measurement of 4 gingival spots near the cervical regions of maxillary central and lateral incisors. Multiple regression analysis was made with x, y and V values of the healthy papillary gingiva as objective variable and with each element of the observed data (twenty-dimensional observed value vector) upon the manifestation of gingival redness, which has bi-graded according to the degree of redness (slight redness, redness), as explanatory variable.As a result, the analysis of a bi-graded observed data series according to the degree of gingival redness was confirmed to make it possible to presume the original gingival color of the papillary part in healthy condition, suggesting the usefulness for its clinical application.

Colorimetric studies of the gingiva. Color variation of the gingiva in the upper anterior region

The purpose of this study is to analyze, using CIELAB color system, the range ofgingival color variables in healthy gingiva of the maxillary incisor region.Results indicated:1. Color differences (dE) among the bilateral attached andmarginal gingiva of the incisor and lateral incisor regions were under 2.0. However, the attached and marginal gingiva of the canine regions were about 2.88 and2.45 respectively. The papillary gingiva was over 2.0 in each region.2. Compared to the incisor region, an increase in chromaticness and hue a*, b* with a decrease in lightness was observed in the attached, marginal, and papillary gingiva of the lateral incisor and canine region. The range in dE was from 2.28 to 3.36. In the attached and papillary gingiva, dE between the incisor and canine region was significantly bigger than the incisor and lateral incisor region.3.Decrease in chromaticness, lightness, and hue a*, b* was observed from the marginal to papillary gingiva, and dE was from 3.13 to 3.71 with a high being in theincisor region.4. Increase in chromaticness and hue a*, b* with a slight decreasein lightness was observed from the attached to marginal gingiva, and dE was from2.25 to 2.75.

Fundamental study in measurement of gingival color. Measurement apparatus and conditions of measurements

From the standpoint of diagnosing the condition of the gingiva as well as esthetics, gingival color is found to play an important role in dentistry. Thus, it is important to be able to differentiate the changes in color of the portion of gingiva which is in contact with the crown. We the authors of this report, decided to measure the gingival color and make basic investigations pertaining to the conditions in relation to color measurements. The results revealed the following.It was possible to accurately measure the marginal and papillary gingiva using the modified version of the CD-270 colorimeter, which is considered to be one of the most accurate source of equipement in differentiating color shade.The detectable color differentiation limit among the dentist of our department was found to be 1.12.The fixation apparatus for the colorimeter was found to show stable and repeatable data.It was possible to be able to control the color difference below the afore mentioned detectable color differentiation limit value by a constant color setting established by our department.

The topography of papillary gingiva in health and early gingivitis.

Using stereo-images, topographical features within the maxillary papillary gingiva between the lateral and central incisors were investigated in 36 healthy young adults. The features studied were surface stippling, presence of a gingival groove, papillary length and papillary area. The prevalence of stippling was found to be 95%. The intensity of stippling varied considerably between individuals, the mean being 2.6 depressions/mm2. A gingival groove only occurred in 19% of the cases examined. The maximum length of the papilla from the base to its most incisal tip was measured in relation to the length of the crown of the lateral incisor. This ratio was found to be close to 0.5, indicating a healthy papilla reaching about halfway to the incisal edge. The surface area of the papilla was measured in relation to the labial surface area of the lateral incisor. This ratio was close to 0.25, indicating that the papillary surface under healthy conditions amounts to about 1/4 of the labial surface of the lateral incisor crown. Changes resulting from 20 days of plaque accumulation were also investigated. A mean GI of 0.8 was recorded at the end of the experimental period; however, no measurable changes in stippling intensity or papillary shape could be established. These findings suggest that the early stages of gingivitis are characterized mainly by changes in gingival colour, while changes in surface texture and shape are secondary characteristics of clinical inflammation.

Acute recurrent gingivitis: A clinical entity

A typical case of a previously undescribed form of gingivitis which is self-limiting and recurrent is discussed. The signs and symptoms include acute pain and swelling of interdental papillae with regional lymphadenopathy. As the disease progresses the localized swelling quickly spreads to the adjacent marginal and papillary gingiva. Ulceration is infrequent and without pseudomembrane formation or interdental cratering. We believe this to be a unique form of gingivitis and suggest the name acture recurrent gingivitis (ARG).

Studies on Efficacy of the Dentifrice containing Aluminium Chlorhydroxy Allantoinate on the secondary Preve Rtion of Preiodontal Diseases

It is most important for the secondary prevention of periodontal diseases to brush the teeth daily with a dentifrice. From this point of view, two double blind studies were conducted using two dentifrices, one containing 0.30 percent Aluminium Chlorhydroxy Allantoinate, which is effective for treatment of diseases, and the other a placebo.As a medical examination for the present study, objective symptoms of the gingiva were checked by PMA-Index, P-Index, and S-Index, before and after using the two dentifrices. P-Index and S-Index are new methods by which papillary gingiva shape on a plaster cast (P-Index) and stippling distribution on a plaster cast (S-Index) are estimated. On the other hand, subjective symptoms of bleeding from the gingiva were observed by checking questionaires.The placebo had a little effect, but the dentifrice containing the above drug was proven to be more effective than the placebo, for the relief of inflammation of gingiva and for the hemostasis of hemorrhage from the gingiva, and also the drug was proven to cause no irritations to the oral mucosa. The dentifrice containing the drug was proven to be effective for the secondary prevention of periodontal deseases. Good correlation was found between the PMA-Index and the two methods by the use of plaster casts. Change of gingival shape can be observed precisely, placing the two impressions side by side, before and after the use of the toothpaste. It was thought that the P-Index and S-Index are useful methods, according to these facts, in such a test case.