Vestibular Depth Research Articles

Retrospective analysis of keratinized tissue augmentation using a xenogeneic collagen matrix for resolving peri-implant mucositis and peri-implantitis.

The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

Formation and stability of mucogingival junction on teeth without clinically detectable mucogingival junction secondary to vestibular extension procedure done for multiple adjacent teeth: A clinical study.

There are very limited data on the postsurgical formation of a mucogingival junction (MGJ) on teeth without its clinical detectability. The purpose of this study was to assess the formation and stability of MGJ on teeth without clinically detectable MGJ secondary to vestibular extension procedures for multiple adjacent teeth evaluated 6 months postoperatively. This prospective interventional single-arm clinical study was conducted in the department of Periodontology, which was approved by the institutional ethical committee, MUHS, Nashik, and registered with the Clinical Trial Registry of India. This trial included 22 participants aged between 18 and 50 years of either gender, including teeth without clinically detectable MGJ along with adjacent teeth having detectable MGJs. The following clinical parameters were taken at baseline, presurgical, immediate postsurgical, 1-month and 6-month follow-ups: plaque index, gingival index, and position of MGJ. gingival margin level, probing depth, width of keratinized gingiva, width of attached gingiva, clinical attachment level, and vestibular depth. Descriptive statistics included mean, median, mode, etc., and the inferential statistics done were analysis of variance along with post hoc Tukey and independent sample tests. Apical shift of MGJ was observed from baseline to 6 months secondary to split-full-split repositioning MGJ with vestibular extension procedure, which was statistically significant (P < 0.05). The formation of MGJ was delineated by clinical and biochemical methods at sites with nondetectable MGJ. The coronal migration of MGJ at 6 months as compared to 1 month was not statistically significant (P > 0.05). The MGJ remained stable at 6 months postoperatively at detectable and nondetectable sites. Within the limitations of this study, we can conclude that there is a definite formation of MGJ in participants without clinically detectable MGJ treated with "split-full-split MGJ-repositioning vestibular extension procedure." The MGJ, which formed apically at a 1-month postsurgical visit compared to the presurgical position, remained stable for 6 months to 1-year follow-up period at both detectable and nondetectable sites.

Electromyographic Evaluation of Superior Orbicularis Oris Muscle Activity in Patients With Complete Cleft Lip and Cleft Palate Before and After Vestibuloplasty Using Carbon Dioxide Laser Therapy.

Introduction: Cleft lip and cleft palate are the most typical congenital craniofacial anomalies. Post-surgical scars in cleft lip patients can cause shallow upper labial sulcus and reduced upper lip length. The aim of the present study was to evaluate the impact of CO2 laser vestibuloplasty on the electromyographical (EMG) activity of patients' superior orbicularis oris muscle, depth of labial sulcus, and upper lip length, and their satisfaction with the procedure and its results. The CO2 laser is an effective vestibuloplasty procedure, is safe and highly acceptable for patients, and has little effect on muscle contraction. Methods: A total of 15 cleft lip and cleft palate patients participated in this study. Vestibuloplasty was performed using carbon dioxide laser therapy in one session in such a way that EMG activity in the upper lip muscle, depth of labial sulcus, and upper lip length were measured two times: before (T0) and twenty days after surgery (T1). Patients' satisfaction surveys were also recorded using a patient questionnaire at T1. Results: The mean values for vestibular depth at T0 and T1 were 2.00±1.71 and 4.52±1.43, respectively. The mean values for upper lip length at T0 and T1 were 6.90±2.32 and 8.00±2.40, respectively, suggesting a significant change in vestibular depth and upper lip length. The vestibular depth and upper lip length significantly increased at T1. The EMG recording of the upper lip muscle experienced a moderate decrease after laser treatment, both at rest and at maximum lip protrusion. Moreover, patients' satisfaction with the surgical procedure was 82% positive. Conclusion: Using the CO2 laser increased the vestibular depth and upper lip length successfully and made small changes in the EMG activity of the superior orbicularis oris.

ONE STEP SOLUTION FOR MULTIPLE MARGINAL TISSUE RECESSION IN THIN GINGIVAL BIOTYPE

Gingival recession is a common concern due to esthetic and root sensitivity especially in mandibular anterior teeth. Various treatment modalities and mucogingival techniques have been carried out for the treatment of recession. The presence of shallow vestibule, inadequate width of attached gingiva may pose a challenge for which several surgical solutions are reported in the literature. Bridge flap technique is one such technique that can be used as a single surgical entity for covering multiple gingival recession, along with increasing vestibular depth without a second surgical site. The treated cases showed adequate root coverage &amp; increase in width of attached gingiva 12 months post operatively.

An Interrelation between the Width of Attached Gingiva, Vestibular Depth and its Impact on Dental Hygiene Care

Abstract Introduction The portion of the keratinized gingiva that is firmly attached to the bone is a significant determinant influencing oral hygiene and aids in the removal of deposits from the gingival crest, upgrades esthetics, and minimizes erythema in the area of the restituted dentition. Aim To assess an interrelation among the thickness of attached gingiva, erythema, and dental hygiene. An interrelation of vestibular height, thickness of attached gingiva, and dental hygiene. Materials and Methods A transverse study has been conducted. A total of 150 individuals were polled for information. The thickness of attached gingiva and vestibular height were assessed in six front dentitions by means of functional method. Clinical metrics comprising Oral hygiene index and modified gingival index has been documented. Results There was a positive correlation association among attached gingival width and oral health care (p &lt; 0.01). The vestibular depth, in contrast did not demonstrate any correlation (p &lt; 0.01). Conclusion An adequate amount of attached gingiva is essential to maintain the gingival health and overall oral hygiene, whereas the depth of vestibule did not show any association with oral hygiene maintenance.

GINGIVAL RECESSION IN RELATION TO MUCOGINGIVAL DEFORMITIES AND OTHER PREDISPOSING FACTORS AFFECT FEMALES IN LOWER ESTHETIC ZONE

Background: Gingival recession (GR) is one of the most common esthetic problems affecting the middle and older aged peoples. GR can lead to many changes as root caries, hypersensitivity, erosions, abrasions, plaque retention and aesthetic dissatisfaction. This study aimed to evaluate the prevalence of gingival recession in relation to mucogingival deformities in lower esthetic zone. Methods: A cross-sectional study was done on a sample of 290 females. The participants were interviewed for personal habits and examined for intraoral distribution of gingival recession and its various predisposing factors. Results: The prevalence of gingival recession in lower anterior teeth was 234, 80.69 %.Around half of the participants had Millers' class I GR (n=146, 49%), thin gingival phenotype (n=168, 56.9 %), mucosal and gingival labial frenum attachment(n=132, 44.7%, n=148, 50.2%). Most of the participants had a sufficient attached gingiva (n=246, 83.4%) and normal vestibular depth(n=278, 94.2%). GR were statistically significant with vestibular depth, gingival biotype and attached gingiva (P≤0.05). Conclusion: Gingival recession in lower aesthetics zone was high in females especially Miller class I gingival recession due to thin gingival phenotypes. Most of Yemeni females have adequate attached gingiva, normal vestibular depth with a frequent mucosallabial frenum in lower anterior teeth. Peer Review History: Received: 1 September 2022; Revised: 28 September; Accepted: 6 November, Available online: 15 November 2022 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com Similar Articles: RISK FACTORS OF PERIODONTAL DISEASES AMONG YEMENI YOUNG DENTAL PATIENTS ORAL CANDIDA ALBICANS COLONIZATION RATE IN FIXED ORTHODONTICS PATIENTS PREVALENCE OF MALOCCLUSION AMONG YEMENI CHILDREN OF PRIMARY SCHOOLS

Partial Extraction Therapy for Implant Placement: A Newer Approach in Implantology Practice.

One of the most popular treatment modalities in routine implantology practice is extraction followed by immediate or delayed implant insertion. Teeth removal alone is insufficient, particularly in the maxillary anterior region of the jaw. Patients may experience several issues after tooth extractions. Due to trauma and the loss of periodontal ligaments, post-extraction alveolar ridge resorption cannot be prevented. Atraumatic extraction, socket preservation, grafting, and implant placement immediately after the extraction are some of the procedures that are carried outto minimize or prevent the resorption ofalveolarbone. Osseointegration is essential for keeping the clinical effectiveness of dental implants. If the supporting tissues at an implant site resorb and are worsened by risk factors for recession, there may be considerable esthetic and functional failure. Implant placement at the retained root structure preserves the buccal bone resulting in an excellent emergence profile. Resorption in the posterior alveolar ridge may result in a decrease in attached keratinized tissue and a decrease in vestibular depth. This might have a negative impact on the stability of the implant and leads to peri-implantitis resulting in the failure of the implant. Without papilla loss or arch collapse, partial extraction therapy has resulted in effective esthetic outcomes. The socket shield technique is a minimally invasive surgical procedure that helps to maintain both soft and hard tissues by preserving a small section of the root. It lessens the necessity for surgeries on bone and mucogingival grafts, cutting the length of the overall recovery process and reducing the treatment time.When soft and hard tissue grafts are used to fill the socket before applying pressure with pontics, it is known as the pontic shield procedure. However, there is no published study that explains partial extraction therapy in a straightforward and clear manner that can guide a practitioner in determining a shield design with a proven track record of success. This review article focuses on the partial extraction procedure which is very helpful for preserving soft and hard tissues in cases involving immediate implant insertion post-extraction. It has long-term therapeutic success with implant and pontic therapy. This review article will also be helpful for clinicians to understand shield design in different case scenarios and help to learn step-wise procedures carried out in partial extraction therapy.

Management of Epulis Fissuratum of Mandibular Anterior Region By Maintaining The Vestibular Depth. A Case Report

OBJECTIVES Epulis Fissuratum or Denture-induced hyperplasia is benign tumor-like hyperplasia of fibrous connective tissue, which develops usually in association with an ill-fitting complete or partial denture. The aim of this report is to present a case showing the treatment of Epulis fissuratum in relation to an ill-fitting denture with a Simple but innovative technique. The epulis was removed with the conventional surgical approach in which the excision of the epulis was carried out by a split-thickness flap approach in which the wound healing is achieved by secondary closure. The existing denture was relined with a soft tissue conditioner to maintain the depth of the vestibule by preventing the post-surgical wound contracture during healing and to prevent further surgery for vestibulopathy. In addition, the patient continued using the existing denture for functional and aesthetic purposes. After two weeks of wound healing, the vestibular depth was maintained by the relined existing denture. Then the new dentures were fabricated accordingly. After one month of follow-up, no signs of recurrence of epulis fissuratum were noticed.

The Buccally Displaced Palatal (BDP) Flap to Increase Quantity and Thickness of Peri-implant Soft Tissue.

Common challenges encountered for atrophic maxilla rehabilitation are the inadequate width and height of attached keratinized mucosa (AKM) and shallow vestibular depth. This study presents a buccally displaced palatal (BDP) flap technique to increase the tissue thickness and AKM width at the second-stage surgery and reestablish the correct fornix depth. The peri-implant pocket depths, modified Plaque Index score, modified sulcus Bleeding Index score, and soft tissue recession were evaluated 6 and 12 months after prostheses loading. A total of 52 implants were placed and analyzed, and no implant failures were found. No significant changes in peri-implant parameters were observed between 6 and 12 months, and mean recession was less than 0.2 mm after 12 months. Though this change was statistically significant, it was clinically irrelevant. The results demonstrate that adequately healthy peri-implant soft tissues and substantial dimensional stability of vestibular soft tissues at the 1-year follow-up were achieved with the BDP flap technique. The BDP flap could represent a viable option for increasing the width and the height of AKM and establishing the correct maxillary fornix depth.

Comparative evaluation of sulcus/ vestibular depth by intraoral examination and on master cast/denture in completely edentulous cases

Context: Residual ridge resorption(RRR) affect the patient’s satisfaction with complete denture by decreasing the sulcus / vestibular depth, Aims: The aim of this study is to find the correlation between difference in sulcus / vestibular depth by intraoral examination and on master cast/ old denture with patient’s satisfaction from complete denture. Settings and Design: The study included old denture wearer and complete denture prosthesis made by different operators in the college. Methods and Material: The vestibular sulcus depths at 7 different sites in edentulous maxilla and 12 different sites in edentulous mandible and respective flange height in maxillary and mandibular denture were measured. Prevalidated questionnaire was used to measure the satisfaction of patients with denture. Statistical analysis used: Pearson correlation was done to find the correlation between satisfaction score and difference in sulcus / vestibular depth. Results: The difference in sulcus depth in maxilla with maxillary cast and mandible with mandibular master cast/ denture showed medium to large negative correlation with p value 0.01. The increase in difference will lead to decrease in satisfaction score of patients.

Influence of vestibular depth on the outcomes of root coverage therapy: A prospective case series study.

The purpose of this study was to investigate the influence of vestibular depth (VD) on the outcomes of root coverage therapy. Patients presenting gingival recession defects (GRD) with a minimum depth of 2mm underwent root coverage therapy consisting of a coronally advanced flap plus a connective tissue graft (CAF+CTG). Clinical examinations were performed, and intraoral scans were obtained at baseline, 3 and 6 months after surgery to assess changes in probing depth (PD), keratinized tissue width (KTW), recession depth (RD), GRD area, marginal gingival thickness (MGT), and VD. The influence of VD on percentage of root coverage (%RC) and the likelihood of achieving complete root coverage (CRC) were explored. A total of 20 patients were enrolled, and 44 teeth were treated. RD decreased and MGT increased in all treated sites. At 6 months, mean %RC was 87.47±18.37 and CRC was observed in 61.4% of sites. Mean baseline VD was 7.33±2.67mm. Mean VD reduction from baseline to 6 months was 1.98±1.27mm. %RC and CRC were significantly correlated with baseline VD. Each additional 1mm of baseline VD implied a gain of 6.58% for %RC and increased 2.75 times the probability of achieving CRC. Narrow baseline KTW and mandibular arch location were associated with inferior treatment outcomes. Lower %RC and likelihood of achieving CRC can be expected after root coverage therapy via CAF+CTG in sites presenting a shallow vestibulum.

Gingival Phenotype Changes and the Prevalence of Mucogingival Deformities during the Early Transitional Dentition Phase-A Two-Year Longitudinal Study.

Thin gingival phenotype (GPh) may contribute to periodontal tissue breakdown and recession development. Thus, the early identification of thin GPh in children can allow proper preventive care and the identification of children at risk during orthodontic treatment. The present long-term study aimed to monitor GPh changes, i.e., thickness (GT) and width of attached gingiva (AGW) during the early transitional dentition phase, as well as its potential associations with the mucogingival deformities. Materials and Methods: 83 systematically healthy children were examined twice with an interval of 2 years. Probing depth, GT and AGW at mandibular incisors, vestibular depth, type of lower lip frenum attachment and mucogingival defects were recorded. Results: 95.2% of participants at baseline and 93.9% at 2-year examination expressed thin GPh. During the transition from the deciduous to permanent dentition, GT and AGW declined, but the GT of permanent incisors already erupted at the baseline examination increased in the observation period. Conclusions: Gingival phenotype undergoes changes in the early transitional dentition phase. In spite of the thin gingival phenotype, only single pseudo-recessions and primary shallow vestibule were noticed.

Effect of Soft Tissue Condition on Peri-implant Health and Disease: A Retrospective Clinical Study.

This study retrospectively evaluated the effect of soft tissue condition on peri-implant health. Clinical variables (Plaque Index, keratinized tissue width, gingival biotype, and vestibular depth) were recorded. Probing depth, soft tissue recession, bleeding on probing, and radiographic marginal bone loss were assessed in relation to independent variables. Statistical analysis was performed using Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model at the implant level. A total of 139 implants in 43 patients were assessed. Bleeding on probing was recorded at 54.7% sites, which was significantly related to the biofilm accumulation. Gender, history of periodontal disease, patient adherence to recall visits, and the presence of plaque were associated with higher peri-implant probing-depth values. The maximum soft tissue recession was recorded at sites with a thin biotype and shallow vestibular depth (P = .0). The logistic regression analysis revealed that plaque (P = .002) and vestibular depth (P = .043) were significantly associated with peri-implantitis. Within the study limitations, patients with high plaque accumulation and shallow vestibular depth are more prone to peri-implant disease.

Dimensional changes of keratinized mucosa after accordion versus conventional free gingival graft around dental implants: A randomized two-arm parallel clinical trial.

Free gingival graft (FGG) is the most effective way to increase the apico-coronal width of the keratinized mucosa. In case of limited donor tissue, the accordion technique can be used. This study compared FGG for dimensional and clinical changes using accordion and conventional methods. Ninety-four implants with keratinized tissue deficiency (<2mm) were randomly assigned to treatment with accordion (49 implants) and conventional (45 implants) FGG. Endpoints including apico-coronal keratinized tissue width, vertical shrinkage, vestibular depth, probing depth, bleeding on probing, and plaque index were measured. The graft harvesting and recipient bed preparation method were similar in the two groups, and the only difference was the graft length. FGG was harvested with a length 40% shorter than the mesiodistal length of the recipient area in the accordion method and as much as the recipient area in the conventional method. vertical graft shrinkage 1, 3, and 6months following conventional graft placement was 12.04±14.99, 17.12±20.40, and 23.29±24.63 percent, respectively. In the accordion graft group, the shrinkage was significantly greater with 30.10±16.12, 36.99±15.51, and 43.75±18.78 percent at 1, 3, and 6months, respectively (p-value<.001). Other factors did not show a clinically significant difference between the two groups. Comparison of vertical shrinkage changes shows that the shrinkage rate in the accordion group is significantly higher than the conventional group. IRCT20190721044296N1 (Evaluation of dimensional changes of peri-implant attached mucosa following the treatment of free gingival graft by conventional and accordion methods; randomized clinical trial two-arm parallel).

Peri-implant soft tissue stability through vestibular extension procedure: a retrospective study.

The present retrospective study assessed the width of keratinized mucosa (WKM) and vestibular depth (VD) adjacent to dental implants subsequent to vestibular extension procedure in patients exhibiting inadequate WKM. A correlation between these two parameters with peri-implant soft tissue stability and the incidence of peri-implant soft tissue dehiscence (PSTD) was also examined. The study included 36 patients (age range 30 to 50 years) with implant restoration. The patients with an inadequate WKM and VD underwent vestibular extension procedure in areas of implant placement. The Modified Plaque Index, Gingival Index, Sulcus Bleeding Index, WKM, VD, and the peri-implant probing depth were measured and compared at baseline, 3 months, and after 1 and 2 years post vestibular extension procedure. A significant enhancement was observed in VD dimensions for both men and women from baseline (1.73 ± 1.10 mm and 1.57 ± 0.98 mm, respectively) to 2 years posttherapy (6.93 ± 0.88 mm and 7.95 ± 1.12 mm, respectively). Similarly, there was an increase in WKM of 4.14 ± 0.24 mm in men and 4.84 ± 0.14 mm in women. However, a weak and insignificant negative correlation was observed between WKM, VD, and PSTD after 2 years. The results of the present study indicate that the vestibular extension procedures around dental implants enable the clinician to achieve greater WKM and VD posttherapy, which is maintainable for a considerable time. The peri-implant soft tissue stability achieved thereafter ensures proper oral hygiene at the site and also negatively correlates with the PSTD.

Comparative evaluation of vascular and clinical changes in micro and macrosurgical techniques in the management of mucogingival problems.

Background:Mucogingival surgery is performed to resolve the problems arising due to high frenum attachment and shallow vestibular depth (VD). The surgical procedures are mainly indicated to prevent gingival recession and for esthetic reasons. The aim of this study was to compare the degree of vascularization in the treatment of mucogingival problems by both microsurgical and macrosurgical techniques.Materials and Methods:Forty-two participants with aberrant frenum and shallow VD were randomly selected for frenectomy, frenotomy, and vestibular deepening either by a microsurgical (test) or macrosurgical (control) approach. Fluorescein angiography was performed at 1, 7, and 14 days after the surgical procedures. In addition, patient's satisfaction scores were recorded postoperatively.Results:Angiographic evaluation at test site revealed a statistically significant vascularization at 1, 7, and 14 days after the surgical procedure when compared to control sites. Probing pocket depth(PPD) in both the groups in vestibular deepening procedure decreased from 1 month to 6 months, but the reduction was insignificant. There was significant reduction in VD in both the groups over a period of 6 months. Microsurgical approach in all three procedures was superior in terms of patient satisfaction than macrosurgical approach. Mean surgical time spent in vestibular deepening and frenectomy procedures was highly significant in micro group as compared to the macro group.Conclusion:This clinical study indicates that microsurgical approach improved the percentage of vascularization and patient satisfaction compared with macrosurgical approach.

Use of Free Gingival Graft and PRF to Increase the Width of the Attached Gingiva: A Novel Approach

Inadequate width of attached gingiva can lead to difficulty in maintaining oral hygiene, can cause recession and if the patient is undergoing orthodontic treatment the bands and brackets might get engrossed in the buccal mucosa. Therefore, increasing the width of attached gingiva is necessary. A 19-year-old female patient who was referred from the Department of Orthodontics for impinging of bands into gingiva which was identified to be because of in adequate width of attached gingiva. Horizontal incision was given at mucogingival junction from 34 to 44 region. Full-thickness flap was raised till the required vestibular depth recipient site is required. Free Gingival Graft (FGG) of size 15×10 mm in size was harvested from left palatal mucosa from distal to 24 to mesial to 26 region. Harvested FGG was sutured from 32 to 42 region in the recipient site. Platelet Rich Fibrin (PRF) membrane was prepared using patients own blood and this membrane was sutured at 33 and 43 region at the recipient site. An aluminium foil was kept at the donor site and above the membrane at the recipient site on which periodontal pack was given. After 21 days of healing, the width of attached gingiva increased from 2 mm at baseline to 8 mm. According to visual analog scale, mild pain was felt by the patient and no difference in the colour was seen at both recipient and donor site at 21 days after surgery. Use of FGG and PRF helps to achieve improved results for increase width of attached gingiva.

Clinical Evaluation of Lateral Pedicle Flap Stabilized with Cyanoacrylate Tissue Adhesive: A Randomized Controlled Clinical Trial.

Context:Gingival recession is the most common mucogingival defect and is susceptible to tooth hypersensitivity, root caries, and esthetic problems if left untreated. A lateral pedicle flap is used to cover denuded roots that have adequate donor tissue laterally and adequate vestibular depth. A carefully planned surgery needs proper immobilization of the flap at the recipient site and this can be achieved by proper wound closure technique with appropriate material such as sutures or tissue adhesives.Aim:The aim of the present study is to evaluate the clinical outcomes of lateral pedicle flap stabilized with cyanoacrylate tissue adhesive and resorbable sutures.Materials and Methods:Twenty-two patients with Miller's class I and class II gingival recession were randomly divided into two groups: lateral pedicle flap stabilized with cyanoacrylate tissue adhesive (test) and lateral pedicle flap stabilized with resorbable sutures (control). Plaque index, gingival index, probing pocket depth, clinical attachment level, recession depth and width, height and thickness of keratinized gingiva were evaluated at baseline and 1st and 3rd month postoperatively. The percentage of root coverage was evaluated at the end of 3rd month postoperatively.Statistical Analysis Used:Intergroup comparisons for the clinical attachment level, recession depth, recession width, thickness of keratinized gingiva, and height of keratinized gingiva were made by Mann–Whitney test by analyzing the difference of two time periods. Intragroup comparisons were made by the Kruskal–Wallis test. Mann–Whitney test was used to compare the difference between various time periods within the group for all the selected variables.Results:The mean plaque index and gingival index at the 1st and 3rd month were found to be statistically significant and did not present any significant influence over other clinical parameters evaluated. A partial root coverage was observed in both the groups (71.97% for the test group and 61.36% for the control group).Conclusions:Cyanoacrylate tissue adhesive is clinically effective in the stabilization of the lateral pedicle flap and can be used as an alternative to resorbable sutures.

Vestibuloplasty using Diode Laser: A Case Report

Inadequate vestibular depth causes deficiency in width of keratinised gingiva which ultimately results in poor plaque control and difficulty in maintenance. Vestibuloplasty is a novel procedure for managing shallow vestibular depth and can be achieved with scalpel, electrocautery, cryosurgery, or laser. With the recent advancements in dentistry, laser therapy has gained popularity over conventional modalities as it is effective yet non-invasive procedure. Among various lasers available, diode lasers are extensively used in oral soft tissue surgery. This case report describes the management of a shallow vestibule using diode laser.

The Vestibuloplasty Using Non-eugenol-based Non-zinc Oxide Oral Dressing Material

This study describes a patient with insufficient vestibular depth who was operated with a vestibuloplasty using a non-eugenol-based non-zinc oxide oral dressing material. Partial thickness flap was elevated on recipient. After stabilization of apical positioned flap, the dressing material was applied on the recipient site with additional fixation by suture. The patient presented minimal discomfort such as in pain, food impaction and management of oral hygiene. Adequate vestibular depth without relapse was observed until 4 weeks after surgery. The vestibuloplasty with the oral dressing material may be an option for obtaining proper vestibular depth without complications.