Abstract:
BACKGROUND:Gingival augmentation procedures around natural teeth and dental implants are performed to facilitate plaque control, to improve patient comfort, to prevent future recession, and in conjunction with restorative, orthodontic, or prosthetic dentistry. The aim of this study is to answer the most common questions related to this treatment modality based on the most relevant and current knowledge in the field. METHODS:Two reviewers worked to answer the five most common and clinically relevant questions with supporting literature to understand the role of gingiva around teeth. 1) What circumstances require an increased zone of keratinized tissue (KT), or is KT important? 2) What is the ideal thickness of an autogenous gingival graft? Is a thick autogenous gingival graft more effective than a thin autogenous gingival graft? 3) What are the alternatives to autogenous gingival grafting to increase the zone of attached gingiva? 4) Does orthodontic intervention affect soft tissue health and dimensions? 5) What is the patient-reported patient outcome for minimal KT compared with that for an enhanced zone of KT? An extensive literature search was performed using PubMed, the Cochrane Oral Health Group Specialized Trials Registry (the Cochrane Library), and the most respected journals in the field. RESULTS:Although gingival augmentation procedures were first introduced in 1960s, there have not been in-depth comparative studies examining the five questions that have been proposed by the authors. Lack of relevant systematic reviews and randomized clinical trials (RCTs) on this topic do not allow authors to answer those questions with a strong level of evidence. However, the following can be recommended after reviewing case reports and case series on these topics. 1) There is enough clinical evidence to support maintaining an adequate band of gingiva for intracrevicular margin restoration. 2) Thick grafts do not appear to result in better clinical outcomes than thin grafts. Thick grafts are likely to result in more primary contraction, whereas thin grafts tend to be prone to secondary contraction. 3) Viable alternative treatment modalities are currently available that are capable of providing KT augmentation without the need for palatal donor tissue. 4) Appropriately applied orthodontic forces do not cause permanent damage to a healthy periodontium. The probability of recession during tooth movement in thin biotype is high to justify gingival augmentation when the dimension of gingiva is inadequate. In addition, cases in which there will be a facial tooth movement outside of the alveolar process need to be considered for a gingival augmentation procedure. 5) Although the articles that have been published on this topic did not consider patient-reported outcomes and esthetics as part of the overall treatment success assessment, patients who have received alternative treatment modalities that did not depend on palatal tissue harvesting appear to have reported more satisfaction and less discomfort after treatment. CONCLUSIONS:Autogenous gingival grafts are still considered to be the "gold standard" procedure with unmatched success rates and clinical success when gingival augmentation procedures are required. However, tissue-engineered materials may offer viable options to palatal tissue harvesting for gingival augmentation. KT augmentation may prevent the development and progression of gingival recession, especially when restorative margins may interact with the periodontium and/or orthodontic treatment is indicated. Patient-reported outcomes should be considered for future studies on this topic. Additional RCTs and systematic reviews are needed to support these conclusions.
journal_name
J Periodontoljournal_title
Journal of periodontologyauthors
Kim DM,Neiva Rdoi
10.1902/jop.2015.130684subject
Has Abstractpub_date
2015-02-01 00:00:00pages
S56-72issue
2 Suppleissn
0022-3492issn
1943-3670journal_volume
86pub_type
杂志文章,评审abstract:BACKGROUND:Generalized aggressive periodontitis is described as a clinical entity affecting both deciduous and permanent dentition with extensive alveolar bone loss, mobility, and exfoliation of all or many teeth. Controversy exists on dental implant use to restore missing dentition in younger patients. METHODS:This c...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2001.72.3.411
更新日期:2001-03-01 00:00:00
abstract::Periodontal conditions and salivary levels of immunoglobulins sIgA, IgM, and IgG subclass distribution and albumin, quantified by enzyme-linked immunosorbent assay, were determined in 20 patients with Down syndrome and 19 healthy controls. Gingival inflammation was more extensive (P < 0.05) among Down syndrome subject...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1998.69.10.1119
更新日期:1998-10-01 00:00:00
abstract::Linear IgA disease (LAD) is a chronic, subepithelial blistering disease that is associated with the presence of linear deposits of IgA along the basement membrane zone. Etiopathogenic aspects of LAD are only partially known. LAD is clinically characterized by vesiculobullous skin and mucous lesions. Although more than...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2003.74.6.879
更新日期:2003-06-01 00:00:00
abstract::This report is an example of tumor metastasis to the temporomandibular joint and its effect on pain, restriction of jaw movement, and the subsequent inability of the patient to function normally. Neoplasm is not the usual etiology of myofascial pain dysfunctionsyndrome and the muscle sparm component of this patient's ...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1975.46.5.309
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:Reduction of alveolar height and width after tooth extraction may present problems for implant placement, especially in the anterior maxilla where bone volume is important for biologic and esthetic reasons. Different graft materials have been proposed to minimize the reduction in ridge volume. The aim of thi...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2009.080400
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The aim of this study is to compare the colonization, immunoglobulin (Ig) G response, and alveolar bone loss in Aggregatibacter actinomycetemcomitans (Aa)-inoculated Fawn Hooded Hypertensive (FHH), Dahl Salt-Sensitive (DSS), and Brown Norway (BN) rats. METHODS:Each rat strain was divided into wild-type Aa-i...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2010.100250
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Gingival augmentation procedures are indicated primarily to increase an insufficient amount of gingiva and sometimes to halt the progression of gingival recession. The aim of this retrospective long-term study was to evaluate changes in the amount of keratinized tissue (KT) and in the position of the gingiva...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2008.070414
更新日期:2008-04-01 00:00:00
abstract::Accumulating evidence suggests that chronic infections, such as periodontitis, are associated with increased risk for cardiovascular diseases (CVD). The mechanisms behind the association are not known. Like herpes viruses and Chlamydia pneumoniae, periodontal pathogens cause atherosclerosis in experimental animals and...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1902/jop.2005.76.11-S.2085
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The primary goal of periodontal therapy is the reduction or elimination of inflammation. Traditionally, this is accomplished through removal of subgingival tooth-borne accretions using non-surgical and/or surgical treatment modalities. Numerous studies indicated the difficulty in removing these accretions to...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2008.080190
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:This study examined conditions under which gingival crevicular blood (GCB) could be used to obtain a useful glucose reading to screen for undiagnosed diabetes during routine dental visits. METHODS:GCB and capillary finger-stick blood (CFB) glucose readings obtained with a glucometer were compared for 46 pat...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2009.080542
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Prevalence of peri-implantitis is directly proportional to the time of functional loading. The aim of this retrospective study was to assess the survival and success rates as well as the incidence of peri-implantitis among patients with a history of periodontitis and among implants with 1 to 10 years of func...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1002/JPER.18-0715
更新日期:2019-12-20 00:00:00
abstract:BACKGROUND:Although some studies show a positive association between periodontitis and blood pressure (BP) elevation, research on the effect of intensive periodontal treatment on decline in BP levels and endothelial microparticles (EMPs) without any antihypertensive management is lacking. Therefore, the present clinica...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2017.160447
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:The aim of this in vivo study was to evaluate the effects of plaque control on the patency of dentinal tubules using vital teeth of beagle dogs. METHODS:Class V cavities were prepared on the cervical areas of the mandibular and maxillary molars in each dog with a diamond point. To simulate the state of dent...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2006.050159
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Evaluation of clinical long-term results 20 years after connective tissue grafting (CTG) or guided tissue regeneration (GTR) using bioabsorbable barriers for root coverage therapy. METHODS:Initially, 15 patients with 38 Miller Class I and II recession defects underwent CTG or GTR according to random assignm...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1002/JPER.19-0203
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Periodontal disease is a major complication of type 1 diabetes mellitus (T1DM). The aim of the present study is to investigate the relationship between glycated hemoglobin and circulating levels of interleukin (IL)-6, IL-8, and C-X-C motif chemokine ligand 5 (CXCL5) in non-smoking patients suffering from T1D...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2015.150149
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:This study compared 6-month and 3-year outcomes for root coverage (RC) by coronally advanced flap (CAF) procedures in localized gingival recessions. METHODS:Two centers, that had participated in a 6-month multinational multicenter randomized clinical trial (RCT), followed up 18 patients with 36 Miller Class...
journal_title:Journal of periodontology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1902/jop.2017.160767
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Recent studies showed the clinical benefits of a one stage full-mouth disinfection, when compared to the worldwide standard treatment strategy of consecutive root planings per quadrant without proper disinfection of the remaining intraoral niches. The purpose of this study was to investigate the microbiologi...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.1999.70.6.646
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Periodontal root coverage procedures to treat recession areas are indicated for unesthetic, exposed, and/or painful root surfaces. Many methods, most using autogenous soft tissue grafts, have been utilized, but with associated morbidity at the donor sites. An alternative donor material would reduce the morbi...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章
doi:10.1902/jop.2001.72.8.998
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:A disintegrin and metalloproteinase 28 (ADAM28) is considered to be the possible virulence gene for congenital hypoplasia of tooth root. Periodontal ligament stem cells (PDLSCs) are regarded as playing crucial roles in the developing process of the periodontium and are generally used in dental regenerative m...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2010.090703
更新日期:2010-06-01 00:00:00
abstract::Osseous grafting techniques represent one mode of therapy to manage combination pocket-osseous defects. They have their greatest applicability in the intrabony defect although encouraging results have been noted in furcation and suprabony sites. Like all treatment modalities, their usage is dictated by the therapeutic...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1902/jop.1977.48.9.570
更新日期:1977-09-01 00:00:00
abstract::The American Academy of Periodontology has developed the following parameter on the treatment of "refractory" periodontitis. Patients should be informed of the disease process, therapeutic alternatives, potential complications, expected results, and their responsibility in treatment. Consequences of no treatment shoul...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2000.71.5-S.859
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:The aerosol generated by an ultrasonic scaler contains microorganisms that can penetrate into the body through the respiratory system of dental surgeons and patients. The aim of this pilot study is to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorh...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2013.120616
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The clinical success of root coverage with autogenous connective tissue (CT) or acellular dermal matrix (ADM) has been well documented. However, limited histological results of CT grafts have been reported, and a case report of a human block section has been published documenting an ADM graft. The purpose of...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.2005.76.2.178
更新日期:2005-02-01 00:00:00
abstract::Subtraction radiography requires radiographs made with identical projection geometry. Recently a new radiographic aiming device and an x-ray beam manipulator made it possible to repeat radiographic exposures in vivo with small angular errors and to measure the angular errors occurring. The purpose of the present inves...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1993.64.4.278
更新日期:1993-04-01 00:00:00
abstract::THE MORBIDITY and incidence of bacteremia in periodontal surgery with or without cephalexin prophylaxis were assessed in adults on the basis of clinical evaluations and blood cultures. Cephalexin reduced the incidence of polymicrobic bacteremias. There was no correlation between objective signs of tissue healing and a...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1982.53.5.319
更新日期:1982-05-01 00:00:00
abstract::von Willebrand's disease (vWD) is one of the most common hereditary hemorrhagic disorders. A mild to moderate deficiency of factor VIII and von Willebrand factor (vWf) often is associated with gingival bleeding. In this case report, the periodontal treatment of a patient with vWD is described. A 45-year-old woman with...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1999.70.5.548
更新日期:1999-05-01 00:00:00
abstract::A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1- to 2-week interval. Such a so-called "quadrant or sextant therapy" might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of t...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.1996.67.12.1251
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Matrix metalloproteinases (MMPs) are a family of host-derived proteinases reported to mediate multiple functions associated with periodontal destruction and inflammation. Most of the existing data have been gathered from adults with chronic periodontitis. The purpose of this study was to determine the MMP le...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2008.070513
更新日期:2008-05-01 00:00:00
abstract::This review defines terms such as accuracy, validity, and reliability, which are used to describe the quality of methods for taking x-rays and for analyzing digital images. Values for these parameters are described for techniques of taking standardized x-rays such as ear-rod fixation and fixation by use of teeth with ...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1902/jop.2000.71.3.497
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:This study determines the effects of a routine assessment (Treatment as Usual, TAU) versus a risk communication intervention (Risk) versus a Goal-Setting, Planning and Self-Monitoring (GPS) intervention on periodontal disease patients' clinical and psychological outcomes. METHODS:In a three-arm randomized c...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1002/JPER.18-0385
更新日期:2019-09-01 00:00:00