There exists an intimate relationship between periodontal health and the restoration of teeth. The maintenance of gingival health has a direct impact on the longevity of the teeth and associated restorations. Therefore, a good clinician requires an adequate understanding of the relationship between periodontal tissues and restorative dentistry and its impact on the form, function, aesthetics, and comfort of the dentition.
The teeth are embedded into the bone of the maxilla or the mandible. The biologic width is a protective seal existing around the teeth to protect the alveolar bone against bacterial infection (Rajendran et al., 2014). ‘The biological width is defined as the dimension of the soft tissue, which is attached to the portion of the tooth coronal to the crest of the alveolar bone (Nugula, et al. 2012)’. Gargiulo et al. (1961) described the dimensions and relationship of the dentogingival junction in humans. Based on his
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Providing sub-gingival margins provides excellent aesthetics, but at the same time acts as a permanent irritant to the periodontium. A high degree chance of Biologic width encroachment exists when planning for subgingival restorations. Hence, limiting subgingival margin extension to 0.5-1.0 mm is recommended because as it is highly difficult for the clinician to detect where the sulcular epithelium ends and the junctional epithelium begins (Nugula et al. 2012).
Biologic width violation causes serious consequences like chronic progressive gingival inflammation, clinical attachment loss and alveolar bone loss. Destructive inflammatory response to plaque located at deep pockets can cause the above diseases. Gingival hyperplasia is also most frequently found in subgingivally placed restorative margins (Rajendran,
better the process and the causes of periodontal disease ( I talked to the patient
However, the gingival margin indicated that Mr. Jay-jay has recession on tooth # 5, 6,7,8,9,10,11,12,13,14&15, all in the direct facial aspect of the tooth. The gingival margin of the upper arch range from 1mm to 4mm. Not as much recession on the lingual aspect of those teeth it there were only 1mm shown on the direct lingual of those teeth.
A frequently cited study for the justification of the 3-month interval is Stanton et al (1969) time series study investigating the rate of wound healing of human gingivae by measuring hydroxyproline present in gingival collagen against time (N= 99). Their results yielded a 50% regeneration of collagen after 25 days. Through regression analysis their existing data, they extrapolated full connective tissue repair would require at least 49 days. Weaknesses with this study include inadequate follow up necessitating them to estimate their findings and their small sample size. As well, it did not relate directly to periodontal therapy, as their study only investigated wound healing following a gingivectomy. Canton et al (1982) investigated the maintenance of healed pockets following root planning to evaluate clinical stability of 128 periodontal pockets over the course of 3 months. They observed that across 4 to 16 weeks following root planning there was a
Based on the principle of Melcher (1976), GTR can be considered as a therapeutic resource that facilitates the repair of bone and periodontal defects, furcation lesions and gingival recessions, regenerating tooth support tissues, through the use of barrier materials such as membranes, that exclude the gingival epithelium from the root surface and provide allow spaces held by the barrier membranes (BM) to be filled by desired tissue (bone). (2, 3) By selecting the type of cells that will repopulate the wound, we allow the cells of the periodontal ligament to regenerate the lost tissues, inhibiting the early migration of the epithelial cells. (4-6) Despite the use of biomaterials to support membranes seems to improve the results, there still are many problems
The world prison population has increased by 25-30% in the last 15 years. 144 people per 100,000 globally are prisoners. To meet the oral health needs of prisoners at this growing rate there has not been a corresponding increase in the level of dental health services. The growth in the number of prisoners has placed huge demands for dental healthcare services in prison settings. The majority of prisoners are young. However, there has been a sharp increase in the number of older prisoners due to longer sentences being given for serious crimes. Both age groups have significantly different oral health needs. Young prisoners have a high number of decayed surfaces and gingival bleeding scores. Older prisoners have more missing teeth and periodontal
Esthetic restorations are in vogue today and their demand is increasing day by day. Composites represent two major advances in restorative dentistry. Composite resins have been introduced into the field of conservative dentistry to minimise the drawbacks of the acrylic resins that replaced silicate cements (the only aesthetic materials previously available) in the 1940s. In 1955, Buonocore used orthophosphoric acid to improve the adhesion of acrylic resins to the surface of the
The main problem in distal extension cases is the absence of a posterior abutment. The Viscoelastic behavior of the gingiva due to application of
When a procedure as basic as scaling and root planning and the sight of reduced post-operative inflammation – seeing the gingiva turn to a benign pink from red gives you a sense of fulfillment and satisfaction that is incomparable, you know that being a Periodontist is everything you have ever wanted. Holding a scalpel, incising the gingival and periodontal tissues and raising a flap almost perfectly for the very first time, is perhaps one of the most exhilarating experiences I have ever had and, at the risk of sounding too dramatic, the clockwise and anti-clockwise turning of the wrist during suturing is nothing short of sheer poetry in motion to me.
Clinical assessments Periodontal parameters including plaque index (PI) (15), papillary bleeding index (PBI) (16), probing pocket depth (PPD), clinical attachment level (CAL) and gingival recession parameters including recession depth (RD), recession width (RW), keratinized tissue width (KTW) and gingival thickness (GT) were assessed using William’s graduated periodontal probe (Hu Friedy, Chicago, IL, USA) and rounded up to the nearest 0.5 millimeter. RD was measured from the CEJ to
Periodontitis is one of the most common diseases affecting the population with 10-15% incidence rate among
This sequentially becomes a reason for tooth loss and other dental difficulties such as gingivitis, periodontal diseases. In due course, we undergo treatments such tooth withdrawal, root canal treatment, tooth whitening, etc. Whether you believe it or not, but each time a tooth loss happens, it affects the alveolar bone. Ultimately, the gum tissues and bone begins to depreciate. However, the loss just does not finish there. With tooth loss and alveolar bone loss, you will begin losing the basal bone and this finally disturbs the whole edifice of teeth. This is the reason why we need to take expert dental help. Visiting Dr. Neha Garg, a dentist in Gurgaon at the Dental Hub or an orthodontist in Gurgaon twice a year will guarantee that the teeth and mouth are healthy and you do not struggle with any other
This is a type of surgical procedure utilized to aid in the elimination of inflammation and infection, thus restoring the tissues and preventing tooth loss (Bhide & Lai, N.d.). The goal of any periodontal treatment is the reduction and/or elimination of pocket depth. Osseous resective surgery is no exception. There are many types of treatment methods that can be utilized to assist in such. Some of the procedures are more invasive than others. For example, scaling and root planning is a routine procedure that requires little post-operative healing. However, osseous resective surgery is a more complex procedure that requires the assistance of a specialist. In the world of dentistry, it is known that periodontal disease destroys bone and surrounding tissues in the oral cavity. Management of a patient with periodontal disease can sometimes be too complex thus requiring the patient be referred to a specialist such as a periodontist. The gingival and periodontal tissues must be treated in order for the patient to be able to maintain proper oral hygiene. Osseous resective surgery is considered to be highly effective in the management and treatment of periodontal disease (Bhide & Lai, N.d.). Once the procedure has been completed and the gingival and periodontal tissues are restored back to health, the patient is much more able to effectively maintain their oral hygiene. In fact, completion of this procedure has been shown to minimize the chance of a periodontal pocket reforming (Osseous resective surgery, N.d). Reduction and/or elimination of periodontal pockets are crucial for the treatment and management of periodontal
The morphological features and the mineral amounts and allocations of primary teeth are unlike the permanent teeth. That means that variances can exist amid the restorative handlings for primary and permanent teeth(13). There are slight dissimilarities between primary and permanent teeth in relations to dentin structure and shape. Study of SEM of resin dentin boundary in primary and permanent teeth exposed that the hybrid layer formed withinn etch-and rinse adhesive structures was thicker in primary than permanent teeth, and therefore lower bond to primary dentin. Primary tooth dentin is more sensitive to acid media, so
The normal healthy appearance of the gingiva is coral pink with a scalloped coronal border known as the free gingival margin. The free gingival margin is approximately located 1.5 to 2 mm coronal to the cementoenamel junction (CEJ) in healthy fully erupted teeth [204]. On the other end, the gingiva becomes continuous with the loose, red lining mucosa known as “the alveolar mucosa”. The alveolar mucosa differs in colour since it has a thin non-keratinized epithelium and loose connective tissues that contain numerous blood vessels but no rete pegs. Typically, the gingiva can be easily
Individual tooth is the unit of the study in this trial. 120 patients [450 teeth] including between the age group of 16 and 600 years are to be recruited without any gender bias.