The condition of the periodontium in patients with clefts]

41 patients with total clefts, having an average age of 14.6 years, were examined. In these patients, the bone index was determined by means of the radiographic method of Schei et al. (as modified by Engelberger, Rateitschat and Marthaler). Furthermore, the teeth were tested for mobility, and the gingival retraction and the pocket depth were measured. The degree of gingival inflammation was scored using the PMA index according to Mühlemann and Mazor. The findings from the cleft quadrants were compared to those from the non-cleft quadrants of the upper jaw and to those from the mandibular quadrants.     

Orthopantomographic assessment of the width of attached gingiva

By revealing the mucogingival junction with Schiller's iodine solution and marking it separately at each tooth with a short piece of metal wire, attached to the tooth and gingiva with a strip of Squibb's Orahesive Dental Bandage, the location of the borderline between the attached gingiva and the free alveolar mucosa was made visible in the orthopantomogram. The orthopantomographic width of the attached gingiva was measured to the nearest millimeter by determination of the distance between the mucogingival and cementoenamel junctions along the long axis of each tooth. When the orthopantomograms of ten dentulous adults were measured twice with a one week interval, the reading error was ± 0,5 mm. When the mucogingival junctions of five dentulous adults were marked again after two months and the orthopantomographic width of the attached gingiva remeasured to the nearest millimeter, the difference between the results was ± 0,6 mm. The total deviation (± 0,7 mm) being less than the one millimeter unit of measurement, the method was judged reliable for orthopantomographic studies on gingival anatomy.     

Lack of association between width of attached gingiva and development of soft tissue recession

The purpose of this study was to longitudinally monitor changes in the position of the soft tissue margin at 26 buccal sites surgically deprived of all gingival tissue. A baseline examination carried out 6 months after treatment revealed that the sites to be monitored were lacking or had only a minimal zone (less than 1 mm) of regenerated attached gingiva. 12 control sites with an "adequate" width of attached gingiva (greater than 1 mm) were also examined. Assessments of oral hygiene and gingival conditions, probing pocket depths, probing attachment levels, position of the soft tissue margin, and gingival width were carried out at baseline and after 5 years. The results revealed that in the test sites, a slight increase of the width of the gingiva occurred during the observation period. 7 out of the 26 areas showed a coronal regrowth of the soft tissue margin, while 2 sites showed a further apical displacement of the soft tissue margin. In the control areas, 3 sites developed recession accompanied by a reduction in the width of the gingiva. Hence, it appears that in patients maintaining a proper plaque control, the lack of an "adequate" zone of attached gingiva does not result in an increased incidence of soft tissue recessions.     

Pedunculated soft-tissue mass on the alveolar gingiva

A case of peripheral ameloblastoma, a rare intraoral neoplasm, has been presented. The lesion appears most commonly as a mass on the mandibular lingual gingiva of patients in their fifth and sixth decades of life. The peripheral ameloblastoma does not share the aggressive nature of the intraosseous variant. The lesion has been overtreated in the past and warrants only a local supraperiosteal excision.     

Facio-lingual width of the alveolar base

Importance is attached to assessment of anterior facio-lingual maxillary and mandibular apical base widths in determining limits to incisor root movements. There is absence of similar assessment of facio-lingual base widths for premolars and molars. The aims of this paper are two-fold: to determine the strength of associations between the facio-lingual widths of the anterior and buccal alveolar apical bases, and to determine if an association might exist between the posterior alveolar base width and specific lateral cephalometric measurements. Comparative measurements were made on 40 adult Thai skulls and their companion mandibles using lateral cephalometric radiographs, linear tomography, and direct measurements of the dento-alveolar and basal structures. Wide variation was found in facio-lingual widths of the alveolar bases. No significant correlations were found between the facio-lingual widths of the anterior and posterior alveolar bases in the maxillae and mandible. Significant inverse correlations were found between the alveolar base widths at the mandibular incisors and the FP-MP and PP-MP angles, and between maxillary incisor base widths and the gonial angle. Importantly, no cephalometric indicators were found to predict posterior alveolar base widths. There is a need to continue to search for assessment indicators.     

Correlation between radiographic and histopathological findings in squamous cell carcinomas of the gingiva

Summary The relationship between the radiographic features of jaw bone destruction and the histopathological features of tumor cells in 115 squamous cell carcinomas of the lower gingiva was investigated. The radiographic features were classified into four patterns as saucer-shaped, permeated, geographic and moth-eaten. Histopathologically, the cases were divided into three groups, a) the highly differentiated type showing papillary and nest structure well keratinized, b) the moderately differentiated type showing small cord and strand structure with moderate keratinization, and c) the poorly differentiated type showing marked cellular dissociation with poor keratinization. In the group of saucer-shaped, permeated, geographic and moth-eaten type, the proportion of histologically highly differentiated tumors was high. Namely, highly differentiated tumors tended to reveal a fairly mild and compressive resorption and poorly differentiated tumors showed more invasive and aggressive potential to the bone. This study suggested that the radiographic images of the mode of bone destruction in squamous cell carcinomas of the gingiva are influenced by the histopathological nature of the tumor cells.     

The width of lingual mandibular attached gingiva.

One hundred and twenty individuals in good oral health were divided into six groups according to age. Measurements were made on the depth of the gingival sulcus, and the distance from the margin of the free gingiva to the mucogingival junction on the lingual mandibular teeth. The mean, extreme, standard deviation and analysis of variance were computed. A distinct pattern of the width of healthy lingual attached gingiva was found. The largest width was found lingual to the first and second molars with a mean height of 4.7 mm. This was followed by the third molar [3mm] second bicuspid [2.5 mm] first bicuspid [2 mm], and cuspid, lateral and central [1.9mm]. Lingual attached gingiva showed that there was a variation in width with each tooth and between individuals. There was no variation in width of lingual attached gingiva between sexes. The extreme measuremtns ranged from less than 1 mm to 8 mm. The data from the study gives the dentist some indication of the mean and extreme ranges of lingual attached gingiva. This data can serve as a guide in diagnoiss and treatment planning and in selecting procedures to reestablish these zones of attached gingiva.     

The increase with age of the width of attached gingiva

The purpose of the study was to determine the variation with age of the width of attached gingiva and the location of the mucogingival junction. The material comprised orthopantomograms of 20 male and 20 female dental students aged 20–30 years and 20 male and 20 female adults aged 39–51 years. All the subjects had practically full dentitions and no supraerupted teeth. The mucogingival junctions were revealed with Schiller's iodine solution and marked with short pieces of metal wire, attached to the teeth and gingivae with Squibb's Orahesive Dental Bandage in the midline of the facial surface of each tooth. The orthopantomograms were taken with the X-ray beam passing the horizontally positioned occlusal level at a –5° angle. From the radiographs the distance from the cemento-enamel to the mucogingival junction was measured to the nearest millimeter separately for each tooth. In the mandible also the distance from the mucogingival junction to the lower border of the jaw was assessed accordingly. The results showed that the measured anatomical width of attached gingiva does not differ between sexes but also that it increases significantly with age. The distance between the mucogingival junction and the lower border of the mandible did not increase with age. It was concluded that the mucogingival junction remains at a probably genetically predetermined location while the teeth move in an occlusal direction through adult life. In the absence of concurrent retraction of the gingival margin this results in an increase of the width of attached gingiva with advancing age.     

The width of attached gingiva on supraerupted teeth

On basis of earlier results it seems justified to assume that the antomical width of the attached gingiva, i.e. the distance from the mucogingival junction to the cemento-enamel junction in human type of teeth is in direct proportion to the amount of past tooth eruption. For experimental verification of this hypothesis a study was designed to assess the anatomical width of attached gingiva on supraerupted teeth in man. The material of the sutdy comprised 28 first and second maxillary mucogingival junction was marked with short pieces of metal wire, orthopantomograms were taken, and the distances from the mucongingival junction to the floor of the nasal cavity and to the cemento-enamel junction used as controls. A comparision wa also made between the supraerupted teeth and previously measured normally occluding teeth. The results indicated that even during pronounced supraeruption the teeth tend to erupt with their investing tissues while the location of the mucogingival junction remains constant. This finding is of special interest as it should make it possible to treat the problem of a too narrow zone of attached gingiva by grinding the tooth out of occlusion and allowing it and its gingival margin to erupt.     

The width of clinically-defined keratinized gingiva in the mixed dentition

Some authors have noticed a clear decrease of the width of keratinized gingiva when they compared the width over deciduous and newly erupted permanent teeth. The aim of this cross-sectional study was to assess the width of keratinized gingiva over permanent and deciduous teeth present in 6 to 11-year old children in an urban environment. The greatest width of keratinized gingiva was found over deciduous canines and permanent incisors. When comparing the width of keratinized gingiva over deciduous canines and molars and permanent first incisors and first molars, statistically significant differences were found only between 6- and 11-year-old groups. The findings do not seem to support previously published data, but do suggest that periodontal mucogingival surgery is not needed before the patient reaches the adult age, since there is a tendency of an increase of the width of keratinized gingiva.     

Exfoliative cytology of the periodontium]

Under certain conditions (reproducibility of the results, standardization of the sampling sites and of the procedure of staining), the exfoliative cytology can facilitate the primary and secondary prevention of periodontal diseases. The reproducibility of the counts was tested on 114 smears by repeated determinations and confirmed by statistical analysis. The comparison of the counts from smears from the vestibular papilla 32/33 and the lingual papilla 36/37 showed that the molar region is better suited for the early detection of periodontal lesions. Due to the greater reproducibility of its results, the technique of Shorr and Pundel is recommended for the fixation and staining of the exfoliated cells. The differentiation of the superficial cells should also be based on the affinity for dyes of the cytoplasm.