PubMed · 13318764
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C A O'SULLIVAN. 1956. Gingivectomy.. https://pubmed.ncbi.nlm.nih.gov/13318764/
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This is the second article in a 2-part series on the variations of oral mucosa. We describe the following 5 conditions that deviate from normalcy: lateral soft palate fistulas, double lip, fissured tongue, racial gingival pigmentation, and geographic tongue.
During the treatment planning process, it is important for clinicians to appreciate that the differences in gingival tissue can affect treatment outcomes. The concept of thick vs. thin gingiva has previously been introduced. This concept has been expanded to describe the different ways these tissue types respond to inflammation, restorative trauma, and parafunctional habits. The resulting defects from these traumatic events will dictate varying treatment management modalities. As restorative dentists begin to appreciate the differences in gingival morphology, they will discover that working with thick gingiva is easier and more predictable. In the past, restorative dentists had no options for influencing the tissue quality they had to work with during restorative procedures. Recent advances in periodontal surgery have made it possible not only to reposition tissues to meet esthetic demands, but also to change the tissue quality of the restorative environment for more-predictable treatment outcomes.
In this article some indications and procedures of mucogingival and plastic periodontal surgery are reviewed. Frenectomy, vestibulary extension and free gingival graft, which all are widely used among periodontitsts, are described. In the second part of this review different surgical methods for covering recession-like periodontal defects are discussed. The clinical results of coronally advanced flap, connective tissue graft, and guided tissue regeneration are compared. The preference of the Nijmegen periodontal clinic to use coronally advanced flap--with or without connective tissue graft--is explained.