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At least 127 records · Page 7Linked to original sources
PubMed1999

Periodontal plastic surgery in a dystrophic epidermolysis bullosa patient: review and case report.

Epidermolysis bullosa (EB) is a group of genetic disorders in which patients frequently present with fragile skin and mucosal surfaces that blister following minor trauma; 23 subtypes have been recognized, but their precise pathogenesis and etiology remain obscure. There is no treatment for EB, only palliative therapy. Oral bullae are the most common oral finding and affect all surfaces. Patients with EB present a unique challenge in terms of periodontal therapy. The following article reviews this disorder and describes the complications encountered when providing periodontal plastic surgery to a patient exhibiting this condition. A 36-year-old female with dystrophic EB presented for treatment of a 3 mm recession area with minimal attached gingiva on the facial of #24 and 25. Oral evaluation revealed multiple ulcers. The treatment consisted of a subepithelial connective tissue graft in conjunction with a coronally positioned flap and buccal frenectomy. Most of the epithelium associated with the surgical area and buccal vestibule sloughed. During the postoperative course, the frenum had regenerated at a more coronal level and was applying tension on the gingival tissues. It appeared that a connective tissue union had formed between the de-epithelialized surface of the facial flap and the buccal mucosa of the vestibule. A second frenectomy was performed, and a clear acrylic stent was fabricated to prevent the union of the connective tissue of the facial flap to the buccal mucosa. The stent prevented the fusion of both connective tissue layers and allowed time for epithelium migration.

Adult↗
PubMed2006

Coronally positioned flap with subepithelial connective tissue graft for root coverage: various indications and flap designs.

Aesthetic concerns and functional abnormalities, such as dentin hypersensitivity, are often associated with gingival recession defects. Root coverage procedures aim to restore both gingival aesthetics and function in recession defects. The coronally positioned flap combined with the subepithelial connective tissue graft is one of the most widely used root coverage procedures. The present report illustrates four different indications where this procedure has been successfully employed. An isolated Miller class II recession defect associated with frenum pull, multiple adjacent Miller class I defects in the aesthetic zone, an isolated Miller class I defect associated with dentin hypersensitivity, and an isolated Miller class II defect on a retained deciduous tooth are the four diverse conditions treated by periodontal plastic surgery. Different approaches were used to create the coronally positioned flap. Treatment resulted in complete root coverage, resolution of hypersensitivity, and satisfaction of the patients' aesthetic concerns. An effective and predictable treatment modality, such as the coronally positioned flap combined with the subepithelial connective tissue graft, should be considered when treatment planning for gingival recession defects.

Adult↗
PubMed1977

[Anatomy and physiology of the muscles and median frenum of the upper lip. Initial results of selective electromyography].

Usually when reference is made to the Orbicularis oris muscle of the upper lip only the horizontal bands of muscle are mentioned. This muscle also comprises oblique fibres (Orbicularis externus) that are of very great importance in lip movements. The balance of the lip derives from the activity of the two types of muscle fibers. The lip can thus perform, at the same time, a movement of compression of the underlying structures and projection movements whereby these structures are freed. These different modes of action are well demonstrated by selective electromyography. There is also, in the middle of the upper lip, a medial cellulo-fibrous septum forming a prolongation of the septum and penetrating into the median interincisive suture and ending at the frenulum of the upper lip. This medial septum seems to play a very important physiological role in the growth of the premaxilla.

Electromyography↗
PubMed2006

Evaluation of patient perceptions after frenectomy operations: a comparison of carbon dioxide laser and scalpel techniques.

BACKGROUND: A frenum that encroaches on the margin of the gingiva may interfere with plaque removal and cause tension. Frenectomy is the complete removal of the frenum that can be made by scalpels or with soft tissue lasers. The aim of this article was to compare the degree of postoperative pain, such as discomfort and functional complications (eating and speech), experienced by patients after two frenectomy operation techniques. METHODS: Forty patients requiring frenectomy were randomly assigned to have treatment either with a conventional technique or with a carbon dioxide (CO2) laser. The postoperative pain and functional complication ratings of each patient were recorded using a visual analog scale on days 1 and 7. RESULTS: The results indicated patients treated with the CO2 laser had less postoperative pain and fewer functional complications (speaking and chewing) (P <0.0001 each) and required fewer analgesics (P <0.001) compared to patients treated with the conventional technique. CONCLUSIONS: This clinical study indicates that CO2 laser treatment used for frenectomy operations provides better patient perception in terms of postoperative pain and function than that obtained by the scalpel technique. Considering the above advantages, when used correctly, the CO2 laser offers a safe, effective, acceptable, and impressive alternative for frenectomy operations.

Adolescent↗
PubMed1989

Medial thighplasty, prevention of scar migration, and labial flattening.

As more people seek body contour surgery spurred on by the media's great interest in suction lipectomy and the seemingly increasing numbers of satisfied patients, we should re-examine an area where results of body contour surgery have been less satisfying, the inner thigh. In those patients whose problem remains skin flabbiness rather than excessive fat, either alone or after successful or partially successful suction lipectomy, an inner-thigh procedure is indicated.

Cicatrix↗
PubMed1980

Mucogingival problems and the movement of mandibular incisors: a clinical review.

In recent years "mucogingival problems" have received considerable attention in the literature. This clinical review distinguishes between variations in gingival morphology having minimal attachment and frank localized pathosis. It is suggested that some cases of potential or actual mucogingival deficiencies may be improved by tooth movement. Since orthodontic and conservative periodontal therapy may induce changes in the character and level of the attached gingiva, surgical grafts may be unnecessary or at least deferable.

Adolescent↗
PubMed1985

Dentofacial findings in a child with unrepaired median cleft of the lip at 4 years of age.

Dentofacial findings, audiometric and tympanometric studies, and the results of a speech evaluation of a 4-year-old boy from Yucatan, Mexico, with a rare median facial cleft are reported. It is of interest to note that all the abnormalities present in this patient were limited to the midline structures of the maxillary arch. The case presented fits into the second of the two groups of median facial anomalies described by DeMyer and his associates. There was minimal deficiency of the midline facial tissue, and there were no apparent abnormalities of the underlying brain. A brief description of the surgical techniques used for repair of the lip and palate is presented.

Child, Preschool↗
PubMed1989

The carbon dioxide laser in soft tissue preprosthetic surgery.

The surgical carbon dioxide laser has the ability to vaporize soft tissues with little bleeding, pain, swelling, or wound contraction. The laser was evaluated on 27 patients requiring soft tissue preprosthetic surgery, including frenectomies, tuberosity reduction, hyperplasia removal, and sulcus deepening. Surgery was performed on an ambulatory basis with no bleeding or infection. Swelling was minimal and pain, as measured on a linear pain scale, was moderate. One third of the patients required no analgesics. Wound contraction did occur but was less than is historically quoted for scalpel wounds. The carbon dioxide laser would appear to have advantages for soft tissue preprosthetic surgery that warrant further evaluation.

Carbon Dioxide↗