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PubMed2004

Characterization of a new full length TMPRSS3 isoform and identification of mutant alleles responsible for nonsyndromic recessive deafness in Newfoundland and Pakistan.

BACKGROUND: Mutant alleles of TMPRSS3 are associated with nonsyndromic recessive deafness (DFNB8/B10). TMPRSS3 encodes a predicted secreted serine protease, although the deduced amino acid sequence has no signal peptide. In this study, we searched for mutant alleles of TMPRSS3 in families from Pakistan and Newfoundland with recessive deafness co-segregating with DFNB8/B10 linked haplotypes and also more thoroughly characterized the genomic structure of TMPRSS3. METHODS: We enrolled families segregating recessive hearing loss from Pakistan and Newfoundland. Microsatellite markers flanking the TMPRSS3 locus were used for linkage analysis. DNA samples from participating individuals were sequenced for TMPRSS3. The structure of TMPRSS3 was characterized bioinformatically and experimentally by sequencing novel cDNA clones of TMPRSS3. RESULTS: We identified mutations in TMPRSS3 in four Pakistani families with recessive, nonsyndromic congenital deafness. We also identified two recessive mutations, one of which is novel, of TMPRSS3 segregating in a six-generation extended family from Newfoundland. The spectrum of TMPRSS3 mutations is reviewed in the context of a genotype-phenotype correlation. Our study also revealed a longer isoform of TMPRSS3 with a hitherto unidentified exon encoding a signal peptide, which is expressed in several tissues. CONCLUSION: Mutations of TMPRSS3 contribute to hearing loss in many communities worldwide and account for 1.8% (8 of 449) of Pakistani families segregating congenital deafness as an autosomal recessive trait. The newly identified TMPRSS3 isoform e will be helpful in the functional characterization of the full length protein.

Alleles↗

PubMed1999

Genetic localization of a new locus for recessive familial spastic paraparesis to 15q13-15.

OBJECTIVE: To characterize a new gene locus for familial spastic paraparesis (FSP). BACKGROUND: FSP is a genetically heterogeneous group of upper motor neuron syndromes. It can be inherited as an autosomal dominant, autosomal recessive, or X-linked disorder. Four loci for autosomal dominant FSP have been genetically mapped, and two genes have been shown responsible for the X-linked type. In addition, two loci for autosomal recessive type have been reported and mapped to chromosomes 8q and 16q. The gene for the 16q locus has been characterized as a mitochondrial protein. METHODS: Eight recessive FSP families from America and Europe were used for genetic linkage analysis. The known recessive loci (8q and 16q) and the X-linked loci (PLP and L1CAM genes) were screened through PCR amplification, followed by linkage analysis, single-strand conformational polymorphism, or both. RESULTS: All the families except one revealed lack of linkage to the known loci for recessive and X-linked types of FSP. One of the eight families showed data consistent with linkage to the previously characterized 8q locus. Analysis of all the families for possible linkage to other candidate loci revealed significant positive lod scores for markers in chromosome 15q. The maximum multipoint combined lod score for the non-8q families was Z = 3.14 for markers D15S1007, D15S971, D15S118, and D15S1012, at a distance of 6.41 cM from the marker D15S1007, in between D15S971 and D15S118. CONCLUSIONS: Our data suggest a new locus for recessive FSP linked to chromosome 15q, and that this may be the most common one.

Adolescent↗

PubMed1991

Autosomal recessive lethal mutations in two mutator stocks of Drosophila ananassae.

The frequency of recessive lethals in the 2nd chromosome was examined in two mutator stocks of Drosophila ananassae, ca and ca; px. They are characterized respectively by possessing an extrachromosomal clastogenic mutator in males, and by the retrotransposon "tom", which induces Om mutability only in females. The frequencies of recessive lethal mutations in the 2nd chromosome among progenies from males and females of the ca; px stock are 0.35 and 0.34 percent, respectively. Similarity of these frequencies indicates that tom does not induce recessive lethals in females. In contrast to the ca; px stock, the frequency of recessive lethals in males of the ca mutator stock was estimated to be 1.54 percent for the 2nd chromosome. No visible mutants except Minutes were recovered. Some recessive lethals derived from ca stock males were associated with chromosomal rearrangements. Being consistent with its high rate of Minute mutation it was demonstrated that the ca clastogenic mutator also induced recessive lethals.

Animals↗

PubMed1992

Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal gingival recession.

A surgical technique involving membranes was used to treat localized human buccal recessions 3 mm to 8 mm. The results on 25 patients (test group) were evaluated 18 months postoperatively and compared with the results obtained in 25 other patients (control group) having undergone mucogingival surgery. In the test group, a trapezoidal flap with a large base was raised beyond the mucogingival junction. The exposed root surface was scaled thoroughly to a concave shape. A membrane was bent and adapted onto the concave root surface. The flap was sutured far coronally and the membrane removed one month later. The control patients underwent a 2-step procedure, consisting of a free gingival graft and a coronally positioned flap. The amount of root coverage obtained was similar in the 2 groups (test = 72.73%; control = 70.87%), although the clinical attachment gain (test = 5.12 mm; control = 3.56 mm) and pocket variation (test = 1 mm reduction; control = 0.06 mm increase) differed significantly (P < 0.001). The keratinized tissue width was greater in the control group. The regression analysis showed that the amount of covered root surface after treatment was in strict correlation with the depth of the original recession in the test group, while no correlation was found in the control group. The expected root coverage was greater in the test group when the recession was greater than 4.98 mm, while it was greater in the control group when the recession was less than 4.98 mm. These results indicate that a guided tissue regeneration procedure can be used to successfully treat recession. The membrane procedure compared favorably with the mucogingival surgery in the treatment of deep recession.

Adolescent↗

PubMed1992

Effect of free gingival grafts on naturally-occurring recession in miniature swine.

Miniature swine exhibit naturally-occurring, progressive recession on facial surfaces of the permanent mandibular incisors. The purpose of this study was to determine whether placing a free gingival graft to augment the width of keratinized gingiva of mandibular incisors in miniature swine would prevent or retard recession at the grafted site compared to an untreated contralateral control site. In 8 litter-mate miniature swine, free gingival grafts were placed on the facial surface of the permanent central and lateral incisors on one side of the mandible. The contralateral mandibular incisors did not receive any treatment and served as controls. Clinical measurements, including eruption, recession, pocket depth, attachment level, and keratinized gingival width were obtained preoperatively, 2 to 3 weeks after surgery to assess the success of gingival augmentation, and 3, 6, and 9 months postoperatively. Eight grafted sites were successful and showed significant augmentation of the keratinized gingival width, with a mean increase of 5.8 +/- 0.7 mm, while 6 grafts failed and showed a slight decrease in the mean width of -0.4 +/- 0.5 from the preoperative to postoperative examination. All sites showed significant recession during the experimental period. Successful sites showed no statistically significant or clinically major difference in the rate or amount of recession than contralateral control sites. By 9 months, the average increase in recession from the baseline examination was 2.8 +/- 1.5 mm for successfully grafted sites and 2.6 +/- 1.3 mm for contralateral controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Subepithelial connective tissue grafts in the treatment of gingival recessions. A comparative study of 2 procedures.

Thirty (30) class I and class II recessions in 30 subjects were treated with a subepithelial connective tissue graft procedure. In one group (15 sites), the surgery was carried out in a traditional fashion: the epithelial collar of the graft was preserved and left exposed (CTG group). In the second group (15 sites), the epithelial collar of the graft was removed and the recession areas were conditioned with citric acid. The graft was then sutured and completely immersed under the facial flap which was coronally repositioned (CR group). Clinical assessments included probing depth, probing attachment level, surface area of the recession, and gingival width. These measurements were taken at baseline and at 6 months. In addition, an esthetic evaluation was done. The differences between treatments were not statistically significant except for the augmentation of gingiva (P < or = 0.05). Based on the midfacial measurements taken in the central area of the recession, the mean percentage of root coverage was 69.2%. In the CR group, 3 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 65.5%. In the CTG group, 5 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 94.4%. The mean surface area of root exposure was reduced from 13.82 mm2 and 13.67 mm2 to 2.15 mm2 and 2.34 mm2 for the CR group and the CTG group, respectively. One-hundred percent (100%) of good-to-moderate esthetic results were found by a panel of independent examiners; there was tendency toward better results in the CR group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Controlled clinical evaluation of the subpedicle connective tissue graft for the coverage of gingival recession.

The purpose of this study was to clinically evaluate the 1-year coverage of gingival recessions by a subpedicle connective tissue graft according to the original technique compared to untreated recessions by measuring probing sulcus depth (PSD), height of keratinized tissue (HKT), and mucogingival junction location changes. Paired gingival recessions were selected in 15 patients. In each patient, one recession was randomly assigned for treatment (test group) and the other recession was left untreated (control group) for 1 year. Surgery consisted of a connective tissue graft covered by a double papilla full thickness flap. Height of recession (HR), PSD, HKT, and cemento-enamel junction to mucogingival junction distance (CEJ-MGJ) were recorded with a calibrated probe before surgery and 1 year postoperatively. The control group showed no statistically significant differences in any of the parameters. In the test group, HR mean decreased significantly (P < 0.0006) from 3.66 mm to 1.09 mm, representing a mean root coverage of 70.5%. HKT mean increased significantly (P < 0.0006) from 1.60 mm to 4.30 mm, and PSD mean showed no statistical difference. CEJ-MGJ remained statistically unchanged. The subpedicle connective tissue graft may provide a good amount of root coverage and a substantial increase of keratinized tissue. Connective tissue grafted beneath the alveolar mucosa does not induce its transformation into keratinized gingival tissue.

Adult↗

PubMed1995

Healing response of human buccal gingival recessions treated with expanded polytetrafluoroethylene membranes. A retrospective report.

Twenty-four (24) deep wide buccal gingival recessions were treated with ePTFE membrane according to guided tissue regeneration principles (GTR). Factors affecting the surgical outcome of the regenerative procedure were retrospectively analyzed. In 16 cases, the barrier membrane was used in conjunction with tetracycline root conditioning and fibrin-fibronectin system application, and 8 cases were treated with the membrane alone. Healing response was evaluated 12 months after surgery. Since no difference was observed between the two treatment protocols, all available data were grouped. Mean recession depth was reduced from 4.6 mm to 1.3 mm postoperatively, which represents an average root coverage of 71.7%. Fifty percent (50%) of the cases showed clinical attachment gain greater than or equal to 4 mm and a mean increase of keratinized tissue of 1.0 mm was observed. Baseline recession depth and extent of membrane exposure at the reentry procedure significantly influenced the amount of newly-formed tissue under the membrane. Recession reduction positively correlated with the preoperative recession depth and the regenerated tissue gain. Treatment was also affected by tooth location, recession reduction, and attachment gain, being significantly greater in upper than lower archs. Results suggest that GTR technique represents a predictable procedure to improve the soft tissue conditions of deep mucogingival defects. Randomized controlled trials of other forms of management of mucogingival defects as compared to the GTR technique will be necessary to fully evaluate the utility of the GTR technique.

Adult↗

PubMed1998

Subpedicle connective tissue graft versus guided tissue regeneration with bioabsorbable membrane in the treatment of human gingival recession defects.

The purpose of the present clinical study was to evaluate the effect of guided tissue regeneration (GTR) in comparison to subpedicle connective tissue graft (SCTG) in the treatment of gingival recession defects. A total of 12 patients, each contributing a pair of Miller's Class I or II buccal gingival recessions, was treated. According to a randomization list, one defect in each patient received a polyglycolide/lactide bioabsorbable membrane, while the paired defect received a SCTG. Treatment effect was evaluated 6 months postsurgery. Clinical recordings included full-mouth and defect-specific oral hygiene standards and gingival health, recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KT). Mean RD significantly decreased from 3.1 mm presurgery to 1.5 mm at 6 months postsurgery for the GTR group (48% root coverage), and from 3.0 mm to 0.5 mm for the SCTG group (81% root coverage). RD reduction and root coverage were significantly greater in SCTG group compared to GTR group. Mean CAL gain amounted to 1.7 mm for the GTR group, and 2.3 mm in the SCTG group. No significant differences in PD changes were observed within and between groups. KT increased significantly from presurgery for both treatment groups, however gingival augmentation was significantly greater in the SCTG group compared to GTR group. Results indicate that: 1) treatment of human gingival recession defects by means of both GTR and SCTG procedures results in clinically and statistically significant improvement of the soft tissue conditions of the defect; and 2) treatment outcome was significantly better following SCTG compared to GTR in terms of recession depth reduction, root coverage, and keratinized tissue increase.

Absorbable Implants↗

PubMed1998

Mucogingival versus guided tissue regeneration procedures in the treatment of deep recession type defects.

The objective of the study was to compare the clinical efficacy of 3 surgical approaches in the treatment of deep recession type defects. Fifty-four (54) gingival recessions > or = 5 mm were randomly assigned to 1 of the 3 treatment groups by blocking the prognostic variables. The first group was treated with a guided tissue regeneration (GTR) procedure using a bioabsorbable membrane, the second with non-resorbable membrane, and the third with a mucogingival surgical approach consisting of a connective tissue graft combined with a coronally advanced flap (bilaminar technique). No differences, in terms of baseline oral hygiene and defect characteristics, were observed among the 3 groups showing an effective blocking approach. The 1-year results indicated that 1) all treatment approaches resulted in clinically significant root coverage and attachment gain; 2) a statistically significant treatment effect (P = 0.012, ANOVA) was observed comparing the bioabsorbable (4.9+/-0.3 mm), the non-resorbable (4.5+/-0.8 mm), and the bilaminar (5.3+/-0.7 mm) groups, in terms of root coverage; 3) the difference in terms of root coverage between the bilaminar and the non-resorbable membrane groups was statistically significant while differences between the 2 GTR groups or between the bilaminar and the bioabsorbable membrane groups did not reach statistical value; 4) the 95% confidence intervals for the proportions of complete successes showed a similar pattern; 5) no statistical difference was demonstrated in the amount of attachment gain among the 3 groups (P=0.73, ANOVA). A regression model showed that the amount of root coverage was significantly affected by the initial recession depth, the procedure and smoking habits: a poorer root coverage result is expected in case of shallow recession type defects, when either bioabsorbable (P < 0.05) or non-resorbable (P < 0.001) membranes are used instead of a bilaminar technique and if the patient smokes (P < 0.01). It was concluded that the mucogingival bilaminar technique is at least as effective as GTR procedures in the treatment of gingival recession > or = 4 mm and thus recession depth is not the parameter which influences the selection of the surgical procedure.

Absorption↗

PubMed2000

Gingival recession treatment: guided tissue regeneration with bioabsorbable membrane versus connective tissue graft.

BACKGROUND: Gingival recession represents a significant concern for patients and a therapeutic problem for clinicians. Several techniques have been proposed to achieve root coverage. The purpose of this randomized clinical trial was to evaluate the effect of a guided tissue regeneration (GTR) procedure in comparison to connective tissue graft (CTG) in the treatment of gingival recession defects. METHODS: Twelve patients, each contributing a pair of Miller Class I or II buccal gingival recessions, were treated. In each patient one randomly chosen defect received a poly(lactic acid)-based bioabsorbable membrane, while the paired defect received a CTG. Clinical recordings included oral hygiene standards and gingival health, recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KT). RESULTS: Mean RD statistically significantly decreased from 2.5 mm presurgery to 0.5 mm with GTR (81% root coverage), and from 2.5 mm to 0.1 mm with CTG (96% root coverage), at 6 months postsurgery. Prevalence of complete root coverage was 58% for the GTR group and 83% for the CTG group. Mean CAL gain was 2.0 mm for the GTR group and 2.2 mm for the CTG group. No statistically significant differences between treatment groups were observed for changes in RD, RW, PD, CAL, and KT. CONCLUSIONS: Treatment of human gingival recession defects by means of either GTR or CTG results in clinically and statistically significant improvement of the soft tissue conditions of the defect when pre- and post-treatment measurements were compared. Although differences between CTG and GTR in mean root coverage and prevalence of complete coverage consistently favored the CTG procedure, the differences in measurements were not statistically significant.

Absorbable Implants↗

PubMed2000

Evaluation of a new bioabsorbable barrier for recession therapy: a feasibility study.

BACKGROUND: The objective of this study was to evaluate the feasibility of a new polylactic acid bioabsorbable barrier in the treatment of gingival recession. METHODS: Twenty patients with buccal recession defects (Miller class I, II, and III; mean recession: 4.0 +/- 1.2 mm; range: 2.0 to 6.8 mm) participated. After thorough scaling and root surface conditioning with 10% tetracycline-HCl, a trapezoidal mucoperiosteal flap was prepared. A customized barrier was applied to cover the defect. Barriers adhered directly to tooth and bone and no sutures were used. The barrier was subsequently covered by a coronally positioned flap. Assessments of probing depths were performed by means of a controlled-force electronic probe, and recession was determined on stone models with a digital caliper at baseline and 12 months following therapy. RESULTS: Eight barriers showed limited exposure (1 to 2 mm) with minimal signs of gingival inflammation between 2 and 6 weeks following surgery. Comparing baseline measurements with outcomes at 12 months, significant root coverage and probing attachment gain were observed (P <0.0001, paired t test). Mean gingival recession was reduced to 0.4 +/- 0.5 mm, corresponding to a mean root coverage of 91.9%, and overall attachment gains amounted to 4.2 mm. A significant gain of keratinized tissue was found (2.9 +/- 0.7 mm), and mean probing depths were slightly reduced from 2.2 to 1.7 mm. CONCLUSIONS: The results of this study indicate favorable outcomes after using a new bioabsorbable barrier material for root coverage in recession-type defects.

Absorbable Implants↗

PubMed2000

Treatment of gingival recession: comparative study between subepithelial connective tissue graft and guided tissue regeneration.

BACKGROUND: Various procedures have been proposed to treat gingival recession, but few studies compare these procedures to each other. The purpose of this study was to evaluate a clinical comparison of subepithelial connective tissue graft (SCTG) and guided tissue regeneration (GTR) with a collagen membrane in the treatment of gingival recessions in humans. METHODS: Twenty-four defects were treated in 12 patients who presented canine or pre-molar Miller Class I and/or II bilateral gingival recessions. Both treatments were performed in all patients, and clinical measurements were obtained at baseline and 18 months after surgery. These clinical measurements included gingival recession height (GR), root coverage (RC), probing depth (PD), keratinized tissue width (KT), and final esthetic result. RESULTS: Both SCTG and GTR with a bioabsorbable membrane and bone graft demonstrated significant clinical and esthetic improvement for gingival recession coverage. The SCTG group was statistically significantly better than GTR for height of GR (SCTG = 0.2 mm, GTR = 1.12 mm, P= 0.02) and KT (SCTG = 4.58 mm, GTR = 2.5 mm, P<0.0001). However, PD was statistically significantly better for GTR than SCTG treatment (GTR = 1.66 mm, SCTG = 1.00, P= 0.01). The 2 procedures were statistically similar in root coverage (SCTG = 95.6%, GTR = 84.2%, P= 0.073). The esthetic condition after both treatments was satisfactory (P= 0.024). CONCLUSIONS: It was concluded that the gingival recessions treated with the SCTG group were superior for GR, RC, and KT clinical parameters, while GTR demonstrated better PD reduction. The final esthetic results were similar using both techniques.

Absorbable Implants↗

PubMed2001

Comparison of 2 techniques of subepithelial connective tissue graft in the treatment of gingival recessions.

BACKGROUND: The clinical outcome of connective tissue grafts in the treatment of gingival recessions has been documented in numerous studies. However, no attempt has been made to correlate the postoperative mucogingival changes with the surgical parameters. The present retrospective clinical study was undertaken to 1) evaluate root coverage and mucogingival changes 1 to 1.5 years following treatment of Miller's Class I and II recession defects using 2 variants of the subepithelial connective tissue graft (SCTG) procedure, and 2) assess the effect of the surgical parameters on the postoperative gingival width. METHODS: Thirty-one recessions in 10 patients treated with the envelope technique (E) and 31 recessions in 11 patients treated with coronally positioned flap combined with connective tissue graft (CP) were retrospectively analyzed to evaluate: 1) percentage of root coverage obtained with the 2 procedures and variations in width of keratinized tissue (KT) 1 to 1.5 years postsurgery, and 2) the effect of the surgical parameters on the postoperative gingival width. RESULTS: Results showed a mean root coverage percentage of 89.6 +/- 15% for the E group and 94.7 +/- 11.4% for the CP group; the difference between groups was statistically insignificant (P = 0.1388). Mean KT increased significantly from 1.4 +/- 1.1 mm presurgery to 4.5 +/- 1.1 mm postsurgery for the E group while a minor increase in KT was observed in the CP group (2 +/- 1.5 mm presurgery versus 2.7 +/- 1.6 mm postsurgery). For both treatment groups, the mean postsurgical width of keratinized tissue (POSTKT) was found to be mathematically correlated with the mean presurgical width of keratinized tissue (PREKT) and the corono-apical height of the graft that remained exposed (GE) coronal to the flap margin in the recipient site. CONCLUSIONS: Treatment of human gingival recession defects by the 2 variants of SCTG resulted in significant recession reduction. When SCTG is grafted beneath alveolar mucosa using the combined technique (CP), transformation of the mucosa into keratinized tissue does not seem to occur, at least within 1 to 1.5 years postsurgery. The treatment outcome in terms of keratinized tissue width seems to be correlated with the presurgical gingival dimensions and the height of the graft that remains exposed at the end of the surgical procedure.

Adult↗

PubMed2002

Viral etiology of gingival recession. A case report.

Herpes simplex virus-type I (HSV-1) is responsible for both primary and recurrent infections of the oral mucosa. The aim of this case report is to show how HSV-1 may cause periodontal damage such as gingival recession. A 26-year-old male patient presented in a private office for the treatment of gingival recessions. He reported that the recessions had appeared suddenly with marginal inflammation of the gingiva and vesicle formation; within a few hours, the gingival tissue had been completely destroyed. The lesions were accompanied by pain, fever, and regional lymphadenopathy. Two weeks later, the patient returned complaining of a recurrence accompanied by pain and lymphadenopathy. The following day, the patient's condition had worsened and the depth of the recession had increased. A biopsy was taken for histological examination. A free epithelial-connective tissue graft was performed. Histological and direct immunofluorescence examinations confirmed the herpetic origin of the lesion. Eight months after surgery, a new herpetic lesion was detected in correspondence to the gingival margin of the first lower right premolar; therefore, acyclovir was prescribed. After 1 week, the antiviral therapy was completely successful; the gingival lesion disappeared, and no recession of the soft tissue margin was observed. Based on these clinical features, diagnosis of gingival recession induced by HSV-1 must be carried out at an early stage to establish a successful therapy.

Acyclovir↗

PubMed2002

Root coverage of advanced gingival recession: a comparative study between acellular dermal matrix allograft and subepithelial connective tissue grafts.

BACKGROUND: Acellular dermal matrix allograft (ADMA) has successfully been applied as a substitute for free connective tissue grafts (CTG) in various periodontal procedures, including root coverage. The purpose of this study was to clinically compare the efficiency of ADMA and CTG in the treatment of gingival recessions > or = 4 mm. METHODS: Seven patients with bilateral recession lesions participated. Fourteen teeth presenting gingival recessions > or = 4 mm were randomly treated with ADMA or CTG covered by coronally advanced flaps. Recession, probing depth, and width of keratinized tissue were measured preoperatively and 12 months postoperatively. Changes in these clinical parameters were calculated within and compared between groups and analyzed statistically. RESULTS: Baseline recession, probing depth, and keratinized tissue width were similar for both groups. At 12 months, root coverage gain was 4.57 mm (89.1%) versus 4.29 mm (88.7%) (P = NS), and keratinized tissue gain was 0.86 mm (36%) versus 2.14 mm (107%) (P < 0.05) for ADMA and CTG, respectively. Probing depth remained unchanged (0.22 mm/0 mm), with no difference between the groups. CONCLUSIONS: Recession defects may be covered using ADMA or CTG, with no practical difference. However, CTG results in significantly greater gain of keratinized gingiva.

Adult↗

PubMed2002

Tongue piercing: impact of time and barbell stem length on lingual gingival recession and tooth chipping.

BACKGROUND: The increasing popularity of tongue piercing has prompted several case reports documenting oral complications of this practice. However, there are no studies assessing potentially significant parameters. The purpose of this study was to evaluate the effect of time (years of wear) and tongue barbell size (stem length) on gingival recession and tooth chipping. METHODS: Fifty-two adults (mean age 22) with tongue piercings were examined for gingival recession on the lingual aspect of the 12 anterior teeth and for tooth chipping anywhere in the mouth. Subjects were grouped according to years of wear (0 to 2, 2 to 4, and 4+ years) and barbell stem length (long > or =1.59 cm, or short <1.59 cm). Data analysis was based on binomial test and non-parametric tests. RESULTS: No subject with a tongue piercing <2 years (group 0-2) exhibited lingual recession or tooth chipping. Lingual recession was found on mandibular central incisors in 50% of subjects wearing long barbells for 2 or more years. Tooth chipping was found on molars and premolars in 47% of subjects with a tongue piercing for 4+ years. CONCLUSIONS: Tongue piercing is associated with lingual recession of mandibular anterior teeth and chipping of posterior teeth. Long-term use of a tongue barbell increases the prevalence of these complications. Barbell stem length appears to differentially affect prevalence of recession and chipping. Since the overwhelming majority of subjects with tongue piercings are young adults, cessation efforts are needed to target this population.

Adolescent↗

PubMed2004

Prevention of gingival recession following flap debridement surgery by subepithelial connective tissue graft: consecutive case series.

BACKGROUND: Surgical debridement with flap repositioning may result in significant gingival recession. This manuscript reports on a series of cases that were treated for deep periodontal pockets by flap debridement surgery combined with subepitheial connective tissue graft for the prevention of postoperative recession. METHODS: Fourteen patients (27 teeth) with deep periodontal pockets and bone loss in the mandibular central incisors area underwent flap debridement combined with subepithelial connective tissue graft. Probing depth, recession depth, and clinical attachment levels were recorded prior to surgery, 6 months post-surgery, and again 19 to 58 months post-surgery. RESULTS: Mean probing depth at baseline was 6.20 mm, while 6 months post-surgery it was 1.97 mm (P < 0.0001), and 19 to 58 months after surgery it was 1.32 mm. Clinical attachment level measurements followed the same pattern (baseline 9.37 mm, 6 months 3.29 mm, final examination 2.00 mm). While the mean recession depth at baseline was 3.17 mm, 6 months post-surgery it was reduced to 1.30 mm (P < 0.0001). Additional reduction in recession depth was recorded over time. CONCLUSION: Within the limitations of a single group study, the results suggest that flap debridement combined with subepithelial connective tissue graft, followed by maintenance therapy, is an effective procedure for maintaining long-term periodontal health and for prevention of postoperative gingival recession in the mandibular anterior dentition.

Adult↗