This study was performed to evaluate the effects of orthodontic therapy on the width of the zone of keratinized gingiva. Pre‐ and post‐treatment photographic slides, plaster study casts, and cephalograms were examined. The labial surfaces of 966 teeth in a sample of 100 orthodontic patients were studied. Widths of the keratinized gingiva were determined from photographic slides. Crown lengths were measured from the study casts, and measurements were performed on the cephalograms. Data were collected and analyzed in three categories: 1) The overall changes in the width of the keratinized gingiva and the lengths of the clinical crowns during the course of orthodontic therapy; 2) An analysis of grouped data with a comparison of the pre‐existing widths of keratinized gingiva to the post‐treatment periodontal status of the patient; and 3) A correlation analysis of the changes in the dimensions of the tissues to the changes in tooth position as measured on the cephalograms. The results of the study revealed: 1) Increases in the width of the keratinized gingiva may occur on some teeth during the course of orthodontic therapy; 2) Statistically significant increases in the clinical crown during orthodontic therapy are not reflected in statistically significant decreases in the width of keratinized gingiva; 3) Minimal widths of keratinized gingiva (less than 2 mm) are capable of withstanding the stresses of orthodontic mechanics; 4) Teeth that are lacking in any keratinized gingiva prior to orthodontic treatment will not form any new keratinized tissue during the course of orthodontic therapy; 5) Mucogingival problems noted after orthodontic therapy are often the result of a pre‐existing mucogingival problem; 6) Changes in the dimensions of the keratinized gingiva correlated statistically with the orthodontic movement of the maxillary central incisors (P < 0.001) and, with the maxillary and mandibular cuspids (P < 0.02).

This report details surgical procedures for ridge expansion by means of splitting the crest of an edentulous ridge. Atrophic bony ridges present a unique challenge to the dental implant surgeon. In the past, onlay grafts of bone harvested from the hip, maxillary tuberosity, symphysis of the chin, or external oblique ridge have all been used with success in reconstruction of atrophic ridges. However, bone onlay grafting procedures require a secondary surgical site, which exhibits typical postoperative morbidity associated with bone harvesting performed with chisels and burs. Additionally, onlay grafts often require a healing period of 6 months to a year before dental implants can be placed, and the onlay graft sometimes fails to fuse to the augmented site. The segmental ridge-split procedure provides a quicker method wherein an atrophic ridge can be predictably expanded and grafted with bone allograft, eliminating the need for a second surgical site.

Immediate placement of dental implants into tooth extraction sites is an effective treatment option. When immediate placement procedures are performed with a round implant, a void is often evident between the implant and the orifice of the socket. Previous treatment focused on the use of membranes or special closure techniques to induce bone growth into the void. Anatomically shaped dental implants provide a predictable alternative to previous filling techniques since the anatomical implants decrease or completely fill the void at the socket opening. This article describes a surgical technique developed for the immediate placement of these implants in extraction sites.