With the advent of esthetic dentistry, implant treatment has gained much importance, and osseointegrated implant requires appropriate positioning three-dimensionally to achieve optimum functional and esthetic results. The various techniques available for implant site development are mostly invasive with variable outcomes. On resorting to alternate modalities, orthodontic extrusion/forced eruption is the primary choice as it is noninvasive and aids in optimal increase in the volume of residual bone and soft tissue. In orthodontic extrusion, the available periodontal ligament acts as a source of cell supply and signals, while the socket itself acts as a naturally occurring scaffold for regeneration. The presence of gingival inflammation or active periodontal disease is always a negative predictor for periodontal regeneration. Hence, periodontal ligament in an uninflamed state is essential before performing orthodontic extrusion. This article aims to provide an insight into the mechanisms by which the periodontal ligament cells act at a molecular level to provide an improved bone and soft tissue levels for optimum implant placement.
A
BSTRACT
Introduction:
Gingival thickness plays a very important role in framing the protocol in various dental treatments such as implantology, prosthodontics, and more importantly in periodontics. During periodontal management, it is important to consider the gingival thickness of the patient, which can result in more satisfactory treatment outcomes. Smoking has its effect on periodontium, affecting the physical and functional properties. Assessing the relation between these two entities is becoming important. This clinical study is sought to compare the thickness of gingiva in systemically healthy smokers and nonsmokers.
Materials and Methods:
A total of 180 periodontally healthy patients were divided into smokers and nonsmokers, and subdivided into Group 1 (18–25 years), Group 2 (26–39 years), and Group 3 (>40 years). Gingival thickness was assessed 6 mm from the gingival margin in the midbuccal area between maxillary central and lateral incisor. Statistical analysis was performed to assess the difference in gingival thickness among smokers and nonsmokers and correlated with age.
Results:
The results showed the presence of changes in gingival thickness for all the age groups. But, a significant
P
value was not obtained for the age groups 18–25 and 26–39 years. In >40 years of age group, there was a statistically significant change in the
P
value (0.008) of the mean and standard deviation in smokers and nonsmokers ( significance
: P
< 0.001).
Conclusion:
On the basis of the results of this study, gingival thickness was decreased with age among smokers and nonsmokers. This study also proved that smoking has a negative influence on the gingival thickness.
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