A Study of the Width of Attached Gingiva

Abstract

I N recent years, much attention has been focused on the width of attached gingiva. 1 " 9 It has been observed that in the absence, or following the removal, of the attached gingiva the remaining tissue (alveolar mucosa) will curl and will not respond to treatment. 10 In addition, alveolar mucosa will not withstand the rigors of mastication or oral physiotherapy. 11It has been suggested that the presence of the band of attached gingiva represents the most significant diagnostic clue in estimating the prognosis for periodontal treatment. If a patient does not have an "adequate" band of attached gingiva he should be impressed with the need for proper home treatment to avoid inflammation. 12 Other investigators have called attention to the need for an "adequate" width of attached gingiva, but no one has denned "adequate."In order for the dentist to better understand the problems in dealing with the width of attached gingiva there are many questions not covered in the literature that need to be answered. Does the width of attached gingiva vary with each tooth? With each individual? With age? With sex? What are the average and extreme widths of attached gingiva? What factors affect the width of attached gingiva? This clinical study sought to answer these questions. MATERIALS AND METHODSOne hundred and sixty subjects with the clinical signs of normal gingiva 13 were selected. They were separated into four age groups: 3-5 (deciduous dentition), 15-25, 25-35, and over 35. There were 20 males and 20 females in each group.In an effort to determine what factors affect the width of attached gingiva 80 additional subjects with one or more of the following were examined: malposed teeth, high frenum attachments and recession. Summary of a Thesis submitted to

Periodontal plastic pioneering procedures revisited

“…In a healthy and intact periodontium the attached gingiva extends from the level of gingival crevice coronally to the mucogingival junction apically. 2,3 Surgical techniques thus evolved which either preserved or augmented the attached gingiva. These included the contiguous soft tissue autograft introduced by Grupe and Warren 4 as the lateral sliding flap in 1956 and the free soft tissue autograft introduced by King and Pennel 5 in 1964.…”

Alterações quantitativas nos tecidos moles da fissura labiopalatina submetida a enxerto ósseo alveolar secundário tardio com e sem vestibuloplastia

“…Desde que não ocorra uma recessão gengival, sua largura aumenta com a idade (Bowers 1963, Ainamo e Talari 1976 e Ainamo, Ainamo e Poikkeus 1981) da dentadura decídua para a permanente (Bowers 1963 e Rose e App 1973), sendo maior na maxila do que na mandíbula (Müller e Eger 2002). É dependente da altura do processo alveolar e da dimensão vertical da face (Mazeland 1980), parecendo não haver diferença significante na sua largura entre os gêneros (Bowers 1963).…”

“…Tem dimensões aproximadas de 1,00 a 9,00 mm entre diferentes dentes e maxilares, tendendo a aumentar com a erupção constante dos dentes, apresentando variação intra e interindividual e pelo tipo e superfície do dente (Bowers 1963 (Serino et al 1994).…”

“…Dentes malposicionados, inserções altas de freios labiais e recessão gengival podem comprometer a largura da mucosa ceratinizada (Bowers 1963).…”

“…Existe controvérsia na literatura quanto à quantidade de gengiva inserida para preservar uma margem gengival saudável com autores considerando suficiente a largura menor do que 1,00 mm (Miyasato, Crigger e Egelberg 1977), pelo menos 1,00 mm (Bowers 1963 e Lang e Löe 1972) ou que exceda a 3,00 mm (Corn 1962), embora outros não associem a manutenção da saúde gengival à presença ou não de ampla faixa de gengiva inserida (Dorfman, Kennedy e Bird 1982e Kennedy et al 1985.…”