Location of the mucogingival junction 18 years after apically repositioned flap surgery

Abstract

The apically repositioned flap procedure, by definition, implies that the mucogingival junction (MGJ) is shifted into an apical location. That this actually would be the case has never been shown in long-term studies. The 13 subjects in the present study had during the years 1964-1965 received treatment of moderately advanced periodontal disease (probing pocket depths less than or equal to 5 mm) in the lower jaw. An apically repositioned flap (ARF) procedure was applied in the left or right half of the mandible and a gingivectomy (GE) was performed in the contralateral side. Starting in December 1981, the patients were recalled for clinical and radiographic determination of long-term results. The width of the band of keratinized gingiva was measured clinically and the distance from the MGJ to the lower border of the mandible (LBM) was measured from orthopantomograms. Slightly less keratinized gingiva was observed on the sides where GE had been used. There was no statistically significant difference in the orthopantomographic distance from the MGJ to the LBM between ARF and GE operations. The results indicate that the apically repositioned flap procedure does not result in a permanent apical shift of the MGJ.

Alterations in Location of the Mucogingival Junction 5 Years After Coronally Repositioned Flap Surgery

“…27,28 and 2) the tendency of the MGJ to regain its "genetically" defined position following its coronal "dislocation" with the CRF procedure used to achieve root coverage. Support for the concept that the MGJ will, over time, regain its original position is evident in a study by Ainamo et al, 3 who reported that the apically repositioned procedure did not result in a permanent apical shift. The mechanism of tissue specificity appears to rest within the connective tissue; that is, tissue from alveolar mucosa forms a non-keratinized epithelium, whereas that from gingival connective tissue and the periodontal ligament forms a keratinized gingival epithelium.…”

“…Ainamo et al 3 explored the position of the MGJ 18 years after contralateral gingivectomies and apically repositioned flap procedures and observed no differences in the width of gingival tissues, but a shift in the position of the MGJ to its original position. This observation was partly attributed to the hypothesis that muscular attachments that are surgically displaced apical to the MGJ revert back to their original location.…”

“…Two oblique releasing incisions(3) were carried out from the mesial and distal extremities of the horizontal incisions across the MGJ reaching the alveolar mucosa.…”

Modified coronally advanced flap with and without orthodontic button application in management of multiple proximate gingival recession defects: A randomized clinical trial

“…[15] This MGJ has tendency to reestablish itself to the original position leading to gain in KTW. [2223]…”

“…The second part, related to patient satisfaction with the esthetic consequence evaluated at the 6-months follow-up visit based on a VAS (VAS-E). [1015]…”