Gingivectomy

齿龈切除术
  • 文章类型: Case Reports
    近年来,计算机辅助设计和计算机辅助制造(CAD/CAM)牙科已经显着改变了工作流程。修复和设备现在可以数字化设计和3D打印,用于牙科护理目的。此临床病例报告为牙龈切除术和牙齿预备指南的数字设计和3D制造提供了简单的协议。这些类型的引导件改善了前牙的牙龈结构,并在唇陶瓷贴面之前提供了可控的牙齿准备。周到的临床评估始于听取患者的主诉以及口腔内外评估。然后进行了数字上蜡,然后是口腔内模型,评估建议修复体的形状。患者接受后,临床程序从牙龈切除术和牙齿准备开始。手工制作的瓷贴面在橡胶坝隔离下粘合,以避免任何污染并最大化粘合协议。审美和功能需求得到充分满足。每当对所有步骤进行细致的评估和执行时,都可以获得可预测的结果。三维打印技术允许制造诸如牙龈切除术和牙齿复位引导件之类的设备,以帮助实现所需的结果。
    Computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry have significantly changed workflows in recent years. Restorations and devices can now be digitally designed and 3D-printed for dental care purposes. This clinical case report provides straightforward protocols for the digital design and 3D manufacture of gingivectomy and tooth preparation guides. These types of guides improved the gingival architecture of the anterior teeth and provided controllable tooth preparations prior to labial ceramic veneers. Thoughtful clinical evaluation started with listening to the patient\'s chief complaint and extra- and intra-oral evaluations. Then a digital wax-up was performed, followed by an intra-oral mock-up, to evaluate the shape of the proposed restorations. After patient acceptance, the clinical procedure started with the gingivectomy and tooth preparation. Hand-crafted porcelain veneers were bonded under rubber dam isolation to avoid any contamination and maximize the bonding protocol. The esthetic and functional demands were fully satisfied. Predictable outcomes can be obtained whenever a meticulous evaluation and execution of all the steps are performed. Three dimensional printing technology allows the fabrication of devices such as gingivectomy and tooth reduction guides that help accomplish the desired results.
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  • 文章类型: Case Reports
    本文旨在描述由于牙齿健康状况不佳和牙齿错位而引起的有目的的再植和炎性纤维增生病例。一名17岁的男性患者因前牙下部区域的软组织生长而被转诊至牙科专科医院。回顾和临床检查显示,31号牙齿严重发育不良。进行了外科手术和有目的的重新植入,组织学检查显示炎性纤维增生.在后续任命期间,看到进展和患者的满意度是可行的。尽管炎性纤维增生的发生率低,重要的是要注意,牙齿定位在其正常排列的牙弓之外会导致牙菌斑和结石积聚,然后可以成为炎性纤维增生的病因。因此,牙医必须专心,以建立诊断和治疗治疗以及监测这些情况。
    帮派A,MurryJN,Jungio议员,etal.在炎性纤维增生中通过有目的的自体植入建立美学:12个月的随访病例报告。IntJClinPediatrDent2024;17(2):216-220。
    This article aims to describe purposeful reimplantation and inflammatory fibrous hyperplasia cases caused due to poor dental health and malpositioning of teeth. A 17-year-old male patient was referred to a dental specialty hospital for soft tissue growth in the lower anterior tooth region. Anamnesis and clinical examination revealed that tooth #31 was severely hypoplastic. A surgical procedure and purposeful reimplantation were carried out, and a histological examination revealed inflammatory fibrous hyperplasia. During the follow-up appointments, it was feasible to see progress and the patient\'s satisfaction. Despite the low occurrence of inflammatory fibrous hyperplasia, it is important to note that tooth positioning outside of its normal alignment in the arch can contribute to plaque and calculus accumulation, which can then become etiological factors for inflammatory fibrous hyperplasia. As a result, dentists must be attentive in order to establish a diagnosis and therapeutic therapy as well as monitor these instances.
    UNASSIGNED: Gangwar A, Murry JN, Jungio MP, et al. Establishing Aesthetics by Purposeful Autoreimplantation in Inflammatory Fibrous Hyperplasia: A 12-Month Follow-up Case Report. Int J Clin Pediatr Dent 2024;17(2):216-220.
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  • 文章类型: Case Reports
    牙龈增大(GE)是牙龈大小的增加。这可能是由于广泛的斑块积聚引起的炎症,药物的摄入,怀孕和青春期等全身状况,系统性疾病,如白血病或韦格纳肉芽肿病,遗传性牙龈纤维瘤病,和肿瘤或假性扩大。特发性GE是病因不明的牙龈大小的大量增加。它可能有遗传基础,与身体损伤有关,或从原发性或永久性牙列萌出开始。它也被称为牙龈病,遗传性牙龈纤维瘤病,象皮病牙龈,巨大的牙龈,或先天性巨大牙龈。增大的牙龈损害口腔卫生维护,其次增加了肿大的炎症成分。总之,这夸大了现有的状况。这种广泛毁容的牙龈会影响言语,咀嚼,和美学,导致口臭,扰乱个人的整体福祉。手术切除增大的牙龈以及细致的非手术控制斑块的方法有望提供令人满意的功能和美学结果。该病例报告介绍了一个罕见的长期大规模III级GE病例,该病例在17岁的系统健康患者中延伸到咬合水平,涉及两个拱门的非综合征年轻女性,从而构成诊断困境。使用常规技术通过牙龈切除术治疗,以促进精确切口,更低的成本,和更快的再上皮化。随后使用电灼术进行牙龈成形术。术后三个月的效果在功能和美学方面令人满意,愈合顺利。目前正在对同一问题采取进一步的后续行动。
    Gingival enlargement (GE) is an increase in the size of the gingiva. It may be due to inflammation caused by extensive plaque accumulation, intake of drugs, systemic conditions like pregnancy and puberty, systemic diseases such as leukemia or Wegener\'s granulomatosis, hereditary gingival fibromatosis, and neoplastic or false enlargement. Idiopathic GE is the massive increase in the size of the gingiva with an unknown etiology. It may have a hereditary basis, be linked to physical impairment, or begin with eruption of primary or permanent dentition. It is also referred as gingivomatosis, hereditary gingival fibromatosis, elephantiasis gingivae, gigantism of the gingiva, or congenital macrogingivae. The enlarged gingiva compromises oral hygiene maintenance, which secondarily adds to the inflammatory component of enlargement. Altogether, this exaggerates the existing condition. This type of extensively disfigured gingiva affects speech, mastication, and esthetics, causes halitosis, and disturbs the overall well-being of the individual. Surgical removal of the enlarged gingiva along with meticulous non-surgical means of plaque control is expected to provide a satisfactory functional and esthetic outcome. This case report presents a rare case of long-standing massive grade III GE extending up to the occlusal level in a 17-year-old systemically healthy, non-syndromic young female involving both arches, thereby posing a diagnostic dilemma. It was treated by gingivectomy using a conventional technique to facilitate precise incision, lower cost, and faster re-epithelialization. This was followed by gingivoplasty using electrocautery. The postoperative results of three months were satisfactory in terms of function and esthetics with uneventful healing. Further follow-up is ongoing for the same.
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  • 文章类型: Case Reports
    牙龈肿大(GE)可由牙龈炎症引起,纤维过度生长,或者这两个因素的结合。各种病因对GE有贡献,包括低级创伤,医源性原因,药物诱导的作用,全身性疾病,斑块积累,荷尔蒙的影响,维生素缺乏,遗传倾向,和特发性原因。临床实践中的有效治疗取决于准确诊断根本原因。其中,斑块诱导的炎症是最常见的,由斑块和结石的积累驱动。保持口腔卫生的一个挑战是正畸治疗,会影响言语,咀嚼,美学,和心理健康。在这个案例报告中,一名21岁女性患者出现了与正畸矫治器使用相关的GE.为了解决这个问题,在局部麻醉下使用牙龈切除术和牙龈成形术手术切除多余的牙龈组织,切除的组织被送去进行组织病理学检查。手术后,应用牙周敷料(GCCoePack™)以保护组织并帮助愈合。该病例强调牙龈组织增大,覆盖了近一半的牙冠,导致斑块积累和美学问题。手术后,实现了一个适当的牙龈轮廓消除了上的口袋,增强了美观的外观。患者显示出积极的结果,没有剩余的超口袋,导致自然的牙龈轮廓,改进的美学,和减少斑块保留。在这种情况下,手术牙龈切除术和牙龈成形术被证明是成功的干预措施。
    Gingival enlargement (GE) can result from gingival inflammation, fibrous overgrowth, or a combination of both factors. Various etiological factors contribute to GE, including low-grade trauma, iatrogenic causes, drug-induced effects, systemic diseases, plaque accumulation, hormonal influences, vitamin deficiencies, genetic predispositions, and idiopathic reasons. Effective treatment in clinical practice hinges on accurately diagnosing the underlying cause. Among these, plaque-induced inflammation is the most common, driven by the accumulation of plaque and calculus. One challenge in maintaining oral hygiene is orthodontic treatment, which can impact speech, chewing, aesthetics, and psychological well-being. In this case report, a 21-year-old female patient developed GE associated with orthodontic appliance use. To address this, excess gingival tissue was surgically removed under local anesthesia using gingivectomy and gingivoplasty procedures, and the excised tissue was sent for histopathological examination. Following the surgery, a periodontal dressing (GC Coe Pack™) was applied to protect the tissue and aid in healing. The case underscores that enlarged gingival tissue, covering nearly half of the dental crowns, led to plaque accumulation and aesthetic concerns. Post-procedure, achieving a proper gingival contour eliminated suprabony pockets and enhanced the aesthetic appearance. The patient showed positive outcomes with no remaining suprabony pockets, resulting in a natural gingival contour, improved aesthetics, and reduced plaque retention. Surgical gingivectomy and gingivoplasty proved to be successful interventions in this case.
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  • 文章类型: Case Reports
    Zimmermann-Laband综合征(ZLS;MIM135500)是一种罕见的遗传性疾病,主要临床表现为牙龈纤维瘤病和指/趾指甲发育不全。KCNH1(钾通道,电压门控,亚科H,member-1),KCNN3(钾通道,电压门控,亚科H,成员3)和ATP6V1B2(ATPaseH转运V1亚基B2)基因被认为是ZLS的致病基因。然而,关于不同临床表现和遗传异质性的报道有限.有必要报告有关表型-基因型相关性和ZLS治疗的更多信息。该病例报道了一名2岁的牙龈肿大患者,乳牙萌出失败,指甲严重发育不全。在系统检查和相关文献综述的基础上,我们对ZLS进行了初步临床诊断。使用全外显子组测序鉴定了KCNH1基因中的一种新的致病性变体,以证实我们的初步诊断。组织病理学结果与牙龈纤维瘤病一致。全麻下进行牙龈切除术和牙龈成形术。手术后,牙龈外观明显改善,牙齿的咀嚼功能得到恢复。经过2年的随访,牙龈稍有增生。系统检查和基因测序首先有助于为ZLS的早期诊断提供信息。然后及时去除增生性牙龈有助于建立正常的咬合关系,并改善口腔美学。
    Zimmermann-Laband Syndrome (ZLS; MIM 135500) is a rare genetic disorder with the main clinical manifestations of gingival fibromatosis and finger/toe nail hypoplasia. KCNH1 (potassium channel, voltage-gated, subfamily H, member-1), KCNN3 (potassium channel, voltage-gated, subfamily H, member-3) and ATP6V1B2 (ATPase H+ transporting V1 subunit B2) genes are considered causative genes for ZLS. However, there are limited reports about the diverse clinical presentation and genetic heterogeneity. Reporting more information on phenotype-genotype correlation and the treatment of ZLS is necessary. This case reported a 2-year-old patient with gingival enlargement that failure of eruption of the deciduous teeth and severe hypoplasia of nails. Based on a systemic examination and a review of the relevant literature, we made an initial clinical diagnosis of ZLS. A novel pathogenic variant in the KCNH1 gene was identified using whole-exome sequencing to substantiate our preliminary diagnosis. The histopathological results were consistent with gingival fibromatosis. Gingivectomy and gingivoplasty were performed under general anesthesia. After surgery, the gingival appearance improved significantly, and the masticatory function of the teeth was restored. After 2-year follow-up, the gingival showed slightly hyperplasia. Systemic examination and gene sequencing firstly contribute to provide information for an early diagnosis for ZLS, then timely removal of the hyperplastic gingival facilitates the establishment of a normal occlusal relationship and improves oral aesthetics.
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  • 文章类型: Journal Article
    目的:白藜芦醇是一种具有抗炎、抗氧化等生物活性的天然多酚类化合物。其抗纤维化作用已在胰腺和肝脏中得到实验证明。这项研究旨在确定白藜芦醇对成纤维细胞的抗增殖作用,这些成纤维细胞来自诊断为幼年透明纤维瘤病(JHF)的患者的增生性牙龈组织。
    方法:通过JHF患者的牙龈切除术从牙龈生长组织中获得原代牙龈成纤维细胞系。用或不用3种不同剂量的白藜芦醇(50、100、200μM)处理牙龈成纤维细胞。在24、48和72小时后评估细胞毒性和细胞增殖。胶原蛋白,TGF,和CTGF在48小时上清液中通过ELISA分析。
    结果:与对照组相比,所有三种剂量的白藜芦醇在24和48小时均抑制了JHF牙龈成纤维细胞的增殖,而没有表现出任何细胞毒性作用(p<0.0001)。在72小时,100和200μM白藜芦醇显示出明显更少的增殖(p<0.0001),更少的胶原蛋白,CTGF,TGF-β(p<0.001)高于对照组。
    结论:白藜芦醇对从JHF牙龈扩大获得的牙龈成纤维细胞具有深远的抗增殖作用,这表明它可以用作通过抑制胶原蛋白来防止细胞过度生长的治疗剂,CTGF,TGF-β的合成与增生的发病机制有关。
    OBJECTIVE: Resveratrol is a natural polyphenolic compound with biological activities such as anti-inflammation and antioxidation. Its anti-fibrotic effect has been experimentally demonstrated in the pancreas and liver. This study aims to determine the anti-proliferative effect of resveratrol on fibroblasts obtained from hyperplastic gingival tissues from a patient diagnosed with Juvenile Hyaline Fibromatosis (JHF).
    METHODS: Primary gingival fibroblast cell lines were obtained from gingival growth tissues by the gingivectomy of a patient with JHF. Gingival fibroblasts were treated with or without 3 different doses of resveratrol (50, 100, 200 µM). Cytotoxicity and cell proliferation were evaluated after 24, 48, and 72 h. Collagen, TGF, and CTGF were analyzed by ELISA in the 48-hour supernatants.
    RESULTS: All three doses of resveratrol suppressed the proliferation of JHF gingival fibroblasts at 24 and 48 h without showing any cytotoxic effect compared to the control group (p < 0.0001). At 72 h, 100 and 200 µM resveratrol showed significantly less proliferation (p < 0.0001), less collagen, CTGF, and TGF- β (p < 0.001) than the control group.
    CONCLUSIONS: Resveratrol had a profound anti-proliferative effect on gingival fibroblasts obtained from gingival enlargements with JHF, suggesting that it can be used as a therapeutic to prevent excessive cell growth by suppressing collagen, CTGF, and TGF- β synthesis in the pathogenesis of hyperplasia.
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  • 文章类型: Case Reports
    法团,粘膜的褶皱,将嘴唇和脸颊连接到肺泡粘膜,牙龈,和下面的骨膜。当系带过度靠近牙龈边缘时,它有可能损害牙龈健康,阻碍斑块控制努力并诱导肌肉压力。系带切除术是用于异常系带附着的常用纠正措施。在最近的一个临床病例中,一名21岁的女性患者因乳头型异常唇系附着和右上和左上中切牙周围过多的牙龈组织而从正畸科转诊至牙周病科。病人接受了全系切除术,牙龈切除术,以及在局部麻醉下进行的牙龈成形术,以使用手术刀解决异常的系带附着和牙龈过度生长。已证明这种方法可在正畸治疗中对表现出增强的系带附着和牙龈过度生长的患者产生最佳效果。在实现止血后,应用牙周包以促进愈合和保护软组织。
    The frenum, a fold of mucous membrane, connects the lip and cheek to the alveolar mucosa, gingiva, and underlying periosteum. When the frenum is positioned excessively near the gingival margin, it has the potential to compromise gingival health, impeding plaque control efforts and inducing muscular stress. A frenectomy is a commonly employed corrective measure for anomalous frenum attachments. In a recent clinical case, a 21-year-old female patient was referred from the Department of Orthodontics to the Department of Periodontics due to a papillary-type aberrant labial frenum attachment and excessive gingival tissue surrounding the upper right and left central incisors. The patient underwent a frenectomy, gingivectomy, and gingivoplasty procedures under local anesthesia to address the abnormal frenum attachment and gingival overgrowth using a scalpel. This approach has been demonstrated to yield optimal outcomes in orthodontic therapy for patients exhibiting elevated frenum attachment and gingival overgrowth. Following the achievement of hemostasis, a periodontal pack was applied to facilitate healing and preserve the soft tissue.
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  • 文章类型: Journal Article
    自1884年发现以来,牙龈切除术一直是首选方法。它从“盲”龈下缩放演变为“软组织切除”。在临床情况下,这些技术的使用不再是强制性的;因此,研究人员已经搜索了许多已注册的有关牙龈切除术的出版物。本研究旨在通过评估更多关于牙龈切除术及其在牙周学讨论主题中的趋势来填补利基区域。
    通过评估2022年7月从SCOPUS获得的出版物的整个书目数据中的VOS查看器映射和计算的结果,进行描述性和分析性观察。
    有六种出版物中的660种出版物。相关关键字通过网络映射进行编译和可视化。捐款国之间在每本期刊的文件数量和引用次数方面存在很大差距。然而,在其他目标中差距最小,如作者,期刊,以及机构对牙龈切除术主题出版的贡献。
    在过滤过程之后的分析中,共包含1914篇文章中的660篇,这些文章被引用了5910次,平均每篇文章引用9次。
    UNASSIGNED: Gingivectomy has been the preferred method since the findings in 1884. It evolved from \"blind\" subgingival scaling to \"the excision of the soft tissue\". The use of these techniques is no longer mandatory in clinical situations; therefore, researchers have searched for numerous publications that have been registered regarding gingivectomy. This research aims to fill the niche area by assessing more about gingivectomy and it\'s trend among the periodontology topic of discussion.
    UNASSIGNED: Descriptive and analytical observation by evaluating the result of the VOS viewer mapping and calculation throughout the bibliographic data from publications obtained from SCOPUS in July 2022.
    UNASSIGNED: There are 660 publications from six types of publication. Related keywords are compiled and visualized by network mapping. There is a significant gap among the contributing countries in the number of documents and number of citations per journal. However, a minimal gap is seen in other objectives, such as authors, journals, and institutions on their contribution towards the publication of gingivectomy topics.
    UNASSIGNED: A total of 660 of 1914 articles were included in the analysis after the filtering process, and these articles were cited 5910 times, with an average of 9 citations per article.
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  • 文章类型: Journal Article
    背景:在牙冠延长期间要保持的重要因素之一是生物宽度(BW),最近称为骨上组织附着。具有足够BW的健康牙周组织对于修复牙齿的成功非常重要。有各种技术来执行牙冠延长程序。大多数研究都集中在评估边缘牙龈和骨骼位置的变化作为结果参数,而不是BW。此外,大部分研究都是在动物模型上进行的。
    目的:本研究的目的是评估两种不同的牙冠延长手术后三个月和六个月的牙周组织变化。
    方法:60例需要手术牙冠延长术的患者中的60例下颌第一磨牙被纳入研究,并接受两种不同的手术,牙龈切除术(I组;n=30)和顶部定位的皮瓣进行骨切除术(II组;n=30)。在基线时记录以下参数:三个月,六个月,游离牙龈边缘(FGM)的位置,探测深度(PD),相对附着水平(RAL),骨水平(BL),和BW。这些测量是在每个患者的三个部位进行的:治疗的牙齿部位(TT),相邻牙齿的相邻部位(AD),和相邻牙齿的非相邻部位(NAD)。然后使用SPSS软件(版本20.0)对数据进行统计分析。统计学显著性设定为p<0.05。
    结果:当在三个月和六个月时比较I组和II组时,女性生殖器切割的位置没有统计学差异,PD,和RAL(p>0.05)。当在三个月和六个月比较两组之间的BW时,II组在任何给定时间段显示更好的BW重建,并且具有统计学意义(p<0.05)。
    结论:在手术牙冠延长后,骨水平在顶部移动,并允许重建BW。在六个月的随访中,与牙龈切除术相比,顶部定位的皮瓣在恢复BW方面更优。
    BACKGROUND: One of the important things to preserve during crown lengthening is the biologic width (BW), recently called supracrestal tissue attachment. A healthy periodontium with adequate BW is very essential for the success of restored teeth. There are various techniques to perform crown lengthening procedures. Most of the studies have focused on assessing the changes in the position of the marginal gingiva and bone as outcome parameters rather than BW. Also, most of the research was done on animal models.
    OBJECTIVE: The purpose of this study was to assess the periodontal tissue changes at three months and six months following two different surgical crown lengthening procedures.
    METHODS: Sixty mandibular first molars among 60 patients that required surgical crown lengthening were enrolled in the study and subjected to two different procedures, gingivectomy (Group I; n=30) and apically positioned flap with ostectomy (Group II; n=30). The following parameters were recorded at baseline, three months, and six months, position of free gingival margin (FGM), probing depth (PD), relative attachment level (RAL), bone level (BL), and BW. These measurements were made at three sites in every patient: treated tooth sites (TT), adjacent tooth\'s adjacent sites (AD), and adjacent tooth\'s non-adjacent sites (NAD). The data was then subjected to statistical analysis using SPSS software (Version 20.0). Statistical significance was set to p<0.05.
    RESULTS: When groups I and II were compared at three and six months, there was no statistical difference in terms of position of FGM, PD, and RAL (p>0.05). When BW was compared between the two groups at three and six months, group II showed better reestablishment of BW at any given time period and was statistically significant (p<0.05).
    CONCLUSIONS:  Following surgical crown lengthening, the bone level was shifted apically and allowed for the reestablishment of BW. At six months of follow-up, the apically positioned flap with ostectomy was superior in restoring the BW compared to gingivectomy.
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  • 文章类型: Case Reports
    特发性牙龈纤维瘤病(IGF),一种病因不明的罕见纤维增生性疾病,影响牙龈组织,并对患者产生重大不利影响。因此,IGF的发病机制需要更广泛和深入的研究。在这种情况下,一名确诊为IGF的患者接受了初始非手术牙周治疗和牙龈切除术,预后良好。患者没有牙周附着丧失,但在纤维肿大之前有牙龈肿胀和出血的病史,这促使进一步调查。我们探索了患者的龈下微生物组,发现了大量的牙周病原体。牙龈组织活检显示丰富的纤维组织含有多个炎症细胞浸润。这些结果表明,继发于牙周病原体的牙龈炎症可能有助于IGF的发作。
    Idiopathic gingival fibromatosis (IGF), a rare fibroproliferative disease of unknown etiology, affects gingival tissue and has substantial adverse effects on patients. Therefore, the pathogenesis of IGF requires more extensive and in-depth research. In this case, a patient with confirmed IGF underwent initial nonsurgical periodontal therapy and gingivectomy, and the prognosis was good. The patient had no loss of periodontal attachment but had a history of swelling and bleeding of the gingiva prior to fibrous enlargement, which prompted further investigation. We explored the patient\'s subgingival microbiome and found a high abundance of periodontal pathogens. Gingival tissue biopsy revealed abundant fibrous tissue containing multiple inflammatory cell infiltrates. These results suggest that gingival inflammation secondary to periodontal pathogens can contribute to IGF onset.
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