Journal of Dental Medicine

---

Normal 0 false false false EN-US X-NONE AR-SA Frenum or Frenulum is defined by Miller as a membrane joining two parts that causes movement limitation. Oral cavity frenums are : 1) labial frenums of maxilla and mandible which are also known as inhibition of lips. 2) lingual frenum of tongue located between central incisors 3) frenum in mandibular premolar area. Frenum can be one or double layered. If The attachment located in gingival line and alveolar mucosa and attached gingival, no complication is anticipated while higher locations to free gingival directions, it would be a high frenum that can cause periodontal and orthodontic complications and treatment relapse. Complete evaluation on bone destructions in central incisors area, diasthema and teeth mobility related to frenum should be carried out.

---

Normal 0 false false false EN-US X-NONE AR-SA Two Root coverage methods of free gingival graft method (FGG) and coronally positioned flap (CPF) by using citric acid were evaluated in anterior mandibular labial site of 16 patients. The measurements were done before first FGG surgery, after FGG and two months following the second surgery. The results showed 1% improvement of root coverage after surgery while in two stage CPF method by using citric acid, significant effect of citric acid was obtained. The width of Keratinized gingiva changed to 6.25mm from 1.18mm which was statistically significant.

---

Nowadays, due to recent developments and researches in dental science, it is possible to preserve and restore previously extracted cases such as teeth with extensive caries, fractured or less appropriate cases for crown coverage as well as teeth with external perforation caused by restorative pins. In order to restore the teeth with preservation of periodontium, we should know thoroughly physiological aspects of periodontium and protection of Biologic Width which is formed by epithelial and supracrestal connective tissue connections. Considering biologic width is one of the principal rules of teeth restoration, otherwise we may destruct periodontal tissues. Several factors are involved in placing a restoration and one of the most important ones is where the restoration margin is terminated. Many studies have been conducted on the possible effects of restoration margin on the gingiva and due to the results of these studies it was concluded that restoration margin should be finished supragingivally. However, when we have to end the restoration under Gingival Crest, First a healthy gingival sulcus is required. Also, we should not invade the biological width. Since a normal biologic with is reported 2 mm and sound tooth tissue should be placed at least 2 mm coronal to the epithelial tissue, the distance between sound tooth tissue and crown margin should be at least 4mm. Thus, performing crown lengthening is essential to increase the clinical crown length. Basically, two objectives are considered: 1) restorative 2) esthetic (gummy smile) Surgical procedure includes gingivectomy and flap procedure. Orthodontic procedure involves orthodontic extrusion or force eruption technique which is controlled vertical movements of teeth into occlusion. Besides, this procedure can also used to extrude teeth defects from the gingival tissue. By crown lengthening, tooth extraction is not required and furthermore, adjacent teeth preparation for placing a fixed prosthesis would not be required. Additionally, by remaining the tooth root, the alveolar bone is preserved and both esthetic and hygiene are extensively improved so the results would be much more satisfying.

---

This study is aimed to evaluate the effect of covering exposed root surface by collagen membrane and to compare this method with coronoally advanced flap covering. 26 teeth in 20 patients (12m/8f) with Miller1 gingival recession were selected. 14 teeth were allocated into test group and 12 teeth in control group. Following first phase of treatment, clinical parameters including the height and width of gingival recession, attachment height, gingival crevice depth and keratinized tissue width were measured. In test group, coronally advanced flap was prepared and gingistat (as space maintainer) and collagen membrane was applied. For control group, coronally advanced flap method was applied without any further action. The measurements were done in 1,2 and 3 months post surgery. In test group, the reported root coverage was 71% while in control group was 57% which represents statistically significant difference. From first to third month post surgically, the average gingival recession in test group was 0.21 mm which was considered as creeping attachment phenomenon while in control group gingival height was increased 0.14 mm. the average width of recession and crevice depth decrease was not significantly different between the groups. On the other hand, The average attachment gain and keratinized tissue increase was significantly varied among the groups. In general, it can be concluded that application of collagen membrane as well as gingastat space maintainer can bring about satisfactory results in covering exposed root surfaces.

---

Background and Aim: A major aspect of the adaptive host response in periodontitis is the antibodies. Several risk and susceptibility factors for periodontitis, including smoking, age and composition of the subgingival microflora, have also been suggested to influence antibody production. The present study was conducted to investigate plasma levels of immunoglobulin (Ig) G antibodies in periodontitis patients of Caucasian Iranian heritage referred to dental faculty, Tehran University of Medical Sciences in relation to disease severity and smoking.

Materials and Methods: In this study, 36 patients with severe periodontitis, 39 with moderate periodontitis and 40 controls without periodontal destruction were enrolled. From the total of 80 patients, 21 were diagnosed with aggressive periodontitis and 54 with chronic periodontitis. IgG isotypes were analyzed in plasma samples.

Results: Patients group in comparison with control group had shown higher level of Immuno globolins. There was no significant difference about the IgG1 level in moderate and seven group and also in chronic and aggressive groups (p<0/001). But the level of IgG2 was shown the significant difference in the all study groups. Smoking was significantly reduced the level of IgG1 and IgG2.

Conclusion: The current study shows that non-smoker periodontitis patients have higher levels of IgG2 than smoker periodontitis patients.