PERIODONTOLOGY
CONTEMPORARY ESTHETIC PERIODONTICS
Diana Bronstein 1a * , Kevin Suzuki 2b , Mehdi Garashi 1c , Jon B Suzuki 1 , 3 , 4 , 5 , 6 , 7 , d
1
Department of Periodontology , College of Dental Medicine , Health Profession Division , Nova Southeastern University , Fort Lauderdale , FL , USA
2
Department of Periodontology and Oral Implantology , School of Dentistry , Temple University , Philadelphia , PA , USA
3
Microbiology and Immunology , School of Medicine , Temple University , Philadelphia , PA , USA
4
Periodontology and Oral Implantology , School of Dentistry , Temple University , Philadelphia , PA , USA
5
National Naval Medical Command , U . S . Navy , Bethesda , MD , USA
6
Department of Periodontology , School of Dentistry , University of Maryland , Baltimore , MD , USA
7
Maimonides University , Buenos Aires , Argentina a
DDS , MS , MS , Associate Professor , Associate Director of Predoctoral Periodontology b
DMD , MS , Clinical Assistant Professor c
DDS , Postgraduate Resident d
DDS , PhD , MBA , Clinical Professor
Cite this article : Bronstein D , Suzuki K , Garashi M , Suzuki JB . Contemporary Esthetic Periodontics . StomaEduJ . 2016 ; 3 ( 2 ): 212-222 .
Received : August 16 , 2016 Accepted : August 18 , 2016
Available online : August 24 , 2016
ABSTRACT
Aim : In contemporary dentistry , disease prevention and regeneration have dictated the paradigm shift from the practitioner ’ s reactive approach to disease occurrence in his increasingly educated and demanding patient population to an innovative and proactive patient treatment . This clinical paper with case reports will address these aspects of muco-gingival surgery around teeth and implants . Summary : Successful periodontal disease control and elimination by skilled dental professionals may leave patients with an esthetic or sensitivity concern . The historical “ longer teeth , or no longer teeth ” and its sequela require targeted intervention from today ’ s dental team to prevent lesion progression and improve patient satisfaction . After surgical technique and patient compliance with oral hygiene and wound care instructions , the patient ’ s physiology , immunology and molecular biology , is responsible for the clinical outcome of the procedure . Key Learning Points : In cases with lack of keratinized attached gingiva , the results of the present case reports on teeth and implants , indicate that a free gingival graft which deepened the vestibule and created a wide band of attached and keratinized gingiva can aid in reducing discomfort during oral hygiene practices by the patient , improve gingival health and overall patient satisfaction . Keywords : periodontics , gingival recessions , periodontal surgery , oral health-related quality of life .
1 . Introduction In contemporary dentistry , disease prevention and regeneration have dictated the paradigm shift from the practitioner ’ s reactive approach to disease occurrence in his increasingly educated and demanding patient population to an innovative and proactive patient treatment . Successful periodontal disease control and elimination by skilled dental professionals may leave patients with an esthetic or sensitivity concern . The historical “ longer teeth , or no longer teeth ” and its sequelae require targeted intervention from today ’ s dental team to prevent lesion progression and improve patient satisfaction . After surgical technique and patient compliance with oral hygiene and wound care instructions , the patient ’ s physiology , immunology and molecular biology are responsible for the clinical outcome of the procedure . This article will address aspects such as muco-gingival surgery around teeth and implants .
2 . The biological background of wound healing in esthetic periodontal surgery The fundamental difference in wound healing of tissues surrounding the tooth compared to other areas of the body is in the interface of the soft tissue to the hard tissue . The different healing patterns after flap surgery have been identified by previous histological and animal studies 1-4 . The surgical elevation of a full thickness flap from the underlying dental and osseous structures leads to a variety of healing mechanisms . Long junctional epithelium constitutes healing by tissue repair and is a hemi-desmosomal adhesion between the connective tissue of the periodontal flap and
* Corresponding author :
Associate Professor Diana Bronstein , DDS , MS , MS , Associate Director of Predoctoral Periodontology , Department of Periodontology , College of Dental Medicine , Health Profession Division , Nova Southeastern University 3200 South University Drive , Room 7385 , Fort Lauderdale , FL-33162-2018 , USA Tel : ( 954 ) 262 7381 / Fax : ( 954 ) 262-3293 , e-mail : db1473 @ nova . edu
212 STOMA . EDUJ ( 2016 ) 3 ( 2 )