Background:The presence of an adequate width of keratinized tissue is important to maintain a healthy dentogingival junction. In case of inadequate width of attached gingiva, the gingival augmentation procedure has been performed classically using the patient's own masticatory mucosa and more recently, using an acellular dermal allograft as the donor material.Aims:The aim of the clinical study was to evaluate and compare the effectiveness of free gingival graft (FGG) and acellular dermal matrix (ADM) allograft in the ability to increase the zone of attached gingiva.Materials and Methods:Fifteen patients with 30 sites showing the inadequate width of attached gingiva (≤1 mm) were enrolled for the split-mouth study. The width of keratinized gingiva and other clinical parameters were recorded at baseline and 12th month postoperatively.Statistical Analysis:The difference in clinical parameters within the group was assessed by Wilcoxon signed rank test. However, Mann–Whitney U-test was used to analyze the differences between test and control groups.Results:The width of attached gingiva increased significantly (P < 0.01) following both the treatments but comparatively lesser gain with ADM allograft (2.13 mm vs. 4.8 mm). ADM site had significantly more shrinkage (76.6%) than FGG site (49.7%). Though FGG was found to be more effective, clinicians can prefer ADM allograft because of its certain advantages over the FGG.Conclusion:ADM allograft has resulted in sufficient increase in width of attached gingiva although lesser than FGG. Considering the disadvantages of FGG, it can be concluded that ADM allograft can be used as an alternative to FGG in increasing width of attached gingival in certain clinical situations.

Various etiological factors are associated with gingival recession which may be anatomical, physiologic, or pathologic factors. Several root coverage procedures have been described to manage the gingival recession. However, it has been found that root coverage procedures in Miller's Class III and IV gingival recession have a poor prognosis with current techniques. A newer predictable technique, pedicled buccal fat pad (PBFP) has been introduced in cases of severe gingival recession. The buccal fat pad (BFP) is a specialized capsulated fat tissue that has the property of maintaining its volume and structure over a long period of time. It can also serve as a well vascularized, readily obtainable local flap for reconstructive purposes and increasing the dimensions of keratinized mucosa. The aim of this case report is to establish a new technique for root coverage using pedicled BFP in Miller Class IV recession on the maxillary right first molar.

Context:Nowadays esthetics plays an important role in dentistry along with function of the prosthesis. Various soft tissue augmentation procedures are available to correct the ridge defects in the anterior region. The newer technique, vascularized interpositional periosteal connective tissue (VIP-CT) flap has been introduced, which has the potential to augment predictable amount of tissue and has many benefits when compared to other techniques.Aim:The study was designed to determine the efficacy of the VIP-CT flap in augmenting the ridge defect.Materials and Methods:Ten patients with Class III (Seibert's) ridge defects were treated with VIP-CT flap technique before fabricating fixed partial denture. Height and width of the ridge defects were measured before and after the procedure. Subsequent follow-up was done every 3 months for 1-year.Statistical Analysis Used:Paired t-test was performed to detect the significance of the procedure.Results:The surgical site healed uneventfully. The predictable amount of soft tissue augmentation had been achieved with the procedure. The increase in height and width of the ridge was statistically highly significant.Conclusion:The VIP-CT flap technique was effective in augmenting the soft tissue in esthetic area that remained stable over a long period.

No abstract

Context:Tobacco smoking is considered to be a major risk factor associated with periodontal disease. Smoking exerts a major effect on the protective elements of the immune response, resulting in an increase in the extent and severity of periodontal destruction.Aims:The aim of the present study was to assess viability and phagocytic function of neutrophils in circulating blood of the smokers and nonsmokers who are periodontally healthy.Settings and Design:Two hundred subjects in the mean range of 20–30 years of age were included in the study population. It was a retrospective study carried out for 6 months.Materials and Methods:Two hundred subjects were divided into four groups: 50 nonsmokers, 50 light smokers (<5 cigarettes/day), 50 moderate smokers (5–15 cigarettes/day), and 50 heavy smokers (>15 cigarettes/day). Full mouth plaque index, sulcus bleeding index, and probing depths were measured. Percentage viability of circulating neutrophils and average number of phagocytosed Candida albicans were recorded.Statistical Analysis Used:Means and standard deviations were calculated from data obtained within the groups. Comparison between the smokers and nonsmokers was performed by Kruskal–Wallis ANOVA analysis. Comparison between smoker groups was performed using Mann–Whitney–Wilcoxon test.Results:Percentage viability of neutrophils was significantly less in heavy smokers (66.9 ± 4.0), moderate (76.6 ± 4.2), light smokers (83.1 ± 2.5) as compared to nonsmokers (92.3 ± 2.6) (P < 0.01). The ability of neutrophils to phagocytose, i.e., mean particle number was significantly less in light smokers (3.5 ± 0.5), moderate smokers (2.3 ± 0.5), and heavy smokers (1.4 ± 0.5) compared to nonsmokers (4.9 ± 0.7) (P < 0.01) with evidence of dose-response effect.Conclusions:Smoking significantly affects neutrophils viability and phagocytic function in periodontally healthy population.