Background:The width of attached gingiva varies from tooth to tooth and also among individuals with mixed opinions regarding an “adequate” or “sufficient” dimension of the gingiva. Although the need for a so-called adequate amount of keratinized tissue for maintenance of periodontal health is questionable, the mucogingival junction serves as an important clinical landmark in periodontal evaluation. There are various methods of locating the mucogingival junction namely the functional method and the visual method with and without histochemical staining, which aid in the measurement of the width of attached gingiva.Materials and Methods:This study was carried out to assess the full mouth mid-buccal width of attached gingiva in individuals of four different age groups. This study also evaluated the difference in visual and histochemical methods in identification of the mucogingival junction to calculate the width of attached gingiva.Results:It was seen that the width of attached gingiva increases with age, and there was no significant difference in the width of attached gingiva by both the methods.Conclusion:Width of attached gingival varies in different areas of the mouth and also increases with age with no significant difference in the method of its assessment.

Introduction: Gingival recession presents with destruction of both soft and hard tissues and can cause major functional and esthetic problems. Treatment of gingival recession especially multiple recession defects presents a challenge because several recession defects must be treated at a single surgical session to minimize patient discomfort. New materials and techniques are being developed these days to obtain predictable root coverage. This article describes the use of vestibular incision subperiosteal tunnel access (VISTA) technique in combination with platelet rich fibrin (PRF) membrane in the treatment of gingival recession defects. This is probably the first article that describes the use of PRF membrane reinforced VISTA technique.Case Presentation: Four patients with multiple gingival recessions were selected for this case series. VISTA technique allowed coronal repositioning of gingival margin, which was then stabilized by coronally anchored suturing technique. PRF membrane was inserted inside the subperiosteal tunnel and vertical incision was sutured. Patients were kept under observation for 6 months.Conclusion: This use of PRF membrane along with VISTA technique allows clinician to successfully treat multiple recession defects.

Introduction:Demand for cosmetic therapy of gingival melanin pigmentation is common. Re-pigmentation after gingival depigmentation is an important point. The aim of this study is to evaluate the effect of surgical scraping and electrosurgery on postoperative pain, healing and recurrence of pigmentation.Materials and Methods:Fifteen patients with esthetic concern related to black gums were selected and treated by surgical scraping with respect to right quadrant and electrosurgery with respect to left quadrant. Patients were recalled post-operatively to evaluate healing and recurrence of pigmentation. Each patient was asked to complete the Visual Analogue Scale (VAS) index cards 2 and 24 hours postoperatively.Results:In the initial post-operative period, VAS index cards showed that the discomfort and pain level associated with electrosurgery was significantly higher than conventional scalpel surgery (P < 0.05). Clinically delayed healing was observed in the electrosurgically treated site. Electrosurgery showed better results as compared to epithelial excision for recurrence of pigments. At the end of 15 months, 7 sites in the scalpel excision group showed recurrence, whereas only 4 site showed recurrence in the electrosurgically treated group.Conclusion:The methods used here produced desired results and above all, the patients were satisfied with the outcome. Increased pain level and clinically delayed healing was associated with electrosurgery as compared to scalpel surgery, whereas repigmentation occurred more frequently in scalpel-treated sites.

The foremost indication for gingival depigmentation is patient demand for improved aesthetics. In most cases after the removal of pigmented layer, the area is covered with periodontal packs. These dressings have no curative properties. They only minimise the likelihood of surface trauma during mastication. However, platelet-rich fibrin (PRF) accelerates wound healing by effective neovascularisation and promoting fast cicatricial tissue remodelling. In the present split mouth study, PRF membrane was applied in the first quadrant and non-eugenol dressing (Coe-Pack) in the second quadrant after depigmentation. Clinical evaluation of epithelization with toluidine blue revealed that PRF treated sites stained substantially less indicating better wound healing as compared to Coe-Pack sites, which appeared more erythematous after 5 days. The histologic evaluation also revealed greater inflammatory cell infiltrate on Coe-Pack sites as compared to PRF. Thus, PRF membrane as a periodontal dressing is a successful approach to protect the raw wound area of the depigmented site to reduce healing time and patient discomfort.

Background:A paucity of conclusive research exists on the optimal design and mode of action of toothbrushes, leading to the introduction of new generation of toothbrushes. Sonic and ionic toothbrushes belong to this new generation of toothbrushes. The aim of the present study was to clinically assess and compare the efficacy of the sonic and ionic toothbrushes.Materials and Methods:A single blind study, using a split-mouth method, was conducted for 45 days on a total of 22 (11 males and 11 females) student volunteers, with age of 17 to 21 years. Plaque, gingival, and bleeding indices were recorded after every 15 days.Results:Both the toothbrushes showed significant reduction in all three parameters. However, the sonic toothbrush proved to be more effective than the ionic toothbrush on the percentage basis, the difference in parameters was statistically nonsignificant.Conclusion:It may be concluded from the present study that though the sonic toothbrush was insignificantly superior to the ionic toothbrush, both the toothbrushes are clinically effective in removing plaque and improving the gingival conditions.