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한세현,이상훈,김정욱,김종철,유인아 大韓小兒齒科學會 2000 大韓小兒齒科學會誌 Vol.27 No.1
각화치은, 부착치은의 폭경, 치은열구의 깊이에 대해 성인에서는 많은 연구가 있었으나 아동에서의 연구는 드물었기 때문에, 유치열기, 혼합치열기 및 영구치열기의 모든 치아에 대하여 아동의 협측 각화치은 및 부착치은의 폭경과 치은 열구 깊이에 대한 정상치을 구하고, 악골의 발육 및 치아의 맹출과의 관련성를 고찰하며, 점막치은문제의 발현빈도를 조사하고자 하였다. 결론은 다음과 같다. 1. 유치열의 부착치은 폭경은 상악 유측절치 및 유견치에서 각각 3.50mm, 3.55mm로 최대값은, 하악 제1유구치에서 1.35mm로 최소값은 나타내었다. 영구치열의 경우에는 상악 측절치에서 3.00mm로 최대값을, 하악 제1소구치에서 0.55mm로 최소값은 나타내었다. 상하악 동명치아 비교시 상악 치아가 하악 치아보다 더 큰 값을 나타내었고, 남녀간 차이에는 특별한 규칙이 발견되지는 않았다. 2. 연령증가에 따른 부착치은 폭경의 변화 양상은 유치열의 경우 유견치, 제1유구치, 제2유구치에서 6세부터 증가하였다. 영구치의 경우 남자에서는 하악 중절치와 상악 제1대구치의 측정값만이 연령에 따른 층가 추세를 나타냈으나(P<0.05), 여자에서는 상하악 중절치 측절치 및 상악 제1대구치에서 통계적으로 유의성 있는 각화치은 폭경의 증가 추세를 관찰 할 수 있었다(P<0.05). 3. 치아교대기에서 부착치은 폭경의 차이는 남자 상악 중절치를 제외한 모든 경우에 유치에서의 측정값이 영구치에서의 측정값보다 큰 것으로 나타났다(P<0.05). 4. 6세부터 12세까지는 각화치은의 폭경과 치은열구의 깊이는 대부분 유치 초기값보다 그 계승영구치 최종값이 더 높은 값을 나타냈으나(P<0.05), 부착치은의 폭경에서는 유치 초기와 그 계승영구치 최종값 사이에 통계적으로 유의성 있는 차이가 나타나지 않았다. 5. 점막치은 문제 발현 빈도는 남녀에 상관없이 유치열은 상하악 제1유규치가, 영구치열은 상하악 모두 제1소구치가 최고치를 나타냈으며 유치에서 보다 그 대응 계승영구치에서 그 빈도가 더욱 높게 나타났다. 연령증가에 따라 점막치은 문제의 발현 빈도는 유치열, 영구치열에서 모두 감소하였으나, 하악 제1유규치, 하악 영구견치, 제1. 제2소구치의 경우 연령 의 증가와 상관없이 비슷하게 유지되거나 증가하는 경향을 보였다. The aim of this study is (1) to establish the baseline information concerning the width of keratinized gingival, depth of gingival sulcus and width of attached gingiva on the buccal surface of the teeth : and (2) to determine the relationship between the above values and tooth eruption: and (3) to estimate the frequency of mucogingival problems. The results were as follows: 1. The mean width of attached gingiva of the children aged 6-12 proved to be wider in the maxilla than in the mandible. Of the primary teeth, the widest width was found in the areas of maxillary primary lateral incisors and maxillary primary canines (3.50mm and 3.55mm). The narrowest was noted in the area of mandibular first primary molars (1.34mm). In the permanent dentition, the greatest width was found in the areas of maxillary permanent lateral incisors (3.00mm). The narrowest was noted in the area of mandibular first premolars (0.55mm). 2. In the primary dentition, the width of attached gingiva of primary canines and first and second primary molars became wider from the age of six as the age increased. In the permanent dentition of the boys, only mandibular central incisors and maxillary first molars showed the tendency towards increase in the width of attached gingiba with increasing age. In the permanent dentition of girls, central and lateral incisors of both jaws and maxillary first molars showed statistically significant increase in the width of attached gingiva with increasing age (p<0.05). 3. At the age of tooth change, the attachcd gingiva of primary teeth were almost wider than those of successive permanent teeth(p<0.05). 4. During the period of 6 to 12 years of age, the width of keratinized gingiva and the depth of gingival sulcus of permanent tooth at the age of twelve were larger than those of primary tooth at the of six (p<0.05). 5. The maximum in the frequency of mucogingival problems was found in the areas of upper and lower first primary molars of primary dentition, and in the upper and lower first premolars of permanent dentition regardless of sex. The frequency was higher in primary teeth than in the corresponding successive permanent teeth. These teeth showed tendency towards increase in mucogingival problems with age.
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김민정,정현주,김옥수,김영준,Kim, Min-Jeong,Chung, Hyun-Ju,Kim, Ok-Su,Kim, Young-Joon 대한치주과학회 2003 Journal of Periodontal & Implant Science Vol.33 No.2
The autogenous free gingival graft is the most predictable procedure currently used to increase the width of the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artifcia1 dermis ($Terudermis^{(R)}$; Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1,2,3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue, Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.
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