Gingival dimensions after root coverage with free connective tissue grafts.

Traumatic injury in the presence of a thin and narrow zone of gingival tissue may lead to gingival recession. Especially in class I and II recessions, root coverage may be accomplished with connective tissue grafts. In order to prevent recurrent recession, altering gingival dimensions width and thickness might be of advantage. In the present study, dimensions of gingiva were followed for 1 year after root coverage with connective tissue grafts. The study population consisted of 18 patients with a total of 28 class I or II recessions. Gingival width and depth of the recession were measured with a caliper, and thickness of the marginal tissue with an ultrasonic device. Periodontal probing depth was determined with a pressure-controlled electronic probe. Mean (+/-sd) recession depth at baseline was 3.1+/-1.4 mm. After 12 months, coverage amounted to 74+/-30%. Width of gingiva rose from 2.1+/-1.0 mm to 3.2+/-1.4 mm, whereas thickness was increased from 0.8+/-0.3 mm to 1.5+/-0.7 mm, on average. No significant alteration of periodontal probing depth was observed but a mean gain of clinical attachment of 1.7+/-1.1 mm was ascertained. In a multiple regression analysis, recession depth and presence of the recession in the maxilla, but not tooth type significantly influenced relative root coverage (R2=0.34, p<0.01). Attachment gain after surgery depended on baseline attachment loss and was negatively influenced by smoking. The present results point to the possibility of doubling gingival thickness after root coverage with connective tissue grafts.

Cognitive frontal lobe dysfunction in obsessive-compulsive disorder.

BACKGROUND: There is evidence that dysfunction within associative frontostriatal circuits represents a feature of obsessive-compulsive disorder (OCD). Previous neuropsychologic studies have yielded diverging results, which may in part be explained by differences in the selection of subjects and methods. The present study focused on the question of cognitive frontal lobe performance in OCD. METHODS: Twenty-nine unmedicated OCD patients were compared to a double-size control group of normal subjects matched individually for age, sex, and intelligence. A series of 12 neuropsychologic tests was applied, most of which are thought to be sensitive to different aspects of cognitive frontal lobe function. RESULTS: OCD patients were unimpaired at tests of abstraction, problem solving, set-shifting, response inhibition, active memory search, and choice reaction speed. Deficits of approximately one standard deviation were observed at timed tests of verbal and nonverbal fluency, attentional processing, and weight sorting. CONCLUSIONS: OCD patients exhibited selective deficits in tasks involving controlled attentional processing and self-guided, spontaneous behavior. We discuss a link between this neuropsychologic profile and dysfunctioning within the anterior cingulate, but not the dorsolateral prefrontal circuit.

Alteration of gingival dimensions in a complicated case of gingival recession.

This case report describes possible etiology, treatment, and 2-year outcome of a complicated case of gingival recession in the mandibular anterior dentition. Deep, cleftlike Miller Class I and II recessions at both mandibular canines and all incisors were treated using subperiosteal connective tissue grafts and coronally repositioned flaps. During surgery it was noted that the facial aspects of the roots had lost bone near the apex. After surgery profound alterations of gingival dimension occurred. Mean gingival thickness increased from 0.87 +/- 0.20 mm to 258 +/- 0.65 mm, and width of keratinized tissue increased from 1.34 +/- 0.79 mm to 4.80 +/- 0.97 mm. Periodontal probing depths increased from 1.06 +/- 0.33 mm to 2.74 +/- 0.81 mm, and depth of the recessions was reduced by 56% +/- 5%. Gingival thickness and periodontal probing depth remained stable over the 2 years of observation. Gingival width decreased and the mucogingival border moved a mean 2.5 mm coronally. Creeping attachment resulted in a 74% +/- 24% coverage of recession after 2 years and a gain in clinical attachment of 1.79 +/- 1.56 mm. The present observations point to long-lasting, continuous alterations in the mucogingival region following periodontal surgery in a case of cleftlike Class II recession.