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Previous surgical crown lengthening studies have investigated positional changes of the free gingival margin but not the biological width. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biological width. However, very little work has been done in humans. Therefore, the purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown lengthening in human subjects.Twenty-three (23) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent teeth with adjacent and non-adjacent sites: plaque and gingival indexes, free gingival margin, probing depth, attachment level, bone level, direct bone level, and biological width. During surgery, the bone level was reduced based on the future prosthetic margin and predetermined biological width; flaps were placed at the bony crest. Patients were examined at baseline and at 3 and 6 months postoperatively.Eighteen patients completed the study. Overall, the amount of bone resected was 1 to 5 mm. At 90% of treated sites,or = 3 mm of bone was removed. At 3 months, the apical displacement of the free gingival margin at non-adjacent, adjacent, and treated sites was 2.46 +/- 0.25 mm, 2.68 +/- 0.20 mm, and 3.07 +/- 0.16 mm, respectively. There was no significant change in the position of the free gingival margin from 3 to 6 months. The biological width at all sites was smaller at 3 and 6 months compared to baseline (P0.05) except for the treated sites, which were not significantly different from baseline at 6 months.During surgical crown lengthening, the bone level was lowered for placement of the prosthetic margin and reestablishment of the biological width. The biological width, at treated sites, was reestablished to its original vertical dimension by 6 months. In addition, a consistent 3 mm gain of coronal tooth structure was observed at the 3- and 6-month examinations.

Within dentistry, a limited body of literature exists regarding the referral relationships between general practitioners (GPs) and specialists. The purpose of this study was to investigate the referral relationship between GPs and periodontists within the state of Virginia.A survey was developed that focused on the demographic variables in the referral relationship between GPs and periodontists. The survey was mailed to 800 dentists throughout the state of Virginia. Descriptive statistics were completed along with multivariate logistic regression analysis comparing the responses with the number of patients referred per month to periodontists.Female respondents were more likely to refer three or more patients per month to a periodontist than a male respondent (P0.02). Those dentists who practiced with one other dentist were twice as likely to refer more frequently when compared to solo practitioners or larger group practices (P0.03). Dentists employing two hygienists were more likely to refer patients than those with fewer hygienists (P0.02). Those whose practices were5 miles from the nearest periodontist were more likely to refer patients compared to dentists geographically closer to a periodontist (P0.02). No other variables had a significant effect on the referral of more patients per month to a periodontist.This study indicates that four demographic variables have a statistical influence on the number of referrals per month from a GP to a periodontist. These variables are as follows: female gender, practicing with one other dentist, employing two or more hygienists, and being5 miles away from the nearest periodontist.

It is the aim of this article to present a case report involving the biopsy and subsequent histologic analysis of an acellular dermal matrix. The area of the graft in contact with the root surface did not demonstrate a histologic attachment, but was defined as fibrous tissue apposition to the root surface. In addition, the coronal portion of the graft did not appear to be revascularized or revitalized as would be expected with an autogenous soft tissue graft. Finally, no new cementum formation was seen, but displacement of the junctional epithelium was observed.