Alterations of the position of the marginal soft tissue following periodontal surgery.

The present study was performed to examine the alterations of the position of the marginal soft tissue ("gingival margin") on the buccal surface of teeth in patients who following periodontal surgery were enrolled in a supervised maintenance care program for 10--11 years. The material consisted of 43 patients with severe destruction of the periodontal tissues. Following initial treatment comprising scaling, root planing and instructions in plaque control measures, deepened periodontal pockets were eliminated by the use of an apically repositioned flap procedure including osseous surgery to eliminate bony defects. After treatment, the patients were recalled once every 3--6 months for maintenance care. In all patients, the distance between the cemento-enamel junction and the gingival margin on the buccal surfaces of all treated teeth was assessed (1) prior to surgery, (2) after initial healing, and (3) at a reexamination 10--11 years after treatment. In addition, the presence or absence of keratinized gingiva was determined. The results showed that (1) during active periodontal treatment the position of the gingival margin was shifted in an apical direction, (2) this displacement was to some extent compensated for by a coronal regrowth during the postoperative maintenance care period, (3) the alterations of the position of the gingival margin followed a similar pattern in areas with and without a zone of keratinized gingiva, (4) the number of gingival units devoid of keratinized gingiva decreased during the maintenance care period.