OBJECTIVES The main objective of this study was to assess changes in the position of the gingival margin (GM) after performing an aesthetic crown lengthening (ACLP) by means of submarginal incisions, buccal osseous surgery, and a replaced flap after a healing period of 6 months. METHODS Twenty-one patients who needed a surgical crown lengthening in the maxillary anterior teeth were included. An individual stent was fabricated to record changes in the position of the GM. Clinical measurements were recorded pre-surgically; immediately post-surgically (baseline); and at 42, 90, and 180 days. RESULTS After the ACLP, the GM displacement did not change significantly after 42, 90, and 180 days (4.32 ± 1.17 mm, 4.29 ± 1.14 mm, and 4.26 ± 1.11 mm, respectively). Tissue rebound seems to be related to the distance from the GM to the alveolar bone (AB) at the time of suturing (GM-AB(X)). When GM-AB(X) was ≤ 2 mm, 3 mm, and ≥ 4 mm, the GM rebound at 6 months was 0.94 ± 0.53 mm, 0.10 ± 0.28 mm, and - 0.26 ± 0.40 mm, respectively. These differences were statistically significant (P < 0.001). CONCLUSIONS An ACLP releasing the flap up to the mucogingival junction, with a ≥ 3-mm distance from the bone crest to the gingival margin can lead to a stable GM position at 42, 90, and 180 days. CLINICAL RELEVANCE This article focuses on variables affecting the stability of the GM, which is a critical factor that may compromise the biological and aesthetic long-term outcomes.

中文翻译：

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通过替换皮瓣和颊骨手术在前区进行美观的冠延长手术后，牙龈边缘的稳定性：前瞻性研究。

目的本研究的主要目的是评估在经过6次愈合后，通过边缘下切口，颊骨手术和皮瓣置换术进行美学冠延长（ACLP）后，评估牙龈边缘（GM）位置的变化。几个月。方法包括21例需要在上颌前牙中加长手术冠的患者。制造单个支架以记录GM位置的变化。术前记录临床测量；手术后立即（基线）；以及第42、90和180天。结果ACLP后，第42、90和180天后GM位移没有明显变化（分别为4.32±1.17 mm，4.29±1.14 mm和4.26±1.11 mm）。组织反弹似乎与缝合时从GM到牙槽骨（AB）的距离有关（GM-AB（X））。当GM-AB（X）≤2 mm，3 mm和≥4 mm时，六个月的GM回弹分别为0.94±0.53 mm，0.10±0.28 mm和-0.26±0.40 mm。这些差异具有统计学意义（P <0.001）。结论ACLP释放皮瓣直至粘膜龈交界处，从牙rest到牙龈边缘的距离≥3 mm，可以在42、90和180天时保持稳定的GM位置。临床相关性本文重点讨论影响转基因稳定性的变量，这是可能损害生物学和美学长期结果的关键因素。和-0.26±0.40 mm。这些差异具有统计学意义（P <0.001）。结论ACLP可将皮瓣释放至粘膜与牙龈交界处，从牙顶到牙龈边缘的距离≥3 mm，可在第42、90和180天使GM位置稳定。临床相关性本文重点讨论影响转基因稳定性的变量，这是可能损害生物学和美学长期结果的关键因素。和-0.26±0.40 mm。这些差异具有统计学意义（P <0.001）。结论ACLP释放皮瓣直至粘膜龈交界处，从牙rest到牙龈边缘的距离≥3 mm，可以在42、90和180天时保持稳定的GM位置。临床相关性本文重点讨论影响转基因稳定性的变量，这是可能损害生物学和美学长期结果的关键因素。