Skip to main content

Advertisement

SpringerLink
Log in

Stability of the gingival margin after an aesthetic crown lengthening procedure in the anterior region by means of a replaced flap and buccal osseous surgery: a prospective study

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Nugala B, Kumar BS, Sahitya S, Krishna PM (2012) Biologic width and its importance in periodontal and restorative dentistry. J Conserv Dent 15:12–17

    Article  Google Scholar 

  2. Valderhaug J, Birkeland JM (1976) Periodontal conditions in patients 5 years following insertion of fixed prostheses pocket depth and loss of attachment. J Oral Rehabil 3:237–243

    Article  Google Scholar 

  3. Schmidt JC, Sahrmann P, Weiger R, Schmidlin PR, Walter C (2013) Biologic width dimensions–a systematic review. J Clin Periodontol 40:493–504

    Article  Google Scholar 

  4. Arora R, Narula SC, Sharma RK, Tewari S (2013) Evaluation of supracrestal gingival tissue after surgical crown lengthening: a 6-month clinical study. J Periodontol 84:934–940

    Article  Google Scholar 

  5. Pontoriero R, Carnevale G (2001) Surgical crown lengthening: a 12-month clinical wound healing study. J Periodontol 72:841–848

    Article  Google Scholar 

  6. Vacek JS, Gher ME, Assad DA, Richardson AC, Giambarresi LI (1994) The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent 14(2):154–165

  7. Hamasni FM, El Hajj F (2017) Comparison of the clinical biological width with the published stanndard histologic mean values. J Int Soc Prev Commuinty Dent 7:264–271

    Google Scholar 

  8. Deas DE, Moritz AJ, McDonnell HT, Powell CA, Mealey BL (2004) Osseous surgery for crown lengthening: a 6-month clinical study. J Periodontol 75:1288–1294

    Article  Google Scholar 

  9. Olsson M, Lindhe J (1991) Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontol 18:78–82

    Article  Google Scholar 

  10. Smukler H, Chabi M (1997) Periodontal and dental considerations in clinical crown extension: a rational basis for treatment. Int J Periodontics Restorative Dent 17:464–477

    PubMed  Google Scholar 

  11. Lanning SK, Waldrop TC, Gunsolley JC, Maynard JG (2003) Surgical crown lengthening: evaluation of the biological width. J Periodontol 74:468–474

    Article  Google Scholar 

  12. Shobha KS, Mahantesha HS, Mani R, Kranti K (2010) Clinical evaluation of the biological width following surgical crown-lengthening procedure: a prospective study. J Indian Soc Periodontol 14:160–167

    Article  Google Scholar 

  13. Herrero F, Scott JB, Maropis PS, Yukna RA (1995) Clinical comparison of desired versus actual amount of crown lengtheing. J Periodontol 66:568–571

    Article  Google Scholar 

  14. Pennel BM, Kenneth OK, Malbern NW, Barron JM (1967) Repair of the alveolar process following osseous surgery. J Periodontol 38:426–431

    Article  Google Scholar 

  15. Wilderman MN, Pennel M, King K, Barron JM (1970) Histogenesis of repair following osseous surgery. J Periodontol 41:551–565

    Article  Google Scholar 

  16. Donnnennfeld OW, Hoag PM, Weissman DP (1970) A clinical study on the effect of osteoplasty. J Periodontol 41:131–141

    Article  Google Scholar 

  17. Brägger U, Pasquali L, Kornman KS (1988) Remodelling of interdental alveolar bone after periodontal flap procedures assessed by meas of computer-assisted densitometric image analysis (CADIA). J Clin Periodontol 15:558–564

    Article  Google Scholar 

  18. Oakley E, Rhyu IC, Karatzas S, Gandini-Santiago L, Nervis M, Caton J (1999) Formation of the biologic width following crown lengthening in nonhuman primates. Int J Periodontics Restorative Dent 19:529–541

    PubMed  Google Scholar 

  19. Deas DE, Mackey SA, Sagun RS Jr, Hancock RH, Gruwell SF, Campbell CM (2014) Crown lengthening in the maxillary anterior region: a 6-month prospective clinical study. Int J Periodontics Restorative Dent 34:365–373

    Article  Google Scholar 

  20. Brägger U, Lauchenauer D, Lang NP (1992) Surgical lengtheing of the clinical crown. J Clin Periodontol 19:58–63

    Article  Google Scholar 

  21. de Waal H, Castellucci G (1994) The importance of restorative margin placement to the biologic width and periodontal health. Part II. Int J Periodontics Restorative Dent 14:70–83

    PubMed  Google Scholar 

  22. Abou-Arraj RV, Majzoub ZAK, Holmes CM, Geisinger ML (2014) Healing time for final restorative therapy after surgical crown lengtheing procedures: a review of related evidence. Clin Adv Periodontics 5(2):131–139

  23. Pilalas I, Tsalikis L, Tatakis DM (2016) Prerestorative crown lengthening surgery outcomes: a systematic review. J Clin Periodontol 43:1094–1108

    Article  Google Scholar 

  24. Ainamo J, Löe H (1966) Anatomical characteristics of gingiva. A clinical and microscopic study of the free and attached gingiva. J Periodontol 37:5–13

    Article  Google Scholar 

  25. Nart J, Carrió N, Valles C, Solís-Moreon C, Nart M, Reñé R, Esquinas C, Puigdollers A (2014) Prevalence of altered passive eruption in orthohdontically treated and untreated patients. J Periodontol 85:348–353

    Article  Google Scholar 

  26. Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:22–35

    Google Scholar 

  27. De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosynn J (2009) The gingival biotype revised: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 36:428–433

    Article  Google Scholar 

  28. Silva CO, Soumaille JM, Marson FC, Progiante PS, Tatakis DN (2015) Aesthetic crown lengthening: periodontal and patient-centred outcomes. J Clin Periodontol 42:1126–1134

    Article  Google Scholar 

  29. Cortellini P, Bissada NF (2018) Mucogingival conditions in the natural dentition: narrative review, case definitions, and diagnostic considerations. J Clin Periodontol 45:S190–S198

    Article  Google Scholar 

  30. La Rocca AP, Alemany AS, Levi P Jr, Juan MV, Molina JN, Weisgold AS (2012) Anterior maxillary and mandibular biotype: relationship between gingival thickness and width with respect to underlying bone thickness. Implant Dent 21:507–515

    Article  Google Scholar 

Download references

Funding

The work was supported by the university dental clinic of Universitat Internacional de Catalunya, Spain.

Author information

Authors and Affiliations

  1. Department of Periodontology, Universitat Internacional de Catalunya (UIC), C/Josep Trueta s/n, 08195, Sant Cugat del Valles, Barcelona, Spain

    Eduard Domínguez, Andrés Pascual - La Rocca, Cristina Valles, Neus Carrió, Laura Montagut, Antonio Santos Alemany & Jose Nart

Authors
  1. Eduard Domínguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrés Pascual - La Rocca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cristina Valles
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Neus Carrió
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Laura Montagut
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonio Santos Alemany
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jose Nart
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrés Pascual - La Rocca.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Domínguez, E., Pascual - La Rocca, A., Valles, C. et al. Stability of the gingival margin after an aesthetic crown lengthening procedure in the anterior region by means of a replaced flap and buccal osseous surgery: a prospective study. Clin Oral Invest 24, 3633–3640 (2020). https://doi.org/10.1007/s00784-020-03239-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-020-03239-y

Keywords

Search

Navigation