Dental and Periodontal Dimensions Stability After Esthetic Clinical Crown Lengthening Surgery: a 12-month Clinical Study

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2024 Jan 5

PMID 38180519

Authors

Valeria Martins de Araujo Carneiro

Andressa Meireles Seabra Gomes

Monica Umpierre Marinho

Gabriel Simino de Melo

Feras Kasabji

Tien-Li An

Cristine Miron Stefani

Maria do Carmo Machado Guimaraes

Carlos Alexandre Soares Andrade

Affiliations

Soon will be listed here.

Abstract

Objectives: To evaluate the stability of periodontal tissues 3 (T), 6 (T), and 12 (T) months after esthetic crown lengthening (ACL) and the possible correlations between changes in those structures.

Materials And Methods: Twenty individuals were evaluated through clinical assessment, photography, and tomography. Measurements included gingival margin (GM), clinical crown length (CCL), interdental papilla height (PH) and width (PW), gingival thickness (GT), bone thickness (BT), probing depth (PD), distance between alveolar crest and GM, distance between alveolar crest and cementoenamel junction. Nonparametric and correlation statistics were performed (p < 0.05).

Results: CCL at T was 7.42 ± 0.70 mm and increased to 9.48 ± 0.49 mm immediately after ACL, but it decreased to 8.93 ± 0.65 mm at T. PD decreased 0.60 mm from T to T, and it increased 0.39 mm from T to T. BT decreased 0.20 mm, while GT increased 0.29 mm from T to T. Both PW and PH showed enlargement in T. A positive moderate correlation was found between CCL/T and CCL/T, GT/T and AC-GM/T, BT/T and GT/T. A few negative moderate correlations were PD/T and CCL/T, PD/T and PH/T, PD/T and BT/T.

Conclusions: ACL procedure was effective. Although some rebound occurred, that was not clinically important. PD tended to reestablish its original length, partially due to a migration of GM during the healing period. Besides, a thickening of supracrestal soft tissues was observed.

Clinical Relevance: The present study centers on the factors influencing the stability of periodontal tissues after esthetic crown lengthening, underscoring the procedure's influence on esthetics and biology and the need for careful treatment planning.

Citing Articles

Outcomes of Flapless Er:YAG and Er,Cr:YSGG Laser-Assisted Crown Lengthening: A Systematic Review.

Elafifi Ebeid H, Altayeb W, Parada Avendano I, Abad-Sanchez D, Arnabat-Dominguez J Dent J (Basel). 2024; 12(12).

PMID: 39727475 PMC: 11674419. DOI: 10.3390/dj12120418.

Effects of polymethyl methacrylate-based bone cement graft for treating excessive gingival display and its dimensional facial changes: 12-Month clinical study.

Martins de Araujo Carneiro V, Roquete M, Seabra Gomes A, Marinho M, Simino de Melo G, Kasabji F J Oral Biol Craniofac Res. 2024; 14(3):326-334.

PMID: 38660054 PMC: 11039310. DOI: 10.1016/j.jobcr.2024.04.007.

References

Kim Y, Park J, Kim S, Koo K, Seol Y, Lee Y . New method of assessing the relationship between buccal bone thickness and gingival thickness. J Periodontal Implant Sci. 2017; 46(6):372-381. PMC: 5200863. DOI: 10.5051/jpis.2016.46.6.372. View

Varghese P, Cherian B, Sukumaran B, Anu S, Jacob B, Varma Raja V . Analysis of Geometric Proportions on Maxillary Anterior Teeth for Esthetic Smile Design: An Study. J Pharm Bioallied Sci. 2021; 13(Suppl 1):S778-S782. PMC: 8375964. DOI: 10.4103/jpbs.JPBS_808_20. View

Amid R, Mirakhori M, Safi Y, Kadkhodazadeh M, Namdari M . Assessment of gingival biotype and facial hard/soft tissue dimensions in the maxillary anterior teeth region using cone beam computed tomography. Arch Oral Biol. 2017; 79:1-6. DOI: 10.1016/j.archoralbio.2017.02.021. View

Batista Jr E, Moreira C, Batista F, Oliveira R, Pereira K . Altered passive eruption diagnosis and treatment: a cone beam computed tomography-based reappraisal of the condition. J Clin Periodontol. 2012; 39(11):1089-96. DOI: 10.1111/j.1600-051X.2012.01940.x. View

Caporossi L, Studzinski Dos Santos C, Calcia T, Cenci M, Muniz F, Lima G . Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis. Clin Oral Investig. 2020; 24(8):2559-2578. DOI: 10.1007/s00784-020-03401-6. View

Pilalas I, Tsalikis L, Tatakis D . Pre-restorative crown lengthening surgery outcomes: a systematic review. J Clin Periodontol. 2016; 43(12):1094-1108. DOI: 10.1111/jcpe.12617. View

Bouguezzi A, Boudour O, Sioud S, Hentati H, Selmi J . Mucosal coronally positioned flap technique for management of excessive gingival display. Pan Afr Med J. 2021; 36:235. PMC: 7908332. DOI: 10.11604/pamj.2020.36.235.22597. View

Pontoriero R, Carnevale G . Surgical crown lengthening: a 12-month clinical wound healing study. J Periodontol. 2001; 72(7):841-8. DOI: 10.1902/jop.2001.72.7.841. View

Kurtzman G, Silverstein L . Diagnosis and treatment planning for predictable gingival correction of altered passive eruption. Pract Proced Aesthet Dent. 2008; 20(2):103-8. View

10.

Coslet J, Vanarsdall R, Weisgold A . Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. Alpha Omegan. 1977; 70(3):24-8. View

11.

Dolt 3rd A, Robbins J . Altered passive eruption: an etiology of short clinical crowns. Quintessence Int. 1997; 28(6):363-72. View

12.

Lavanya C, Sriteja D, Bandari G, Rajasri V, Smriti C, Pradeep N . Evaluation of Maxillary Anterior Teeth Width and Their Relation to the Calculated Values for Smile Designing. J Contemp Dent Pract. 2021; 22(4):378-387. View

13.

Abou-Arraj R, Majzoub Z, Holmes C, Geisinger M, Geurs N . Healing Time for Final Restorative Therapy After Surgical Crown Lengthening Procedures: A Review of Related Evidence. Clin Adv Periodontics. 2020; 5(2):131-139. DOI: 10.1902/cap.2014.140014. View

14.

Weinberg M, Eskow R . An overview of delayed passive eruption. Compend Contin Educ Dent. 2001; 21(6):511-4, 516, 518 passim; quiz 522. View

15.

Kan J, Morimoto T, Rungcharassaeng K, Roe P, Smith D . Gingival biotype assessment in the esthetic zone: visual versus direct measurement. Int J Periodontics Restorative Dent. 2010; 30(3):237-43. View

16.

Bhola M, Fairbairn P, Kolhatkar S, Chu S, Morris T, de Campos M . LipStaT: The Lip Stabilization Technique- Indications and Guidelines for Case Selection and Classification of Excessive Gingival Display. Int J Periodontics Restorative Dent. 2015; 35(4):549-59. DOI: 10.11607/prd.2059. View

17.

Deas D, Mackey S, Sagun Jr R, Hancock R, Gruwell S, Campbell C . Crown lengthening in the maxillary anterior region: a 6-month prospective clinical study. Int J Periodontics Restorative Dent. 2014; 34(3):365-73. DOI: 10.11607/prd.1926. View

18.

Vacek J, Gher M, Assad D, Richardson A, Giambarresi L . The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent. 1994; 14(2):154-65. View

19.

Shobha K, Mahantesha , Seshan H, Mani R, Kranti K . Clinical evaluation of the biological width following surgical crown-lengthening procedure: A prospective study. J Indian Soc Periodontol. 2011; 14(3):160-7. PMC: 3100858. DOI: 10.4103/0972-124X.75910. View

20.

Dong J, Jin T, Cho H, Oh S . The esthetics of the smile: a review of some recent studies. Int J Prosthodont. 1999; 12(1):9-19. View