背景:在牙冠延长期间要保持的重要因素之一是生物宽度(BW),最近称为骨上组织附着。具有足够BW的健康牙周组织对于修复牙齿的成功非常重要。有各种技术来执行牙冠延长程序。大多数研究都集中在评估边缘牙龈和骨骼位置的变化作为结果参数,而不是BW。此外,大部分研究都是在动物模型上进行的。
目的:本研究的目的是评估两种不同的牙冠延长手术后三个月和六个月的牙周组织变化。
方法:60例需要手术牙冠延长术的患者中的60例下颌第一磨牙被纳入研究,并接受两种不同的手术,牙龈切除术(I组;n=30)和顶部定位的皮瓣进行骨切除术(II组;n=30)。在基线时记录以下参数:三个月,六个月,游离牙龈边缘(FGM)的位置,探测深度(PD),相对附着水平(RAL),骨水平(BL),和BW。这些测量是在每个患者的三个部位进行的:治疗的牙齿部位(TT),相邻牙齿的相邻部位(AD),和相邻牙齿的非相邻部位(NAD)。然后使用SPSS软件(版本20.0)对数据进行统计分析。统计学显著性设定为p<0.05。
结果:当在三个月和六个月时比较I组和II组时,女性生殖器切割的位置没有统计学差异,PD,和RAL(p>0.05)。当在三个月和六个月比较两组之间的BW时,II组在任何给定时间段显示更好的BW重建,并且具有统计学意义(p<0.05)。
结论:在手术牙冠延长后,骨水平在顶部移动,并允许重建BW。在六个月的随访中,与牙龈切除术相比,顶部定位的皮瓣在恢复BW方面更优。
BACKGROUND: One of the important things to preserve during crown lengthening is the biologic width (BW), recently called supracrestal tissue attachment. A healthy periodontium with adequate BW is very essential for the success of restored teeth. There are various techniques to perform crown lengthening procedures. Most of the studies have focused on assessing the changes in the position of the marginal gingiva and bone as outcome parameters rather than BW. Also, most of the research was done on animal models.
OBJECTIVE: The purpose of this study was to assess the periodontal tissue changes at three months and six months following two different surgical crown lengthening procedures.
METHODS: Sixty mandibular first molars among 60 patients that required surgical crown lengthening were enrolled in the study and subjected to two different procedures,
gingivectomy (Group I; n=30) and apically positioned flap with ostectomy (Group II; n=30). The following parameters were recorded at baseline, three months, and six months, position of free gingival margin (FGM), probing depth (PD), relative attachment level (RAL), bone level (BL), and BW. These measurements were made at three sites in every patient: treated tooth sites (TT), adjacent tooth\'s adjacent sites (AD), and adjacent tooth\'s non-adjacent sites (NAD). The data was then subjected to statistical analysis using SPSS software (Version 20.0). Statistical significance was set to p<0.05.
RESULTS: When groups I and II were compared at three and six months, there was no statistical difference in terms of position of FGM, PD, and RAL (p>0.05). When BW was compared between the two groups at three and six months, group II showed better reestablishment of BW at any given time period and was statistically significant (p<0.05).
CONCLUSIONS: Following surgical crown lengthening, the bone level was shifted apically and allowed for the reestablishment of BW. At six months of follow-up, the apically positioned flap with ostectomy was superior in restoring the BW compared to
gingivectomy.