Gingival recession following apical surgery in the esthetic zone: a clinical study with 70 cases.
The present study evaluated gingival recession 1 year following apical surgery of 70 maxillary anterior teeth (central and lateral incisors, canines, and first premolars). A visual assessment of the mid-facial aspect of the gingival level and of papillary heights of treated teeth was carried out using photographs taken at pre-treatment and 1-year follow-up appointments. In addition, changes in the gingival margin (GM) and clinical attachment levels (CAL) were calculated with the use of clinical measurements, that is, pre-treatment and 1-year follow-up pocket probing depth and level of gingival margin. Changes in GM and CAL were then correlated with patient-, tooth-, and surgery-related parameters. The following parameters were found to significantly influence changes in GM and CAL over time: gingival biotype (P < 0.05), with thin biotype exhibiting more gingival recession than thick biotype; pre-treatment pocket probing depth (PPD) (P < 0.03), with cases of pre-treatment PPD < 2.5 mm demonstrating more attachment loss than cases of PPD > or = 2.5 mm; and type of incision (P < 0.01), with the submarginal incision showing considerably less gingival recession compared with the intrasulcular incision, papilla-base incision or papilla-saving incision. The visual assessment using pre-treatment and 1-year follow-up photographs did not demonstrate significant changes in gingival level or papillary height after apical surgery. In conclusion, gingival biotype, pre-treatment PPD, and type of incision may significantly influence changes in GM and CAL following apical surgery in maxillary anterior teeth.
von Arx
Thomas
T
Department of Oral Surgery and Stomatology, School of Dental Medicine University of Bern, Switzerland. thomas.vonarx@zmk.unibe.ch
Salvi
Giovanni E
GE
Janner
Simone
S
Jensen
Simon S
SS
D000328:Adult; D000368:Aged; D001047:Apicoectomy; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology; D005889:Gingival Recession / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010027:Osteotomy; D010485:Periapical Periodontitis / Q000601:surgery*; D010514:Periodontal Pocket / Q000150:complications; D011183:Postoperative Complications