von Arx Thomas, Salvi Giovanni E, Janner Simone, Jensen Simon S
Department of Oral Surgery and Stomatology, School of Dental Medicine University of Bern, Switzerland.
Eur J Esthet Dent. 2009 Spring;4(1):28-45.
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.
本研究评估了70颗上颌前牙（中切牙、侧切牙、尖牙和第一前磨牙）根尖手术后1年的牙龈退缩情况。使用治疗前和1年随访时拍摄的照片，对治疗牙齿的牙龈水平的中面部外观和乳头高度进行了视觉评估。此外，通过临床测量（即治疗前和1年随访时的牙周袋探诊深度和牙龈边缘水平）计算牙龈边缘（GM）和临床附着水平（CAL）的变化。然后将GM和CAL的变化与患者、牙齿和手术相关参数进行关联。发现以下参数会随着时间显著影响GM和CAL的变化：牙龈生物型（P < 0.05），薄生物型比厚生物型表现出更多的牙龈退缩；治疗前牙周袋探诊深度（PPD）（P < 0.03），治疗前PPD < 2.5 mm的病例比PPD > 或 = 2.5 mm的病例显示出更多的附着丧失；以及切口类型（P < 0.01），与龈沟内切口、乳头基部切口或保留乳头切口相比，龈下切口显示出的牙龈退缩明显更少。使用治疗前和1年随访照片进行的视觉评估未显示根尖手术后牙龈水平或乳头高度有显著变化。总之，牙龈生物型、治疗前PPD和切口类型可能会显著影响上颌前牙根尖手术后GM和CAL的变化。
