Paniz Gianluca, Nart Jose, Gobbato Luca, Chierico Andrea, Lops Diego, Michalakis Konstantinos
Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.
Department of Prosthodontics, School of Dentistry, University of Padova, Padova, Italy.
Clin Oral Investig. 2016 Jul;20(6):1243-52. doi: 10.1007/s00784-015-1616-z. Epub 2015 Oct 8.
Subgingival margin placement is sometimes required due to different reasons and is often associated with adverse periodontal reactions. The purpose of this study was to determine if a single restoration with subgingival margin on a tooth, in the maxillary anterior zone, would affect its periodontal soft tissue parameters, and whether or not a deep chamfer preparation has a different influence in the periodontium when compared to a feather edge preparation.
Plaque and gingival indexes, periodontal probing depth, bleeding on probing, and patient's biotype were registered. One hundred six teeth were prepared with a deep chamfer, while 94 were prepared with a feather edge finishing line. Twelve months after the restoration delivery, the same parameters were evaluated. Repeated measure one-way analysis of variance (ANOVA) (α = 0.05) was used.
A statistically significant difference between the baseline and the 12-month follow-up is present in regard to plaque index, gingival index, and periodontal probing depth, but no statistically significant difference between chamfer and feather edge finishing lines. There is a statistically significant difference between the baseline and the 12-month follow-up in regard to bleeding on probing. Feather edge preparation presents significantly more bleeding on probing and less gingival recession than the chamfer.
Subgingival margins do influence the periodontal soft tissue response. Statistically significant difference exists between feather edge and chamfer finishing lines in regard to bleeding on probing and gingival recession.
Subgingival margins should be carefully selected, especially when feather edge finishing line is utilized.
由于各种不同原因,有时需要进行龈下边缘修复,而这往往与不良的牙周反应相关。本研究的目的是确定上颌前牙区单颗牙进行龈下边缘修复是否会影响其牙周软组织参数,以及与羽状边缘预备相比,深凹槽预备对牙周组织的影响是否不同。
记录菌斑指数、牙龈指数、牙周探诊深度、探诊出血情况以及患者的生物学类型。106颗牙采用深凹槽预备,94颗牙采用羽状边缘精修线预备。修复体戴入12个月后,对相同参数进行评估。采用重复测量单因素方差分析(α = 0.05)。
在菌斑指数、牙龈指数和牙周探诊深度方面,基线与12个月随访之间存在统计学显著差异,但深凹槽和羽状边缘精修线之间无统计学显著差异。在探诊出血方面,基线与12个月随访之间存在统计学显著差异。羽状边缘预备的探诊出血明显更多,牙龈退缩比深凹槽预备更少。
龈下边缘确实会影响牙周软组织反应。在探诊出血和牙龈退缩方面,羽状边缘和深凹槽精修线之间存在统计学显著差异。
应谨慎选择龈下边缘,尤其是在使用羽状边缘精修线时。