Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Via del Pozzo 71,, 41124, Italy.
European Research Group on Periodontology (ERGOPERIO), Bern, Switzerland.
Clin Oral Investig. 2020 Feb;24(2):1001-1011. doi: 10.1007/s00784-019-02998-7. Epub 2019 Jul 8.
To compare the clinical and histological response of supracrestal periodontal tissues to subgingival composite restorations versus natural root surfaces MATERIAL AND METHODS: In 29 subjects with a single tooth requiring subgingival restorations, a deep margin elevation (DME) procedure with composite resin was applied. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), and focal probing depth (PD) were measured at baseline, before DME, and after 3 months. The distance between the coronal marked (CM) point to the apical margin of the composite reconstruction (AMR), at baseline, and to the tip of the periodontal probe inserted to reach the bottom of the sulcus (APP), 3 months later, was measured. An all-around secondary flap, harvested to ensure the subsequent single-crown prosthetic rehabilitation was histologically processed. The histological inflammation degree was evaluated in areas of gingival tissues adjacent to the composite (group B) and adjacent to the natural surface of each single tooth (group A).
Significant FMPS, FMBS, and PD decreases were observed (p < 0.05). CM-AMR and CM-APP were significantly different (p < 0.05), suggesting an attachment gain after 3-months. The inflammation level of gingival tissue was similar in groups A and B (p > 0.05).
For the first time, this topic was clinically and histologically studied in humans. Subgingival restorations resulted compatible with gingival health, with levels similar to that of untreated root surfaces.
Deep margin elevation procedure produces favorable clinical and histological outcomes allowing a routine utilization in reconstructive dentistry.
比较龈下复合修复与天然根面治疗龈上牙周组织的临床和组织学反应。
在 29 名需要龈下修复的单个牙齿患者中,应用复合树脂进行深边缘抬高(DME)处理。在基线、DME 前和 3 个月时测量全口菌斑评分(FMPS)、全口出血评分(FMBS)和焦点探诊深度(PD)。在基线、DME 前和 3 个月后,测量从冠方标记点(CM)到复合重建的根尖边缘(AMR)的距离,以及插入牙周探针到达沟底时的距离(APP)。采集全面的二次瓣,以确保随后的单冠修复体的修复在组织学上得到处理。评估与复合区相邻的牙龈组织(B 组)和每个单个牙齿的天然表面相邻的牙龈组织(A 组)的组织学炎症程度。
FMPS、FMBS 和 PD 显著降低(p<0.05)。CM-AMR 和 CM-APP 有显著差异(p<0.05),提示 3 个月后附着增加。A 组和 B 组的牙龈组织炎症水平相似(p>0.05)。
本研究首次从临床和组织学角度在人类中研究了这一课题。龈下修复与牙龈健康兼容,水平与未经处理的根面相似。
深边缘抬高术产生了有利的临床和组织学结果,允许在重建牙科中常规应用。