Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
251 Hellenic Air Force General Hospital, P. Kanelopoulou Av. 3, 11525, Athens, Greece.
Oral Maxillofac Surg. 2024 Mar;28(1):253-267. doi: 10.1007/s10006-023-01138-6. Epub 2023 Jan 25.
Aim of this study was to assess the influence of restorative treatment timing on the periodontal, patient and operator-reported outcomes following crown lengthening surgery (CLS).
Eighteen study participants requiring CLS were divided into two groups based on prosthetic rehabilitation timing (6 or 14 weeks postoperatively). Clinical parameters were recorded around treated and neighboring teeth before and after surgery, 6 and 14 weeks postoperatively, at prosthesis delivery, and three and six months after. Soft tissue and radiographic bone changes were evaluated. Patients assessed their perception of the procedure by means of a questionnaire. The final treatment outcome was rated by both patients and prosthodontists.
CLS resulted in statistically significant and stable apical displacement of the gingival margin, at both treated and adjacent sites. Plaque and bleeding scores remained low throughout. No statistically significant differences were observed between groups for any clinical or radiographic parameter examined. Healing was uneventful and treatment outcome was satisfying for both patients and prosthodontists, without statistically significant differences between groups.
The present study has been characterized as pilot, because it was not possible to reach the sample size indicated by the a priori power analysis. CLS is an effective pre-prosthetic procedure as long as it is performed under a certain surgical protocol which predicts for at least a 3 mm distance between bone crest and the flap margin at suturing. Within the limitations of this study, six weeks after surgery may be an adequate healing time for the onset of prosthetic restoration.
Crown lengthening surgery is commonly performed in daily clinical practice with the aim to restore teeth with short clinical crowns. Based on periodontal, patient and operator-reported criteria, 6 weeks after CLS may be adequate healing time before the onset of prosthetic restoration.
ClinicalTrials.gov Identifier: NCT03947658, 13/05/2019, retrospectively registered.
本研究旨在评估修复治疗时机对牙冠延长术后牙周、患者和术者报告结局的影响。
将 18 名需行牙冠延长术的患者根据修复时机（术后 6 周或 14 周）分为两组。分别在术前、术后、术后 6 周和 14 周、修复体戴入时以及术后 3 个月和 6 个月记录治疗牙和邻牙的临床参数。评估软组织和影像学骨变化。患者通过问卷调查评估对手术的感知。最终治疗结局由患者和修复医生共同评价。
牙冠延长术导致牙龈边缘在治疗牙和邻牙处均出现统计学上显著且稳定的根尖向移位。菌斑和出血评分一直较低。各组间任何临床或影像学参数均无统计学差异。愈合过程顺利，患者和修复医生均对治疗结局满意，组间无统计学差异。
由于无法达到先验功效分析所指示的样本量，本研究被归类为初步研究。只要遵循特定的手术方案，牙冠延长术是一种有效的术前治疗方法，该方案预测在缝合时牙槽嵴和瓣边缘之间至少有 3mm 的距离。在本研究的限制范围内，术后 6 周可能是开始修复的合适愈合时间。
牙冠延长术是日常临床实践中常见的治疗方法，旨在恢复临床冠较短的牙齿。基于牙周、患者和术者报告的标准，牙冠延长术后 6 周可能是开始修复前的合适愈合时间。
ClinicalTrials.gov 标识符：NCT03947658，2019 年 5 月 13 日，回顾性注册。
