Abdulkarim Hesham H, Antoine Nathan M, Wang Mary Ying-Fang, Rosales Elio Reyes, Miley D Douglas
Department of Advanced Periodontics & Dental Implant Care, A.T. Still University, Missouri School of Dentistry & Oral Health, Saint Louis, Missouri, USA.
Private Practice, Reno, Nevada, USA.
Clin Adv Periodontics. 2024 Dec;14(4):310-318. doi: 10.1002/cap.10280. Epub 2024 Feb 13.
The aim of this study is to measure, in vivo, the supracrestal tissue attachment dimensions (STADs) by means of a noninvasive digital method and to investigate the association between STADs and gingival thickness (GT), tooth position, tooth length, tooth width, keratinized tissue width (KTW), buccal bone thickness (BBT), and bone crest (BC) level.
Nineteen periodontally healthy subjects who previously received full mouth periodontal charting, cone beam computed tomography, and intraoral scan for the purpose of implant planning were included in the study. A digital imaging software was used for the superimposition of Digital Imaging and Communications in Medicine and stereolithography files, along with hard and soft tissue measurements. Pearson's correlation and ANOVA statistical analyses were used to investigate potential trends between STADs and other dentogingival components.
A total of 203 teeth were assessed, with an average STADs of 2.05 mm (±0.99 mm). STADs were larger in mandibular than maxillary teeth (p-value <0.001) and decreased from anterior to posterior teeth. STADs exhibited an inverse relationship with BBTs and GTs (p-value <0.001) and the KTW (p-value = 0.05). Positive correlations were found between GT and BBT (p-value <0.001), whereas both were negatively correlated with the distance between the cementoenamel junction and BC (p-values 0.019 and 0.006, respectively) and positively correlated with KTW (p-value <0.001).
This study highlighted the dynamic nature of STA relative to tooth position. Additionally, it explored the intricate relationships of STADs with various dentogingival components.
To the best of the authors' knowledge, this study represents the first application of CBCTs, intraoral scans, and clinical probe depths for noninvasive supracrestal tissue attachment measurements. This study advocates for a personalized assessment of supracrestal attachments, incorporating tooth position and other dentogingival components. The study emphasizes the importance for practitioners to consider the specific patient gingival phenotypes during restorative or surgical planning to avoid adverse outcomes.
本研究旨在通过一种非侵入性数字方法在体内测量龈上组织附着尺寸（STADs），并研究STADs与牙龈厚度（GT）、牙齿位置、牙长、牙宽、角化组织宽度（KTW）、颊侧骨厚度（BBT）和牙槽嵴（BC）水平之间的关联。
本研究纳入了19名牙周健康受试者，他们之前因种植计划接受了全口牙周检查、锥形束计算机断层扫描和口腔内扫描。使用数字成像软件对医学数字成像和通信文件与立体光刻文件进行叠加，并进行软硬组织测量。采用Pearson相关性分析和方差分析统计方法研究STADs与其他牙-牙龈成分之间的潜在趋势。
共评估了203颗牙齿，平均STADs为2.05毫米（±0.99毫米）。下颌牙齿的STADs大于上颌牙齿（p值<0.001），且从前往后牙逐渐减小。STADs与BBT和GT呈负相关（p值<0.001），与KTW呈负相关（p值=0.05）。GT与BBT呈正相关（p值<0.001），而两者均与牙骨质釉质界与BC之间的距离呈负相关（p值分别为0.019和0.006），与KTW呈正相关（p值<0.001）。
本研究强调了龈上附着相对于牙齿位置的动态性质。此外，还探讨了STADs与各种牙-牙龈成分之间的复杂关系。
据作者所知，本研究首次应用锥形束计算机断层扫描、口腔内扫描和临床探诊深度进行非侵入性龈上组织附着测量。本研究提倡结合牙齿位置和其他牙-牙龈成分对龈上附着进行个性化评估。该研究强调了从业者在修复或手术计划过程中考虑特定患者牙龈表型以避免不良后果的重要性。
