GINGIVAL RECESSION FOLLOWING APICAL SURGERY IN THE AESTHETIC ZONE: A CLINICAL STUDY WITH 70 CASES
DMD
Professor, Department of Oral and Maxillofacial Surgery and Surgical Dentistry, Faculty of Dentistry, University of Bern (Bern, Switzerland).
PD, DMD
Graduate Student, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Switzerland.
DDS
Research Fellow Consultant Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Switzerland and Department of Oral & Maxillofacial Surgery, University Glostrup Hospital Copenhagen, Denmark.
DMD
Graduate Student, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Switzerland.
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 pretreatment 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 CA L were then correlated with patient-, tooth- and surgery-related parameters. The following parameters were found to significantly influence changes in GM and CAL overtime: 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 > 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.