The study aims to compare the effect of periodontal accelerated osteogenic orthodontics (PAOO) with horizontal or vertical releasing incisions on operation time, healing, adverse effects, and effectiveness of bone augmentation. Methods: A total of 22 patients requiring PAOO surgery due to orthodontic treatment were enrolled in this trial, and randomly divided into test or control group, consisting of 11 subjects in each. The test group will receive PAOO with horizontal extending incisions on both sides of the flap; while the control group will receive PAOO with vertical releasing incisions; the two groups use the same surgical technic except for the incision design. Outcome measures include: operation time, postoperative scar, radiographic data (alveolar height and alveolar ridge thickness), gingival thickness, etc. Clinical evaluation will be performed at 1 week, 2 weeks, 3months, 6 months and 12 months after operation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
22
a papilla preserving incision will be made on the labial side of the front teeth with a thin alveolar bone or dehiscence and/or fenestration. Then horizontally extending incisions will be added to each side of the initial incision, extending one to two teeth beyond the defected area, before a full-thickness flap is lifted.
a papilla preserving incision will be made on the labial side of the front teeth with a thin alveolar bone or dehiscence and/or fenestration. Vertical releasing incisions will be made on each side of the initial incision before a full-thickness flap is lifted. The incision formed an oblique trapezoidal flap with a wider base.
2nd Affiliated Hospital, School of Medicine, Zhejiang University
Hangzhou, Zhejiang, China
Surgery Time
Timing will start when the first incision is about to be made, and end when the last suture is complete. The time in between will be recorded as surgery time.
Time frame: 1 day
Probing Depth (PD)
Distance from gingival margin to base of periodontal pocket. It will be measured at baseline and 3 months, 6 months, and 12months after surgery.
Time frame: 12 months
Clinical Attachment Level (CAL)
Distance from CEJ to base of periodontal pocket. It will be measured at baseline and 3 months, 6 months, and 12months after surgery.
Time frame: 12 months
Keratinized Gingival Width (KGW)
From mucogingival junction to free gingival margin It will be measured at baseline and 3 months, 6 months, and 12months after surgery.
Time frame: 12 months
Gingival Recession Depth (GRD)
Distance from CEJ to gingival margin. It will be measured at baseline and 3 months, 6 months, and 12months after surgery.
Time frame: 12 months
Root Length
the distance from the CEJ to the apex of the root. It will be measured at baseline, 6 months, and 12months after surgery.
Time frame: 12 months
Vertical Bone Height (VBL)
the distance from the cemento-enamel junction to the crest of the labial alveolar bone. It will be measured at baseline, 6 months, and 12months after surgery.
Time frame: 12 months
Alveolar Bone Width Measured at 2 mm Below the CEJ (BW2)
Alveolar bone width measured at 2 mm below the CEJ on the labial side of the alveolar bone, representing the distance from the tooth root surface to the labial bone surface.It will be measured at baseline, 6 months, and 12months after surgery.
Time frame: 12 months
Alveolar Bone Width Measured at 4 mm Below the CEJ (BW4)
Alveolar bone width measured at 4 mm below the CEJ on the labial side of the alveolar bone, representing the distance from the tooth root surface to the labial bone surface.It will be measured at baseline, 6 months, and 12months after surgery.
Time frame: 12 months
Alveolar Bone Width Measured at 6 mm Below the CEJ (BW6)
Alveolar bone width measured at 6 mm below the CEJ on the labial side of the alveolar bone, representing the distance from the tooth root surface to the labial bone surface.It will be measured at baseline, 6 months, and 12months after surgery.
Time frame: 12 months
Number of Participants With Visible Scarring
Gingival scarring was evaluated at 12 months postoperatively through visual inspection. Participants were classified as scar-positive if any visible scar was present at the surgical site, including normotrophic scars (flat and white) and pathological scars (raised or irregular in shape). Each participant was counted once regardless of scar characteristics.
Time frame: 12 months
Pain Level
measured with visual analogue score (VAS): 0 (no pain/normal sensation) to 10 (intolerable pain/complete numbness)
Time frame: 2 weeks
Membrane Exposure
membrane exposure was observed and assessed as a binary outcome (yes/no). Recorded "no" if there is no membrane exposure, and "yes" if there is any membrane exposure.
Time frame: 2 weeks
Facial Swelling
recorded "0" for no facial swelling; "1" for mild facial swelling; "2" for severe facial swelling. It will be measured at 1 and 2 weeks after surgery.
Time frame: 2 weeks
Mucosal Color
recorded "0" for no redness along the incision; "1" for slight redness; "2" for obvious redness. It will be measured at 1 and 2 weeks after surgery.
Time frame: 2 weeks
Mucosa Edema
recorded "0" for no edema around the surgery area; "1" for mild edema; "2" for severe edema.It will be measured at 1 and 2 weeks after surgery.
Time frame: 2 weeks
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