The goal of this observational study is to learn how the health and thickness of the gums and supporting bone around the teeth change over 6 months in adults having jaw surgery to correct the bite. The main questions it aims to answer are: * Do gum and tooth-support measurements change from before surgery to 1, 3, and 6 months after surgery? * Do CT scan-based measurements of the tooth-supporting bone change over the same time period? Participants will: * Have a gum check-up (periodontal examination) before surgery and at 1, 3, and 6 months after surgery. * Have CT scan-based measurements (CBCT) taken at the same time points for study assessment.
This two-center prospective observational cohort study will enroll adult patients who are scheduled to undergo orthognathic surgery according to standard clinical indications. Orthognathic surgeries will be performed at Kocaeli Health and Technology University, while periodontal clinical examinations and CBCT-based assessments will be conducted at Trakya University. Participants will be evaluated at baseline (preoperatively) and at 1, 3, and 6 months after surgery. Clinical periodontal assessments will include predefined periodontal phenotype-related parameters recorded using a standardized protocol. CBCT datasets will be obtained and analyzed using a standardized measurement protocol to assess buccal alveolar bone-related parameters and the presence of dehiscence/fenestration where applicable. To minimize assessment bias, CBCT images will be coded and evaluated by an independent assessor blinded to surgical details and group classification, and clinical periodontal examinations will be performed by an examiner blinded to the surgical procedure details.
Study Type
OBSERVATIONAL
Enrollment
100
Trakya University Faculty of Dentistry
Edirne, Turkey (Türkiye)
Kocaeli Health and Technology University Faculty of Dentistry
Kocaeli, Turkey (Türkiye)
Change in width of keratinized gingiva (mm)
Width of keratinized gingiva is measured as the distance from the gingival margin to the mucogingival junction, recorded in mm.
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Change in gingival thickness phenotype (thin vs thick)
Gingival thickness is assessed with a periodontal probe by the probe-transparency method and categorized as thin (≤1 mm; probe visible) or thick (\>1 mm; probe not visible)
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Change in buccal cortical bone thickness on CBCT (mm)
Buccal cortical bone thickness is measured on CBCT as the horizontal distance from the deepest point of the buccal marginal bone curvature (A) to the CEJ, and additionally at 4 mm apical to A and at the apex level, as defined in the protocol
Time frame: Baseline (preoperative) and postoperative follow-up CBCT records were obtained during routine controls (planned at 6 months).
Probing pocket depth (mm)
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Bleeding on probing (0/1)
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Gingival Index (0-3)
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Plaque Index (0-3)
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Papilla loss classification (Nordland & Tarnow)
Time frame: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Gingival recession (mm)
Time frame: Baseline and postoperative 1, 3, 6 months.
Fenestration/dehiscence presence on CBCT (yes/no) (and/or counts)
Time frame: Baseline and postoperative 6 months.
Clinical attachment loss (mm)
Time frame: Baseline and postoperative 1, 3, 6 months
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