This prospective, single-group interventional study will evaluate the stability of periodontal tissues after esthetic periodontal surgery for the correction of altered passive eruption in individuals with excessive gingival display. Ten adult participants with excessive gingival display associated with altered passive eruption and involvement of the alveolar bone will be included. Participants will undergo esthetic crown-lengthening surgery consisting of gingivectomy and osseous recontouring. Periodontal clinical measurements, intraoral digital scans, cone-beam computed tomography, standardized photographs, and patient-reported outcomes will be obtained before surgery and during follow-up. Clinical and three-dimensional tissue changes, esthetic perception, satisfaction, and oral health-related quality of life will be evaluated for up to 12 months after treatment.
Excessive gingival display may be associated with altered passive eruption, a condition characterized by excessive gingival coverage of the anatomical crown and an altered relationship between the gingival margin, cementoenamel junction, and alveolar bone crest. Esthetic crown-lengthening procedures may be indicated to expose the anatomical crown and establish an appropriate periodontal tissue relationship. This prospective, non-randomized, before-and-after clinical study will include 10 adult participants presenting with an esthetic complaint related to excessive gingival display and a diagnosis of altered passive eruption involving the alveolar bone. Before surgery, participants will undergo clinical examination and periodontal preparation. Esthetic periodontal surgery will consist of gingivectomy associated with osseous recontouring. The surgical approach, including flap elevation when required, will be determined according to the periodontal phenotype and local anatomical characteristics. Periodontal clinical measurements will be performed before surgery and during postoperative follow-up. Intraoral digital scanning will be performed before treatment and at 3, 6, and 12 months to evaluate three-dimensional changes and soft-tissue stability. Cone-beam computed tomography will also be used to evaluate periodontal tissue dimensions and remodeling. Standardized intraoral and extraoral photographs will document esthetic changes. Patient-reported outcomes, including postoperative discomfort, esthetic perception, satisfaction, and oral health-related quality of life, will also be assessed. Participants will be followed for 12 months after surgery to determine the stability of the clinical and three-dimensional periodontal outcomes.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Esthetic periodontal surgery will be performed to correct altered passive eruption. Gingival tissue will be removed by an internal bevel gingivectomy. Osseous recontouring will then be performed to establish an adequate relationship between the cementoenamel junction and the alveolar bone crest. Depending on the periodontal phenotype and anatomical characteristics, osseous recontouring may be performed with or without flap elevation.
School of Dentistry of Ribeirão Preto, University of Sao Paulo
Ribeirão Preto, São Paulo, Brazil
RECRUITINGMean Change From Baseline in Clinical Crown Length
Clinical crown length will be recorded in millimeters. The mean change from baseline will be calculated at each postoperative assessment to evaluate the stability of the surgical outcome over time.
Time frame: Baseline, 2 weeks, 3 months, 6 months, and 12 months after surgery
Mean Change From Baseline in the Distance Between the Cementoenamel Junction and Alveolar Bone Crest
The distance between the cementoenamel junction and the alveolar bone crest will be measured in millimeters using cone-beam computed tomography to evaluate postoperative periodontal tissue remodeling.
Time frame: Baseline, 3 months, 6 months, and 12 months after surgery
Mean Change From Baseline in Gingival Thickness
Gingival thickness will be measured in millimeters using cone-beam computed tomography to evaluate changes in periodontal soft-tissue dimensions after surgery.
Time frame: Baseline, 3 months, 6 months, and 12 months after surgery
Mean Change From Baseline in Alveolar Bone Thickness
Alveolar bone thickness will be measured in millimeters using cone-beam computed tomography to evaluate bone remodeling after esthetic crown-lengthening surgery.
Time frame: Baseline, 3 months, 6 months, and 12 months after surgery
Three-Dimensional Change in Gingival Soft Tissues
Intraoral digital scans obtained at follow-up visits will be compared with baseline digital models to assess three-dimensional changes in gingival morphology and soft-tissue stability.
Time frame: Baseline, 3 months, 6 months, and 12 months after surgery
Change in Oral Health-Related Quality of Life Assessed by OHIP-14
Oral health-related quality of life will be assessed using the 14-item Oral Health Impact Profile (OHIP-14). Each item is scored from 0 (never) to 4 (very often), with higher scores indicating a greater negative impact of oral health on quality of life.
Time frame: Baseline, 3 months, 6 months, and 12 months after surgery
Postoperative Pain Intensity
Postoperative pain will be assessed using a 0-to-100 numerical rating scale, where 0 indicates no pain and 100 indicates unbearable pain.
Time frame: 3 months, 6 months, and 12 months after surgery
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