ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Stability of periodontal architecture created by crown lengthening surgery
Clinical Question Are gingival and bone heights created by crown lengthening surgery stable over time for patients with subgingival restoration margins?
Clinical Bottom Line The periodontal tissues are expected to remain stable if adequate osseous reduction and the gingival level established at the time of suturing allows for the regeneration of the preoperative biologic width, approximately 3mm on average. Insufficient osseous reduction will result in a decrease in the length of crown gained at the time of surgery as the biologic width reestablishes over time. In addition, surgically placing the gingival margin too close to the newly established crest of bone will also decrease the crown gained as the soft tissue rebounds coronally to form biologic width. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 12747451Lanning/200323 patients with healthy periodontium, between the ages of 28 and 72 (mean 39) requiring crown lengthening surgeryUncontroller Clinical Study
Key results90% of treated sites had ≥ 3mm osseous reduction (3.5 ± 0.59mm p<0.05) with final apical displacement of the gingival margin at 3.33 ± 0.16mm (p<0.05) at 6 months. At 6 months, the change in biologic width of treated teeth was -0.07 ± 0.09mm and the change in probing depth of treated teeth was +0.22 ± 0.50mm. (neither value was significantly different from baseline).
Evidence Search "Crown Lengthening"[Mesh] AND "Gingiva"[Mesh] AND ((Clinical Trial[ptyp]) AND English[lang])
Comments on
The Evidence
Additional clinical trials in which the patients are randomized would provide more reliable evidence.
Applicability This evidence could be used as a guide when planning the final restoration margins and the osseous and soft tissue reshaping of any patient receiving crown lengthening surgery.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Crown lengthening surgery, biologic width, bone level, subgingival margin
ID# 522
Date of submission: 01/20/2010spacer
E-mail kartaltepe@uthscsa.edu
Author Christen Kartaltepe
Co-author(s) Jay A. Bonnin
Co-author(s) e-mail
Faculty mentor/Co-author Erica Oliveira, DDS, MPH
Faculty mentor/Co-author e-mail OLIVEIRAE@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
post a comment
by Karissa Rumple (San Antonio, TX) on 04/13/2012
After doing a PubMed search on this topic in April 2012, I found a more recent publication with a PubMed: 21760669. The clinical trial involving 15 patients provides essentially the same key results.
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