Gummy Smile
Conditions
Brief summary
the study compare gingival margin stability following conventional approach versus microsurgical approach of esthetic crown lengthening in management of patients with short clinical crowns in the upper anterior region.In management of patients with short clinical crowns in the upper anterior region, there is no difference in gingival margin stability between conventional and microsurgical approaches of esthetic crown lengthening.
Interventions
PROCEDURETest group
The surgery will be done with the use of 4x magnification loop, the knives are micro blades and micro-sutures 7//0 used with the microsurgical instruments kit
PROCEDUREControl group
esthetic crown lengthening with conventional approach with an internal bevel incision, following CEJ anatomy, this will be followed by an intra-sulcular incision, removal of the strip of outlined marginal gingiva and elevation of a mucoperiosteal flap to the level of the alveolar bone crest.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients with healthy systemic condition. * Adult patients ˃ 18 years old. * The presence of the six upper anterior teeth. * Absence of sites with attachment loss and probing depth (PD) \>3 mm * Keratinized gingiva of at least 2mm width. * Compliance with good oral hygiene. * Patients accepts 6-months follow-up period (cooperative patients). * Patients provides an informed consent
Exclusion criteria
* Gummy smile with normal tooth proportions * Presence of prosthetic crowns * Extensive restorations * Extensive incisal edge attrition. * Misalignment on maxillary anterior teeth. * Smokers ˃ 10 cigarettes / day.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mid-buccal gingival margin level | 6 months | periodontal probe with William's graduation will be used to measure the distance from the CEJ to the gingival margin at the mid-buccal surface |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pink Esthetic Score (PES) | 6 months | The PES is based on seven variables: mesial papilla, distal papilla, soft-tissue level, soft tissue contour, alveolar process deficiency, soft-tissue color and texture. Each variable shall be assessed with a 2-1-0 score, with 2 being the best and 0 being the poorest score. The mesial and distal papilla will be evaluated for completeness, incompleteness or absence |
| Post-Surgical swelling | 7days | will be evaluated post-surgically with Verbal Rating Scale with words ranging from (absent-slight-moderate-intense) Absent (no swelling), Slight (intraoral swelling at the operated area), Moderate (moderate intraoral swelling at the operated area) and Intense (intensive extra oral swelling extending beyond the operated area). |
| Post-Surgical Patient Satisfaction: 3-item questionnaire | 6 months | A 3-item questionnaire is asked and the patients shall use a 7-point answer scale |
Outcome results
None listed