Pain, Postoperative
Conditions
Brief summary
Compare pain response following microsurgical conventional flap approach using Piezosurgery versus flapless approach for esthetic crown lengthening in management of patients with short clinical crowns in the upper anterior region.
Detailed description
The conventional approach: Anesthesia will be given followed by bone sounding using William graduated periodontal probe and measuring the pocket depth (using magnification loupes and microsurgical blades) * Marking the bleeding points * An internal bevel incision is made followed afterwards by a sulcular incision. * The gingival collar is eliminated. * Elevation of the flap is proceeded to allow access for osteoplasty using piezo surgery and an apical position of the bone 2-3mm beyond CEJ. * Mattress suture (6.0) is made The intervention approach: Surgery is done the same as in the conventional approach but without opening a flap, gaining access via a tunneling instrument and piezo tips for osteoplasty
Interventions
PROCEDURETunneling micro-surgical crown lengthening approach using piezo-surgery
excess gingiva is eliminated. 2 mm bone is removed from CEJ-bone crest with piezo surgery via tunneling
PROCEDUREMicro-surgical crown lengthening approach using Piezosurgery
excess gingiva is eliminated. 2 mm bone is removed from CEJ-bone crest with piezo surgery with conventional flap elevation.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Patients with healthy systemic condition. 2. Adult patients ˃ 18 years old. 3. The presence of the six upper anterior teeth. 4. Patients who have short clinical crowns due to altered passive eruption classified as Type I subclass B (Coslet, Vanarsdall and Weisgold, 1977). 5. Absence of sites with attachment loss and probing depth (PD) \>3 mm. 6. Keratinized gingiva of at least 2mm width (Pontoriero and Carnevale, 2001). 7. Compliance with good oral hygiene. 8. Patients accepts 6-months follow-up period (cooperative patients). 9. Patients provides an informed consent.
Exclusion criteria
1. Presence of prosthetic crowns 2. Extensive restorations 3. Extensive incisal edge attrition. 4. Smokers ˃ 10 cigarettes / day 5. Pregnant females
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain VAS | 48 hours | Visual Analogue Scale for Pain (numbers from 0 to 10 ('no pain' to 'worst pain imaginable') measured daily for the first 2 days postoperative |
Secondary
| 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 a prefabricated grooved stent vertically- to the level of the gingival margin at the mid-buccal surface (measured at baseline, 3 and 6 months postoperatively) |
| Post-Surgical Patient Satisfaction. | 6 months | Numerical Rating Scale (A 3-item questionnaire is asked, and the patients shall use a 7-point answer scale. ) |
| Pink Esthetic Score | 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. All other variables will be assessed by comparison to a reference tooth. |
| Post-Surgical swelling | 14 days | 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. (Assessed in day 7 and 14 postoperatively) |
Countries
Egypt
Outcome results
None listed