Insufficient Clinical Crown Length
Conditions
Keywords
Crown lengthening
Brief summary
The objective of this research is to compare the diagnostic accuracy in the detection of the cementoenamel junction (CEJ) and alveolar bone ridge using guided digital planning versus conventional analog planning for patients with excessive gingival exposure in the smile (gummy smile) due, at least in part, to altered passive eruption.
Detailed description
Forty-four subjects will be randomly assigned to the planning groups according to a digital methodology, DM (n=22) or an analog methodology AM (n=22). Surgical guides will be developed to establish the location of the acementoenamel junction and bone crest. The digital methodology will consist of obtaining a digital scan and a computed tomography (CBCT) that will be aligned using a digital program for the elaboration of a digital wax-up and fabrication of a printed surgical template. The analog wax-up will be elaborated based on a silicone impression and periapical radiographs with parallel technique, which will allow us to elaborate an essix type surgical splint. Measurements will be recorded at baseline, on the day of surgery, at 4, 6 and 12 months of follow-up. Variables related to the patient's experience will also be recorded.
Interventions
DIAGNOSTIC_TESTDigital planning
The digital methodology will consist of obtaining a digital scan and a computed tomography (CBCT) that will be aligned using a digital program for the elaboration of a digital wax-up and fabrication of a printed surgical template.
DIAGNOSTIC_TESTAnalogic planning
The analog wax-up will be elaborated based on a silicone impression and periapical radiographs with parallel technique, which will allow us to elaborate an essix-type surgical splint.
Sponsors
Universidad Complutense de Madrid
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Over 18 years of age * Presence of teeth in the second sextant (edentulous section of a single tooth with the presence of adjacent teeth on both sides of the absence is accepted). * No sites with attachment loss (AL) \> 3 mm in the area to be treated (second sextant). * Present full mouth plaque index (Ainamo and Bay, 1975) \<15%. * Have bleeding on probing (BoP; Ainamo & Bay 1975) \<15%.
Exclusion criteria
* pregnancy or lactation * patients who smoke * patients under treatment with antimicrobials and anti-inflammatory drugs in the last 2 months or with medications associated with changes in the gingival tissue (antiepileptics, calcium channel blockers, etc.) * subjects with systemic conditions that alter the normal presentation of the gingival tissue (hereditary gingival fibromatosis) or those diagnosed with uncontrolled diabetes mellitus * patients with severe dental malposition and/or presence of dental implants in the area to be treated * use of orthodontic appliances * all those who present a disability or mental disorders that make it difficult for the patient to understand or follow them during the study period. study period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The accuracy of surgical guide. | 12 months | The accuracy of surgical guide to detect the cementoenamel junction and position of the alveolar bone crest: distance from the splint margin to the CEJ measured intra-surgically in mm at 3 points per tooth using a CP-15 periodontal probe (Hu Friedy®, Leimen, Germany). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The stability of the crown length | 12 months | The stability of the crown length established over a 12-month period (tissue rebound) measured at 3 points per tooth with a CP-15 millimeter periodontal probe and by intraoral digital scanning. |
| Patient's phenotype | 12 months | Therapeutic response according to the patient's phenotype, based on the transparency of the periodontal probe CP-15 (Hu Friedy®, Leimen, Germany) through the gingival margin while probing the buccal sulcus, according to the classification of Rouck et al 2009. |
| The number of teeth and patients in which the second phase was necessary. | 12 months | The number of teeth and patients in which the second phase was necessary and the amount of removal of keratinized tissue (gingivectomy) in the second phase (at 4 months) in millimeters using a CP-15 millimeter periodontal probe. |
| The time spent | 12 months | The time spent in digital/analog recording in minutes. |
| Patient satisfaction | 12 months | Patient satisfaction according to the validated survey (Oral Health Impact Profile OHIP-14). |
Countries
Spain
Contacts
Primary ContactGeorgina Carbajo, DDS,MSc
Backup ContactMariano Sanz Alonso, MD,DDS,MSc,PhD
Outcome results
None listed