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ENDO - Endodontic Practice Today

Edited by Bun San Chong and Edgar Schäfer

Official Publication of the Belgian Association for Endodontology and Traumatology (BAET) and the French Society of Endodontics (SFE)

ISSN (print) 1753-2809 • ISSN (online) 1753-2817


Winter 2009
Volume 3 , Issue 4

Pages: 255 - 268
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Gingival recession following apical surgery in the aesthetic zone: A clinical study with 70 cases

von Arx, Thomas / Salvi, Giovanni E / Janner, Simone / Jensen, Simon S

The present study evaluated gingival recession 1 year following apical surgery of 70 maxillary anterior teeth (central and lateral incisors, canines, and first premolars). A visual assessment of the midfacial aspect of the gingival level and of papillary heights of treated teeth was carried out using photographs taken at pre-treatment and 1-year follow-up appointments. In addition, changes in the gingival margin (GM) and clinical attachment levels (CAL) were calculated with the use of clinical measurements, that is, pre-treatment and 1-year follow-up pocket probing depth and level of gingival margin. Changes in GM and CAL were then correlated with patient-, tooth- and surgeryrelated parameters. The following parameters were found to significantly influence changes in GM and CAL over time: gingival biotype (P< 0.05), with thin biotype exhibiting more gingival recession than thick biotype; pre-treatment pocket probing depth (PPD) (P< 0.03), with cases of pre-treatment PPD < 2.5 mm demonstrating more attachment loss than cases of PPD ≥ 2.5 mm; and type of incision (P< 0.01), with the submarginal incision showing considerably less gingival recession compared with the intrasulcular incision, papilla-base incision or papilla-saving incision. The visual assessment using pre-treatment and 1-year follow-up photographs did not demonstrate significant changes in gingival level or papillary height after apical surgery. In conclusion, gingival biotype, pre-treatment PPD, and type of incision may significantly influence changes in GM and CAL following apical surgery in maxillary anterior teeth.

Keywords: aesthetics, apical surgery, follow-up study, gingival recession, periodontal parameters

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