Influência da cirurgia para aumento de coroa clínica na resposta periodontal à reabilitação com coroas cerâmicas: um ensaio clínico de 6 meses

Abstract

Aim: the aim of this study was to assess the impact of crown lengthening surgery on teeth restored with single ceramic crowns and adjacent and non-adjacent sites over periodontal clinical parameters after rehabilitation. Methods: 15 patients participated in this controlled clinical trial, totaling 29 lithium disilicate ceramic crowns and polymer-infiltrated-ceramic crowns (PIC), divided into two groups: G1 (n = 14) who were treated with crown lengthening surgery and G2 (n = 15) without periodontal surgery. The parameters Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were analyzed full-mouth and in the restored area. Probing Depth (PD), Bleeding on Probing (BP) and Attachment Level (AL) were analyzed in treated sites (T), adjacent (AD) and nonadjacent (NAD) sites. Furthermore, Gingival Phenotype (GP), Gingival Recession (GR), Keratinized Mucosa (KM) and Margin Level (ML) at baseline (T0), at 1 month (T1) and 6 months (T2) after rehabilitation. Statistical analysis was performed using the Wilcoxon and Friedman tests, the Kruskal-Wallis test, the Mann-Whitney test and the Chi-square and Fisher's exact tests. Results: Total VPI, total and regional GBI and BP did not show statistically significant differences between the groups at T0, T1 and T2. The regional VPI showed a statistically significant difference between the groups at 6 months, being relatively higher in G2. The total VPI decreased significantly over time in both groups. In addition, regional VPI also showed a statistical difference in G1, with a significant decrease from T0 to T2, while the BP did not show significant variation. PD of the treated and non-adjacent sites showed a statistical difference between the groups, being higher in G1 at 6 months. There was an increase in the frequency of GR over time from 6 cases in T0 to 9 cases in T2. There was a significant association when performing surgery and the occurrence of GR. For the KM parameter, there were no statistically significant differences. Conclusion: it was concluded that, in general, the periodontal parameters related to hygiene had a favorable impact in relation to the treatment; when surgery is performed, there is a more positive impact on regional indexes after 6 months. Attachment parameters did not change significantly over time, but surgery causes an increase in these after 6 months in non-adjacent sites. The performance of the surgery also affects the development of gingival recessions over time.