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Pre-restorative crown lengthening surgery: influence of restorative treatment timing on clinical outcomes—a pilot study

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Abstract  

Objectives

Aim of this study was to assess the influence of restorative treatment timing on the periodontal, patient and operator-reported outcomes following crown lengthening surgery (CLS).

Materials and methods

Eighteen study participants requiring CLS were divided into two groups based on prosthetic rehabilitation timing (6 or 14 weeks postoperatively). Clinical parameters were recorded around treated and neighboring teeth before and after surgery, 6 and 14 weeks postoperatively, at prosthesis delivery, and three and six months after. Soft tissue and radiographic bone changes were evaluated. Patients assessed their perception of the procedure by means of a questionnaire. The final treatment outcome was rated by both patients and prosthodontists.

Results

CLS resulted in statistically significant and stable apical displacement of the gingival margin, at both treated and adjacent sites. Plaque and bleeding scores remained low throughout. No statistically significant differences were observed between groups for any clinical or radiographic parameter examined. Healing was uneventful and treatment outcome was satisfying for both patients and prosthodontists, without statistically significant differences between groups.

Conclusions

The present study has been characterized as pilot, because it was not possible to reach the sample size indicated by the a priori power analysis. CLS is an effective pre-prosthetic procedure as long as it is performed under a certain surgical protocol which predicts for at least a 3 mm distance between bone crest and the flap margin at suturing. Within the limitations of this study, six weeks after surgery may be an adequate healing time for the onset of prosthetic restoration.

Clinical relevance

Crown lengthening surgery is commonly performed in daily clinical practice with the aim to restore teeth with short clinical crowns. Based on periodontal, patient and operator-reported criteria, 6 weeks after CLS may be adequate healing time before the onset of prosthetic restoration.

Trial registration

ClinicalTrials.gov Identifier: NCT03947658, 13/05/2019, retrospectively registered.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece

    Georgia A. Malamoudi, Ioanna Tsachouridou & Lazaros Tsalikis

  2. 251 Hellenic Air Force General Hospital, P. Kanelopoulou Av. 3, 11525, Athens, Greece

    Georgia A. Malamoudi

  3. Private Practice, Ithakis 40, 56224, Evosmos, Thessaloniki, Greece

    Ioanna Tsachouridou

  4. School of Agriculture, Laboratory of Agronomy, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece

    Georgios Menexes

  5. Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece

    Georgios Mikrogeorgis

  6. Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece

    Dimitrios Tortopidis

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  1. Georgia A. Malamoudi
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Contributions

GAM contributed to patient recruitment, recalled participants during observation period, collected patient-centered data, and wrote the manuscript with input from other authors. IT registered the clinical trial, recruited patients, performed all surgical procedures, and recorded clinical data. GMe performed statistical analysis. GMi digitally analyzed radiographs and performed all radiographic measurements. DT supervised the adherence to the study protocol during prosthetic rehabilitation. LT contributed to study design, directed implementation of the research, was responsible for allocation concealment, and was the study coordinator. All authors reviewed and approved the submitted manuscript.

Corresponding author

Correspondence to Georgia A. Malamoudi.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Aristotle University of Thessaloniki Ethics committee (AUTH Protocol #30/03–05-2017). The study was registered retrospectively in the clinicaltrials.gov registry (ClinicalTrials.gov Identifier: NCT03947658, 13/05/2019). The study meets the CONSORT requirements for randomized trials and CONSORT 2010 checklist and flow diagram are provided. Informed consent was obtained from all individual participants included in the study.

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All authors reviewed this manuscript and consented to publishing.

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The authors declare no competing interests.

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Malamoudi, G.A., Tsachouridou, I., Menexes, G. et al. Pre-restorative crown lengthening surgery: influence of restorative treatment timing on clinical outcomes—a pilot study. Oral Maxillofac Surg 28, 253–267 (2024). https://doi.org/10.1007/s10006-023-01138-6

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