Aesthetic Crown Lengthening with Flapless Piezoelectric Surgery in Comparison with Traditional Open Flap Approach

• Main Authors: Suleiman Taher Dayoub, Mohammad Ali Yousef
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-08-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: altered passive eruption; excessive gingival display; minimally invasive; piezosurgery
• Online Access: https://jcdr.net/articles/PDF/13089/42016_CE[Ra1]_F(KM)_PF1(PoG_KM)_PN(SL).pdf
• ISSN: 2249-782X; 0973-709X

Introduction: Aesthetic crown-lengthening surgery is still the most common treatment for gingival smile caused by altered passive eruption type 1B. The traditional techniques and instruments of this surgery have many disadvantages like gingival tissue coronal rebound, trauma, and pain, which necessitate further research into methods that produce more effective and satisfying results. Aim: This study aimed to compare the clinical results of a minimally invasive flapless approach and an open-flap approach in aesthetic crown lengthening for the treatment of gingival smile up to three months after piezoelectric bone surgery. Materials and Methods: This prospective, split-mouth, controlled clinical study was carried out in the periodontal department of Damascus University. A total of 16 patients were selected from those who fulfilled the inclusion and exclusion criteria. 32 sites of the maxillary arch were treated by either open flap or flapless aesthetic crown lengthening technique. The right quadrant was distributed at random to receive either the open flap or flapless technique by a computer-generated table. Afterwards, the contra-lateral left quadrant was allocated to the other group. Both therapies were performed during one appointment by the same operator. Paired and independent sample t-tests were used for statistical analysis. Results: Sixteen patients (11 females, 5 males), aged 24.4±3.5 years (range: 21-35 years), were recruited at the beginning of the study. The results revealed that using piezosurgery in bone resection is effective with both surgical approaches. Both approaches created a significant increase in the length of clinical crowns compared to baseline (p<0.05) without significant differences between the groups (p>0.05). Statistically lower means of pain, bleeding on probing, and surgical time were observed in the flapless group (p<0.05). Conclusion: The minimally invasive flapless approach and piezosurgery offer truly promising alternative techniques compared to traditional methods of aesthetic crown lengthening.