Radiographic evaluation of a cross-shaped incision technique for thick-gingiva and thin-gingiva patients treated with implant-supported fixed prosthesis

Wen Luo, Xinyu Wang, Yaqian Chen, Yuping Hong, Yili Qu, Yi Man, Yingying Wu, Wen Luo, Xinyu Wang, Yaqian Chen, Yuping Hong, Yili Qu, Yi Man, Yingying Wu

Abstract

Background: To evaluate a cross-shaped incision technique for thick-gingiva and thin-gingiva patients treated with implant-supported fixed prosthesis.

Methods: Total 55 patients receiving cross-shaped incision were assigned into thick-gingiva group (29 cases) and thin-gingiva group (26 cases). Follow-up was performed at 3 and 12-month after final restoration.

Results: Mesial and distal papilla height was significantly greater in thick-gingiva group than thin-gingiva group at 3 and 12 months, while periodontal depth and crestal marginal bone level around implant had no significant difference between the two groups during follow-up. No case of recession of buccal marginal gingiva was observed in thick-gingiva group. However, the recession of marginal gingiva of buccal aspect of the crown was found in 5 patients (19.2%) with thin-gingiva.

Conclusions: The cross-shaped incision may be applied to reconstruct gingival papillae and avoid the gingival recession in patients with thick-gingiva phenotype. Trial registration This study was registered at ClinicalTrials.gov (registration number NCT04706078, date 12 January 2021, Retrospectively registered).

Keywords: Cross-shaped incision; Fixed prosthesis; Gingiva; Implant; Recession of marginal gingiva.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
The phenotype of gingiva determined by a periodontal probe
Fig. 2
Fig. 2
Clinic procedures for patients subjected to cross-shaped incision. a Buccal view of implant sites; b Cross-shaped incision was made across gingival sulcus after the disconnection of healing abutments; c Buccal view of the cross-shaped incision with definitive abutment; d X-ray was taken to make sure the abutment and crown were properly seated; e Customized resin abutment was made; f Buccal view of free gingival around implant after final restoration; g Buccal view of gingival papilla around implant 3 months after final restoration; h Buccal view of gingival papilla around implant 12 months final restoration
Fig. 3
Fig. 3
Schematic drawing illustrating the landmarks used for the measurement of gingival marginal level. MAP: the most apical point of the gingival margin at the buccal aspect of the crown; PMD: the line connecting the peak of the adjacent mesial and distal natural teeth (PMD); GML: the distance from MAP to PMD; Magnification: the length of the natural crown next to the implant supported prosthesis was recorded to correct any changes in magnification
Fig. 4
Fig. 4
Schematic drawing illustrating the landmarks used for periapical radiographs measurement. IS: implant shoulder; fBIC: first bone-implant contact; a the vertical distance the first bone-implant contact to implant shoulder measured from radiograph. b Implant length. x (fBIC-IS): the real vertical distance the first bone-implant contact to implant shoulder
Fig. 5
Fig. 5
Recession of marginal gingiva was found in the middle of buccal aspect around crown 3 months after cement

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