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Effekten af ​​at bruge to forskellige suturteknikker på fri tandkødsmarginal stabilitet

1. november 2026 opdateret af: Ahmed Hesham Mohamed, Ain Shams University

Effekten af ​​at bruge to forskellige suturteknikker på fri tandkødsmarginal stabilitet efter æstetisk kroneforlængelse til behandling af gummismil (randomiseret klinisk forsøg)

Gummy smile is one of the major esthetic problems nowadays; it is due to several causes that either dental or skeletal. Etiology of the gummy smile is altered passive eruption, vertical maxillary excess, different gingival enlargement conditions, deficient maxillary lip length and excessive maxillary lip mobility, dento alveolar extrusion, combination of all these factors.

Altered passive eruption is considered to be one of the most major causes, it is classified into two types according to the location of the mucogingival junction with respect to the bone crest and each type has two subtypes . Esthetic crown lengthening is the treatment of choice for subtype B in both types as bone removal is mandatory to create a space for the biological width.

Most of the studies stated that there is some degree of relapse of the gingival tissues after the procedures in the follow ups, that relapse was related to the biotype of the gingival tissues, the flap placement close or far from the bone can be correlated to the suturing technique used for closure of the tissues.

In the investigator's study comparing of two different suturing technique was done to evaluated their effect on gingival tissue relapse, 30 patients (26 females and 4 males) were divided between 2 groups each group consisted of 15 patients. In the first group vertical mattress suturing technique was done in the secondperiosteal vertical suturing technique was.

Evaluation of the tissue relapse was done through the assessment of the amount of the attached gingival tissues level of gingival margin and marginal tissue contour before and after the surgery.

The results of the study showed that tissue relapse was more in the periosteal suturing technique group that was related to the pressure on the tissues due to the fixation of the suture at the periostium, the papillary tissue also showed more inflammation in the follow up period prior to suture removal. The figure of eight group showed less relapse and tissue inflammation as it prevents flap edge overlap and is tension free therefore better blood supply to the tissue.

Patients were generally satisfied post-surgical with their smile, gingival tissue visibility and teeth dimensions inspite of the relapse but it was better than prior to surgery. Also they would recommend it to other patients complaining from the same problem.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Thirty patients (26 females, 4 males), who were candidates for esthetic crown lengthening, participated in this prospective clinical trial.

Group I (15 patients) (vertical mattress suturing technique) :

Esthetic crown lengthening procedure: internal bevel, sulcular and interdental incisions, flap elevation, bone removal then External vertical mattress suture was done (periosteal suture).

Group II (15 patients) (periosteal vertical suturing technique) :

Esthetic crown lengthening procedure: internal bevel, sulcular and interdental incisions, flap elevation, bone removal then periosteal vertical suture was done

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

30

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Cairo, Egypten
        • Faculty of Dentistry Ain Shams University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

20 år til 40 år (Voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients complaining from gummy smile (altered passive eruption)
  • Bone level is 2 mm or less from the cemento enamel junction
  • Teeth included were free from any periodontal destruction
  • Good compliance with the plaque control instructions following initial therapy.
  • Availability for follow up and maintenance program

Exclusion Criteria:

  • Presence of systemic diseases which could influence the outcome of the therapy (American society of anesthesiologists I, ASA I).
  • Patient suffering from periodontitis stage 4 grade c.
  • Presence of smoking habit.
  • Presence of occlusion interference.
  • Pregnant females and lactating females. .
  • Vulnerable groups of patients (handicapped, mentally retarded, prisoners).
  • Restored teeth.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: vertical mattress suturing technique

vertical mattress suturing technique is done to close the flap

vertical mattress suturing technique used for flap closure after esthetic crown lengthening

Aktiv komparator: periosteal vertical suturing technique

periosteal vertical suturing technique is done to close the flap

figure of eight suturing technique used for flap closure after esthetic crown lengthening

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
evaluation of the marginal soft tissue levels rebound
Tidsramme: 6 months

determination of soft tissue rebound: is measured as the difference between (the level of free gingival margin after suturing) and (the level of the free gingival margin 6 months post surgical) both measured from fixed reference point on the stent to the free gingival margin

6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Supracrestal gingival tissue
Tidsramme: 6 months

the difference between the bone level and the free gingival margin (measured from a fixed reference point on the stent)

6 months
Patient satisfaction
Tidsramme: at 6 months post surgical

questionnaire (After surgery)

  • Is the patient satisfied with the gingival display during talking and smiling, teeth display during talking and smiling (not at all, slightly, somewhat, very and extremely).
  • How was the procedure experience (much worse, worse, same as I thought, better and much better).
at 6 months post surgical

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studieleder: ahmed gamal, professor, faculty of dentistry ain shams university

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2017

Primær færdiggørelse (Faktiske)

1. juni 2018

Studieafslutning (Faktiske)

1. november 2019

Datoer for studieregistrering

Først indsendt

30. december 2019

Først indsendt, der opfyldte QC-kriterier

4. januar 2020

Først opslået (Faktiske)

7. januar 2020

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. november 2026

Sidst verificeret

1. januar 2025

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • PER16-35M

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

when the study is done the results will be published with the protocol

IPD-delingstidsramme

the data will be available starting next month and for 1 year

IPD-delingsadgangskriterier

the keywords esthetic crown lengthening, suturing techniques in dentistry

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP

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