A novel volumetric analysis using cad/cam scanners in gingival recession treatment

Abstract

Objective: In this study, randomized clinical trial (RCT), the aim was to compare clinical periodontal data of subepithelial connective tissue graft (SCTG) group and SCGT+enamel matrix derivatives (EMD) group in terms of gained gingiva volume (GGV) and gained gingiva surface area (GGSA) by scanners of computer-aided design/computer-aided manufacturing (CAD/CAM) devices. Material and Methods: In this study, a total of 35 Miller class I-II gingival recession defects were involved (n=17 in SCTG group, n=18 in SCTG+EMD group). In addition to, periodontal clinical parameters, and  three dimensional (3D) images were recorded by using CAD/CAM system before the treatment, at the 1st month and the 6th months after the treatment. The images were superimposed by using softwares and GGV, and GGSA were calculated. Results: There was no significant difference in terms of GGV and GGSA values at the 1st month and 6th months between SCTG+EMD and SCTG groups. Similarly, there was no  significant difference in periodontal clinical parameters between groups. Conclusion: Images obtained from CAD/CAM system can be easily used in calculating GGV and GGSA data after the gingival recession treatment and in determining of the success of administered treatment. It is expected that the evaluation of the success of many therapeutic approaches for periodontal treatment will be carried out by using CAD/CAM system in the future.

Keywords

• Subepitelial connective tissue grafts,Enamel matrix derivatives,Gingival recession,CAD/CAM,Dentistry,Periodontics

Kaynakça

1. 1. Köseoğlu S, Sağlam M, Pekbağrıyanık T, Savran L, Sütçü R. Level of Interleukin-35 in Gingival Crevicular Fluid, Saliva, and Plasma in Periodontal Disease and Health. J Periodontol [Internet]. 2015 Aug [cited 2017 Jan 15];86(8):964–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25786564
2. 2. Valderhaug J. Periodontal conditions and carious lesions following the insertion of fixed prostheses: a 10-year follow-up study. Int Dent J [Internet]. 1980 Dec [cited 2017 Aug 16];30(4):296–304. Available from: http://www.ncbi.nlm.nih.gov/pubmed/6935162
3. 3. Goldstein M, Nasatzky E, Goultschin J, Boyan BD, Schwartz Z. Coverage of Previously Carious Roots Is as Predictable a Procedure as Coverage of Intact Roots. J Periodontol [Internet]. 2002 Dec [cited 2017 Aug 16];73(12):1419–26. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12546091
4. 4. Silva RC Da, Joly JC, de Lima AFM, Tatakis DN. Root Coverage Using the Coronally Positioned Flap With or Without a Subepithelial Connective Tissue Graft. J Periodontol [Internet]. 2004 Mar [cited 2017 Aug 16];75(3):413–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15088880
5. 5. Sculean A, Windisch P, Keglevich T, Gera I. Histologic evaluation of human intrabony defects following non-surgical periodontal therapy with and without application of enamel matrix derivatives. J Periodontol. 2003;74:153–60.
6. 6. Ronay V, Sahrmann P, Bindl A, Attin T, Schmidlin PR. Current Status and Perspectives of Mucogingival Soft Tissue Measurement Methods. J Esthet Restor Dent [Internet]. 2011 Jun [cited 2016 Dec 4];23(3):146–56. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21649828
7. 7. Weinländer M, Lekovic V, Spadijer-Gostovic S, Milicic B, Krennmair G, Plenk Jr H. Gingivomorphometry - esthetic evaluation of the crown-mucogingival complex: a new method for collection and measurement of standardized and reproducible data in oral photography. Clin Oral Implants Res [Internet]. 2009 May [cited 2017 Aug 16];20(5):526–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19522978
8. 8. Rosin M, Splieth C, Hessler M, Gärtner C, Kordass B, Kocher T. Quantification of gingival edema using a new 3-D laser scanning method. J Clin Periodontol [Internet]. 2002 Mar [cited 2016 Dec 4];29(3):240–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11940144

9. 9. Strebel J, Ender A, Paqué F, Krähenmann M, Attin T, Schmidlin PR. In Vivo Validation of a Three-Dimensional Optical Method to Document Volumetric Soft Tissue Changes of the Interdental Papilla. J Periodontol [Internet]. 2009 Jan [cited 2016 Dec 4];80(1):56–61. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19228090
10. 10. Seelbach P, Brueckel C, Wöstmann B. Accuracy of digital and conventional impression techniques and workflow. Clin Oral Investig [Internet]. 2013 Sep 21 [cited 2016 Dec 4];17(7):1759–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23086333
11. 11. Silness J, Löe H. Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal Condition. Acta Odontol Scand [Internet]. Taylor & Francis; 1964 Jan 2 [cited 2016 Dec 4];22(1):121–35. Available from: http://www.tandfonline.com/doi/full/10.3109/00016356408993968
12. 12. Löe H, Silness J. Periodontal Disease in Pregnancy I. Prevalence and Severity. Acta Odontol Scand [Internet]. Taylor & Francis; 1963 Jan 2 [cited 2016 Dec 4];21(6):533–51. Available from: http://www.tandfonline.com/doi/full/10.3109/00016356309011240
13. 13. Rebele SF, Zuhr O, Schneider D, Jung RE, Hürzeler MB. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part II. Volumetric studies on healing dynamics and gingival dimensions. J Clin Periodontol. 2014 Apr;41:593–603.
14. 14. McGuire M, Scheyer E, Nunn M. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue: comparison of clinical parameters at 10 years. J Periodontol. 2012 Nov;83(11):1353–62.
15. 15. Roman A, Soancă A, Kasaj A, Stratul S-I. Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of Miller class I and II gingival recessions: a controlled randomized clinical trial. J Periodontal Res [Internet]. 2013 Oct [cited 2016 Dec 4];48(5):563–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23317049
16. 16. Zuhr O, Rebele S, Schneider D, Jung R, Hürzeler M. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part I. Clinical and patient-centred outcomes. J Clin Periodontol. 2014 Oct;41:582–92.
17. 17. Rasperini G, Silvestri M, Schenk R, Nevins M. Clinical and histologic evaluation of human gingival recession treated with a subepithelial connective tissue graft and enamel matrix derivative (Emdogain): a case report. Int J Periodontics Restor Dent. 2000;20(3):269–75.
18. 18. Henriques P, Pelegrine A, Nogueira A, Borghi M. Application of subepithelial connective tissue graft with or without enamel matrix derivative for root coverage: a split-mouth randomized study. J Oral Sci. 2010;52(3):463–71.
19. 19. Hammarström L, Heijl L, Gestrelius S. Periodontal regeneration in a buccal dehiscence model in monkeys after application of enamel matrix proteins. J Clin Periodontol [Internet]. 1997 Sep [cited 2016 Dec 4];24(9 Pt 2):669–77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9310871
20. 20. Moses O, Artzi Z, Sculean A, Tal H, Kozlovsky A, Romanos GE, et al. Comparative Study of Two Root Coverage Procedures: A 24-Month Follow-Up Multicenter Study. J Periodontol [Internet]. 2006 Feb [cited 2016 Dec 4];77(2):195–202. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16460244
21. 21. Pilloni A, Paolantonio M, Camargo PM. Root Coverage With a Coronally Positioned Flap Used in Combination With Enamel Matrix Derivative: 18-Month Clinical Evaluation. J Periodontol [Internet]. 2006 Dec [cited 2016 Dec 4];77(12):2031–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17209788
22. 22. Aroca S, Keglevich T, Nikolidakis D, Gera I, Nagy K, Azzi R, et al. Treatment of class III multiple gingival recessions: a randomized-clinical trial. J Clin Periodontol [Internet]. 2010 Jan [cited 2016 Dec 4];37(1):88–97. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19968743
23. 23. Mehl A, Gloger W, Kunzelmann K-H, Hickel R. A New Optical 3-D Device for the Detection of Wear. J Dent Res [Internet]. 1997 Nov 8 [cited 2017 Aug 16];76(11):1799–807. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9372798
24. 24. Lehmann KM, Kasaj A, Ross A, Kämmerer PW, Wagner W, Scheller H. A New Method for Volumetric Evaluation of Gingival Recessions: A Feasibility Study. J Periodontol [Internet]. 2012 Jan [cited 2016 Dec 4];83(1):50–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21563950
25. 25. Lehmann KM, Kasaj A, Ross A, Willershausen I, Schmidtmann I, Staedt H, et al. A novel method for evaluating periodontal recession: a feasibility study. Int J Comput Dent [Internet]. 2011 [cited 2017 Aug 16];14(4):297–307. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22324221
26. 26. Windisch SI, Jung RE, Sailer I, Studer SP, Ender A, Hämmerle CHF. A new optical method to evaluate three-dimensional volume changes of alveolar contours: a methodological in vitro study. Clin Oral Implants Res [Internet]. 2007 Oct [cited 2016 Dec 4];18(5):545–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17590160