Abstract
Background:The soft tissue healing and quality around dental implant is a current debated topic in the recent literature. The free gingival margin and the quantity and quality of the mucosa around teeth and surrounding dental implants still determine the hard and soft tissue healing status.Objective:The aim of this study is to assess inter and intra-operative measurement concordance of a method aimed at evaluating the apico-coronal migration of free gingival margin, using intra-oral photography.Methods:The method was tested on peri-implant tissues that were treated with a connective tissue graft on the second stage surgery. Thirty-eight measurements on 13 implants in 8 patients were recorded. An intra-oral photograph was taken for the graft and the provisional crown, which enclosed a circular landmark with a previously determined diameter. The landmark was prepared with a red-resin by the same technician. Before crown cementation, the landmark was calibrated with a digital calibrator by the main investigator, to determine the precise diameter up to two decimal numbers.Results:On the intra-oral photograph, the distance was measured from the most apical point of the determined landmark to the zenith of the gingiva, using an image-processing program designed for scientific multidimensional images (Image J). Three independent examiners took these measurements.Conclusion:The main advantage of the present non-invasive technique is that the spatial plane of the prosthetic landmarks is the same of the tooth unlike the utilization of periodontal probe, which is generally positioned on different plans in the space (generally more vestibular).
Highlights
The monitoring of soft tissue changes is an essential factor to assess short and long term results of prosthetic, periodontal and implant therapy [1, 2]
The method was tested on peri-implant tissues that received a connective tissue graft on the second stage surgery
The rationale of the present research is related to a current debated topic; to find a predictable method in order to standardize and quantify the periodontal tissue consistency without measurements errors. For this reason the present study aim is to investigate by digital evaluation the consistence and the health of surrounding dental implant gingiva [1, 7, 15, 16]
Summary
The monitoring of soft tissue changes is an essential factor to assess short and long term results of prosthetic, periodontal and implant therapy [1, 2]. The combination of X-ray investigation and individual clinical outcome parameters, such as periodontal deep (PD), bleeding on probing (BOP), and others, provide the basis to assess classification systems for oral health and periodontitis, and they provide the basis to improve diagnosis accuracy [1 - 6]. The periodontal probe is mostly used in common clinical practice to perform this type of measurements like keratinized tissue amount, papilla height, and gingival recessions with a mean error of 1 mm [3 - 6]. This imprecision can generate an incorrect interpretation by the clinician, which can potentially result in an alteration of the data reported in several studies comparing different therapeutic treatments or techniques. The free gingival margin and the quantity and quality of the mucosa around teeth and surrounding dental implants still determine the hard and soft tissue healing status
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