Changes in Correlations Between Cervical Crown Edg

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CHANGES IN CORRELATIONS BETWEEN CERVICAL CROWN EDGE AND

MARGINAL GINGIVA IN FIXED PROSTHODONTICS
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Mariana Dimova Velitchka Dosseva

Medical University of Sofia Medical University of Sofia
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Journal of IMAB - Annual Proceeding (Scientific Papers) 2006, book 2
CHANGES IN CORRELATIONS BETWEEN

CERVICAL CROWN EDGE AND MARGINAL
GINGIVA IN FIXED PROSTHODONTICS
Mariana Dimova, V. Doseva*
Department of Prosthetic Dentistry,
*Department of Periodontology, Faculty of Stomatology,
Medical University - Sofia, Bulgaria
ABSTRACT: periodontal tissue’s assessment place the main role in

Gingival adaptation of fixed prosthodontics and outcome‘ s reevaluation. Important factors for long-term
periodontal tissue’s assessment place the main role in prognosis are adequate treatment of the periodontal lesions,
prosthodontics long term results. maintenance of healthy periodontium, careful planning,
The aim of this study was to assess changes in design and making of the prosthodontic construction.
correlations between cervical crown edge and marginal Authors paid special attention on perio- prophylactic role of
gingiva in patiens with fixed prosthodontics. provisional and definitive constructions and necessity for
Material and methods: 54 patients: 31 women and healthy and stabilized periodontium in order to achieve long-
23 men, aged from 32 to 71 years (middle age- 52 years) term success (1, 2, 3, 4, 5, 6, 7, 8, 9, 10). Insertion of fixed
were examined. Patients were with different fixed dentures may influence the periodontal conditions. Clinical
constructions: full metal, metal-ceramic, acrylic and PFM observations showed that the gingiva supporting
crowns and bridges with 2 to 25 years longevity (middle prosthodontically treated teeth often is inflamed and that
duration of presence- 14 years). pocket formation, gingival recessions and gingival
Clinical periodontal examinations included: hygiene overgrowth may occur.
index, gingival bleeding (PBI), the distance between cervical The aim of this study was to assess changes in
crown edge and marginal gingiva, probing pocket depth, correlations between cervical crown edge and marginal
clinical attachment level, gingival overgrowth, tooth mobility. gingiva in patiens with fixed prosthodontics.
Results: Clinical examination indicated little
inflammation of the gingival tissues of crowned teeth with MATERIAL AND METHODS:
margins at the gingival and minor clinical signs of Subject of this study were 54 patients: 31 women and
inflammation in cases with supragingivally location of the 23 men, aged from 32 to 71 years (middle age- 52 years),
crown margin. Higher average of PBI was observed when who were examined during clinical practice of students- IVth
the crown margins were located subgingivally. In summary- and Vth year of study. Patients were with different fixed
crowns and fixed prosthodontics increased the incidence of constructions: full metal, metal-ceramic, acrylic and PFM
advanced gingival inflammation adjacent to restorations, crowns and bridges with 2 to 25 years longevity (middle
particularly if they had intracrevicular finish line placement, duration of presence- 14 years). Total number of crowns was
poor marginal adaptation, and rough surfaces. 97: 6 acrylic, 9 gold, 23 metal ceramic, 59- base alloy
Conclusion:The main factors to realize periodontal crowns. Total number of bridges was 24: 1- full metal base
prophylactic role of fixed prostodontics and to preserve alloy, 2 full metal gold, 14 PFM (1- gold and 13- base alloy),
periodontal health are exact adaptation of crowns and 7 metal ceramic. Total number of retainers was 72 and the
retainers toward gingival preparation limits, maximum number of pontics was 36.
release of the interdental spaces, correct contour of the Clinical periodontal examinations included: hygiene
crowns, good polishing, motivation and instruction for mouth index (HI- the % free from plaque surfaces), gingival
hygiene of the patient. bleeding (PBI), the distance between cervical crown edge and
marginal gingiva to the nearest 0,5mm, probing pocket depth
INTODUCTION: (the distance between the gingival margin and the bottom
Biological capacity of reduced and healthy of the pocket to the nearest 0,5mm), clinical attachment level
periodontium to support fixed partial dentures has been ( the distance between the cemento- enamel junction or
documented. Combined periodontal and prosthetic therapy artificial crown margin and the bottom of the pocket to the
tends to a high rate of successful outcomes after 10 to 25 nearest 0,5mm), gingival overgrowth (the negative distance
years. Gingival adaptation of fixed prosthodontics and between crown margin and gingival margin), tooth mobility.
44
Fig. 1, 2, 3, 4, 5, 6, 7: Supragingivally located margin of fixed prosthodontic constructions
RESULTS: increased pocket depth. It has been shown that fixed

Total number of crowns and retainers was 169. They constructions are compatible with periodontal health even
were with different location of the crown margins: 25 in cases of severely reduced periodontal tissue support,
subgingivally located, 39 at the gingival margin and 105 provided crown edges have supragingival location. For
supragingivally located (fig 1-7). In this group of patients esthetic reasons it may be necessary to place crown margins
13% free from plaque surfaces and PBI (papillary bleeding at the gingival margin or with a tolerable limit subgigivally
index)= 2,07 were recorded that demonstrated moderate 0,5mm. Reconstructions with crowns and bridges could be
gingival inflammation and unsatisfactory level of hygiene able to assure interproximal hygiene with interdental
control. Clinical examination indicated little inflammation brushes. Regular oral health maintenance programs for
of the gingival tissues of crowned teeth with margins at the patients receiving fixed prosthodontics may reduce gingival
gingival and minor clinical signs of inflammation in cases inflammation, recessions and overgrowth.
with supragingivally location of the crown margin. Higher
average of PBI was observed when the crown margins were CONCLUSION:
located subgingivally. In summary- crowns and fixed Along with the functional and aesthetic results,
prosthodontics increased the incidence of advanced gingival prosthodontic constructions must correspond to biological
inflammation adjacent to restorations, particularly if they had needs as well. They don’t have to irritate the periodontal
intracrevicular finish line placement, poor marginal tissues, alveolar bone and gingiva. If patients follow a strict
adaptation, and rough surfaces. maintenance program, a good prognosis can be anticipated.
The main factors to realize periodontal prophylactic
DISCUSSION: role of fixed prostodontics and to preserve periodontal health
The role of prosthetic restorations in the final are exact adaptation of crowns and retainers toward gingival
appearance of the surrounding soft tissues has long been preparation limits, maximum release of the interdental
recognized. Outcomes of this study confirm that spaces, correct contour of the crowns, good polishing,
subgingivally located crown margin, crowns, rugged cervical motivation and instruction for mouth hygiene of the patient.
surfaces may retain plaque, cause gingival inflammation,
REFERENCES:
1. Eichner, K., R. Voß: Kronenrand- von Kronen und Brückenzahnersatz auf Whitsett: Grundlagen der Kronen - und
Diskussion. Dtsch. Zahnärztl. Z., 1971, den Kronenrand und das marginale Paro- Brückenprothetik. Quintessenz Veralgs-
26, 742 dontium. Dtsch. Zahnärztl. Z., 1971, 26, GmbH, Berlin - Chicago - London –
2. Eichner, K.: Kronenrand und das 724 Moskau - São Paulo - Tokio, 1977, 159
marginale Parodontium aus klinischer 6. Rehberg, H.: Der Kronenrand. 9. Wirz, J., R. Bangert, K. Jäger:
Sicht. Dtsch. Zahnärztl. Z., 1969, 24, 741 Exakter Randschluss – was ist das? Dtsch. Kronen - und Brückenprovisorien. Teil I:
3. Eichner, K.: Kronenrand und zahnärztl. Z., 26, 1971, 7, 696-699 Anforderungen. Quintessenz, 43, 1992, 8,
Parodontium. Dtsch. Zahnärztl. Z., 44, 7. Schärer, M., L. Rinn, F. Kopp: 1297-1305
1989, 10, 737-741 Ästhetische Richtlinien für die 10. Wirz, J.: Klinische Material - und
4. Hüttner, G.: Nachuntersuchungen rekonstruktive Zahnheilkunde. Quin- Werkstoffkunde. Quintessenz Veralgs-
von Kronen und Brückenzahnersatz – Der tessenz Verlags-GmbH, Berlin - Chicago – GmbH, Berlin - Chicago - London –
Kronenrand und das marginale Parodon- London – Moskau - São Paulo- Tokio, Moskau - São Paulo - Tokio,1999, 86-310
tium. Med. Diss, FU Berlin, 1970 1980, 99-110
5. Hüttner, G.: Nachuntersuchungen 8. Shillingburg, H., S. Hobo, L.
Adress for correspondence:

Dr. Mariana Dimova, PhD,
Dept. of Prosthodontics, Faculty of Stomatology - Sofia,
1, St. G. Sofiiski str., 1359 Sofia, Bulgaria
e-mail: [email protected]
45
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See discussions, stats, and author profiles for this publication at: https://www.researchgate.

CHANGES IN CORRELATIONS BETWEEN CERVICAL CROWN EDGE AND

Mariana Dimova Velitchka Dosseva

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The user has requested enhancement of the downloaded file.

CHANGES IN CORRELATIONS BETWEEN

ABSTRACT: periodontal tissue’s assessment place the main role in

RESULTS: increased pocket depth. It has been shown that fixed

Adress for correspondence:

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