Predictability of Periodontal Surgical Guides Manufactured by Digital Flow in Clinical Crown Lengthening. A Randomized Trial

Abstract

OBJECTIVE: This randomized controlled trial aimed to evaluate the effectiveness of periodontal surgical guides manufactured using a digital workflow in aesthetic clinical crown lengthening procedures. METHODS: Twenty patients with altered passive eruption in the anterior maxilla requiring clinical crown lengthening were randomly divided into two groups: control group-free hand and test group-periodontal surgical guides. All patients underwent CBCT and intraoral digital scanning (IOS) examinations before the surgical procedure. Virtual planning was carried out in both groups, measuring the height of the gingival tissue to be removed. However, the surgical guides were only printed in the test group. IOS was performed on all patients 6 and 12 months after the surgical procedure to verify the predictability of the surgical technique in relation to the initial plan. Patients also answered a visual analog scale to measure postoperative pain. RESULTS: The comparative analysis between the test and control groups showed no statistical difference in the amount of tissue planned to be removed, and the result obtained after 6 months and 1 year (Control group: median of -0.09 to 0.29 mm in 6 months and 0.00 to 0.55 mm in 12 months. Test group: median of -0.05 to 0.70 mm in 6 months and 0.00 to 0.81 mm in 12 months). No differences were noticed between the techniques tested concerning the positioning of the gingival margin in the 6- or 12-month periods in relation to the marginal tissues observed at the baseline period (p > 0.05). The level of pain presented by patients was low in both groups, with reports of minimal discomfort after the 15-day follow-up period. Patients demonstrated high satisfaction levels with the procedure regardless of the surgical technique. CONCLUSION: Both guided and conventional surgery techniques are effective for treating altered passive eruption. However, the painful sensation and tendency for recurrence of the coronal positioning of the marginal tissues were lower when the guided surgery technique was applied. CLINICAL SIGNIFICANCE: This study will help clinicians understand which surgical technique for treating altered passive eruptions is more appropriate for their clinical case.