Clinical and histological reaction of periodontal tissues to subgingival resin composite restorations

Abstract

Objectives To compare the clinical and histological response of supracrestal periodontal tissues to subgingival composite restorations versus natural root surfaces. Material and MethodsIn 29 subjects with a single tooth requiring subgingival restorations, a deep margin elevation (DME) procedure with composite resin was applied. Full mouth plaque score (FMPS), full mouth bleeding score (FMBS) and focal probing depth (PD) were measured at baseline, before DME, and after 3 months. The distance between the coronal marked point (CM) to the apical margin of the composite reconstruction (AMR), at baseline, and to the tip of the periodontal probe inserted to reach the bottom of the sulcus (APP), 3 months later, were measured. An all-around secondary flap, harvested to ensure the subsequent single crown prosthetic rehabilitation was histologically processed. The histological inflammation degree was evaluated in areas of gingival tissues adjacent to the composite (B-group) and adjacent to the natural surface of each single tooth (A-group). ResultsSignificant FMPS, FMBS and PD decreases were observed (p<0.05). CM-AMR and CM-APP were significantly different (p<0.05), suggesting an attachment gain after 3-months. The inflammation level of gingival tissue was similar in A-and B-groups (p>0.05). ConclusionsFor the first time, this topic was clinically and histologically studied in humans. Subgingival restorations resulted compatible with gingival health, with levels similar to that of untreated root surfaces.Clinical Relevance Deep margin elevation procedure produces favorable clinical and histological outcomes allowing a routinely utilization in reconstructive dentistry.

The Relationships Between Tooth‐Supported Fixed Dental Prostheses and Restorations and the Periodontium

“…However, compared to sound tooth surfaces, only amalgam restorations were associated with increased PD and CAL, while composite materials were not 38 . This finding is further supported by a clinical and histologic study that clearly showed that intracrevicular composite restorations are compatible with gingival health, provided that epithelial and connective tissue attachments 1,4 are respected and periodontal supportive therapy is implemented 39 . Therefore, contrary to other materials, 11–14,40 adhesive composite materials, when used for subgingival restorations, appear to elicit a periodontal response that is similar to periodontal tissues behavior around unrestored teeth 41–49 .…”

“…Different materials are also used for a variety of prosthetic procedures. It appears evident, for example, that while some provisional materials 40 and amalgam intracrevicular margins are associated with plaque and inflamed marginal periodontal tissues, adhesive materials, such as composite and RMGI, behave similarly to natural tooth structure when placed in the gingival sulcus 38,39,73 . It is therefore not appropriate to generalize findings across material types as different materials appears to elicit differential periodontal responses.…”

Influence of Tooth-Brushing on Early Healing after Access Flap Surgery: A Randomized Controlled Preliminary Study

“…The bony defect was corrected by fiber retention technique, and a positive bony architecture was obtained. Periosteal anchorage was obtained through suturing to allow for flap stability; to choose the selected position of the flap; and to reduce the coagulum between flap, periosteum, or bone surface [ 36 ]. However, immediately before the surgery, patients were randomly allocated to group A (CHX + ADS), group B (CHX), or group C (placebo).…”

Subgingival = suboptimal? Die Proximal Box Elevation zur Therapie tiefer Defekte

“…die Überlebensrate nach 12 Jahren klinischer Liegedauer betrachteten [20]. Eine weitere Studie kombinierte klinische und histologische Parameter nach einem Untersuchungszeitraum von 3 Monaten [21].…”