Avaliação clínica e radiográfica das dimensões anatômicas de pacientes com erupção passiva alterada: série de casos

Abstract

Altered Passive Eruption (APE) can compromise smile esthetics and self-esteem. For its diagnosis and treatment plan, it is essential to identify the position of periodontal anatomical structures. The aim of the present study was to evaluate dental and periodontal clinical and radiographic measurements of participants with APE before and after periodontal surgery; and the differences between measurement methods. For this, 12 participants diagnosed with APE were selected (mean age of 23.3 years), from which anamnesis data were collected. Measurements of 72 maxillary teeth grouped into central incisors (CI), lateral incisors (IL) and canines (Can) were also performed by means of clinical examination, plaster model, and periapical radiographs. The patients underwent surgery with gingivoplasty, osteotomy and osteoplasty, and the data collected were statistically analyzed. The distance between the cemento- enamel junction and the buccal bone crest (CEJ-CB) was evaluated by means of a preoperative transperiodontal probe, and subsequently, during the transoperative period. Thus, it was observed that the measurement collected with the closed flap was significantly higher, both in CI and IL (p = 0.001). Four months after the surgical procedure, when seven patients returned for clinical care, there was a significant increase in the height of the clinical crown of the CI (8.7 mm to 10.0 mm), LI (7.1 mm to 8.6 mm) and Can (8.0 mm to 9.3 mm); and reduction of the width-height ratio also in the CI (0.97 to 0.84), LI (0.96 to 0.78) and Can (0.97 to 0.84) (p < 0.001). In the present study, the surgical procedure used was successful in increasing the size of the clinical crown and reducing the width-to-height ratio; and preoperative probing was not efficient to assess the real distance between the CEJ-CB.