Influência do afastamento labial na avaliação tomográfica dos tecidos ósseo e gengival da maxila anterior

Abstract

The aim of this study was to evaluate the thickness of the buccal bone and the gingival tissue in the region of upper incisors by using computed tomography cone beam (CBCT), obtained with or without lip retractor. This is a clinical-tomographic study, in which the thickness of the buccal bone and gingiva were collected from 120 upper incisors. Bone and gingival thickness, with and without lip retractor, were measured in different regions of CBCT images. To validate the use of CBCT for measuring gingival tissue, the tomographic measurements were correlated with data acquired by clinical probing. The images with or without lip retractor were also compared regarding their quality. The bone thickness measurement located at the cervical portion (1 mm above the bone crest), was higher when lip retractor was employed (paired t-test/ p = 0.021). The thicknesses of the bone tissue were significantly correlated with those of the gingival tissue (Pearson correlation/ p ≤ 0.02). The gingival tissue could only be measured in CBCT scans obtained with lip retractor. The gingival thickness from CBCT showed significant correlations with those obtained clinically (Pearson correlation/ p ≤ 0.001). Regarding the preference of the evaluators, 76% of radiologists and 56% of implant specialists preferred the images obtained with the lip retractor. It was concluded that in addition to the classical bone tissue examination, the use CBCT with lip retractor is a simple and reliable technique for measuring the gingival tissues.