ABSTRACT Aim To assess the clinical, profilometric, radiographic and patient‐reported outcomes following aesthetic crown lengthening (ECL) with ostectomy performed using either piezosurgery (PS) or rotary burs (RB). Methods Fifteen patients with altered passive eruption underwent ECL from maxillary premolar to premolar in a 6‐month split‐mouth randomised design. Ostectomy was performed with either PS or RB. Clinical, profilometric and radiographic assessments, as well as patient‐reported outcomes, were collected. The primary outcome was the change in gingival margin (GM) position between 6 weeks and 6 months, analysed with a linear mixed model with treatment as a fixed effect and patient as a random effect. Results Between 6 weeks and 6 months (primary outcome), GM change was 0.16 ± 0.19 mm in the PS group and 0.12 ± 0.21 mm in the RB group ( p = 0.170). The greatest reduction in crown height occurred between suturing and 7 days (−0.63 ± 0.35 mm). CEJ–BC remodelling from surgery to 6 months was −0.22 ± 0.42 mm ( PS ) and −0.26 ± 0.44 mm ( RB ) ( p = 0.491). Conclusion PS and RB showed no significant difference in GM stability following ECL, with the greatest changes in the first week and stability by 6 weeks.
ABSTRACT Aim To prospectively evaluate periodontal soft‐ and hard‐tissue changes in the mandibular incisor region after labial augmented corticotomy (AC) in skeletal Class III patients undergoing orthodontic–orthognathic treatment. Materials and Methods Thirty‐five skeletal Class III patients were included. A total of 140 mandibular incisors treated with AC were evaluated at baseline, 6 months after surgery and at treatment completion. Clinical parameters, gingival thickness, cemento‐enamel junction (CEJ) to alveolar crest distance and labial and lingual alveolar bone areas were assessed using clinical examination, cone‐beam computed tomography and integrated digital models. Results Probing depth and labial gingival recession showed no significant overall changes. Width of keratinised gingiva and gingival thickness increased significantly and remained higher than baseline at treatment completion. Labial CEJ to alveolar crest distance decreased and remained lower than baseline, whereas the lingual distance increased. Labial alveolar bone area remained higher than baseline, whereas lingual alveolar bone area progressively decreased over time. Conclusions Labial AC was associated with sustained improvement in periodontal soft tissue and labial alveolar bone in the mandibular incisor region through treatment completion, although lingual alveolar bone area decreased over time.
ABSTRACT Aim To determine the radiographic detection rate of suspected cemental tear on periapical radiographs and to evaluate its association with localised radiographic periodontal breakdown and initial diagnostic pathways. Materials and Methods We retrospectively screened 370,061 periapical radiographs from 203,286 patients (2022–2024) for features suggestive of cemental tear. Three calibrated examiners independently assessed the radiographs and linked their findings to clinical records. Relative radiographic bone loss (rRBL%) was measured at suspected sites and compared with within‐patient reference sites. Results Cemental tear was radiographically suspected in 1573 teeth (tooth‐level detection rate, 0.43%) from 1509 patients (patient‐level detection rate, 0.74%). The detection rate increased with age (OR 1.46 per decade; p < 0.001). The suspected sites showed greater localised radiographic periodontal breakdown than the reference sites ( p < 0.001), and age and sex remained associated with ΔrRBL% after adjustment. Cemental tear was documented as the initial diagnosis in 17 of 1466 tooth‐level records (1.16%). Most of the reviewed records initially documented periodontal or endodontic diagnoses. Conclusions Radiographically suspected cemental tear is associated with greater localised radiographic periodontal breakdown, whereas an initial diagnosis of cemental tear was infrequently documented. Combined clinical‐radiographic evaluation and prospective validation are warranted.
