Assessment of supracrestal tissue attachment variation in patients with chronic periodontitis before and after treatment: A clinical-radiographic study

Shahabe Saquib; Gore Anoop; Nitin Dani; Yaqoob Ashfaque; Abdul Ahad Khan; Nilofer Attar; Saad  Al-qahatani

doi:10.2298/VSP181118007A

Shahabe Saquib College of Dentistry, King Khalid University, Abha, Saudi Arabia.
Gore Anoop H.S.R.M.S Dental College and Hospital, Hingoli, India.
Nitin Dani Mahatma Gandhi Vidyamandir Dental College and Hospital, Nasik, India.
Yaqoob Ashfaque King Khalid University, College of Dentistry, Abha, KSA
Abdul Ahad Khan King Khalid University, College of Dentistry, Abha, KSA.
Nilofer Attar Government Dental College and Hospital, Mumbai, India.
Saad Al-qahatani King Khalid University, College of Dentistry, Department of Periodontics and Community Dental Sciences

DOI: https://doi.org/10.2298/VSP181118007A

Keywords: periodontics;, debridement; surgical flaps;, gingival recession;, dental scaling;, radiography, dental

Abstract

Background/Aim. Healthy periodontium comprises the dento-gingival junction. Periodontal disease starts to appear when the integrity of the junctional epithelium is disturbed. Assessment of the supracrestal tissue attachment (SCTA) is essential because there is a frequent need for restoration or prosthesis after periodontal surgical and non-surgical therapy. The aim of the present study was to evaluate the SCTA variations in a patients with chronic periodontitis before and after treatment. Methods. Thirty systemically healthy patients with periodontitis were enrolled in the study. Fifteen patients were subjected to scaling and root planing and 15 to open flap debridement. Radiographic and clinical findings of the SCTA were assessed before and after treatment at 3-month and 6-month intervals. Results. Comparison between clinical and radiographic findings of the SCTA showed a significant difference in patients with periodontitis (p < 0.05). This difference was not significant after treatment of patients with shallow pockets with scaling and root planing (p > 0.05), but showed a significant difference in patients with moderate pockets treated by open flap debridement (p < 0.05). Conclusion. Progression in periodontal disease causes a reduction in the SCTA dimension, which regains its original dimensions after periodontal therapy. It takes around 3 months for the shallow pockets to regain the supracrestal tissue attachment to the original dimension when treated by scaling and root planing, whereas moderate pockets regain it after 6 months when treated with open flap debridement.

Author Biographies

Shahabe Saquib, College of Dentistry, King Khalid University, Abha, Saudi Arabia.

Assistant professor, Department of Periodontics.

Gore Anoop, H.S.R.M.S Dental College and Hospital, Hingoli, India.

Assistant Professor, Department of Periodontics,

Nitin Dani, Mahatma Gandhi Vidyamandir Dental College and Hospital, Nasik, India.

Professor, Department of Periodontics,

Yaqoob Ashfaque, King Khalid University, College of Dentistry, Abha, KSA

Assistant professor, Department of Prosthodontics,

Abdul Ahad Khan, King Khalid University, College of Dentistry, Abha, KSA.

Assistant professor, Department of Oral and Maxillofacial Surgery,

Nilofer Attar, Government Dental College and Hospital, Mumbai, India.

Assistant professor, Department of Periodontics,

References

Newman MG, Takei HH, Carranza FA. Carranza. Carranza's Clinical Periodontology. Philadelphia: W.B. Saunders Co, 2002.

Bartold PM, Walsh LJ, Narayanan AS. Molecular and cell biol-ogy of gingiva. Periodontol 2000 2000; 24: 28‒55.

Nanci A, Bosshardt DD. Structure of periodontal tissues in health and disease Periodontol 2000 2006: 40; 11‒28.

Listgarten M. Changing concepts about the dento-epithelial junction. J Can Dent Assoc (Tor) 1970; 36(2): 70‒5.

Gargiulo AW, Wentz FM, Orban B. Dimensions and relations of the dento-gingival junction in humans. J Periodontol 1961; 32: 261‒7.

Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortel-lini P et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus re-port of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; 45(Suppl 20): S219‒29.

Ingber JS, Rose LF, Coslet JG. The ‘‘biologic’’ width-A con-cept in periodontics and restorative dentistry. Alpha Ome-gan 1977; 70(3): 62‒5.

Novak MJ, Polson AM, Caton J, Freeman E, Meitner S. A perio-dontal attachment mechanism without alveolar bone. Case report. J Periodontol 1983; 54(2): 112‒8.

Stanley HR Jr. The cyclic phenomenon of periodontitis. Oral Surg Oral Med Oral Pathol 1955; 8(6): 598‒610.

Ganji KK, Patil VA, John J. A comparative evaluation for bio-logic width following surgical crown lengthening using gingivectomy and ostectomy procedure. Int J Dent 2012; 2012: 479241.

Nautiyal A, Gujjari S, and Kumar V. Aesthetic Crown Lengthening Using Chu Aesthetic Gauges And Evaluation of Biologic Width Healing. J ClinDiagn Res 2016; 10(1): ZC51‒5.

Arora R, Narula SC, Sharma RK, Tewari S. Evaluation of su-pracrestal gingival tissue after surgical crown lengthening: a 6-month clinical study. J Periodontol 2013; 84(7): 934‒40.

Novak MJ, Albather HM, Close JM. Redefining the Biologic width in Severe, Generalized, Chronic Periodontitis: Im-plications for Therapy. J Periodontol 2008; 79(10): 1864‒9.

Reetika G, Jayashree M, Ilangovan K, Shrikar D, Harshada S, Roopali T. Determination of clinical SCTA in chronic gen-eralized periodontitis and healthy periodontium: A clinico-radiographical study. J Indian Soc Periodontol 2015; 19: 194‒8.

Listgarten MA, Rosenberg MM. Histological study of repair fol-lowing new attachment procedures in human periodontal lesions. J Periodontol 1979; 50(7): 333‒44.

Waerhaug J. Healing of the dento-epithelial junction follow-ing subgingival plaque control as observed in human biopsy material. J Periodontol 1978; 49(1): 1‒8.

Perez JR, Smukler H, Nunn ME.. Clinical Evaluation of the Supraosseous Gingivae Before and After Crown Lengthen-ing. J Periodontol 2007; 78(6): 1023‒30.

Goodson JM, Haffajee AD, Socransky SS. The relationship be-tween attachment level loss and alveolar bone loss. J Clin Periodontol 1984; 11(5): 348‒59.

Schmidt JC, Sahrmann P, Weiger R, Schmidlin PR, Walter C. Bio-logic width dimensions - A systematic review. J Clin Perio-dontol 2013; 40(5): 493‒504.

Barboza EP, MonteAlto RF, Ferreira VF, Carvalho WR. Supra-crestal Gingival Tissue Measurements in Healthy Human Periodontium. Int J Periodontics Restorative Dent 2008; 28(1): 55‒61.

Stern IB. Current concepts of the dentogingival junction: the epithelial and connective tissue attachments to the tooth. J Periodontol 1981; 52(9): 465‒76.