Evaluation of Periodontal Phenotype Following Orthognathic Surgery: A Two-Center, 6-Month Prospective Clinical and CBCT Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 100
- 试验地点
- 2
- 主要终点
- Change in width of keratinized gingiva (mm)
研究概览
简要总结
The goal of this observational study is to learn how the health and thickness of the gums and supporting bone around the teeth change over 6 months in adults having jaw surgery to correct the bite. The main questions it aims to answer are:
- Do gum and tooth-support measurements change from before surgery to 1, 3, and 6 months after surgery?
- Do CT scan-based measurements of the tooth-supporting bone change over the same time period?
Participants will:
- Have a gum check-up (periodontal examination) before surgery and at 1, 3, and 6 months after surgery.
- Have CT scan-based measurements (CBCT) taken at the same time points for study assessment.
详细描述
This two-center prospective observational cohort study will enroll adult patients who are scheduled to undergo orthognathic surgery according to standard clinical indications. Orthognathic surgeries will be performed at Kocaeli Health and Technology University, while periodontal clinical examinations and CBCT-based assessments will be conducted at Trakya University. Participants will be evaluated at baseline (preoperatively) and at 1, 3, and 6 months after surgery. Clinical periodontal assessments will include predefined periodontal phenotype-related parameters recorded using a standardized protocol. CBCT datasets will be obtained and analyzed using a standardized measurement protocol to assess buccal alveolar bone-related parameters and the presence of dehiscence/fenestration where applicable. To minimize assessment bias, CBCT images will be coded and evaluated by an independent assessor blinded to surgical details and group classification, and clinical periodontal examinations will be performed by an examiner blinded to the surgical procedure details.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged ≥18 years.
- •Presence of a Class III molar relationship of any severity at baseline.
- •Presence of a Class II molar relationship of any severity at baseline.
- •Presence of transverse arch discrepancies.
- •Presence of vertical maxillary excess.
- •Presence of maxillary and/or mandibular asymmetry.
- •Presence of anterior open bite.
- •Full permanent dentition up to the first molars, with no supernumerary teeth and no agenesis (congenital absence) of teeth up to the first molars.
- •No previous orthodontic treatment.
- •No history of tooth extraction other than second or third molars.
- •Availability of complete baseline and end-of-follow-up periodontal parameters and phenotype records suitable for evaluation.
- •Healthy periodontium with no signs of gingival hypertrophy.
- •No systemic disease history or medication use that could affect gingival/periodontal conditions.
排除标准
- •Patients planned for orthodontic camouflage treatment with fixed appliances for Class II/Class III correction instead of orthognathic surgery.
- •History of interproximal enamel reduction (interproximal stripping).
- •Presence of dental implants.
- •Age < 18 years.
- •Pregnant or breastfeeding individuals.
- •Any systemic condition contraindicates orthognathic surgery.
- •Psychiatric disorders.
- •Syndromic conditions.
- •History of previous orthognathic surgery.
- •Refusal to sign the informed consent form.
- •Individuals belonging to a vulnerable population.
研究组 & 干预措施
Group F (Maxillary advancement < 6 mm + maxillary downgrafting)
Group I (Maxillary advancement ≥ 6 mm + maxillary downgrafting)
Group J (Maxillary advancement ≥ 6 mm + no impaction/downgrafting)
Group A (Mandibular setback < 6 mm)
Group B (Mandibular setback ≥ 6 mm)
Group C (Mandibular advancement < 6 mm)
Group D (Mandibular advancement ≥ 6 mm)
Group E (Maxillary advancement < 6 mm + maxillary impaction)
Group G (Maxillary advancement < 6 mm + no impaction/downgrafting)
Group H (Maxillary advancement ≥ 6 mm + maxillary impaction)
结局指标
主要结局
Change in width of keratinized gingiva (mm)
时间窗: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Width of keratinized gingiva is measured as the distance from the gingival margin to the mucogingival junction, recorded in mm.
Change in gingival thickness phenotype (thin vs thick)
时间窗: Baseline (preoperative) and postoperative 1, 3, and 6 months.
Gingival thickness is assessed with a periodontal probe by the probe-transparency method and categorized as thin (≤1 mm; probe visible) or thick (\>1 mm; probe not visible)
Change in buccal cortical bone thickness on CBCT (mm)
时间窗: Baseline (preoperative) and postoperative follow-up CBCT records were obtained during routine controls (planned at 6 months).
Buccal cortical bone thickness is measured on CBCT as the horizontal distance from the deepest point of the buccal marginal bone curvature (A) to the CEJ, and additionally at 4 mm apical to A and at the apex level, as defined in the protocol
次要结局
- Probing pocket depth (mm)(Baseline (preoperative) and postoperative 1, 3, and 6 months.)
- Bleeding on probing (0/1)(Baseline (preoperative) and postoperative 1, 3, and 6 months.)
- Gingival Index (0-3)(Baseline (preoperative) and postoperative 1, 3, and 6 months.)
- Plaque Index (0-3)(Baseline (preoperative) and postoperative 1, 3, and 6 months.)
- Papilla loss classification (Nordland & Tarnow)(Baseline (preoperative) and postoperative 1, 3, and 6 months.)
- Gingival recession (mm)(Baseline and postoperative 1, 3, 6 months.)
- Fenestration/dehiscence presence on CBCT (yes/no) (and/or counts)(Baseline and postoperative 6 months.)
- Clinical attachment loss (mm)(Baseline and postoperative 1, 3, 6 months)
研究者
Ece AÇIKGÖZ ALPARSLAN
Ass. Prof
Trakya University