A Possible Influence of Gingival Dimensions on Attachment Loss and Gingival Recession Following Placement of Artificial Crowns

The aim of the present study was to determine the influence of gingival dimensions on the development of gingival recession following placement of artificial crowns. The study population consisted of 11 periodontally healthy patients in whom 44 maxillary anterior teeth and/or premolars had to be crowned. A total of 36 teeth (82%) had, after crown placement, a mean intracrevicular crown margin of 0.57 ± 0.47 mm. Thirty-nine teeth without restorations served as controls. Immediately after incorporation, as well as after 3, 6, 9, and 12 months, periodontal examinations were carried out. Gingival thickness was determined sonometrically and averaged 1.25 ± 0.40 mm. Mean periodontal probing depth was 1.80 ± 0.54 mm. Twelve months later, crowned teeth had experienced a mean attachment loss of 0.17 ± 0.99 mm as compared to an attachment gain of 0.18 ± 0.46 mm at control teeth. At test teeth, the gingival margin had receded a mean of 0.43 ± 0.74 mm. In multivariate analyses considering the correlated structure of the data employing generalized estimating equation methods, crown placement was identified as a major factor for attachment loss and development of gingival recession. In addition, a shallow probing depth and narrow band of gingiva negatively influenced the level of periodontal attachment. The present results point to the importance of a more detailed periodontal diagnosis of the dentogingival region before placement of artificial crowns.