[Periodontal conditions in patients with crowns and bridgework]

A study evaluating supragingival and subgingival placement of restoration margins in 24 patients following periodontal and reconstruction therapy is presented. After 1 year no significant differences in supragingival plaque retention, tooth mobility, and width of attached gingiva were observed between the two types of restorations. The gingiva of those restorations with supragingival termination of margins showed, however, significantly (p less than 0.001) less inflammation. The pocket depth of restored teeth was significantly greater (p less than 0.001) than that of non-restored. It is concluded that whenever feasable, restorations should terminate above the free margin of the gingiva. Every restoration terminating in the immediate vicinity of or in actual contact with surrounding soft tissue is a potential irritant to that tissue and increases the chance of precipitating periodontal disease. It is mandatory that the patients with such restorations participate in a regular dental hygiene recall program where oral hygiene can be evaluated, physiotherapy procedures reviewed and motivation reenforced.