Soft and Hard Tissue Remodeling after Endodontic Microsurgery: A Cohort Study

The aim of this study was to investigate the impact of the incision type, with or without a coronally repositioning flap (CRF), on soft tissue healing and crestal bone remodeling after endodontic microsurgery (EMS). Clinical pictures and cone-beam computed tomography images from 47 patients (120 teeth) taken before surgery and at the follow-up appointment were included in this study. Clinical pictures were qualitatively evaluated by 2 endodontists for the gingival marginal level (GML) (recession, same position, or coronal root coverage), papillary height (same position/receded), and for presence/absence of scars for each tooth. Cone-beam computed tomography images were used to calculate the changes in the distance between the cementoenamel junction and the crestal bone level (CBL) between the preoperative and follow-up scans. Statistical analyses were performed to determine a correlation between patient-related factors (age, sex, tooth type, position, and presence/absence of a crown), incision techniques, and changes within the CBL. Gingival recession was more prevalent in mandibular teeth, molar teeth, and teeth that received intrasulcular or papilla-based incisions (P