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Objective@#To compare the consistency of the biological widths measured by using cone-beam CT (CBCT) and periodontal probe in patients with two different gingival biotypes.@*Methods@#Totally 27 patients [13 males, 14 females, (37.6±13.7) years old], who planned to receive the crown lengthening surgery, were recruited under the inclusion and exclusion criteria in Department of Periodontology, School of Stomatology, The Fourth Military Medical University during November 2017 to June 2018. A total of 40 teeth (14 front teeth, 26 posterior teeth) were involved in this study. The patients were divided into two groups according to their gingival biotypes: thin gingival biotype [5 males, 8 females, (40.2±15.0) years old, 21 teeth] and thick gingival biotype [8 males, 6 females, (35.1±11.9) years old, 19 teeth]. All the teeth were checked before crown lengthening procedures by using CBCT, and the biological widths and sulcus depths were measured during the surgery by using periodontal probes (Hu-Friedy, U S A). The data were recorded and statistically analyzed.@*Results@#There were no significant differences of the biological widths between the two measuring methods amongst all of the 40 teeth [periodonial probe: (1.64±0.26) mm; CBCT: (1.69±0.20) mm], amongst 21 thin gingival biotype teeth [periodontal probe: (1.49±0.19) mm; CBCT: (1.57±0.12) mm] and amongst 19 thick gingival biotype teeth [periodontal probe: (1.80±0.21) mm; CBCT: (1.87±0.18) mm] (P>0.05). There were no significant differences of the biological widths [anterior teeth: (1.59±0.15) mm, posterior teeth: (1.67±0.29) mm, P=0.42] and of the sulcus depths [anterior teeth: (2.00±0.28) mm, posterior teeth: (2.11±0.43) mm, P=0.44] between anterior teeth and posterior teeth. The difference of biological widths, measured by two methods respectively, between thin and thick gingival biotype groups was statistically significant (P<0.01). There were significant differences of the sulcus depths, measured by the periodontal probes, between the thin [(1.93±0.28) mm] and thick [(2.24±0.41) mm] gingival biotype groups (P<0.01).@*Conclusions@#The biological widths measured by CBCT is consistent with those measured by using periodontal probes. The biological widths and the depths of the sulcus of thin and thick gingival biotypes are different.
ABSTRACT
@#Gingival biotypes are used to describe the morphological characteristics of periodontal tissue. According to thickness, the gingiva can be divided into thin and thick gingival biotypes. The gingival biotype has a wide range of influential factors and can be measured by various methods. In the process of oral treatment, to achieve good therapeutic effects and obtain a clear prognosis, it is particularly important to study the gingival biotype. This article reviews the influential factors and methods for assessing the gingival biotype. The results of literature review show that, factors influencing the gingival biotype include individual factors related to sex, age and ethnicity and oral soft and hard tissue characteristics related to crown shape, tooth position, alveolar bone thickness, keratinized gingival width and gingival papilla height. Gingival hypertrophy mainly occurs in young males and in people with square and round crowns, thicker alveolar bones and wider keratinized gingiva. With the development of methods for measuring the gingival biotype ranging from the traditional direct observation method, direct measurement methods and periodontal exploration methods to cone beam computed tomography and ultrasound have increased the accuracy of these measurements.
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l procedimiento de cobertura radicular para tratar recesiones gingivales es el tratamiento ideal según la literatura actualizada, siendo más utilizado el colgajo de avance coronal con diferentes resultados clínicos y estéticos que ponen en duda si realizar este procedimiento sumando a un injerto de tejido conectivo se van a obtener resultados más predecibles y más estéticos en cuanto a la eliminación del defecto. En este reporte un paciente de 24 años de edad, masculino, refiere hipersensibilidad y disconformidad estética en la zona de la recesión gingival. En este caso se utilizará el cubrimiento radicular con colgajo de avance coronal más injerto de tejido conectivo autólogo. A los seis meses de sanado el paciente refiere mejoras en cuanto a: sensibilidad, control de placa y estética.
he root coverage procedure to treat gingival recessions is the best line of treatment, being the most used the coronal advanced flap. There have been multiple clinical and aesthetic results that cast doubt on whether this procedure by adding a connective tissue graft will be a more predictable and more aesthetic regarding defect removal. In this case report a patient 24-year-old male refers hypersensitivity and aesthetic discomfort in the area of gingival recession. An autologous graft with a coronal flap advancement of connective tissue will be used. After six months of healing the patient reports improvements in: sensitivity, plaque control and aesthetics.
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Objective · To detect gingival thickness of the anterior teeth region of Han nationality youths in Shanghai by cone-beam computerized tomography (CBCT), and evaluate its clinical application feasibility and the gingival biotype. Methods · Firstly, gingival thickness in the same site (5 participators, 30 sites) was detected by bone sounding and CBCT respectively, and the data were compared. A total of 30 participators with healthy gingival were recruited to the study and examined by the CBCT, the gingival thickness of selected sites (330 sites) was assessed and compared. All the subjects were examined by the experienced doctors and classified into three groups, thick-type middle-type and thin-type. Gingival thickness range and the proportion of every type were obtained. All data analyses were performed using SPSS 13.0. Results · There was no statistical difference in the thickness of gingival measured by bone sounding and CBCT (P>0.05). The main gingival biotypes of Han nationality youths in Shanghai were thin-type and middle-type. The average gingival thickness of upper central incisors [(1.32±0.15) mm] was larger than those of upper lateral incisors [(1.07±0.16) mm,P=0.000] and upper canines [(1.08±0.18) mm, P=0.000]. Conclusion · CBCT is feasible for detecting gingival thickness. Gingival thickness of the upper central incisors is significantly larger than those of upper lateral incisors and upper canines. The main gingival biotype of Han nationality youths in Shanghai is middle-type, the proportion of thick-type is least.
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56 teeth in 48 patients were divided into thick gingiva group (28 teeth)and thin gingiva group (28 teeth) and repaired with zirconia ceramic crown.Before 1 and 2 years after repair,gingival index,gingival margin recession and edge color satisfaction were evaluated.1 and 2 years after,repair gingival index was increase in thick group (P ＜ 0.05),but other indices were not (P ＞ 0.05);in thin gingiva group 2 years after repair the gingival margin recession index was increased(P ＜0.05),the other indices were not(P ＞ 0.05).
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PURPOSE: The purpose of this study was to assess the relationship between gingival biotype and underlying crestal bone morphology in the maxillary anterior region. MATERIALS AND METHODS: The maxillary anterior teeth from 40 subjects (20 thin biotype, 20 thick biotype) with ages from 20 to 50 years were included in this study. All subjects had healthy gingiva in the maxillary anterior region and had no history of orthodontic treatment, periodontal treatment, or hyperplastic medication. Using the probe transparency method, the scalloped distance (SCD) between the contact point-bone crest and the midface-bone crest was measured for each maxillary anterior teeth of two groups. RESULT: The mean SCD was 3.00±0.21 mm in thin biotype and 2.81±0.20 mm in thick biotype. The SCD value in the thin biotype was statistically significantly greater than in the thick biotype (t=2.982, P<0.01). Comparing the degree of crestal bone scallop in each maxillary anterior teeth in the two groups, all six teeth in the thin biotype showed higher bone scallop than in the thick biotype. CONCLUSION: A simple procedure using a probe could to determine gingival biotype and to predict the underlying crestal bone morphology was introduced. This may be useful for effective treatment planning.
Subject(s)
Gingiva , Maxilla , Methods , Pectinidae , ToothABSTRACT
Fueron analizados los parámetros de proporción dentaria, posición del cénit gingival, posición y tamaño de las papilas interdentarias, biotipo gingival, cantidad de encía queratinizada y línea de la sonrisa en las 6 piezas anterosuperiores en 31 estudiantes de odontología chilenos. Se estableció un patrón de proporción dentaria similar al descrito previamente en la literatura. La posición de cénit presentó un patrón definido. El biotipo gingival fino fue el más frecuente. Los incisivos laterales presentaron la mayor cantidad de encía queratinizada, seguidos por los incisivos centrales y luego los caninos. La altura de la papila a nivel de los caninos fue mayor que en los incisivos centrales, mientras que los valores más bajos fueron encontrados a nivel de los incisivos laterales. Existió una predominancia de la línea de la sonrisa media.
Tooth proportion, gingival zenith position, position and size of the interdental papillae, gingival biotype, amount of keratinized gingiva and smile line position were evaluated in the 6 upper front teeth in 31 Chilean dental students. The tooth proportion pattern was similar to that described previously in the literature. The zenith position showed an established pattern. A thin gingival biotype was found more frequently. Lateral incisors showed the highest amount of keratinized tissue, followed by central incisors and then the canines. The height of the papillae at the canines was higher than central incisors, while the lowest values were found in the lateral incisors. There was a predominance of a medium smile line.
Subject(s)
Humans , Male , Adult , Female , Young Adult , Tooth/anatomy & histology , Gingiva/anatomy & histology , Mouth Mucosa/anatomy & histology , Students, Dental , Biotypology , Chile , Esthetics, DentalABSTRACT
PURPOSE: The integrity of interproximal hard/soft tissue has been widely accepted as the key determinant for success or degree of root coverage following the connective tissue graft. However, we reason that the gingival biotype of an individual, defined as the distance from the interproximal papilla to gingiva margin, may be the key determinant that influence the extent of root coverage regardless of traditional classification of gingival recession. Hence, the present study was performed with an aim to verify that individual gingival scalloping pattern inherent from biotype influence the level of gingival margin following the connective tissue graft for root coverage. METHODS: Test group consisted of 43 single-rooted teeth from 21 patients (5 male and 16 female patients, mean age: 36.6 years) with varying degrees of gingival recession requiring connective tissue graft; 20 teeth of Miller class I and 23 teeth of Miller class III gingival recession, respectively. The control group consisted of contralateral teeth which did not demonstrate apparent gingival recession, and thus not requiring root coverage. For a biotype determination, an imaginary line connecting two adjacent papillae of a test tooth was drawn. The distance from this line to gingival margin at mid-buccal point and this distance (P-M distance) was designated as "gingival biotype" for a given individual. The distance was measured at baseline and 3 to 6 months examinations postoperatively both in test and control groups. The differences in the distance between Miller class I and III were subject to statistical analysis by using Student?s t-test while those between the test and control groups within a given patient were by using paired t-test. RESULTS: The P-M distance at 3 to 6 months postoperatively was not significantly different between Miller classI and Miller class III. It was not significantly different between the test and control group in a given patient, either, both in Miller classI and III. CONCLUSIONS: The amount of root coverage following the connective tissue graft was not dependent on Miller's classification, but rather was dependent on P-M distance, strongly implying that the gingival biotype of a given patient may play a critical impact on the level of gingival margin following connective tissue graft.