Relationships among the periodontal biotype characteristics in the maxillary anterior / 华西口腔医学杂志

OBJECTIVE@#To explore the correlation among gingival thickness (GT), underlying alveolar bone thickness (BT), and other periodontal biotype characteristics in the maxillary anterior.@*METHODS@#A total of 40 young volunteers with healthy periodontal were involved in this research. The periodontal probe was previously used to divide the gingiva from thick to thin. Two records were measured by cone beam CT (CBCT) GT, which was measured at the cement-enamel junction level; and BT, which was measured at 3 locations: 1, 3, 5 mm below the alveolar crest. Oral and gypsum measurements were used to analyze the associations of the crown width/crown length ratio (CW/CL), the keratinized mucosa width (KM), and the free gingival margin curvature.@*RESULTS@#Significant difference in the GT was observed between the thick and thin biotypes, which were divided by periodontal probe (P<0.01). Difference was observed in each periodontal biotype characteristic between the thick (GT≥1 mm) and thin biotypes (GT<1 mm) (P<0.05). BT was positively associated with GT (r=0.293, P=0.001), CW/CL (r=0.273, P=0.003), KM (r=0.291, P=0.001), and free gingival margin curvature (r=0.290, P=0.001).@*CONCLUSIONS@#The transparency of the probing in the sulcus could analyze the GT qualitatively. The thick and thin biotypes have different periodontal biotype characteristics. Compared with individuals with thick biotype, those with thin biotype are susceptible to risk dental aesthetic.

Avaliação do biotipo periodontal em áreas acometidas por recessão gengival em acadêmicos de odontologia / Evaluation of the periodontal biotype in gingival recession affected areas on academics of dentistry graduation

A determinação do biotipo periodontal é fundamental para estabelecer prognóstico em tratamentos restauradores, ortodônticos e periodontais. Também pode auxiliar na prevenção da ocorrência de recessão gengival. Objetivo: O objetivo deste trabalho foi determinar o biotipo periodontal em áreas acometidas por recessão gengival em acadêmicos de Odontologia. Material e Métodos: Foram avaliados os dentes superiores 11, 13, 14 e 16 de acadêmicos do curso de Odontologia. Foram observados os parâmetros: profundidade de sondagem; largura da faixa de gengiva queratinizada; formato das papilas; formato do dente 11 (triangular ou quadrado); espessura da gengiva marginal, dada pela translucidez da sonda periodontal através da gengiva marginal livre; e a espessura do periodonto de sustentação avaliada por palpação. As recessões gengivais encontradas foram mensuradas e classificadas de acordo com Miller. Os dados numéricos foram anotados em formulário próprio, analisados em porcentagem e estatisticamente. Resultados: Como resultado obteve-se uma prevalência do biotipo periodontal fino-festonado em 48,48% dos acadêmicos, biotipo periodontal espesso-festonado em 33,33% e biotipo periodontal plano-espesso em 18,18%. O biotipo periodontal fino-festonado apresentou estatisticamente significante mais recessões (60,60%) do que os biótipos espesso-festonado (33,33%) eplano-espesso (6,06%). Quando analisados os indivíduos que utilizaram aparelho ortodôntico, o tipo plano-espesso apresentou proporcionalmente menos recessão do que os outros grupos. Conclusão: A recessão gengival foi mais frequente em indivíduos com biotipo periodontal fino e o biotipo plano espesso exibiu menos recessões quando submetido a tratamento ortodôntico (AU)

The determination of the periodontal biotype is crucial to establish prognosis on restorative, orthodontic and periodontal treatments as well. It can also help to prevent the occurrence of retraction of the gingival tissue. Objective: the objective of this study was to determine the periodontal biotype on areas affected by gingival recession on academics of dentistry graduation. Material and Methods: We evaluated the upper teeth: 11, 13, 14 and 16, of academics of dentistry graduation. The following parameters were observed: probing depth; width of the keratinized gum strip; format of the papillae; 11 tooth shape (triangular or square); thickness of the marginal gingiva, given by the translucency of periodontal probe Willians through the free marginal gingiva on the buccal aspect of the mentioned teeth; the thickness of the supporting periodontal was evaluated by palpation and classified as thin or thick. Gingival recessions found were measured (by height and width) and classified according to Miller. Numerical data was noted on a specific form, analyzed in percentage and submitted to statistical analyses. Results: as result was obtained thin-scalloped periodontal biotype (48.48%) on of the students, thick-scalloped periodontal biotype (33.33%) and plan-thick periodontal biotype (18.18%) of them. The thin-scalloped periodontal biotype exhibited statistically significant more gingival recessions (60,60%) than the thick-scalloped biotype (33,33%) and plan-thick biotype (6,06%). Conclusion: Gingival recession was more frequent in patients with thick-scalloped biotype and the plan thick biotype exhibited less recessions when submitted to orthodontic treatment. (AU)

Simetria gengival na região estética ­ estudo transversal com uma população brasileira / Gingival symmetry in the esthetic zone ­ a cross-sectional study with a Brazilian population

Objetivo: avaliar o padrão da disposição da margem gengival (simétrica ou assimétrica) na zona estética. Material e métodos: foram avaliados 55 adultos jovens brasileiros, de ambos os sexos, estudantes do curso de graduação em Odontologia da Faculdade de Nova Friburgo, na faixa etária entre 18 e 25 anos. Foram avaliados incisivos centrais superiores direito e esquerdo, por um único examinador especialista em Periodontia, considerando os seguintes parâmetros clínicos: índice de placa, sangramento a sondagem e profundidade clínica de sondagem, coletados nos sítios distal, vestibular e mesial de cada elemento dentário estudado. Foram realizadas, ainda, análises morfométricas quanto à disposição das margens gengivais (simetria ou assimetria) entre incisivos centrais (direito e esquerdo), através de avaliação visual em fotos, utilizando modelos zocalados para uma segunda avaliação, objetivando fidelizar a avaliação antes realizada nas fotos. Resultados: o incisivo central direito foi responsável por 64% das relações assimétricas observadas. A assimetria das margens gengivais, entre incisivos centrais, foi observada em 25,45%, não havendo diferença estatisticamente significante em relação ao sexo. Conclusão: o reconhecimento dos aspectos gengivais (simetria gengival) e sua relação com elementos dentais tornam-se indispensáveis, visto que no processo de restauração é fundamental o entendimento do normal, possibilitando prever as dificuldades encontradas no processo de reconstrução de estruturas alteradas.

Objective: to evaluate the gingival margin disposition (symmetry of the lack of) in the esthetic zone. Material and methods: 55 Brazilian dental students (18-25 years-old) from both genders were evaluated at the Nova Friburgo Dental School. The maxillary right and left central incisors were examiner by an single specialist in Periodontics, considering the following parameters: plaque index, bleeding on probing, pocket probing depth, collected at the distal, buccal, and mesial sites of each element. Also, morphometric analyses were performed regarding the gingival margin disposition through photographic records and standardized stone casts to confirm the data obtained. Results: the maxillary right central incisor was responsible for 64% of asymmetries. The asymmetry between the central incisors was observed in 25.45% being not statistically different between genders. Conclusion: the identification of gingival aspects (gingival symmetry) and its relationship with the dental elements are invaluable to standardize what can be considered as a reference to normal standards, while it still predicts the drawbacks found in the reconstructive process of altered tissues.

Influência do biótipo periodontal na Implantodontia e na Ortodontia / Influence of periodontal biotype in Implantology and Orthodontics

O objetivo do presente estudo foi realizar uma revisão de literatura para avaliar a importância da definição do biótipo periodontal nos tratamentos ortodônticos e de implantes. Observou-se que as diferenças das características periodontais são semelhantes tanto para pacientes dentados quanto para portadores de implantes, então essa informação deve ser importante para a definição do tratamento ortodôntico e com implantes para evitar transtornos funcionais e estéticos. A definição do biótipo periodontal é fundamental para a previsibilidade desses tratamentos.

The aim of this study was to conduct a literature review to assess the importance of the definition of the periodontal biotype in orthodontic and implants treatments. It was observed that the differences in periodontal characteristics are similar for both dentate patients and for patients with implants, then this information should be important to the definition of orthodontic and implants treatments to avoid functional and aesthetic inconvenience. And the definition of periodontal biotype is critical to the predictability of these treatments.

Descripción de las causas y tipos de tratamiento efectuados en dientes con invasión del espacio biológico o con necesidad de cirugía preprotésica: serie de casos / Descrição das causas e tipos de tratamentos efetuados em dentes com invasão de espaço biológico e/ou necessidade de cirurgia pré-protésica: série de casos / Description of causes and treatment types made in teeth with biological space invasion and/or in need of pre-prosthetic surgery: case series

Antecedentes: la decisión de rehabilitar o extraer un diente la determina conocer las causas de la destrucción dental que influyen en el plan de tratamiento y pronóstico. Objetivo: describir indicaciones, tratamientos quirúrgicos periodontales previos a la restauración dental, dientes más afectados y edad de pacientes con invasión del espacio biológico (IEB) o necesidad de cirugía preprotésica. Método: este trabajo es una serie de casos de 162 pacientes de ambos sexos, quienes fueron atendidos en las clínicas de pregrado de la Universidad Evangélica de El Salvador (UEES). Después del análisis clínico y radiográfico, se verificó la necesidad de procedimientos periodontales para la recuperación de espacio biológico o cirugías preprotésicas. Resultados: el 28% de los pacientes fueron hombres, y el 72%, mujeres. Las causas de IEB y tratamiento preprotésico más frecuentes fueron caries, márgenes subgingivales de restauraciones y fracturas. Los dientes más afectados fueron los premolares y primeros molares. El 60% de los procedimientos se realizaron en pacientes entre 23 y 42 años. Los tratamientos más frecuentes fueron alargamiento de corona clínica con ostectomía (62%), sin ostectomía (23,5%) y gingivectomía con electrobisturí (8,7%). Conclusión: caries, fracturas dentales y restauraciones subgingivales fueron las causas más frecuentes de IEB. El colgajo periodontal con ostectomía continúa siendo el procedimiento más utilizado para resolver dichos problemas. El reconocimiento de las causas de la IEB, los dientes más afectados, la edad de los pacientes y el tipo de tratamiento efectuado establecerá un mejor pronóstico rehabilitador, haciendo énfasis en las medidas operatorias necesarias para reducir el fracaso de la rehabilitación.

Background: The decision to rehabilitate or extract a tooth is determined by the knowledge of the causes of dental destruction affecting treatment plan and prognosis. Aim: Describe indications, surgical periodontal therapy prior to dental restoration, most affected teeth and age of the patients with invasion of biological space (IBS) and/or pre-prosthetic surgery. Methods: This is a case series report of 162 patients, male and female, who were treated at the predoctoral dental program of Universidad Evangélica de El Salvador. After clinical and radiographic analysis, the need for periodontal procedures for the recovery of biological space and/or pre-prosthetic surgery was verified. Results: 28% of patients were male and 72% female. The most common causes of IBS and/or pre-prosthetic treatment were caries, restorations with subgingival margins, and fractures. The most affected teeth were the premolarsand first molars. 60% of the procedures were performed in patients between 23-42 years of age. The most common treatments were clinical crown lengthening without ostectomy (23.5%), with ostectomy (62%), and electrosurgical gingivectomy (8.7%). Conclusion: Caries, fractured teeth and subgingival restorations were the most common causes of IBS The periodontal flap with ostectomy remains to be the most used procedure to solve these problems. Recognizing the causes of the IBS, the most affected teeth, the age of the patients and the type of treatment will allow for a better rehabilitating prognosis, emphasizing on the operative measures necessary to reduce rehabilitation failures.

Antecedentes: a decisão entre conservar ou extrair um dente é determinada pelo conhecimento das causas que produzem a destruição dental que influem no plano de tratamento e prognostico dos dentes envolvidos. Objetivo: descrever os procedimentos cirúrgicos periodontais realizados previamente à restauração dental, etiologia, dente mais afetado e idade dos pacientes. Método: este relatório é uma série de casos de 162 pacientes de ambos os sexos que foram tratados nos clínicas da graduação da Faculdade de Odontologia da Universidade Evangélica de El Salvador. Posterior ao analise clínico, radiográfico e diagnóstico se realizou o plano de tratamento, onde se verificou a necessidade de procedimentos periodontais para a recuperação do espaço biológico (EB) e/ou pré-protéticos. Os procedimentos foram realizados por um operador treinado na área da periodontia. Resultados: 28% dos pacientes foram homens e 72% mulheres. As causas mais freqüentes de invasão do EB e/ou tratamento pré-protético foram caries, margens sub-gengivais de restaurações e fraturas. Os dentes mais afetados foram os pré-molares e primeiros molares. 60% dos procedimentos foram realizados em pacientes entre 23 y 42 anos. Os tratamentos mais freqüentes foram: Aumento de Coroa Clínica associado à Osteotomia (62%), sem Osteotomia (23,5%) e gingivectomia com eletrobisturi (8,7%). Conclusão: o reconhecimento das causas da invasão do EB, os dentes mais afetados, grupo etário e tipo de tratamento efetuado, permitirão estabelecer um melhor prognóstico reabilitador, pondo maior ênfase nas medidas reabilitadoras direcionadas à redução da falha ou fracasso reabilitador.

Three dimensional analysis of Korean dentogingival complex / 대한치주과학회지

PURPOSE: Variation in the morphology of gingival papilla may be determined by the shape and position of anatomic crown as well as contact area and embrasure form of individual teeth. However, periodontal biotype classification is regarded to be subjective because of the lack of definite criteria. In this study, we defined the objective parameters which constitute the periodontal biotype and measured their relationship. MATERIALS AND METHODS: 109 of dental casts were prepared using three dimensional scanner and specialized reconstruction software, then acquiredvirtual models were sent to the 20 professional dentists to define the specific periodontal biotypes. Several parameters around periodontal structures were measured from the virtual models; facial surface area of the anterior tooth (AT), anterior papillary area (AP), proportion of the dento-papillary complex, clinical papillary length (PL), and clinical papillary angle (PA). Statistical analysis was performed to confirm the relationship among parameters. RESULTS: Coincidence rate of periodontal biotype within observers was 63.77+/-16.05%. Coincidence rate between observers was 76.15+/-16.43%. Among the parameters measured, PL showed the most positive correlations and PA presented the most negative correlations. The parameter of the AP and PL of six maxillary anterior teeth showed significant correlation coefficient. CONCLUSION: Anterior papillary area and clinical papillary length would be objective parameters for determining the consistent periodontal biotypes.

Clinical features of the gingiva according to maxillary anterior teeth form in adult / 대한치주과학회지

It has been suggested that morphologic characteristics of the periodontium are partly related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or "biotypes". The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary anterior tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. The thickness of gingiva was measured by ultrasonic device(SDM). 100 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, gingival recession, width of keratinized gingiva, thickness of the keratinized gingiva. From maxillary study cast, the width(at the apical third-CW) and the length(CL) of the crowns of the 6 anterior teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. The 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow(group N) or a short-wide(group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long-narrow form of the central incisors displayed, compared to individuals with a short-wide crown, form (1) a narrow zone of keratinized gingiva, (2) a pronounced "scalloped" contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the keratinized gingiva. The CW/CL-ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisors and canine tooth region. The regression analyses demonstrated that the thickness of the keratinized gingiva in central, lateral incisors and canines was significantly related to the width of the keratinized gingiva.