Gingival biotype modification with collagen matrix or autogenous subepithelial connective tissue graft: Histologic and volumetric analyses in a beagle model.

Objectives: To evaluate the volumetric effect and biocompatibility of porcine tendon-derived type I collagen matrix graft (CG) in gingival biotype modification (GBM) compared with subepithelial connective tissue graft (SCTG) in a beagle model. Methods: Surface analysis using scanning electron microscopy and a collagen degradation assay of CG was performed in vitro. Six adult dogs were used in in vivo experiment, and each received autologous SCTG or CG at the anterior side. Histometric and three-dimensional digital volume analyses were conducted to compare quantitative changes in CG and SCTG in GBM. Immunohistochemical analysis was performed for the qualitative evaluation of CG compared to SCTG. Results: CG had a double-layered structure, and its degradation was slower than that of other well-reported materials. No critical problems were associated with the healing procedure. Changes in gingival thickness and volume in the CG and SCTG groups were equivalent, with no significant differences between the groups. Type I collagen and vascular endothelial growth factor expression levels were similar in both groups. Significance: CG and SCTG had equivalent potential for GBM in terms of quantity and quality. Additionally, CG could be used as a reasonable substitute for SCTG, making surgery convenient and predicting successful clinical outcomes.

Initial assessment of gingival biotype as a potential source of variability in the migration, contraction and gene expression of fibroblasts.

OBJECTIVE: Gingival biotype refers to the clinical classification of gingiva based on the thickness of the tissue, with thick gingival tissues more resistant to trauma and recession than the thin variant. However, to date there has never been an analysis of whether fibroblasts isolated from different biotypes possess inherent phenotypic differences. We hypothesized that gingival fibroblasts from thick and thin biotype would exhibit differences in migration, contraction and gene expression in vitro in the presence of either transforming growth factor beta one (TGF-ß1) or tumor necrosis factor alpha (TNFα), two major cytokines involved in wound repair. DESIGN: Migration was quantified using closure of scratch wound assays, contraction was assessed using attached and detached collagen lattices and extracellular matrix related gene expression using Taqman Realtime polymerase chain reaction. RESULTS: Human gingival fibroblasts isolated from both biotypes showed similar rates of closure of scratch wounds, which was not influenced by the addition of TGF-ß1 or TNFα. Fibroblasts from both biotypes contracted detached, but not attached, collagen gels to 50 % of their original weight although this contraction was not associated with incorporation of α-smooth muscle actin into stressfibres under any tested culture condition. Analysis of gene expression showed that POSTN, and ACTA2 mRNA levels did not significantly change, but CCN2 and COL1A2 mRNA levels were significantly higher in thick compared to thin fibroblasts in response to TGF-ß1. CONCLUSION: While supra-cellular factors influence the healing, esthetic outcomes and recession in thin gingival biotypes, differences in gingival fibroblast gene expression in response to growth factors may also play a role and warrants further investigation.

Evaluation of the association between gingival phenotype and alveolar bone thickness: A systematic review and meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies that evaluated the association between gingival phenotype (GP) and the underlying alveolar bone thickness (ABT). DESIGN: An electronic search was performed in PubMed, Embase, Scopus, ProQuest, and Web of Science. The following inclusion criteria were applied: English original studies that compared the ABT in periodontally healthy patients presenting thin versus thick GPs. Studies that evaluated the correlation between gingival thickness (GT) and ABT were also included. Pooled mean difference (95% confidence interval) was estimated using random-effects maximum likelihood model meta-analysis. RESULTS: From a total of 1427 retrieved articles, 17 were included. The majority of eight studies that compared the ABT between thick and thin GPs, reported a significantly greater ABT associated with a thick phenotype. Based on the meta-analysis results of six studies, the mean difference between the two phenotypes (0.33 mm) was statistically significant (P < 0.01). The majority of ten studies that investigated the correlation between GT and ABT evidenced a significant positive correlation (r = 0.11 -0.49). The association was more evident in the crestal areas and decreased toward the apex. CONCLUSIONS: There is contradictory evidence concerning the correlation between soft and hard tissue thickness; however, the meta-analysis revealed a significantly thicker alveolar plate in the presence of a thick phenotype. Since the evaluation of GP could be simply performed using a periodontal probe, such a relationship could provide clinical perspective at the initial examination. This is particularly beneficial in procedures affecting periodontal structures, including immediate implant placement and orthodontic treatments.

Is There an Association between the Gingival Phenotype and the Width of Keratinized Gingiva? A Systematic Review.

The concept of gingival phenotype and width of keratinized gingiva influencing the diagnosis and treatment in the periodontal scenario is relatively new. Soft and hard tissue dimensions of oral tissues are considered essential parameters in daily clinical practice. Factors such as the biotype category and the width of the keratinized gingiva help dentists seek the perfect therapy plan for each patient to achieve long-term stability of periodontal health. Several methods have been proposed to categorize phenotypes and each phenotype is characterized by various clinical characteristics. This review aims to discuss the possible association between the gingival phenotype and the width of keratinized gingiva along with the results appeared. After a rigorous search in major electronic databases, the results of the included studies indicated that the width of keratinized gingiva seems to be associated with the periodontal phenotype, with thick biotypes being characterized by a more pronounced keratinized gingival width. However, the heterogeneity of the included studies did not allow to make a conclusion about a direct relationship.

Periodontally accelerated osteogenic orthodontics with platelet-rich fibrin in an adult patient with periodontal disease: A case report and review of literature.

BACKGROUND: In the clinical scenario, adult patients with periodontal diseases and dental malformation, characterized by dental crowding in lower anterior teeth with the thin biotype, often require orthodontic treatment. This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics (PAOO) combined with autologous platelet-rich fibrin (PRF) in an adult patient with class I malocclusion along with dental crowding, a thin periodontal biotype, and buccal plate deficiency. CASE SUMMARY: A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic. The patient underwent periodontal risk assessment prior to orthodontic treatment. She was diagnosed with a high risk of gingival recession due to dental crowding, root prominence, loss of buccal plates, and a thin gingival tissue biotype. The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding. Clinically, PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling. Radiographic outcomes also showed statistically significant improvements (P < 0.01) in the mandibular buccal alveolar bone. CONCLUSION: This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease.

Root Coverage with Connective Tissue Graft in Patients with Thin Periodontal Biotype: A Case Series with 12-month Follow-up.

Preoperative gingival thickness is an important factor in the success of complete root coverage. Here, two cases are reported in which a biotype probe was used to assess the periodontal biotype before performance of a root coverage procedure. Clinical examinations were performed at baseline and at 3, 6, and 12 months postoperatively. The following clinical parameters were evaluated: probing depth, recession height, clinical attachment level, bleeding on probing, and width of keratinized gingiva. At baseline and at 12 months postoperatively, periodontal biotype was estimated using the biotype probe. The root coverage esthetic score was assessed to determine esthetic outcome at baseline and at 3, 6, and 12 months postoperatively. The periodontal biotypes in the mandibular central and lateral incisors were judged to be thin. These teeth presented with Miller Class II gingival recession after orthodontic therapy. Gingival recession was treated with a coronally advanced flap and autogenous connective tissue graft. In both cases, improvements in all clinical parameters and root coverage esthetic scores were evaluated at 3, 6, and 12 months postoperatively. The treated recession showed 100% root coverage. The periodontal biotype changed from one that was thin to one that was thick at the surgical sites. In both the present cases, objective preoperative assessment of the periodontal biotype allowed the appropriate surgical procedure to be selected.

[Relationships among the periodontal biotype characteristics in the maxillary anterior].

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.

Prevalence of the generalized periodontitis in patients with different groups blood in depending on age and periodontal biotype.

OBJECTIVE: The aim of the study was to investigate the prevalence of generalized periodontitis depending on age and biotype of periodontium. PATIENTS AND METHODS: Materials and methods: We examined 855 males aged 20-55 years, who were divided into 2 groups: the main group - 570 surveyed with a generalized periodontitis, the comparison group - 285 dental healthy individuals.The diagnosis of generalized periodontitis was established by the classification Danilevsky M.F. (1994) and refined by using paraclinical indices. The periodontal biotype was determined using Hu-Friedy Colourvue Biotype Probe. RESULTS: Results: As a result of the conducted researches was establish, in the carriers of blood group O (I) and A (II), developed forms of generalized periodontitis were found, on average, 2.7 times more often than the initial forms of the disease. Instead, at the representatives of B (III) and AB (IV) groups blood the frequency of initial GP - I degree was on average, 1.2 times greater than the prevalence of developed forms of generalized periodontitis. Also as a result of our researches, we found that the cluster A1 had 39.30% patients, cluster A2 was found at 28, 77%, and cluster B - 31.93% of the total number of patients with generalized periodontitis. CONCLUSION: Conclusions: As a result of our research, it was found that in the carriers of the blood group O (I) and A (II), more advanced forms of generalized periodontitis were observed, which was confirmed by the presence of the biotype of the periodontal disease in the cluster A1 and A2.

Periodontal soft- and hard-tissue changes after augmented corticotomy in Chinese adult patients with skeletal Angle Class III malocclusion: A non-randomized controlled trial.

BACKGROUND: To investigate soft- and hard-tissue changes after augmented corticotomy in Chinese adult patients with skeletal Angle Class III malocclusion. METHODS: This non-randomized controlled trial included 357 anterior teeth from 30 Chinese adult patients with skeletal Angle Class III malocclusion for whom the proposed treatment was augmented corticotomy. Jaws receiving surgery were allocated to a test group (S, surgical group, n = 47) and jaws not receiving surgery were allocated to a control group (NS, non-surgical group, n = 13). Changes in the periodontal biotype, width of the keratinized gingiva (WKG), and labial and lingual horizontal bone thicknesses (BTs) were compared 6 months after surgery by univariate and multivariate analyses. RESULTS: After adjustment for confounding variables, average gains of 0.473 mm in the WKG and 0.649 mm in the labial BT were found in the S group relative to the NS group (P <0.05). The odds of transition from a thin periodontal biotype to a thick biotype in the S group were about 230 times those in the NS group, and the odds of the reverse biotype transition in the NS group were about 83 times those in the S group (P <0.05). CONCLUSIONS: Within the limitations of the present study, augmented corticotomy is a promising approach to improve insufficient periodontal soft and hard tissues in Chinese adult patients with skeletal Angle Class III malocclusion.

Correlation between clinical parameters of crown and gingival morphology of anterior teeth and periodontal biotypes.

BACKGROUND: In this study, we conducted a quantitative analysis of the clinical parameters of crown and gingival morphology (CGM) of the maxillary anterior teeth (MAT). We also analyzed the correlation of these parameters with periodontal biotype (PB), with a view to providing objective standards for PB diagnosis. METHODS: The three-dimensional (3D) maxillary digital models of 56 individuals were obtained using an intra-oral scanner. The following parameters were measured with the SpaceClaim software: gingival angle (GA), papilla width (PW), papilla height (PH), crown length (CL), crown width (CW), crown width/crown length ratio (CW/CL), bucco-lingual width of the crown (BLW), contact surface width (CSW), and contact surface height/crown length ratio (CS/CL). The PB were determined based on the transparency of the periodontal probe through the gingival sulcus. Independent factors influencing PB were analyzed by logistic regression, and the optimal cutoff values for the independent influencing factors were analyzed using receiver operating characteristic curves (ROC curves). RESULTS: There was no significant difference in the parameters of CGM of the MAT at the left and right sides. The thick biotype accounted for 69.6%, and the parameters of GA, PW, PH, CW, CW/CL and CS/CL were significantly correlated with PB (P ≤ 0.2). GA (odds ratio (OR) = 1.206) and PW (OR = 5.048) were identified as independent predictive factors of PB, with areas under the ROC curve (AUC) of 0.807 and 0.881, respectively, and optimal cutoff values of 95.95° and 10.01 mm, respectively. CONCLUSION: The CGMs of the MAT at the left and right side are symmetrical. The thin biotype accounts for a small proportion, and GA and PW are independent influencing factors of PB. GA of 95.95° and PW of 10.01 mm are the optimal cutoff values for categorization of individuals as thick biotype. This indicates that when the GA and PW of the right maxillary central incisor are G ≥ 95.95° and ≥ 10.01 mm, respectively, there is a higher probability that these individuals will be categorized as thick biotype.

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.

Update on Perio-Prosthodontics.

Knowledge of the periodontal-restorative interface is critical in the fabrication of restorations that are functional and esthetic. Understanding biological principles allows the clinician to predict how the periodontium will respond to restorative therapy. Factors that influence the response to therapy in the periodontal-restorative interface are periodontal biotype, gingival architecture, alveolar crest position, gingival margin position, and gingival zenith.

Association between Periodontal Biotype and Clinical Parameters: A Cross-sectional Study in Patients with Skeletal Class III Malocclusion.

OBJECTIVE: To evaluate the prevalence of periodontal biotypes in patients with skeletal Class III malocclusion and to explore its association with age, gender, other periodontal clinical parameters and width of keratinized gingiva (WKG). METHODS: Data were collected for the buccal-middle site of 310 anterior teeth from 26 subjects who received periodontally accelerated osteogenic orthodontics (PAOO) surgery before orthodontic treatment. Univariate and multivariate analysis were performed to calculate and test the correlations between periodontal biotype and age, gender and bleeding index (BI), gingival recession (GR), plaque index (PLI), probing depth (PD) and WKG. RESULTS: Prevalence of thin periodontal biotype was 33.9% in the anterior region. Mean WKG was 4.37 mm. Univariate analysis showed that a moderately positive correlation was found between WKG and thick biotype (r = 0.544, P < 0.001). A low positive correlation was detected between mandibular teeth and thick biotype (r = 0.387, P < 0.001) and a low negative correlation was detected between GR and thick biotype (r = -0.308, P < 0.001). Multi-level logistic regression showed that biotype was significantly associated with dental arch (odds ratio [OR] = 0.174, P = 0.015) and WKG (OR = 2.043, P = 0.002). No significant associations were detected between biotype and other factors. CONCLUSION: Dental arch and WKG were associated with periodontal biotype in patients with skeletal Class III malocclusion.

Effects of crown movement on periodontal biotype: a digital analysis.

Orthodontic treatment has important correlations with periodontal changes. Various mechanical and biological factors are involved in determining such changes, but anatomical and morphological variables, generally addressed as periodontal biotype, play a key role. In measurement of such modifications, digital and non-contact reverse engineering technologies may be of tremendous advantage. The aim of this study is to retrospectively evaluate, in a series of digitized dental casts, some of the parameters addressing periodontal biotype and correlate them to extent and direction of tooth movement. Pre- (T0) and post-treatment (T1) dental casts of 22 patients were scanned by 3Shape TRIOS 3® scanner. A number of variables (crown ratio, gingival margin position, gingival contour, papillae position, gingival scallop) were investigated and their variations calculated after digital measurements on single casts at T0 and T1, or after direct measurement (T1 vs T0) on the superimposition and alignment of digital models. Univariate and multivariate statistics were then performed. No significant correlation was detected between the sagittal or vertical movement of dental crown and displacement of the gingival margin. On the other hand, vestibular gingival contour resulted significantly altered by vestibular and extrusion movements. Further studies are needed to ascertain the differential effect of bone and soft tissue on such modifications. The relationship between orthodontic treatment and the periodontium overcomes the consideration of gingival recession and includes all the concepts of periodontal biotype with its characteristics. Digital technologies and non-contact reverse engineering techniques now available have the potential to allow a more precise definition of such a relationship.

Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations.

OBJECTIVES: This narrative review determines the effects of occlusal trauma and excessive occlusal forces on the periodontium, including the initiation and progression of periodontitis, abfraction, and gingival recession. Case definitions, diagnostic considerations, and the effects of occlusal therapy are also reviewed and discussed. IMPORTANCE: The role of occlusal trauma in the initiation and progression of periodontitis remains a controversial subject in periodontology. Because occlusal trauma can only be confirmed histologically, its clinical diagnosis depends on clinical and radiographic surrogate indicators which make clinical trials difficult. FINDINGS: Investigations have generally agreed that occlusal trauma and excessive occlusal forces do not initiate periodontitis or loss of connective tissue attachment. When plaque-induced periodontitis and occlusal trauma are present at the same time, there is weak evidence that the occlusal trauma may increase the rate of connective tissue loss. Occlusal therapy is indicated as part of periodontal therapy to reduce mobility and increase patient comfort and masticatory function. Existing data do not support the existence of abfraction as a cause for gingival recession. CONCLUSIONS: Occlusal trauma does not initiate periodontitis, and there is weak evidence that it alters the progression of the disease. There is no credible evidence to support the existence of abfraction or implicate it as a cause of gingival recession. Reduction of tooth mobility may enhance the effect of periodontal therapy.

Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations.

BACKGROUND: Mucogingival deformities, and gingival recession in particular, are a group of conditions that affect a large number of patients. Since life expectancy is rising and people are retaining more teeth both gingival recession and the related damages to the root surface are likely to become more frequent. It is therefore important to define anatomic/morphologic characteristics of mucogingival lesions and other predisposing conditions or treatments that are likely to be associated with occurrence of gingival recession. OBJECTIVES: Mucogingival defects including gingival recession occur frequently in adults, have a tendency to increase with age, and occur in populations with both high and low standards of oral hygiene. The root surface exposure is frequently associated with impaired esthetics, dentinal hypersensitivity and carious and non-carious cervical lesions. The objectives of this review are as follows (1) to propose a clinically oriented classification of the main mucogingival conditions, recession in particular; (2) to define the impact of these conditions in the areas of esthetics, dentin hypersensitivity and root surface alterations at the cervical area; and (3) to discuss the impact of the clinical signs and symptoms associated with the development of gingival recessions on future periodontal health status. RESULTS: An extensive literature search revealed the following findings: 1) periodontal health can be maintained in most patients with optimal home care; 2) thin periodontal biotypes are at greater risk for developing gingival recession; 3) inadequate oral hygiene, orthodontic treatment, and cervical restorations might increase the risk for the development of gingival recession; 4) in the absence of pathosis, monitoring specific sites seems to be the proper approach; 5) surgical intervention, either to change the biotype and/or to cover roots, might be indicated when the risk for the development or progression of pathosis and associated root damages is increased and to satisfy the esthetic requirements of the patients. CONCLUSIONS: The clinical impact and the prevalence of conditions like root surface lesions, hypersensitivity, and patient esthetic concern associated with gingival recessions indicate the need to modify the 1999 classification. The new classification includes additional information, such as recession severity, dimension of the gingiva (gingival biotype), presence/absence of caries and non-carious cervical lesions, esthetic concern of the patient, and presence/absence of dentin hypersensitivity.

Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations.

OBJECTIVES: This narrative review determines the effects of occlusal trauma and excessive occlusal forces on the periodontium, including the initiation and progression of periodontitis, abfraction, and gingival recession. Case definitions, diagnostic considerations, and the effects of occlusal therapy are also reviewed and discussed. IMPORTANCE: The role of occlusal trauma in the initiation and progression of periodontitis remains a controversial subject in periodontology. Because occlusal trauma can only be confirmed histologically, its clinical diagnosis depends on clinical and radiographic surrogate indicators which make clinical trials difficult. FINDINGS: Investigations have generally agreed that occlusal trauma and excessive occlusal forces do not initiate periodontitis or loss of connective tissue attachment. When plaque-induced periodontitis and occlusal trauma are present at the same time, there is weak evidence that the occlusal trauma may increase the rate of connective tissue loss. Occlusal therapy is indicated as part of periodontal therapy to reduce mobility and increase patient comfort and masticatory function. Existing data do not support the existence of abfraction as a cause for gingival recession. CONCLUSIONS: Occlusal trauma does not initiate periodontitis, and there is weak evidence that it alters the progression of the disease. There is no credible evidence to support the existence of abfraction or implicate it as a cause of gingival recession. Reduction of tooth mobility may enhance the effect of periodontal therapy.

Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations.

BACKGROUND: Mucogingival deformities, and gingival recession in particular, are a group of conditions that affect a large number of patients. Since life expectancy is rising and people are retaining more teeth both gingival recession and the related damages to the root surface are likely to become more frequent. It is therefore important to define anatomic/morphologic characteristics of mucogingival lesions and other predisposing conditions or treatments that are likely to be associated with occurrence of gingival recession. OBJECTIVES: Mucogingival defects including gingival recession occur frequently in adults, have a tendency to increase with age, and occur in populations with both high and low standards of oral hygiene. The root surface exposure is frequently associated with impaired esthetics, dentinal hypersensitivity and carious and non-carious cervical lesions. The objectives of this review are as follows (1) to propose a clinically oriented classification of the main mucogingival conditions, recession in particular; (2) to define the impact of these conditions in the areas of esthetics, dentin hypersensitivity and root surface alterations at the cervical area; and (3) to discuss the impact of the clinical signs and symptoms associated with the development of gingival recessions on future periodontal health status. RESULTS: An extensive literature search revealed the following findings: 1) periodontal health can be maintained in most patients with optimal home care; 2) thin periodontal biotypes are at greater risk for developing gingival recession; 3) inadequate oral hygiene, orthodontic treatment, and cervical restorations might increase the risk for the development of gingival recession; 4) in the absence of pathosis, monitoring specific sites seems to be the proper approach; 5) surgical intervention, either to change the biotype and/or to cover roots, might be indicated when the risk for the development or progression of pathosis and associated root damages is increased and to satisfy the esthetic requirements of the patients. CONCLUSIONS: The clinical impact and the prevalence of conditions like root surface lesions, hypersensitivity, and patient esthetic concern associated with gingival recessions indicate the need to modify the 1999 classification. The new classification includes additional information, such as recession severity, dimension of the gingiva (gingival biotype), presence/absence of caries and non-carious cervical lesions, esthetic concern of the patient, and presence/absence of dentin hypersensitivity.

An Evaluation of the Effect of Periodontal Biotype on Inter-Dental Papilla Proportions, Distances Between Facial and Palatal Papillae in the Maxillary Anterior Dentition.

PURPOSE: Gingival esthetics are an essential segment of facial beauty. The aim of the present study was to clinically assess the impact of periodontal biotype (PB), the length between the base of interproximal contact area and the interproximal bone crest (CP-BC), the distance between the facial and palatal papillae (DFPP), and papillary proportions (PP) on the presence of interdental papillae (PIP). MATERIALS AND METHODS: 80 patients aged 18 to 60 years were recruited for study. PB and CP-BC were evaluated clinically. Alginate impressions of maxillary arches were made, and DFPPs were measured using a digital Vernier caliper. The impressions were later poured in dental stone, and PP were calculated. RESULTS: Descriptive statistics and ANOVA were used for statistical analysis for correlation among the variables. A greater proportion of individuals who had a thick PB (77.7%) had significantly higher amounts of PIP than did patients with thin PB (60.7%) (p < 0.01). A strong significant positive correlation was found between PIP in thick PB patients and DFPP (p < 0.01, r = 0.56); DFPP and PP (p < 0.01, r = 0.61). A strong negative correlation was seen between PIP in thin PB and DFPP (p < 0.01, r = -0.67). CONCLUSION: According to the results of this study, PB affected the heights and presence of maxillary interdental papillae by affecting papilla proportion and distances between the facial and palatal papillae.

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)