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Dridi SM, Ameline C, Heurtebise JM, Vincent-Bugnas S, Charavet C. Prevalence of the Gingival Phenotype in Adults and Associated Risk Factors: A Systematic Review of the Literature. Clin Pract 2024; 14:801-833. [PMID: 38804396 PMCID: PMC11130957 DOI: 10.3390/clinpract14030064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However, publications on this subject are either old or concerned with the means of assessing the gingival phenotype or the main factors likely to modify it. The main objective of this systematic review of the literature was therefore to investigate the prevalence of different gingival phenotypes in adults in good general health and with a healthy periodontium. A systematic review of the literature was performed following the guidelines of PRISMA recommendations using an electronic search strategy on four databases (PubMed, Scopus, Cochrane Library, and Embase) complemented by a manual search. Three independent authors were involved in study selection, data extraction, and bias assessment. Results: Of 807 articles, 17 of them, published between 2012 and 2023, involving 3277 subjects from 11 countries and 9766 dental sites, fulfilled the inclusion criteria. The prevalence of the gingival phenotype could not be determined at the level of an individual or a dental arch because all the publications assessed this phenotype only at the level of certain dental sectors, and were not chosen at random. The maxillary central incisors and maxillary or mandibular first molar sectors were associated with a high and thick gingival phenotype, independently of the dental morphology, gender, and age of adult subjects. Furthermore, in these regions, this gingival phenotype tended to be associated with a thick vestibular bone table. In contrast, maxillary and mandibular incisors and premolars more often had a thin gingival phenotype. For other teeth, the results were less conclusive. It is important not to rely solely on the overall appearance of the dentition but to independently assess the thickness and height of the gingiva at each dental site requiring intervention. Finally, this study highlights a key point, namely the need for further longitudinal studies to determine the prevalence in healthy adults. For practicality and feasibility reasons, these studies should be designed according to therapeutic needs, dental sector by dental sector, and within homogeneous source populations. PROSPERO registration: CRD 42023392602.
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Affiliation(s)
- Sophie-Myriam Dridi
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France; (C.A.); (S.V.-B.)
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
- Laboratoire MICORALIS, Université Côte d’Azur, UPR 7354, 06800 Nice, France;
| | - Clément Ameline
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France; (C.A.); (S.V.-B.)
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
| | - Jean Michel Heurtebise
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
| | - Séverine Vincent-Bugnas
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France; (C.A.); (S.V.-B.)
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France;
- Laboratoire MICORALIS, Université Côte d’Azur, UPR 7354, 06800 Nice, France;
| | - Carole Charavet
- Laboratoire MICORALIS, Université Côte d’Azur, UPR 7354, 06800 Nice, France;
- Département d’Orthodontie, Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06800 Nice, France
- Unité d’Orthodontie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
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Lin K, Wang S, Xu X, Yu L, Pan R, Zheng M, Yang J, Guo J. Assessment of the correlation between supracrestal gingival tissue dimensions and other periodontal phenotypes components via the digital registration method: a cross‑sectional study in a Chinese population. BMC Oral Health 2024; 24:408. [PMID: 38561756 PMCID: PMC10985880 DOI: 10.1186/s12903-024-04158-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Supracrestal gingival tissue dimensions (SGTDs) has been considered to be an essential element of periodontal phenotype (PP) components. This study aimed to explore the relationship between SGTDs and other PP components by digital superposition method that integrated cone beam computed tomography (CBCT) with intraoral scanning. METHODS This cross-sectional study was conducted at the Stomatology Hospital of Fujian Medical University. Participants were recruited based on the inclusion and exclusion criteria. The data obtained from the digital scanner (TRIOS 3, 3Shape, Denmark) and CBCT images were imported into the TRIOS software (Implant Studio, 3Shape, Denmark) for computing relevant parameters. The significant level was set at 0.05. RESULTS A total of 83 participants with 498 maxillary anterior teeth were finally included. The mean values of supracrestal gingival height (SGH) and the distance from the cementoenamel junction (CEJ) to the crest of the alveolar ridge (CEJ-ABC) on the buccal site were significantly higher than palatal SGH (SGH-p) and palatal CEJ-ABC (CEJ-ABC-p). Men exhibited taller CEJ-ABC and SGH-p than women. Additionally, tooth type was significantly associated with the SGH, SGH-p and CEJ-ABC-p. Taller SGH was associated with wider crown, smaller papilla height (PH), flatter gingival margin, thicker bone thickness (BT) and gingival thickness (GT) at CEJ, the alveolar bone crest (ABC), and 2 mm apical to the ABC. Smaller SGH-p displayed thicker BT and GT at CEJ, the ABC, and 2 and 4 mm apical to the ABC. Higher CEJ-ABC showed lower interproximal bone height, smaller PH, flatter gingival margin, thinner GT and BT at CEJ, and 2 mm apical to the ABC. Smaller CEJ-ABC-p displayed thicker BT at CEJ and 2 and 4 mm apical to the ABC. On the buccal, thicker GT was correlated with thicker BT at 2 and 4 mm below the ABC. CONCLUSION SGTDs exhibited a correlation with other PP components, especially crown shape, gingival margin and interdental PH. The relationship between SGTDs and gingival and bone phenotypes depended on the apico-coronal level evaluated. TRIAL REGISTRATION This study was approved by the Biomedical Research Ethics Committee of Stomatology Hospital of Fujian Medical University (approval no. 2023-24).
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Affiliation(s)
- Kaijin Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Siyi Wang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Xiaofeng Xu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
- The Affiliated Hospital (Group) of Putian University, Putian, 351100, China
| | - Lu Yu
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Rui Pan
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China
| | - Minqian Zheng
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
| | - Jin Yang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
| | - Jianbin Guo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
- Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350001, China.
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Bezerra de Melo N, Sobreira Duarte LN, Maia Vieira Pereira C, da Silva Barbosa J, Matos Gonçalves da Silva A, de Souza Coelho Soares R, Meira Bento P. Thermographic examination of gingival phenotypes: correlation between morphological and thermal parameters. Clin Oral Investig 2023; 27:7705-7714. [PMID: 37924357 DOI: 10.1007/s00784-023-05361-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/22/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES To evaluate the clinical and thermographic aspects of the gingival phenotype (GP) in healthy subjects. MATERIALS AND METHODS The study sample examined 264 teeth, upper and lower incisors, comprising 132 central incisors (CI) and 132 lateral incisors (LI), in 33 healthy volunteers. Four periodontal parameters were recorded systematically: ratio of width to length of the dental crown (CW/CL), height of the gingival attachment (KGW), probing depth (PD), and gingival transparency (GT). The temperatures of the attached gingiva (KGW temp) and the free gingival margin (FGM Temp) were also recorded by way of infrared thermography (IRT). RESULTS The average age of the sample was 30.70 ± 7.65 years. Of the 264 teeth evaluated, 76.1% had a thin GP. There was a significant association between CW/CL (p < 0.001), KGW (p < 0.001), PD (p < 0.007), and FGM Temp (p < 0.006) with the tooth groups. The results show a significant and inversely proportional correlation between clinical parameters and gingival temperature (p < 0.05). A significant association was found between CW/CL (p < 0.026); KGW (p < 0.001); and GP. CONCLUSION CW/CL, KGW, PD, and FGM Temp vary according to tooth group. The majority of the sample presented with the thin GP, which was more prevalent in the lower LIs and CIs. No significant association could be observed between thermographic parameters and GP. CLINICAL RELEVANCE Knowledge of the temperature of the gingival tissues can be useful in helping to diagnose and plan periodontal treatments. Moreover, our findings will help future studies evaluate the use of IR as an auxiliary diagnostic method in dentistry, eliminating GP as a confounding factor, since it does not seem to influence the temperature of the gingival tissues.
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Affiliation(s)
- Niebla Bezerra de Melo
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil.
| | - Lígia Natália Sobreira Duarte
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil
| | - Camila Maia Vieira Pereira
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil
| | - Jussara da Silva Barbosa
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil
| | - Ariane Matos Gonçalves da Silva
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil
| | - Renata de Souza Coelho Soares
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil
| | - Patrícia Meira Bento
- Department of Dentistry, State University of Paraíba, R. Baraúnas, 351, Universitário, Campina Grande, PB, 58429-500, Brazil
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Dong JC, Liao Y, Sun MJ, Gong Y, Chen HW, Song ZC. Modified interproximal tunneling technique with customized sub-epithelial connective tissue graft for gingival papilla reconstruction: report of three cases with a cutback incision on the palatal side. BMC Oral Health 2023; 23:800. [PMID: 37884939 PMCID: PMC10605313 DOI: 10.1186/s12903-023-03525-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Gingival papilla defects, which cause an unpleasant appearance and involve the upper anterior teeth, may be triggered by several factors. Several noninvasive and invasive techniques have been proposed for gingival papilla reconstruction. The combination of interproximal tunneling and customized connective tissue grafts (CTGs) has shown promise in papilla augmentation. However, due to the narrowness and limited blood supply of the gingival papilla, the long-term outcomes of these techniques remain unpredictable. Therefore, achieving tension-free coronal advancement of the interdental papilla and proper placement of the CTG is crucial for successful long-term outcomes and could provide widely applicable methods for papilla augmentation. CASE REPORT In this study, we enrolled three patients with gingival papilla defects in the maxillary anterior teeth. For reconstruction, we proposed a modified interproximal tunneling (MIPT) technique combined with a CTG. A crucial modification based on previous studies involved adding a cutback incision to the base of the palatal vertical incision, resulting in tension-free healing. Additionally, the CTG was sutured upright to further enhance the height of the gingiva papilla. To evaluate the efficacy of the MIPT technique, the clinical parameters-including the Jemt papilla index and the distance from the tip of the papilla to the interproximal contact point-were examined using a periodontal probe (UNC15, Hu-friedy) at baseline and 12 months after surgery. All three patients achieved satisfactory papilla reconstruction 12 months after the surgery. These three cases were used to evaluate the efficacy of the MIPT technique combined with the customized CTG. An average increase in the Jemt papilla score from 1.6 to 2.8 and a reduction in the distance from the papilla tip to the contact point of adjacent teeth from 2 mm to 0.08 mm were observed 12 months after surgery. CONCLUSION The preliminary results confirmed that this technique holds promise for gingival papilla augmentation between tooth/tooth or tooth/implant.
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Affiliation(s)
- Jia-Chen Dong
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, National Center for Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yue Liao
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, National Center for Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Meng-Jun Sun
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, National Center for Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yin Gong
- Department of Stomatology, the first affiliated hospital of Soochow University, Suzhou, Jiangsu, China
| | - Hui-Wen Chen
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
- College of Stomatology, National Center for Stomatology, Shanghai Jiao Tong University, Shanghai, China.
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Zhong-Chen Song
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
- College of Stomatology, National Center for Stomatology, Shanghai Jiao Tong University, Shanghai, China.
- National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China.
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Nalbantoğlu AM, Yanık D. Revisiting the measurement of keratinized gingiva: a cross-sectional study comparing an intraoral scanner with clinical parameters. J Periodontal Implant Sci 2023; 53:362-375. [PMID: 37524382 PMCID: PMC10627736 DOI: 10.5051/jpis.2204320216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the relationships between gingival thickness (GT) and keratinized gingiva width (KGW), papilla height (PH), and crown ratio (CR) by employing transgingival probing and an intraoral scanner (IOS). METHODS This cross-sectional study examined 360 maxillary anterior teeth from 60 patients. GT was assessed using transgingival probing with an endodontic spreader. KGW, CR, and PH were measured using an IOS. One-way analysis of variance, the Student's t-test, and Spearman correlation coefficients were employed for statistical analysis. RESULTS Higher GT was significantly associated with thinner KGW in the central region (P=0.019). There was no statistically significant difference in GT between teeth (P=0.06). PH was lower in lateral teeth than in canines (P=0.047), with a PH of 2.99 mm in lateral teeth. The KGW was narrower in canines than in central teeth (P=0.007). A moderate correlation was observed between KGW and PH in the central region (P=0.01), while a weak negative correlation was found between KGW and CR (P=0.043). CONCLUSIONS A moderate negative correlation was found between GT and KGW, as well as between PH and KGW in central teeth. In contrast, a weak negative correlation existed between CR and KGW. The PH (2.99 mm) was lower in lateral teeth than in canines. The traditional paradigm, which suggests a positive correlation between KGW and GT, was re-evaluated by measuring KGW using an IOS.
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Affiliation(s)
- Ahmet Mert Nalbantoğlu
- Department of Periodontology, Antalya Bilim University, Faculty of Dentistry, Antalya, Turkey
| | - Deniz Yanık
- Department of Endodontics, Antalya Bilim University, Faculty of Dentistry, Antalya, Turkey.
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Yang T, Jiang L, Sun W, Zhu M, Jiang K, Li H, Lei L. The incidence and severity of open gingival embrasures in adults treated with clear aligners and fixed appliances: a retrospective cohort study. Head Face Med 2023; 19:30. [PMID: 37461116 DOI: 10.1186/s13005-023-00375-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/30/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND To evaluate the incidence and severity of open gingival embrasures (OGEs) in adult patients treated with clear aligners and fixed appliances. METHODS Two hundred non-extraction adult subjects with less than 5 mm of crowding (mean age, 24.6 ± 3.8 years) were enrolled in this retrospective study. The subjects were divided into the clear aligner (n = 100) and fixed appliance group (n = 100). The intraoral photographs were utilized to determine the incidence of OGEs in the upper arch between maxillary central incisors, as well as the lower arch between mandibular central incisors. Crown overlap, crown shape, posttreatment root angulation, the distance from the interproximal contact point (ICP) to the alveolar bone crest (ABC) after treatment and interproximal enamel reduction (IPR) were determined in the two groups. RESULTS The incidence of OGEs between maxillary and mandibular central incisors after orthodontic treatment was 35.0% and 38.0% in the clear aligner group, respectively, significantly higher than that (18.0% and 24.0%) in the fixed appliance group (P < 0.05). The average area of an OGE after clear aligner treatment was larger both in the maxilla (0.16 ± 0.12mm2) and mandible (0.21 ± 0.24mm2) compared with that (0.05 ± 0.03mm2 and 0.05 ± 0.06mm2) after fixed appliance treatment (P < 0.05). No difference was found regarding pretreatment crown overlap, crown shape, treatment duration, posttreatment root angulation, amount and distribution of IPR and the distance from ICP to ABC. CONCLUSIONS The incidence and severity of OGEs were higher in adults treated with clear aligners. Clinicians should be aware of the risk of OGEs during treatment with clear aligners.
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Affiliation(s)
- Tianrui Yang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Lishan Jiang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Weiman Sun
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Meng Zhu
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Ke Jiang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Houxuan Li
- Department of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, 30 Zhongyang Road, Nanjing, Jiangsu, 210008, China.
| | - Lang Lei
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, 30 Zhongyang Road, Nanjing, Jiangsu, 210008, China.
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Soltani P, Yaghini J, Rafiei K, Mehdizadeh M, Armogida NG, Esposito L, Spagnuolo G. Comparative Evaluation of the Accuracy of Gingival Thickness Measurement by Clinical Evaluation and Intraoral Ultrasonography. J Clin Med 2023; 12:4395. [PMID: 37445430 DOI: 10.3390/jcm12134395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/10/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to investigate the accuracy of gingival thickness measurement by two methods of clinical evaluation and intraoral ultrasonography. The gingival thickness was measured in the midbuccal area of the right maxillary lateral incisor and first molar teeth in 30 individuals. For clinical measurement, a #15 K-file with rubber stops was vertically inserted 2 mm apical to the gingival margin and the length of the file in the tissue was measured using a digital caliper. Ultrasonographic measurement was performed using an intraoral probe on the gingival surface in the midbuccal area, at the entry point of the file. Statistical analysis was performed by paired t-test, correlation coefficient, and receiver operating characteristic (ROC) curve (α = 0.05). In the anterior region, the mean gingival thicknesses using ultrasonography (1.517 ± 0.293 mm) and clinical evaluation (1.610 ± 0.272 mm) were not significantly different (p = 0.434). In the posterior region, the mean gingival thicknesses were significantly different between ultrasonography (1.372 ± 0.442 mm) and clinical evaluation (1.626 ± 0.310 mm) (p = 0.006). The area under ROC curve values for ultrasonographic measurements in the anterior and posterior regions were 0.681 and 0.597, respectively. The use of ultrasonography with an intraoral probe has acceptable accuracy for the determination of gingival thickness, especially for the anterior regions.
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Affiliation(s)
- Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Jaber Yaghini
- Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
| | - Kosar Rafiei
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
| | - Mojdeh Mehdizadeh
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
| | - Niccolò Giuseppe Armogida
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Luigi Esposito
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
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Chhabra K, Selvaganesh S, N T. Mandibular molar teeth deviations for fabrication of implant-specific strip crowns among Indians. Bioinformation 2023; 19:436-440. [PMID: 37822823 PMCID: PMC10563551 DOI: 10.6026/97320630019436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/30/2023] [Accepted: 04/30/2023] [Indexed: 10/13/2023] Open
Abstract
An understanding of tooth morphology provides better insight and is an important foundation for providing successful endodontic and restorative treatment. It also provides a deeper evaluation and baseline for future prosthetic rehabilitation. The study aimed to measure and characterizes mandibular molars using a normal divider and measurement scale using mandibular casts. Over 300 mandibular first molars were measured in dimensions including the buccolingual width, mesiodistal width, mesiobuccal height, mid-buccal height, and distobuccal height; same were repeated with intra-oral scanners digitally. The mean and standard deviation of the measurements and the correlation to age and gender were calculated using SPSS software to fabricate implant-specific strip crowns.
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Affiliation(s)
- Kshitiz Chhabra
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai 600077, India
| | - Sahana Selvaganesh
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai 600077, India
| | - Thiyaneswaran N
- Department of Implantology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai 600077, India
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Soundarajan S, Malaippan S. Injectable Platelet-Rich Fibrin and Microneedling—A Non-Surgical Approach for Gingival Augmentation: A Randomized Controlled Clinical Trial. JOURNAL OF ADVANCED ORAL RESEARCH 2023. [DOI: 10.1177/23202068231157997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
Aim: The present study aimed to assess the efficacy of combining microneedling (MN) and injectable platelet-rich fibrin (i-PRF) administration with i-PRF alone in augmenting the thickness of gingiva to manage thin periodontal phenotype. Methodology: The clinical trial involved 36 patients who were diagnosed with thin periodontal phenotype. They were randomized under two groups: MN + i-PRF versus i-PRF alone, carried out as a split-mouth trial. One quadrant was treated only with i-PRF delivery through the gingival sulcus, while the contralateral side was treated with MN and i-PRF in 3 sessions at 10-day intervals. The primary parameter measured was the thickness of the gingiva, at baseline and 3 months following therapy. Statistical analysis was performed using the Mann-Whitney U test. Wilcoxon’s signed ranking test for inter-group and intra-group analysis, respectively. Results: The study results showed a significantly greater increase in gingival thickness (GT) in sites where both MN and i-PRF injection was done, compared to i-PRF alone, with a p value of .04. Conclusion: Both treatment modalities showed improvement in GT, being a minimally invasive alternative for mucogingival surgery. Adjunctive MN was found to be more beneficial than i-PRF alone. However, further research should be carried out to address the drawbacks of the study and for a better understanding of this novel approach.
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An Analysis of Maxillary Anterior Teeth Crown Width-Height Ratios: A Photographic, Three-Dimensional, and Standardized Plaster Model’s Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4695193. [PMID: 35229002 PMCID: PMC8882051 DOI: 10.1155/2022/4695193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
Objective. To analyze the width and height ratios of maxillary anterior teeth at different crown levels through photographs, 3D, and plaster dental model techniques in a subset of the Pakistani population. Material and Methods. This clinical study consisted of 230 participants. The maxillary impression, standardized photographs, and models were constructed for crown width and height analysis. The SPSS version 25 was used for statistical analysis. Descriptive statistics were carried out for mean, standard deviation, and percentage calculation of teeth width and height, gender, and age of participants. Paired
-test analysis was carried out to compare the dependent variables (teeth size, width, and height ratios) with independent variables (techniques applied, side disparity). A
value of ≤ 0.05 was considered statistically significant. Results. The mean width and height of maxillary anterior teeth obtained through photographs, 3D, and plater models were statistically different. The 3D dental model analysis showed reliable and accurate results. The mean width and height ratio of teeth were different on both sides of the arch. There was a significant difference (
) in crown width-height ratios at different crown levels. Conclusion. The width and height ratios in the studied population were different at various crown levels. The dimensions of teeth varied from the incisal to the cervical part of the crown. Hence, rather than relying on a single, fixed ratio of 78% to 80% suggested by researchers for anterior teeth, the clinician should adopt different crown width-height ratios to restore teeth with the optimum esthetic outcome.
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Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review. J Funct Biomater 2022; 13:jfb13010015. [PMID: 35225978 PMCID: PMC8883934 DOI: 10.3390/jfb13010015] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/18/2022] Open
Abstract
Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.
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Avetisyan A, Markaryan M, Rokaya D, Tovani-Palone MR, Zafar MS, Khurshid Z, Vardanyan A, Heboyan A. Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses. Molecules 2021; 26:1331. [DOI: https:/doi.org/10.3390/molecules26051331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.
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Avetisyan A, Markaryan M, Rokaya D, Tovani-Palone MR, Zafar MS, Khurshid Z, Vardanyan A, Heboyan A. Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses. Molecules 2021; 26:molecules26051331. [PMID: 33801337 PMCID: PMC7958327 DOI: 10.3390/molecules26051331] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/16/2022] Open
Abstract
The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.
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Affiliation(s)
- Anna Avetisyan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University, Street Koryun 2, Yerevan 0025, Armenia; (A.A.); (M.M.)
| | - Marina Markaryan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University, Street Koryun 2, Yerevan 0025, Armenia; (A.A.); (M.M.)
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Walailak University, Bangkok 10400, Thailand
- Correspondence: (D.R.); (M.R.T.-P.); (M.S.Z.); (A.H.); Tel.: +374-9321-1221 (A.H.)
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
- Correspondence: (D.R.); (M.R.T.-P.); (M.S.Z.); (A.H.); Tel.: +374-9321-1221 (A.H.)
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
- Correspondence: (D.R.); (M.R.T.-P.); (M.S.Z.); (A.H.); Tel.: +374-9321-1221 (A.H.)
| | - Zohaib Khurshid
- Department of Prosthodontics and Implantology, College of Dentistry, King Faisal University, Al-Hofuf, Al-Ahsa 31982, Saudi Arabia;
| | - Anna Vardanyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University, Street Koryun 2, Yerevan 0025, Armenia;
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University, Street Koryun 2, Yerevan 0025, Armenia;
- Correspondence: (D.R.); (M.R.T.-P.); (M.S.Z.); (A.H.); Tel.: +374-9321-1221 (A.H.)
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Collins JR, Pannuti CM, Veras K, Ogando G, Brache M. Gingival phenotype and its relationship with different clinical parameters: a study in a Dominican adult sample. Clin Oral Investig 2021; 25:4967-4973. [PMID: 33515119 DOI: 10.1007/s00784-021-03806-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this study was to estimate the prevalence of thin and thick gingival phenotype (GPh) in a sample of Dominican subjects and correlate it with clinical parameters. MATERIALS AND METHODS One-hundred seven periodontal healthy volunteers in the range of 18-73 years were enrolled in the study. GPh was defined by the transparency of a periodontal probe through the buccal gingival margin on the upper right or left central incisor. Clinical periodontal parameters such as keratinized gingiva width (WKG), attached gingiva width (WAG), probing depth (PD), plaque index (PI), and gingival index (GI) were recorded by a calibrated examiner. Frequency distribution of qualitative variables was calculated. For quantitative variables, Mann-Whitney and Kruskal-Wallis tests were used for comparison of groups. RESULTS There was no association between GPh and sex. There were no significant differences between thin and thick GPh regarding age, PD, GI, and interproximal index. The association between tooth morphology and GPh was significant (p = 0.018). Median amount of keratinized gingiva was significantly larger (p = 0.01) in subjects with thin gingival phenotype (median = 6.00 mm) when compared with subjects with thick gingival phenotype (median = 5 mm). CONCLUSIONS Subjects with thin GPh presented larger WKG. Furthermore, there was an association between tooth morphology and GPh. CLINICAL RELEVANCE This is the first study to report the distribution of gingival phenotype and its relationship with different periodontal parameters of a Caribbean population. Our findings can contribute to the clinicians when planning or performing dental procedures.
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Affiliation(s)
- James Rudolph Collins
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic.
| | - Claudio Mendes Pannuti
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Kenia Veras
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic
| | - Gabriel Ogando
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic
| | - Michael Brache
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic
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Belák Š, Žižka R, Starosta M, Zapletalová J, Šedý J, Štefanatný M. The influence of gingival phenotype on the morphology of the maxillary central papilla. BMC Oral Health 2021; 21:43. [PMID: 33485351 PMCID: PMC7825197 DOI: 10.1186/s12903-021-01400-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preservation of the interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment. It has been described that thicker gingival tissues are more resistant to recession. The main objective of this investigation was to analyze whether a thin gingival phenotype represents a potential risk indicator affecting interdental papilla fill, height, or width in an esthetic region between maxillary central incisors. The secondary goals were: (1) to analyze parameters describing the papilla-fill, height, width, and effect of papilla base width on the vertical papillary dimension; (2) to determine correlation between different non-invasive measurements of gingival thickness; (3) to compare both sexes. METHODS A total of 54 periodontally healthy students (20-30 years old) were included in the study. Gingival thickness was measured using Pirop Ultrasonic Biometer. Gingival phenotype was also assessed by gingival probe transparency. Papilla height and width were measured, and the degree of papilla recession was classified. RESULTS No significant relationship between papilla fill, height, width and gingival probe transparency or gingival thickness was found. Gingival thickness and gingival probe transparency showed a significant relationship (P < 0.001). There was a significant relationship between papilla height and papilla fill (P = 0.028). A papilla which filled the interdental space completely seemed to be shorter. A strong positive correlation between papilla height and papilla width was found (P < 0.0001). The papilla between maxillary central incisors was significantly higher in males (P = 0.01). CONCLUSION The appearance of the interdental papilla may be influenced by various factors. Within the limitations of this study, the results showed that the thin gingival phenotype alone is no potential risk indicator affecting interdental papilla fill, height, or width. It seems that there may be some effect of papilla base width on its vertical dimension. Gingival probe transparency is a simple reliable method of assessment of gingival thickness with a threshold value of 1-mm gingival thickness between the thick and thin phenotypes.
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Affiliation(s)
- Šimon Belák
- Department of Periodontology and Oral Medicine, Institute of Dentistry and Oral Sciences, Palacký University, Palackého 12, Olomouc, 779 00, Czech Republic.
| | - Radovan Žižka
- Department of Periodontology and Oral Medicine, Institute of Dentistry and Oral Sciences, Palacký University, Palackého 12, Olomouc, 779 00, Czech Republic.,Czech Educational and Dental Research Innovative Group (CEDRIG), Brno, Czech Republic
| | - Martin Starosta
- Department of Periodontology and Oral Medicine, Institute of Dentistry and Oral Sciences, Palacký University, Palackého 12, Olomouc, 779 00, Czech Republic
| | - Jana Zapletalová
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University, Hnevotínská 3, Olomouc, 775 15, Czech Republic
| | - Jiří Šedý
- Department of Anatomy, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Michal Štefanatný
- Department of Periodontology and Oral Medicine, Institute of Dentistry and Oral Sciences, Palacký University, Palackého 12, Olomouc, 779 00, Czech Republic
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