Five-Year Prospective Study on Implant Failure and Marginal Bone Remodeling Expected Using Bone Level Implants with Sandblasted/Acid-Etched Surface and Conical Connection

Objective The purpose of the present prospective, case-series study was to report implant survival rate and marginal bone remodeling expected 5 years after loading using dental implants placed in daily practice. Materials and Methods This research was designed as an open-cohort, prospective, case-series evaluation. Any partially or completely edentulous patient, scheduled to receive at least one bone level implant, was considered eligible for this study. Primary outcome measurements were: implant and prosthetic cumulative survival rate and any complications experienced up to the 5-year follow-up. Secondary outcome measures were: thickness of gingival biotype, implant insertion torque, implant stability quotient, and marginal bone loss (MBL). Results Ninety consecutive patients (34 males and 56 females, aged between 24 and 81 years old [mean: 53.2 ± 15.4]) with 243 inserted implants were followed for at least 5 years after loading (mean: 65.4 ± 3.1 months; range from 60 to 72). At the 1-year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the 5-year examination. At the 5-year follow-up examination, six implants lost osseointegration (97.5%). In the same period, four prostheses failed (97.2%). Five complications were reported in five different patients (prosthetic success rate was 96.5%, at patient level). Five years after loading, the mean MBL was 0.41 ± 0.30 mm. The difference from the 1-year data was 0.04 ± 0.19 mm. A statistically significant higher MBL was found for smokers, and patients with thin gingival biotype. The mean implant insertion torque was 42.9 ± 4.8 Ncm (range from 15 to 45 Ncm). Two-hundred and three implants (83.5%) were inserted with an insertion torque ≥35 and ≤45 Ncm. Conclusions High implant survival and success rate could be expected with stable marginal bone remodeling up to 5 years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research studies are needed to confirm these results.

Co-Relation of Gingival Biotype (Periodontal Phenotype) with Width of Keratinized Gingiva in Maxillary Anterior Teeth in Patients Reporting to a Local Tertiary Care Dental Hospital

Objective: To find out the correlation of gingival biotype with width of keratinized gingiva in maxillary anterior teeth in patients at tertiary care dental hospital presenting for routine periodontal care. Materials And Methods: In this crossectional study, a total of 87 patients were observed in department of Periodontology, Fatima Memorial Hospital College of Medicine and Dentistry Lahore. The gingival biotype (gingival thickness) were determined by using the transparency of the periodontal probe through gingival sulcus. The width of the keratinized gingiva was measured by measuring the distance between the most coronal point of the gingival margin and the mucogingival junction measured at the midpoint of the vestibular face of the teeth using a Michigan O periodontal probe with William’s markings. Results: In this study mean age was 38 years with SD ± 10.88. Forty six percent patients were male and 54% patients were female. Mean width of keratinized gingiva was 4.22mm ± 1.10 while mean gingival biotype was 1.5 mm ± 0.65. The correlation coefficient r=0.277 shows a positive correlation of width of keratinized gingiva with gingival biotype Conclusion: The study concluded that there is a positive correlation of gingival biotype with width of keratinized gingiva in maxillary anterior teeth. Keywords: gingival biotype, width of keratinized gingival, maxillary anterior teeth

The influence of gingival biotypes on periodontal health: A cross-sectional study in a tertiary care center

Dimensional characteristic of gingiva is a predisposing factor for initiation and course of periodontal diseases and conditions. Knowledge about variations of gingival biotype among subjects is a prognostic determinant in Periodontics. The purpose of the study was to determine the prevalence of gingival biotypes and to evaluate its influence on various periodontal health parameters. Among the patients who reported to the out-patient section, a cross-sectional study was done on those who satisfied the inclusion criteria. Gingival thickness was measured on six anterior teeth of maxillary and mandibular arch using no.15 endodontic spreader and digital caliper by a single examiner on 112 subjects. Another examiner recorded the clinical parameters pertaining to periodontal health. Subjects with gingival thickness 1.5mm were categorized to thin and those with 2mm into thick gingival biotype. Difference in mean values of quantitative variables was tested by Mann Whitney U test. Bivariate correlation was assessed by Pearson correlation. Multiple linear regression models were developed for modified gingival index and interproximal attachment loss. Prevalence of thin and thick gingival biotype was 48.21% and 39.28% respectively. Mean gingival thickness observed was 1.49±0.59mm. Mean score of all clinical parameters were significantly higher in thin gingival biotype. Gingival biotype had a negative correlation with modified gingival index and interproximal attachment scores. Thicker gingival biotype can be considered to have a protective effect against the development of periodontal pathology.

Prevalence of Gingival Pigmentation and its Association with Gingival Biotype and Skin Colour

Introduction: The facial appearance depends on several oral and extraoral factors including colour of facial skin and pigmentation of gingival epithelium. The colour of the gingiva varies among individuals and is thought to be associated with cutaneous pigmentation which ranges from light to dark brown or black colour. Objective: To assess the prevalence of physiological gingival pigmentation, gingival biotype and their association with skin colur in Nepalese subjects visiting Kantipur Dental College and Hospital (KDCH). Methods: This was an analytical cross-sectional study which was carried out from February 2020 to June 2020 in all patients of age-group 16 to 80 years visiting the Department of Periodontics at KDCH after ethical approval. Patients were recruited by convenience sampling and examined thoroughly to find out gingival biotype and extent of gingival pigmentation intraorally as well as skin colour extraorally. Results: In this study, 210 patients were examined among which, 105 (50%) were males and 105 (50%) were females. Out of 210, 33 (15.7%) had pink tissue without pigmentation, 84 (40%) had pigmentation only in attached gingiva, 58 (27.6%) in attached gingiva and interdental papilla, 32 (15.2%) had diffuse pigmentation involving all parts of gingiva, 2 (1%) had in marginal gingiva only, and 1 (0.5%) in marginal gingiva and interdental papilla. Conclusion: A strong association was found between gingival pigmentation and facial skin colour in present study (P <0.001). Establishing the pattern of gingival pigmentation in Nepalese population will help to choose a specific depigmentation therapy that will harmonise with skin colour.

Frequency Distribution of Gingival Biotype and Related Factors in an Adult Population of Isfahan

Background: Gingival biotype can be influenced by genetic factors, tooth-related factors and biological issues. This study aimed to determine the biotype of facial gingival and related factors. Methods: In this study, 300 patients (128 males and 172 females) with a mean age of 36.2 ± 13.27 were selected by simple random sampling. Patients’ characteristics including age, gender, smoking, dental and keratinized gingival anatomy and oral hygiene parameters were recorded and their associations with gingival biotype were investigated using Transparency method. Collected data were analyzed by SPSS24 using t test, Mann-Whitney, ANOVA, and Pearson correlation coefficient. The P<0.05 was considered significant. Results: Frequency of thin gingival biotype was higher than that of thick gingival biotype. There was a significant relationship between gingival biotype of upper central incisors areas and age (P < 0.001), vibratory brushing (P=0.019) and keratinized gingival width (P=0.021). There was also a significant relationship between the gingival biotype of lower central incisor area and gender (P=0.036), vibratory brushing (P=0.010), vertical brushing (P=0.009) and keratinized gingival width (P=0.011). Moreover, a significant direct relationship was discovered between Gingival biotype of upper and lower central incisors areas. No relationship was found between frequency and duration of brushing, dental flossing, plaque index, tooth shape, and smoking with gingival biotype (P> 0.005). Conclusions: Gingival biotype was associated with age, gender and keratinized gingival width, as well as some brushing characteristics such as the brushing method.

Gingival Biotype: A Secret for Esthetic Success

Gingival biotype, in the recent years, has gained substantial interest as one of the important pillars for esthetic success. This review provides recommendations to be considered prior to performing any dental procedure to attain best clinical results. Several methods for measuring biotype have been suggested. Gingiva is often subjected to various insults during routine dental procedures. Hence, understanding the gingival biotype can provide insights into precautions rendered necessary during tissue handling to avoid undesirable treatment outcomes.

Multilevel analysis of site, implant, and patient-level factors with peri-implant bleeding on probing: a cross sectional study

Aim This study was to evaluate the association between peri-implant bleeding on probing in peri-implant diseases and its association with multilevel factors (site specific factors, implant factors, and patient level factors). Methodology A cross-sectional study involved consented adult patients with ≥ 1 dental implant. Two calibrated operators examined the patients. BoP was outcome variable and peri-implant gingival biotype was principal predictor variable. The effects of site, implant, and patient level factors on BoP were assessed using a multilevel logistic regression model. Results Eighty patients for a total of 119 implants and 714 sites were included in the study. Bleeding on probing was observed in 42 implants (35.29%) with a significant higher risk observed in presence of gingival recession, thin peri-implant gingival biotype, duration of implant placement, smokers, and male patients. Conclusion Peri-implant bleeding on probing was associated with site specific, implant, and patient level factors.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses

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.