Gingival phenotype assessment methods and classifications revisited: a preclinical study

Objective To compare gingival phenotype assessment methods based on soft tissue transparency on different backgrounds and assessor experience levels. Methods For this purpose, 24 gingival specimens were retrieved from pig jaws with tissue thicknesses from 0.2 to 1.25 mm. Three methods were assessed: periodontal probe PCP12 (thin/thick), double-ended periodontal probe DBS12 (thin/moderate/thick) and colour-based phenotype probe CBP (thin/moderate/thick/very thick). Each sample was photographed with each probe underneath and categorized whether the probe was visible or not using different coloured backgrounds. To measure experience level influence, dentists, dental undergraduate students and laypersons (n = 10/group) performed the evaluation. Results PCP12 probe showed a threshold between 0.4 and 0.5 mm. To distinct between thin and moderate thick gingiva, a comparable range for DBS12 was found while moderate thickness was between 0.5 and 0.8 mm and for thick above 0.8 mm. CBP also showed a comparable threshold of 0.5 mm for thin versus moderate as compared with the other methods; above 0.8 mm, predominantly a very thick tissue was measured. In general, the background colour had a minor impact on PCP12 and DBS12, and investigator experience showed no clear influence on GP assessment. Conclusion Based on probe transparency and within the limitation of a preclinical study, we suggest GP differentiation into three entities: thin (< 0.5 mm; high risk), moderate (0.5–0.8 mm; medium risk) and thick (> 0.8 mm; low risk). Clinical relevance All three GP assessment methods are easy to perform and seem to have a high predictive value with a three entities classification for DBS12 and CBP.

The influence of gingival phenotype on the morphology of the maxillary central papilla

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.

The influence of gingival phenotype on the morphology of the maxillary central papilla

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.

A NEW APPROACH FOR INCREASING THE GINGIVAL THICKNESS BY USING INJECTABLE PLATELET RICH FIBRIN (i-PRF) – A CLINICAL AND RADIOGRAPHIC STUDY

The thickness of the gingiva has been described as gingival biotype, which is classified as thin (<1.5 mm) and thick (>1.5 mm). Higher incidence of gingival recession is found in patients with thin biotype, therefore treatment modalities that aim at enhancing the thickness of gingiva can result in better treatment outcome of recession coverage procedures. PRF is the second generation autologous platelet concentrate without use of anticoagulant. In 2014, i-PRF was developed by modifying spin centrifugation forces. The objective of this study was to estimate the efficiency of injectable platelet rich fibrin (i-PRF) in increasing the gingival thickness. 25 systemically healthy patients were selected. Gingival thickness was measured by three techniques. [1]Visual method - probe transparency, [2]Transgingival probing with 15 no. K-file, [3]Radiographic (paralleling technique) method. The intravenous blood was withdrawn from the patients and the i-PRF was prepared. The i-PRF was injected in sites with thin gingival thickness. The patients were recalled after a month and the thickness of gingiva was measured again using above methods. A statistically significant increase in gingival thickness was observed with i-PRF. Gingival thickness increased by 0.54 mm ± 0.0854 (p < 0.05). Injection of i-PRF has proven beneficial for increasing the gingival thickness.

Assessment of Gingival Biotypes in Patients Visiting a Tertiary Care Centre in Eastern Nepal

Background: Evaluation of gingival biotype has become a routine procedure in periodontal examination because the type of gingival biotype can positively or negatively affect the outcome of periodontal, restorative, orthodontic and implant therapy. The aim of the study was to assess the proportion of types of gingival biotypes in patients visiting a tertiary care center in eastern Nepal. Methods: Two hundred and fifty patients between 25 to 45 years attending the Periodontology and Oral Implantology were assessed. Gingival biotype of the patents was determined with Probe Transparency technique Results: Out 250 patients assessed, 73 patients (approximately 29.2 %) had thin gingival biotype and remaining 177 patients (approximately 70.8 %) had thick gingival biotype. The number of the male with thin biotype was 31 whereas the number of the male with thick biotype was 82. Similarly, out of 137 female, 42 had thin biotype and remaining 95 female had thick biotype. The types of biotypes were not associated with gender (p=0.67). Conclusions: Thicker gingival biotype was the more common type of gingival biotype in patients attending the tertiary care center of Eastern Nepal. The occurrence of thick gingival biotype was more common in Adivasi Janajati ethnic community compared to Brahmin / Chhetri ethnic community. Keywords: Adivasi janajati; gingival biotype, probe transparency technique

The Influence of Gingival Phenotype on the Morphology of the Maxillary Central Papilla

BackgroundPreservation 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 factor 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.MethodsA 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.ResultsNo 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).ConclusionThe 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 factor 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.

The influence of gingival phenotype on the morphology of the maxillary central papilla

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 factor 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 correlation 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 correlation between papilla height and papilla fill (P = 0.028). A papilla which filled the interdental space completely seemed to be shorter. A strong positive association 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 factor affecting interdental papilla fill, height, or width. There seems to be an 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.

The influence of gingival phenotype in the morphology of the central maxillary interdental papilla

BackgroundPreservation of interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment. It was described that thicker gingival tissues are more resistant to recession. The main objective of this investigation was to analyze if the gingival phenotype represents a potential risk factor affecting interdental papilla fill, height, or width in an esthetic region between central maxillary incisors. The secondary goals were: 1) analyze parameters describing papilla and the influence of a wide papilla basis for the vertical papillary dimension; 2) the correlation between different non-invasive measurements of gingival thickness; 3) comparison among both sexes.MethodsTogether, 54 periodontally healthy students (20–30 years old) were included in the study. Gingival thickness was measured using Pirop Ultrasonic Biometer. Phenotype was also assessed by gingival probe transparency. Papilla parameters - height and width of the interdental papilla were measured, and the degree of papilla recession was classified.ResultsNo significant correlation between papilla height, width, or papilla fill and gingival probe transparency or gingival thickness was found. Both methods of assessments of gingival phenotype showed a significant relationship. There was a significant correlation of papilla height and papilla fill. Papillae, which filled the interdental space completely, seem to be shorter. A strong positive association between papilla height and papilla width was revealed. Papillae were significantly higher in males.ConclusionThe appearance of interdental papillae could be influenced by various factors. Within the limitations of this study, results showed no significant correlation between the morphology of interdental papillae and soft tissue thickness. It seems that there is an influence of a wide papilla basis for its vertical dimension.

Gingival Biotype in the Maxillary Esthetic Zone: A Pilot Study comparing Three Noninvasive Assessment Methods

ABSTRACT This pilot study aims to compare reliability of visual, probe transparency, and soft tissue cone beam computed tomography (CBCT) methods for estimating gingival biotype in maxillary esthetic zone. This study included 10 patients with indications for dental implant therapy in the esthetic zone of maxilla. Visually, the gingival biotype in the maxillary esthetic zone was examined by two examiners. Subsequently, the gingival sulcus was probed and observed for its transparency, and soft tissue thickness was measured using soft tissue CBCT. A 100% correlation was found between probe transparency and visual inspection. When comparing visual inspection and probe transparency to soft tissue CBCT, a statistical discrepancy of 57.1% was found. However, the p-value of 0.125 indicated a nonsignificant difference. As per our knowledge, this is the first study comparing the reliabilities of these three noninvasive biotype assessments. How to cite this article Nettemu SK, Nettem S, Paulose BJ, How VV, Singh VP. Gingival Biotype in the Maxillary Esthetic Zone: A Pilot Study comparing Three Noninvasive Assessment Methods. Int J Prosthodont Restor Dent 2016;6(4):85-88.