Vojnosanitetski pregled 2022 Volume 79, Issue 8, Pages: 805-810
https://doi.org/10.2298/VSP210318056D
Full text (
329 KB)
Cited by
Gingival biotype - comparative analysis of different evaluation methods
Đorđević Filip (University in Priština/Kosovska Mitrovica, Faculty of Medicine, Department of Oral Surgery, Kosovska Mitrovica, Serbia), Filip85dj@gmail.com
Dubovina Dejan (University in Priština/Kosovska Mitrovica, Faculty of Medicine, Department of Oral Surgery, Kosovska Mitrovica, Serbia)
Bubalo Marija (Military Medical Academy, Clinic of Stomatology, Belgrade, Serbia)
Radosavljević Raša (University in Priština/Kosovska Mitrovica, Faculty of Medicine, Department of Oral Surgery, Kosovska Mitrovica, Serbia)
Bukumirić Zoran 
(University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Background/Aim. Gingival biotype can have a significant impact on the outcome of the periodontal therapeutic procedures and the predictability of their aesthetic outcome. There is a strong correlation between the types of biotype and the potential gingival recession after restorative, periodontal, and implant surgical procedures. Therefore, accurate identification of gingival biotypes before initiating these procedures is one of the significant predictive factors for their success. The aim of this study was to evaluate the reliability of accurate gingival biotype determination with the use of the visual method, periodontal, and trans-gingival probing compared to the direct measurement method. Methods. This prospective study involved 33 patients indicated for apical root resection in the intercanine sector of the upper jaw. Gingival biotype identification was performed in all patients using the following techniques: 1) visual method; 2) periodontal probe technique; 3) trans-gingival probing; and 4) direct measurement after flap elevation. Statistical analysis of the obtained data was performed to assess the diagnostic accuracy of the visual method, periodontal probing method, and trans-gingival probing method in relation to the direct measurement method, used as a gold standard, to discriminate the gingival thickness biotype (thin versus thick). Results. The overall accuracy of the tested diagnostic procedures compared to direct gingival biotype measurement was 66.7% for the visual method, 78.8% for periodontal probing, and 97.0% for trans-mucosal probing. Conclusion. The periodontal probing method can be recommended for gingival biotype determination as a routine method since its sensitivity and overall accuracy are higher compared to the visual method. The trans-gingival method, in terms of sensitivity and comprehensive accuracy, almost completely coincides with the direct method, but it is more invasive compared to the periodontal probing method, and it has to be conducted in local anesthesia.
Keywords: evaluation study, gingiva, methods, periodontium, phenotype, surgery, oral
Show references
Kan JYK, Rungcharassaeng K, Morimoto T, Lozada JL. Facial gingival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: Consecutive case report. J Oral Maxillofac Surg 2009; 67(11 Suppl): 40-8.
Kan JYK, Rungcharassaeng K. Site development for anterior single implant esthetics: The dentulous site. Compend Contin Educ Dent 2001; 22(3):221-6, 228, 230-1; quiz 232.
De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival biotype revisited: Transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 2009; 36(5): 428-33.
Ochsenbein C, Ross S. A reevaluation of osseous surgery. Dent Clin North Am 1969; 13(1): 87-102.
Seibert JL, Lindhe J. Esthetics and periodontal therapy. In: Lindhe J, editor. Textbook of Clinical Periodontology. 2nd ed. Denmark, Copenhagen: Munksgaard; 1989. p. 477-514.
Müller HP, Eger T. Gingival phenotypes in young male adults. J Clin Periodontol 1997; 24 (1): 65-71.
Kan JY, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gingival biotype assessment in the esthetic zone: visual versus direct measurement. Int J Periodontics Restorative Dent 2010; 30(3): 237-43.
Joshi N, Agarwal MC, Madan E, Gupta S, Law A. Gingival biotype and gingival biofilm: determining factors for periodontal disease progression and treatment outcome. Int J Sci Study 2016; 4(3): 220-5.
Ahmadi RS, Tavassoli R, Sayar F, Ghaffari K, Sarlati F. Gingival thickness assessment: Visual versus direct measurement. J Islam Dent Assoc Iran (JIDAI) 2016; 28(4): 149-54.
Olsson M, Lindhe J, Marinello CP. On the relationship between crown form and clinical features of the gingival in adolescents. J Clin Periodontol 1993; 20(8): 570-7.
Kan JYK, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of periimplant mucosa: An evaluation of maxillary anterior single implants in humans. J Periodontol 2003; 74(4): 557-62.
Alves PHM, Alves TCLP, Pegoraro TA, Costa YM, Bonfante EA, de Almeida ALPF. Measurement properties of gingival biotype evaluation methods. Clin Implant Dent Relat Res. 2018; 20(3): 280-4.
Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014; 41 Suppl 15: S123-42.
Linkevicius T, Puisys A, Svediene O, Linkevicius R, Linkeviciene L. Radiological comparison of laser-microtextured and platformswitchedimplants in thin mucosal biotype. Clin Oral Implants Res 2015; 26(5): 599-605.
Goaslind GD, Robertson PB, Mahan CJ, Morrison WW, Olson JV. Thickness of facial gingiva. J Periodontol 1977; 48(12): 768-71.
Esfahrood ZR, Kadkhodazadeh M, Talebi Ardakani MR. Gingival biotype: a review. Gen Dent 2013; 61(4): 14-7.
Kydd WL, Daly CH, Wheeler JB 3rd. The thickness measurement of masticatory mucosa in vivo. Int Dent J 1971; 21(4):430-41.
Slak B, Daabous A, Bednarz W, Strumban E, Maev RG. Assessment of gingival thickness using an ultrasonic dental system prototype: A comparison to traditional methods. Ann Anat 2015; 199: 98-103.
Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL. Tissue biotype and its relation to the underlying bone morphology. J Periodontol 2010; 81(4): 569-74.
Lindhe J, Lang N, Karring Th. Clinical Periodontology and Implant Dentistry. 5th ed. Hoboken: Wiley-Blackwell; 2008; pp 69-71.
Kolte R, Kolte A, Mahajan A. Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol 2014; 18(4): 478-81.
Cosyn J, Sabzevar MM, De Bruyn H. Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis. J Clin Periodontol 2012; 39(4): 895-903.
Muller HP, Eger T, Sorb A. Gingival dimensions after root coverage with free connective tissue grafts. J Clin Periodontol 1998; 25(5): 424-30.
Bengazi F, Wennström JL, Lekholm U. Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study. Clin Oral Implants Res 1996; 7(4): 303-10.
Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res 2008; 19(1): 73-80.
Hwang D, Wang HL. Flap thickness as a predictor of root coverage: a systematic review. J Periodontol 2006; 77(10): 1625-34.
Baldi C, Pini-Prato G, Pagliaro U, Nieri M, Saletta D, Muzzi L, et al Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series. J Periodontol 1999; 70(9): 1077-84.
Kahn S, Almeida RA, Dias AT, Rodrigues WJ, Barceleiro MO, Taba MJr. Clinical Considerations on the Root Coverage of Gingival Recessions in Thin or Thick Biotype. Int J Periodontics Restorative Dent 2016; 36(3): 409-15.