Gingival landmarks and cutting points for gingival phenotype determination: A clinical and tomographic cross‐sectional study

Abstract

Background This cross‐sectional study assessed the role of gingival landmarks (GLs) and cutting points (CPs) for gingival phenotype (GP) determination. Methods Six maxillary anterior teeth (70 subjects) were evaluated using soft tissue cone‐beam computed tomography (ST‐CBCT). Gingival thickness was measured at different GLs: 1) tissue zone (gingival margin [GM], 1 and 2 mm apical to GM, cemento‐enamel junction, above the bone crest); 2) bone zone (buccal bone crest [BBC], 1, 2, and 3 mm apical to BBC). CPs of 0.6, 0.8, 1.0, 1.2, and 1.5 mm were used to discriminate between thin and thick GP. The clinical determination of GP was made based on transparency of the periodontal probe (TRAN). Results The prevalence of thin and thick GP depended on the GL and CP. Considering the CP (1 mm), thin GP at the tissue zone ranged from 99% at the GM to 10.2% above the bone crest. In the bone zone, thick GP ranged from 28% at the BBC to 6% at 3 mm apical to the BBC. The predictability of a correct assessment of GP by TRAN compared with ST‐CBCT was influenced by the GLs and CPs. A slight agreement (kappa <0.2) and low accuracy (area under the curve <0.7) were found between methods. Conclusions The determination of thin and thick GPs is related to the gingival landmarks and CPs. Further studies are required for a well‐defined treatment protocol considering different gingival landmarks in tissue and bone zones. An ST‐CBCT may be useful for this purpose.

Relationship between supracrestal soft tissue dimensions and other periodontal phenotypic features: A cross‐sectional study

“…Interestingly, as reported in a recent study by Moreira and collaborators, the determination of thin and thick gingival phenotypes is related to the apico-coronal level of assessment and the threshold used to differentiate between a thin and a thick phenotype. 38 Indeed, as observed in this study, depending on apico-coronal evaluated, the frequency distribution of thin and thick gingival phenotype and the direction of the association with KTW and PH varied. However, regardless of the vertical level of assessment, it was consistently observed that the thicker the GT, the thicker the facial BT.…”

“…34 The discrepancies between studies could be explained by the differences in the methodology used to measure the gingival and alveolar bone phenotypes, the sample size, the landmark, or the cutting points used to classify and determine thin and thick phenotypes. 38 A positive association between the gingival and bone phenotype both at facial and palatal sites was noticed. Additionally, facial GT and BT were positively correlated with KTW.…”

“…Conversely, a study by Arora and colleagues reported taller PSTH in patients with a thick phenotype 34 . The discrepancies between studies could be explained by the differences in the methodology used to measure the gingival and alveolar bone phenotypes, the sample size, the landmark, or the cutting points used to classify and determine thin and thick phenotypes 38 …”

Identification of thin and thick gingival phenotypes by two transparency methods: A diagnostic accuracy study

“…also observed that the CCP probes did not accurately discriminate the phenotype categories and showed low repeatability. The discrepancies observed in the above studies may be related to the heterogenous methodology and lack of standardization of the distance between measurement and the gingival margin 13,15,11,21,24,25,27,29,33,34 . While in the present study assessment was performed visualizing probes clinically, Bertl et al 24 .…”

“…The discrepancies observed in the above studies may be related to the heterogenous methodology and lack of standardization of the distance between measurement and the gingival margin. 13,15,11,21,24,25,27,29,33,34 While in the present study assessment was performed visualizing probes clinically, Bertl et al 24 evaluated the transparency method from standardized photographs, which may not represent the day-to-day clinical routine.…”