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

Abstract

BackgroundThe purpose of this study was to determine the association between periodontal supracrestal soft tissue dimensions (PSSTDs) and other phenotypic features in non‐molar maxillary teeth.Materials and MethodsAdult subjects in need of comprehensive dental treatment were recruited. Periodontal phenotypic variables (i.e., facial and palatal gingival thickness [GT], alveolar bone thickness [BT], and PSSTDs, namely distance from the gingival margin to the bone crest defined as periodontal supracrestal tissue height [PSTH] and distance from the cementoenamel junction to the bone crest [CEJ‐BC]) were recorded using cone‐beam computed tomography scans. Standardized intraoral photographs were obtained to assess facial keratinized tissue width (KTW) and other anatomical parameters (i.e., tooth type, gingival architecture, and interproximal papilla height).ResultsThe study sample was constituted of 87 participants that contributed with a total of 522 maxillary anterior teeth. Differences in mean values of PSSTDs, KTW, GT, and BT were observed between tooth types and sex. Males exhibited a thicker GT and BT, and taller PSTH and KTW compared to females. Shorter CEJ‐BC was associated with shorter PSTH, wider KTW, and thicker GT and BT. Shorter PSTH was associated with thicker facial BT. Notably, BT and GT were positively correlated at both facial and palatal sites, meaning that the thicker the gingival phenotype, the thicker the bone morphotype. Facial BT and facial GT were positively correlated with KTW. A flat gingival architecture was associated with the thick periodontal phenotype. Square teeth had shorter CEJ‐BC, wider KTW, and thicker GT.ConclusionsPeriodontal phenotypic features vary across and within subjects, between facial and palatal sites at different apico‐coronal levels, and as a function of sex and tooth type. The shorter the PSSTDs, the wider the KTW and the thicker the GT and BT. PSSTDs, particularly PSTH, should be considered an integral component of the periodontal phenotype.

Effects of the GingivalStat approach on early gingival margin remodeling following esthetic clinical crown lengthening: A case series

“…In the context of periodontal anatomy, it has been shown that a flat gingival architecture, a common feature among patients presenting altered passive eruption, is associated with: and (c) a wider keratinized tissue width compared to sites displaying a pronounced scalloped phenotype. 25 Moreover, most of the evidence indicates that sites presenting a thick periodontal phenotype may experience higher rates of coronal soft tissue rebound after crown lengthening procedures. 11,12,15 Overall, soft tissue rebound varied from 0.37 mm for thin-scalloped phenotypes to 0.7 mm for thick-flat phenotypes.…”

“…Regarding the second purpose of the GingivalStat approach, the occurrence of gingival rebound seems to be associated with anatomic and surgical issues. In the context of periodontal anatomy, it has been shown that a flat gingival architecture, a common feature among patients presenting altered passive eruption, is associated with: (a) shorter CEJ‐bone crest and shorter supracrestal soft tissue dimensions; (b) a thicker facial alveolar bone plate and gingival thickness; and (c) a wider keratinized tissue width compared to sites displaying a pronounced scalloped phenotype 25 . Moreover, most of the evidence indicates that sites presenting a thick periodontal phenotype may experience higher rates of coronal soft tissue rebound after crown lengthening procedures 11,12,15 .…”

Multifunctional anatomical prototypes (MAPs): Treatment of excessive gingival display due to altered passive eruption

“…The surgical planning of APE cases requires a comprehensive analysis of the anatomical structures 18 including the supracrestal soft tissue height (SSTH), 19 site phenotype, keratinized tissue height (KT), CEJ, and ABC position. 20,21 These anatomical landmarks are assessed digitally by combining the baseline IOs, the STL file of the AI-segmented teeth (serving as a diagnostic mock-up on patients with APE), and the CBCT DICOM file (Figures 6, 7).…”

Precautions and possibilities in orthodontic treatment of periodontally compromised patients: Current recommendations

“…Periodontal phenotype (Soft tissue) Gingival phenotype (thin vs. thick phenotype) 13 Keratinized tissue width (gingival margin-mucogingival junction) 19 Radiographic examination…”