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

Abstract

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.

Comparison of the Effectiveness of the Ultrasonic Method and Cone-Beam Computed Tomography Combined with Intraoral Scanning and Prosthetic-Driven Implant Planning Method in Determining the Gingival Phenotype in the Healthy Periodontium

“…The current ultrasound devices are adapted to the examination of gingival thickness and provide high measurement accuracy [11,21,39,43]. According to the literature data the ultrasound devices used in the field of dentistry are in A-mode [24,[51][52][53][54], B-mode [37,55], and high frequencies B-mode-40 MHz [56] and 70 MHz in B-mode and Doppler mode acquisitions [57]. B-mode devices are rarely used in dental practice.…”

Clasificación del tipo de sonrisa y fenotipo gingival en pacientes de la Clínica Odontológica de la Universidad Católica de Cuenca

“…El fenotipo delgado por otro lado posee una arquitectura más peculiar, la encía marginal es más fina, festoneada y logra una forma más larga y estrecha de las piezas dentales, en especial de las antero superiores; las papilas interdentales se presentan más amplias, una mayor altura de la cresta ósea, incluso la estructura ósea es delgada, lo que puede generar lesiones como fenestraciones y dehiscencias, la banda de encía queratinizada es angosta y el área de contacto es a diferencia del fenotipo grueso hacia coronal. (Belák et al, 2021;Espíndola et al, 2021). (Cortellini & Bissada, 2018;Zerón, 2018).…”

“…Existen tres tipos de forma dentaria: cuadrada, se presenta con un contorno recto, lóbulos paralelos y ángulos de transición lineales acentuados; ovoidea, se presenta con un contorno redondeado, sin lóbulos paralelos y ángulos de transición lineales suaves, generando convergencia incisiva y cervical, por último, triangular que presenta contorno recto con ángulo de transición lineal y lóbulos acentuados con convergencia hacia cervical. (Belák et al, 2021;Navarrete et al, 2015;Weber et al, 2014).…”

Gingival Recessions

“…The thin periodontal biotype is one of the risk factors for gingival recession (Jing WD et al, 2019) [20] in addition to several studies indicating that patients who have this type of dental biotype are more susceptible to plaque and soft tissue defects. The thick gingival biotype is commonly seen in patients with short but wide crowns, with evident cervical convexities and wide contact areas (Assiri M et al, 2019) [4] in turn thick gingival tissues have been described to be more resistant to recession (Belak S et al, 2021) [6] . Currently, the term "periodontal phenotype" encompasses the aspects gingival phenotype (three-dimensional gingival volume) and dentoalveolar bone morphotype (Lin Gh et al, 2020) [23] , the use of this new terminology has been accepted by periodontic specialties.…”