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Dridi SM, Ameline C, Heurtebise JM, Vincent-Bugnas S, Charavet C. Prevalence of the Gingival Phenotype in Adults and Associated Risk Factors: A Systematic Review of the Literature. Clin Pract 2024; 14:801-833. [PMID: 38804396 DOI: 10.3390/clinpract14030064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
The relevance of assessing the gingival phenotype prior to the initiation of periodontal, orthodontic, or prosthetic therapy has been clearly demonstrated. However, publications on this subject are either old or concerned with the means of assessing the gingival phenotype or the main factors likely to modify it. The main objective of this systematic review of the literature was therefore to investigate the prevalence of different gingival phenotypes in adults in good general health and with a healthy periodontium. A systematic review of the literature was performed following the guidelines of PRISMA recommendations using an electronic search strategy on four databases (PubMed, Scopus, Cochrane Library, and Embase) complemented by a manual search. Three independent authors were involved in study selection, data extraction, and bias assessment. Results: Of 807 articles, 17 of them, published between 2012 and 2023, involving 3277 subjects from 11 countries and 9766 dental sites, fulfilled the inclusion criteria. The prevalence of the gingival phenotype could not be determined at the level of an individual or a dental arch because all the publications assessed this phenotype only at the level of certain dental sectors, and were not chosen at random. The maxillary central incisors and maxillary or mandibular first molar sectors were associated with a high and thick gingival phenotype, independently of the dental morphology, gender, and age of adult subjects. Furthermore, in these regions, this gingival phenotype tended to be associated with a thick vestibular bone table. In contrast, maxillary and mandibular incisors and premolars more often had a thin gingival phenotype. For other teeth, the results were less conclusive. It is important not to rely solely on the overall appearance of the dentition but to independently assess the thickness and height of the gingiva at each dental site requiring intervention. Finally, this study highlights a key point, namely the need for further longitudinal studies to determine the prevalence in healthy adults. For practicality and feasibility reasons, these studies should be designed according to therapeutic needs, dental sector by dental sector, and within homogeneous source populations. PROSPERO registration: CRD 42023392602.
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Affiliation(s)
- Sophie-Myriam Dridi
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d'Azur, 06800 Nice, France
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
- Laboratoire MICORALIS, Université Côte d'Azur, UPR 7354, 06800 Nice, France
| | - Clément Ameline
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d'Azur, 06800 Nice, France
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
| | - Jean Michel Heurtebise
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
| | - Séverine Vincent-Bugnas
- Département de Parodontologie, Faculté de Chirurgie Dentaire, Université Côte d'Azur, 06800 Nice, France
- Unité de Parodontologie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
- Laboratoire MICORALIS, Université Côte d'Azur, UPR 7354, 06800 Nice, France
| | - Carole Charavet
- Laboratoire MICORALIS, Université Côte d'Azur, UPR 7354, 06800 Nice, France
- Département d'Orthodontie, Faculté de Chirurgie Dentaire, Université Côte d'Azur, 06800 Nice, France
- Unité d'Orthodontie, Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06800 Nice, France
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Tastan Eroglu Z, Ozkan Sen D, Oncu E. Association of Peri-Implant Keratinized Mucosa Width and Mucosal Thickness with Early Bone Loss: A Cross-Sectional Study. J Clin Med 2024; 13:1936. [PMID: 38610701 PMCID: PMC11012309 DOI: 10.3390/jcm13071936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Objective: The objective of this study was to evaluate the effects of keratinized mucosa width (KMW) and mucosal thickness (MT) around dental implants on marginal bone loss (MBL). The evaluation was performed one year after loading by comparing clinical, radiographic, and biochemical parameters. Methods: The study included 87 implants in 87 patients undergoing regular follow-ups without hard or soft tissue augmentation one year after loading. Clinical measurements included plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing depth (PD), KMW, and MT. MBL was assessed with periapical radiography. The peri-implant crevicular fluid (PICF) was analyzed for tumor necrosis factor-alpha (TNF-α), receptor activator of nuclear factor-kB ligand (RANKL), osteoprotegerin (OPG), and microRNA-27a. Results: The MBL of implants with thin MT (<2 mm) was higher than that of implants with thick MT (≥2 mm) (p < 0.05). A significant negative correlation (r: -0.217) was established between MT and MBL. No significant association was found between KMW and MBL (p > 0.05). No significant associations was found between KMW and MT with TNF-α, RANKL, OPG and RANKL/OPG (p > 0.05), with the exception of increased microRNA-27a levels in implants with KMW ≥ 2 mm (p < 0.05). Conclusions: Implants with a thick MT had a lower MBL. There may be an association between adequate KMW and high miRNA-27a levels. The relationship between MBL and miRNA-27a remains unclear.
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Affiliation(s)
- Zeynep Tastan Eroglu
- Department of Periodontology, Faculty of Dentistry, Necmettin Erbakan University, Beyşehir Caddesi, Bağlarbaşı Sk., 42090 Konya, Turkey;
| | - Dilek Ozkan Sen
- Department of Periodontology, Faculty of Dentistry, Necmettin Erbakan University, Beyşehir Caddesi, Bağlarbaşı Sk., 42090 Konya, Turkey;
| | - Elif Oncu
- Panoroma Ankara Private Oral and Dental Health Clinic, 06510 Ankara, Turkey;
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Schwarz L, Unger E, Gahleitner A, Rausch-Fan X, Jonke E. A novel approach for gingiva thickness measurements around lower anterior teeth by means of dental magnetic resonance imaging. Clin Oral Investig 2023; 28:18. [PMID: 38135801 PMCID: PMC10746778 DOI: 10.1007/s00784-023-05459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE This diagnostic accuracy study aims to present the first measurements of gingiva thickness around lower anterior teeth using dental magnetic resonance imaging (MRI) and to compare these measurements with two established methods: (1) gingival phenotype assessment via periodontal probing, and (2) the superimposition of cone-beam computed tomography (CBCT) scans with intraoral scans of teeth and gums. MATERIALS AND METHODS Ten patients with substantial orthodontic treatment need and anterior mandibular crowding were consecutively included in this clinical case series. After periodontal probing, each patient underwent a CBCT scan, an intraoral scan of the mandible, and an MRI investigation using a novel mandibula 15-channel dental coil. RESULTS The mean gingiva thickness was 0.72 mm measured on MRI and 0.97 mm measured on CBCT, with a mean difference between the measurement methods of 0.17 ± 0.27 mm (p < 0.001). Measurement agreement between the index tests (MRI and CBCT) and the clinical reference standard (probing) yielded an overall percent agreement of 64.94% and 47.02% for MRI and CBCT, respectively. Teeth with thin phenotypes were associated with lower soft tissue dimensions in both free (MRI: 0.56 mm vs. CBCT: 0.79 mm) and supracrestal gingiva (MRI: 0.75 mm vs. CBCT: 1.03 mm) when compared to those with thick phenotypes. However, only the measurements obtained from MRI scans showed statistically significant differences between the two phenotypes. CONCLUSION Dental MRI successfully visualizes delicate structures like the gingiva in the anterior mandible and achieves a high correlation with superimposed CBCT scans, with clinically acceptable deviations. CLINICAL RELEVANCE The present study helps to establish dental MRI as a radiation-free alternative to conventional radiographic methods.
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Affiliation(s)
- Linda Schwarz
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - André Gahleitner
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Center of Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Erwin Jonke
- Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
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Rodrigues DM, Petersen RL, Montez C, de Moraes JR, Ferreira V, Barboza EP. The relationship between tomographic sagittal root position of maxillary anterior teeth and the bone housing. J Prosthet Dent 2023; 130:705-714. [PMID: 35012769 DOI: 10.1016/j.prosdent.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 01/10/2023]
Abstract
STATEMENT OF PROBLEM In a prosthetically driven treatment plan, the tomographic sagittal root position in relation to the bone housing is an important factor in the decision-making process for immediate implant placement. However, other important parameters must be considered in the bone housing of each tooth, including the alveolar ridge dimensions, the buccal and the palatal bone thickness, and the root dimensions. PURPOSE The purpose of this clinical study was to evaluate the relationship between the sagittal root position of maxillary anterior teeth and the bone housing. MATERIALS AND METHODS A total of 420 maxillary anterior teeth were analyzed in 70 participants. The tomographic scans were classified as sagittal root position classes I, II, III, and IV. Measurements included buccal and palatal bone thickness, alveolar ridge height, alveolar ridge width, apical bone height, root length, and root width. The Pearson correlation, ANOVA, and Tukey post hoc tests were used to determine statistically significant differences (α=0.05). RESULTS The sagittal root position distribution was 65.2%, 9.3%, 0.7%, and 24.8% for classes I, II, III, and IV, respectively. Bone housing measurements were significantly different in relation to the 4 sagittal root position classes (P<.05), except for alveolar ridge height. Post hoc analysis showed that, in class I, buccal bone thickness and alveolar bone height were significantly low, whereas root length and palatal bone thickness were high. The higher buccal bone thickness was found in class II, and lower alveolar ridge width and palatal bone thickness in class IV. These measurements in tooth groups were also significantly different over the sagittal root position classes (P<.05). The buccal bone thickness, palatal bone thickness, and alveolar ridge width presented different levels of correlation with alveolar ridge width over the sagittal root position classes. The buccal bone thickness and palatal bone thickness were weakly correlated in class I (r=0.163) and IV (r=0.222). CONCLUSIONS Bone housing measurements were significantly different in relation to the sagittal root position of maxillary anterior teeth.
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Affiliation(s)
| | - Rodrigo L Petersen
- Radiologist, Petersen Diagnostic Imaging Center, Niterói, Rio de Janeiro, Brazil
| | - Caroline Montez
- Student, Graduate Program, School of Dentistry, Federal Fluminense University (UFF), Niterói, Rio de Janeiro, Brazil
| | - José R de Moraes
- Professor, Department of Statistics, Institute of Statistics and Mathematics, Federal Fluminense University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Vinicius Ferreira
- Student, Post Graduate Program, School of Dentistry, Federal Fluminense University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Eliane Porto Barboza
- Professor of Periodontology, Department of Dental Clinic, School of Dentistry, Federal Fluminense University (UFF), Niterói, Rio de Janeiro, Brazil.
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Mardas N, Macbeth N, Donos N, Jung RE, Zuercher AN. Is alveolar ridge preservation an overtreatment? Periodontol 2000 2023; 93:289-308. [PMID: 37622682 DOI: 10.1111/prd.12508] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/24/2023] [Accepted: 05/19/2023] [Indexed: 08/26/2023]
Abstract
The morphology and dimensions of the postextraction alveolar ridge are important for the surgical and restorative phases of implant treatment. Adequate new bone formation and preservation of alveolar ridge dimensions following extraction will facilitate installation of the implant in a restorative position, while preservation of soft tissue contour and volume is essential for an aesthetic and implant-supported restoration with healthy peri-implant tissues. Alveolar ridge preservation (ARP) refers to any procedure that aims to: (i) limit dimensional changes in the alveolar ridge after extraction facilitating implant placement without additional extensive bone and soft tissue augmentation procedures (ii) promote new bone formation in the healing alveolus, and (iii) promote soft tissue healing at the entrance of the alveolus and preserve the alveolar ridge contour. Although ARP is a clinically validated and safe approach, in certain clinical scenarios, the additional clinical benefit of ARP over unassisted socket healing has been debated and it appears that for some clinicians may represent an overtreatment. The aim of this critical review was to discuss the evidence pertaining to the four key objectives of ARP and to determine where ARP can lead to favorable outcomes when compared to unassisted socket healing.
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Affiliation(s)
- Nikos Mardas
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Neil Macbeth
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
- Defence Centre for Rehabilitative Dentistry, Defence Primary Health Care (DPHC), Dental Centre Aldershot, Guildford, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Anina Nives Zuercher
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Nalbantoğlu AM, Yanık D. Revisiting the measurement of keratinized gingiva: a cross-sectional study comparing an intraoral scanner with clinical parameters. J Periodontal Implant Sci 2023; 53:362-375. [PMID: 37524382 PMCID: PMC10627736 DOI: 10.5051/jpis.2204320216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the relationships between gingival thickness (GT) and keratinized gingiva width (KGW), papilla height (PH), and crown ratio (CR) by employing transgingival probing and an intraoral scanner (IOS). METHODS This cross-sectional study examined 360 maxillary anterior teeth from 60 patients. GT was assessed using transgingival probing with an endodontic spreader. KGW, CR, and PH were measured using an IOS. One-way analysis of variance, the Student's t-test, and Spearman correlation coefficients were employed for statistical analysis. RESULTS Higher GT was significantly associated with thinner KGW in the central region (P=0.019). There was no statistically significant difference in GT between teeth (P=0.06). PH was lower in lateral teeth than in canines (P=0.047), with a PH of 2.99 mm in lateral teeth. The KGW was narrower in canines than in central teeth (P=0.007). A moderate correlation was observed between KGW and PH in the central region (P=0.01), while a weak negative correlation was found between KGW and CR (P=0.043). CONCLUSIONS A moderate negative correlation was found between GT and KGW, as well as between PH and KGW in central teeth. In contrast, a weak negative correlation existed between CR and KGW. The PH (2.99 mm) was lower in lateral teeth than in canines. The traditional paradigm, which suggests a positive correlation between KGW and GT, was re-evaluated by measuring KGW using an IOS.
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Affiliation(s)
- Ahmet Mert Nalbantoğlu
- Department of Periodontology, Antalya Bilim University, Faculty of Dentistry, Antalya, Turkey
| | - Deniz Yanık
- Department of Endodontics, Antalya Bilim University, Faculty of Dentistry, Antalya, Turkey.
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Abdelhafez RS, Mustafa NM. Determining the periodontal phenotype-Probe transparency versus actual: A diagnostic study. J ESTHET RESTOR DENT 2023; 35:1001-1007. [PMID: 36891868 DOI: 10.1111/jerd.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/10/2023]
Abstract
AIMS Assessment of the validity of the transparency of the periodontal probe as a tool for determining the periodontal phenotype. MATERIALS AND METHODS The periodontal phenotype was assessed at the six upper anterior teeth of 75 subjects using two methods. One is through assessing the transparency of the periodontal probe upon insertion into the gingival sulcus. The second method was through the assessment and clustering of the width of keratinized gingiva clinically and the gingival and buccal plate thickness on Cone Beam Computed Tomography scan. RESULTS The probe transparency approach correctly identified thick periodontal phenotype in most cases (41 out of 43 [95%]). However, this was not the case for thin periodontal phenotype; probe transparency approach identified 64% of the thin sites (261 out of 407) and misclassified nearly one third of the patients. CONCLUSION The probe transparency approach is a valid approach in identifying the phenotype in subjects with thick phenotype but not in subjects with thin phenotype. CLINICAL SIGNIFICANCE The definition of periodontal phenotype has recently changed. Accurate designation has been shown to affect treatment outcomes especially esthetic ones in different disciplines of dentistry. Probe transparency is commonly used by clinicians and researchers. Assessment of the validity of this method based on the most recent definition and compared to actual assessment of bone and gingival thickness is of great clinical value.
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Affiliation(s)
- Reem Sami Abdelhafez
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Noor Mohammad Mustafa
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Curiel-Aguilera FP, Griffiths GR, Rossmann JA, Gonzalez JA. Titanium versus zirconia complete arch implant-supported fixed prostheses: A comparison of plaque accumulation. J Prosthet Dent 2023; 130:369-375. [PMID: 34879988 DOI: 10.1016/j.prosdent.2021.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Complete arch implant-supported zirconia prostheses appear to have less plaque accumulation than titanium prostheses, but a comparison of the materials and the possible influence on the adjacent soft tissue is lacking. PURPOSE The purpose of this clinical study was to compare the plaque accumulation and soft-tissue inflammation of complete arch implant-supported fixed maxillary prostheses fabricated with either a titanium framework or monolithic zirconia. MATERIAL AND METHODS Twenty participants with a complete arch implant-supported fixed maxillary prosthesis were enrolled in the study. The participants were divided into 2 groups according to the prosthesis material, titanium (Ti) or zirconia (Zir). The prosthesis had to have been in function for at least 6 months, and participants were examined during at least 3 maintenance appointments at 3-month intervals. Clinical information collected in each appointment included standardized photographs to record the Plaque Area Index (PAI) of the intaglio surface of the prosthesis; clinical parameters including modified Plaque Index (mPI), modified Bleeding Index (mBI), implant mobility (MOB), probing depths ≥5 mm (PD), suppuration (SUP), keratinized tissue band ≥2 mm (KT), and an intraoral photograph of the maxillary arch without the prosthesis to evaluate the redness of the soft tissues. RESULTS MOB was not present at any implant at any time point. SUP could not be analyzed because it was an infrequent finding. Both groups exhibited significant increases in mBI over time. No significant differences were observed for PD between the groups at any time point. Implants in the Ti group had significantly higher KT values than those in the Zir group; levels remained constant over time for both groups. Zirconia prostheses had slightly lower PAI levels than Ti prostheses. The PAI in the Zir group significantly decreased over time (P=.035); in the Ti group, they remained constant (P=.45). Higher PAI levels were correlated with increased levels of erythema; both groups had a significant decrease in erythema values over time (P=.04). CONCLUSIONS Zirconia complete arch implant-supported fixed maxillary prostheses displayed a significant decrease in plaque accumulation in individuals who had received periodic maintenance and oral hygiene instructions. Ti prostheses had significantly higher plaque levels than zirconia prostheses at all time points, which was not reduced by maintenance and oral hygiene measures. The present study suggests that patients receiving zirconia prostheses respond well to plaque control measures, while plaque control for those with titanium prostheses may be more challenging.
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Affiliation(s)
| | - Garth R Griffiths
- Graduate Program Director, Graduate Periodontics, Department of Periodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Jeffrey A Rossmann
- Clinical Professor, Graduate Periodontics, Department of Periodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Jorge A Gonzalez
- Director, Center for Maxillofacial Prosthodontics, Department of Oral Surgery, Texas A&M College of Dentistry, Dallas, Texas
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Díaz L, Fan S, Urrutia P, Uriarte X, Fodich I, Torres A, Sáenz-Ravello G. Correlation between periodontal phenotype and sinus membrane thickness: A systematic review. Clin Oral Implants Res 2023; 34:881-891. [PMID: 37427881 DOI: 10.1111/clr.14121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023]
Abstract
AIM To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans. METHODS This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross-Sectional Studies (AXIS) for articles that met the eligibility criteria. RESULTS Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross-sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias. CONCLUSIONS Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions.
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Affiliation(s)
- Leonardo Díaz
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
- Perioplastic Institute, Santiago, Chile
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
| | - Pablo Urrutia
- Perioplastic Institute, Santiago, Chile
- Postgraduate Implant Dentistry Department, School of Dentistry, Universidad Andrés Bello, Santiago, Chile
| | | | - Ivo Fodich
- Postgraduate Implant Dentistry Department, School of Dentistry, Universidad Andrés Bello, Santiago, Chile
| | - Alfredo Torres
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Gustavo Sáenz-Ravello
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile
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Lao CM, Chen H, Ji C, Lao SH. Minimally invasive management of a socket shield technique complication: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00416-X. [PMID: 37491181 DOI: 10.1016/j.prosdent.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 07/27/2023]
Abstract
The socket shield technique has been used to optimize the esthetic outcome of anterior immediate implant treatment. However, complications have been reported, including internal or external shield exposure, implant failure, and infection. The key to the surgical management of shield exposure is to avoid a full-thickness flap because of the risk of losing soft tissue volume. For this patient, a flapless approach was used to extract the exposed root shield, followed by a simultaneous connective tissue graft. A satisfactory esthetic outcome was observed at the 20-month follow-up after the surgical intervention.
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Affiliation(s)
- Chong Man Lao
- Resident, Center of Oral and Maxillofacial, Kiang Wu Hospital, Santo António, Macau, PR China
| | - Hui Chen
- Clinical Assistant Professor, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, PR China
| | - Chao Ji
- Private practice, Hong Kong, PR China
| | - San Hon Lao
- Implantology Specialist, Center of Oral and Maxillofacial, Kiang Wu Hospital, Santo António, Macau, PR China.
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11
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Zhang Y, Chen F, Kang N, Duan J, Xue F, Cai Y. Clinical and computed tomographic evaluations of periodontal phenotypes in a Chinese population: a cross-sectional study. Clin Oral Investig 2023:10.1007/s00784-023-04970-y. [PMID: 36964225 DOI: 10.1007/s00784-023-04970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/19/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVES To investigate the diagnostic value of probe transparency related to gingival thickness (GT) and keratinized gingival width (KGW) at individual and site levels and explore the relationship of buccal bone plate thickness (BT) with GT and KGW. MATERIALS AND METHODS A total of 1,606 teeth from 167 patients with periodontally healthy maxillary anterior region were included. GT was measured with probe transparency and transgingival probing. KGW was measured directly. BTs were assessed at the level 1 mm apical to the alveolar crest (BT1) and midpoint of the root (BT2) and evaluated at individual and tooth levels along with their mutual associations. RESULTS The prevalence of thick gingiva was 53% with probe transparency measurement and 51% with transgingival probing. The cutoff gingival thickness was 0.8 mm, which correlated moderately with a Cohen's kappa of 0.386. The mean GT, KGW, and BTs (BT1 and BT2) in the maxillary anterior region were 0.97 ± 0.46, 5.51 ± 1.62, 0.85 ± 0.31, and 0.79 ± 0.32 mm, respectively. GT and KGW correlated mildly (r = 0.261), and GT and BTs correlated moderately (BT1: r = 0.298; BT2: r = 0.338). GT and BTs differed significantly between men and women and among different tooth sites. CONCLUSIONS GT and BTs correlated positively in the maxillary anterior region and varied within and among individuals. Sex was a factor influencing the gingival phenotype and bone morphotype. CLINICAL RELEVANCE GT measured with transgingival probing, with a cutoff of 0.8 mm, could serve as an objective measure to distinguish different gingival phenotypes.
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Affiliation(s)
- Yong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China
| | - Fan Chen
- Department of Stomatology, People's Hospital of Peking University, Beijing, 100044, People's Republic of China
| | - Ni Kang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, No.22 South Avenue Zhongguancun, Beijing, 100081, People's Republic of China
| | - Jinyu Duan
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China
| | - Fei Xue
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, People's Republic of China.
| | - Yu Cai
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, No.22 South Avenue Zhongguancun, Beijing, 100081, People's Republic of China.
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12
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Rodrigues DM, Chambrone L, Montez C, Luz DP, Barboza EP. Current landmarks for gingival thickness evaluation in maxillary anterior teeth: a systematic review. Clin Oral Investig 2023; 27:1363-1389. [PMID: 36786957 DOI: 10.1007/s00784-023-04898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To identify and report the current landmarks used for measuring gingival thickness (GT) in healthy maxillary anterior teeth. MATERIAL AND METHODS The protocol of this Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review was registered in PROSPERO. A literature search was conducted to identify articles that met the eligibility criteria published up to 2022. The methods of assessing gingival thickness and the landmarks adopted on the studies were described. Primary outcomes were identified, and the frequency of reporting in the selected articles was calculated. Additionally, risk-of-bias assessments were performed for individual articles. RESULTS Fifty-eight articles (34 with low risk of bias and 24 with medium risk of bias) were selected. A total of 3638 individuals had their gingival thickness measured. Thirty-nine different landmarks were adopted in the studies. Fifty-six articles with 22 landmarks were included in the meta-analysis. A higher heterogeneity was found between the studies (GT ranged from 0.48 to 2.59 mm, mean GT 1.074; 95% CI: 1.024-1.104). The 3 most used landmarks were 2 mm from gingival margin (10 studies, mean GT 1.170 mm, 95% CI: 1.085-1.254), bone crest (9 studies, mean GT 1.01 mm; 95% CI: 0.937-1.083), and cemento-enamel junction (7 studies, mean GT 1.172 mm; 95% CI: 1.105, 1.239). CONCLUSIONS Within the limits of this study, a large heterogeneity in GT was found, and there was no consensus on the ideal landmark for GT measurement. CLINICAL RELEVANCE The landmark 2 mm from gingival margin, located at attached gingiva, can be used for GT measurement by clinical and image-based devices. This is an important step for a quantitative instead of a qualitative evaluation of phenotypes.
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Affiliation(s)
| | - Leandro Chambrone
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz-Cooperativa de Ensino Superior, Caparica, Portugal.,Department of Periodontics, The University of Pennsylvania, Philadelphia, USA.,Unit of Basic Oral Investigation (UIBO), Universidad El Bosque, Bogota, Colombia
| | - Caroline Montez
- Graduate Program, Fluminense Federal University School of Dentistry, Niterói, Brazil
| | - Diogo Pereira Luz
- Post Graduate Program, Fluminense Federal University School of Dentistry, Niterói, Brazil
| | - Eliane Porto Barboza
- Department of Dental Clinic, Fluminense Federal University School of Dentistry, Rua Mario Santos Braga, 28 - Centro, Niterói, Rio de Janeiro, CEP, 24020-140, Brazil.
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Chaudhary DS, Parwani SR, Barkhade S, Gajbhiye M, Parwani R, Sikka G, Kawadkar K, Soni NJ, Armogida NG, Dadlani H, Spagnuolo G. Physiological Gingival Melanin Hyperpigmentation Treatment with Injectable Vitamin C and Scalpel Technique: A Randomised Controlled Clinical Trial. Int J Dent 2023; 2023:4586923. [PMID: 37252615 PMCID: PMC10212675 DOI: 10.1155/2023/4586923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 10/29/2023] Open
Abstract
Harmony between facial complexion and gingival health goes hand in hand. Gingival depigmentation is an aesthetic correction of hyperactive melanocytes in gingival tissues that lead to hyperpigmentation. Current study compares depigmentation, pain scores, and itching with scalpel technique and nonsurgical intramucosal Vitamin C injection. 30 individuals in the age range of 18-40 years conscious of dark gums were randomly allocated to test and control group by lottery method. Thorough Phase I therapy was performed one week before the procedure. Area and intensity of depigmentation were evaluated preoperatively and postoperatively; pain score, itching, and repigmentation percentage were the postoperative parameters. After 24 hrs, test group showed significantly lesser VAS score for pain as compared to control group. There was no statistically significant difference in preoperative area of pigmentation between the test and control group (p=0.936). Postoperatively also, there was no statistically significant difference in area of pigmentation between the test and control group (p=0.932). For comparing area of pigmentation, an independent t-test was applied and Mann-Whitney test was used for differentiating the intensity of pigmentation, repigmentation, and VAS score between the groups. The study concluded that Vitamin C mesotherapy and scalpel technique showed comparable results in reduction of areas and intensity of gingival hyperpigmentation.
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Affiliation(s)
- Dhanashree S. Chaudhary
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Simran R. Parwani
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Shital Barkhade
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Minal Gajbhiye
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Rajkumar Parwani
- Department of Oral Pathology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Geetanjali Sikka
- Department of Periodontology, Eklavya Dental College & Hospital Kotpulti, Rajasthan 303108, India
| | - Kshipra Kawadkar
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Nishita Jaju Soni
- Department of Periodontology, V.Y.W.S. Dental College and Hospital, Amravati, Maharashtra 444602, India
| | - Niccolò Giuseppe Armogida
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples 80131, Italy
| | - Himanshu Dadlani
- Department of Periodontology, Kalka Dental College, Meerut 250002, India
- Kalka Dental College, Meerut 250016, India
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples 80131, Italy
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, Moscow 119991, Russia
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Transepithelial Gingival Depigmentation Using a New Protocol with Q-Switched Nd:YAG: An In Vivo Observational Study. Dent J (Basel) 2022; 11:dj11010002. [PMID: 36661539 PMCID: PMC9857459 DOI: 10.3390/dj11010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Gingival melanin hyperpigmentation is a para-physiological condition that may have a negative impact on smile esthetics. In the present study, the use of the Q-Switched Nd:YAG laser, according to a defined protocol, was proposed to treat Gingival Melanin Hyperpigmentation with a transepithelial approach. A total of 10 Patients with different grades of gingival hyperpigmentation were treated with Q-Switched Nd:YAG in one to four laser sessions without local anesthesia. The grade of depigmentation was evaluated by comparing Oral Pigmentation Index (OPI) and Melanin Pigmentation Index (MPI) at baseline and three weeks after the laser session. Additionally, oral discomfort rated by the Numeric Rating Scale (NRS) was recorded one, three, and five days after the procedure. Complete depigmentation was achieved in all cases. Patients reported no-little discomfort (NRS 0 to 3) during the laser session that lasted a maximum of five days. No major complications were reported, and no recurrences were observed at least after one year of follow-up. In addition, patients were available to be re-treated if necessary. These findings suggested that the Q-Switched Nd:YAG could be an effective and well-tolerated approach in the treatment of gingival melanin hyperpigmentation.
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Rodrigues DM, Petersen RL, de Moraes JR, Barboza EP. Gingival landmarks and cutting points for gingival phenotype determination: A clinical and tomographic cross-sectional study. J Periodontol 2022; 93:1916-1928. [PMID: 35451505 DOI: 10.1002/jper.21-0615] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/20/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023]
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.
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Affiliation(s)
| | | | - José Rodrigo de Moraes
- Department of Statistics, Federal Fluminense University, Statistics and Mathematics Institute, Niterói, Brazil
| | - Eliane Porto Barboza
- Department of Dental Clinic, Federal Fluminense University School of Dentistry, Niterói, Brazil
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Kalina E, Grzebyta A, Zadurska M. Bone Remodeling during Orthodontic Movement of Lower Incisors-Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15002. [PMID: 36429721 PMCID: PMC9691226 DOI: 10.3390/ijerph192215002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 06/15/2023]
Abstract
The tooth movement in the alveolus is possible due to bone remodeling. This process could be the risk factor for the formation of gingival recessions-the most common side effects of orthodontic therapy. Gingival recessions are found 5.8-11.5% more frequently among the orthodontically treated patients. What is more, anterior mandibular teeth are the ones most prone to gingival recession dehiscences and fenestrations. The aim of this narrative review was to evaluate, based on CBCT (Cone beam computed tomography) scans, the changes in the alveolar bone of lower incisors in adolescent and adult patients after orthodontic tooth movements. From the pool of 108 publications, a total of 15 fulfilled the criteria of this review. Both retrospective and prospective longitudinal studies-using CBCT or CT (Computed Topography) and evaluating alveolar bone changes in mandibular incisors during orthodontic treatment performed before and after teeth movement-were included. In the group of growing patients, either proclination or retroclination of mandibular incisors led to increase of the distance from CEJ (cementoenamel junction) to marginal bone crest. The difference in bone loss was greater on the lingual side of the incisors in both types of tooth movement. The results were similar for adults patients. The thickness of the alveolar bone was reduced after proclination (total bone thickness) among growing and non-growing patients and retraction (lingual and buccal) of lower anterior teeth in the group of growing patients. The only improvement was measured for buccal thickness of mandibular incisor in bimaxillary protrusion patients treated with extraction therapy. The control of retraction movement (more root than crown movement) enhanced preservation on bone height and thickness. In order to minimize possible deterioration and place teeth in the center of alveolus, CBCT monitoring and scrupulous clinical evaluation are recommended.
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Initial Assessment of Gingival Biotype as a Potential Source of Variability in the Migration, Contraction and Gene Expression of Fibroblasts. Arch Oral Biol 2022; 144:105554. [DOI: 10.1016/j.archoralbio.2022.105554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/22/2022]
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Ashurko I, Tarasenko S, Esayan A, Kurkov A, Mikaelyan K, Balyasin M, Galyas A, Kustova J, Taschieri S, Corbella S. Connective tissue graft versus xenogeneic collagen matrix for soft tissue augmentation at implant sites: a randomized-controlled clinical trial. Clin Oral Investig 2022; 26:7191-7208. [PMID: 36029335 DOI: 10.1007/s00784-022-04680-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this randomized clinical trial (RCT) is to compare xenogeneic collagen matrix (XCM) versus subepithelial connective tissue graft (SCTG) to increase soft tissue thickness at implant site. MATERIALS AND METHODS The study was a randomized, parallel-group controlled investigation. Thirty patients underwent buccal soft tissue thickness augmentation at the stage of implant placement by two different methods: SCTG (control group) and XCM (test group). Primary outcome was the amount of buccal soft tissue thickness gain, 3 months after the intervention. Secondary outcomes were the operation time, the amount of keratinized mucosa (KM), pain syndrome (PS), and patients' quality of life (QL). Histologic evaluation was also performed. RESULTS The amount of soft tissue thickness gain was 1.55±0.11 mm in SCTG group, and 1.18±0.11mm in XCM group. The difference between the SCTG and XCM was -0.366 (-0.66 to -0.07; p=0.016). Operation time with XCM was 8.4 (3.737 to 13.06) min shorter than that with the SCTG (p=0.001). KT, PS, and QL for both groups were not statistically significantly different at any time point (p>0.05). At histological examination, the general picture in both groups was similar. No significant differences between the studied groups in most indices, except for the average and maximum formation thickness, cellularity of the basal, mitotic activity and also maximum length of rete ridges. CONCLUSION Within limitations, this study demonstrates that the use of SCTG provides a statistically significant superior soft tissue thickness gain than XCM for soft tissue augmentation procedures around implants. CLINICAL RELEVANCE XCM can be used as the method of choice for increasing the thickness of soft tissues.
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Affiliation(s)
- Igor Ashurko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation.
| | - Svetlana Tarasenko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Aleksandr Esayan
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Alexandr Kurkov
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Karen Mikaelyan
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Maxim Balyasin
- Peoples Friendship University of Russia, Moscow, Russian Federation
| | - Anna Galyas
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Julia Kustova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
| | - Silvio Taschieri
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedica, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Stefano Corbella
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaisky Val Street, Moscow, 119048, Russian Federation
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedica, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
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19
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Gingival thickness threshold and probe visibility through soft tissue: a cross-sectional study. Clin Oral Investig 2022; 26:5155-5161. [PMID: 35503136 PMCID: PMC9381477 DOI: 10.1007/s00784-022-04483-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/07/2022] [Indexed: 11/17/2022]
Abstract
Objectives The aim was to retrieve the threshold of gingival thickness (GT), where the attribute of gingival translucency through probe visibility was altered. Methods In 200 patients, the soft tissue thickness was evaluated at both central mandibular incisors using ultrasound quantification (USD). Additionally, probe visibility was determined using a standard periodontal probe (PB) (CPU 15 UNC, Hu-Friedy), inserted 1 mm deep into the gingival sulcus. Frequencies and relative frequencies were calculated. Repeatability analyses and receiver operating characteristics (ROC) were conducted to determine the USD cut-off point for probe visibility. Results Regression model indicated that the probe was not visible at a thickness of 0.82 mm for the mandibular left central incisor (95% CIs 0.77, 0.86) and became visible at a thickness of 0.69 mm (95% CIs 0.65, 0.72). The respective values for the mandibular right central incisor were 0.82 mm (95% CIs 0.77, 0.87) and 0.70 mm (0.68, 0.74). ROC analysis confirmed the retrieved regression results by indicating the best fitting balance for specificity and sensitivity at a thickness of 0.8 mm for both mandibular incisors. Conclusions In the frame of the current study, the data revealed that gingiva becomes non-transparent at a thickness of approximately 0.8 mm. Clinical relevance Probe visibility at mandibular incisors for the discrimination between thin and thick soft tissues was correlated with a gingival thickness of 0.8 mm and a high repeatability.
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Majzoub J, Tavelli L, Barootchi S, Salami A, Inglehart MR, Kripfgans OD, Chan HL. Agreement in measurements of ultrasonography-derived periodontal diagnostic parameters among multiple raters: A diagnostic accuracy study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:375-385. [PMID: 35568639 DOI: 10.1016/j.oooo.2022.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/08/2022] [Accepted: 03/19/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the reproducibility of measurements of ultrasound-derived periodontal diagnostic parameters (PDPs) among raters. STUDY DESIGN Periodontists with various degrees of ultrasound experience were invited to measure 3 PDPs: soft tissue height (STH), soft tissue thickness (STT), and crestal bone thickness (CBT) on 37 human periodontal ultrasound scans acquired at the midfacial site of non-molar maxillary teeth. After an online training session and a 2-week calibration exercise, intraclass correlation coefficients (ICCs) were estimated with mixed linear regression models. The interrater mean absolute differences (MADs) were calculated among the raters and between the raters and a reference standard examiner. RESULTS Thirteen raters participated in the study. MADs among the 13 raters were 0.18 mm (STH), 0.16 mm (STT), and 0.12 mm (CBT). ICC values for STH, STT, and CBT were 0.83, 0.77, and 0.76, respectively. The MADs between the raters and the reference standard were 0.23 mm (STH), 0.19 mm (STT), and 0.14 mm (CBT). Survey results showed that ultrasound has diagnostic value and is generally easy to learn. CONCLUSIONS Within the limitations of this study, good agreement was observed among ultrasound learners with various degrees of experience when measuring ultrasound-derived PDPs.
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Affiliation(s)
- Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Lorenzo Tavelli
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard, School of Dental Medicine, Boston, MA, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Ali Salami
- Department of Mathematics, Faculty of Sciences, Lebanese University, Nabatieh, Lebanon
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA; Department of Psychology, College of Literature, Science and Arts, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
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Wang J, Cha S, Zhao Q, Bai D. Methods to assess tooth gingival thickness and diagnose gingival phenotypes: A systematic review. J ESTHET RESTOR DENT 2022; 34:620-632. [PMID: 35297167 DOI: 10.1111/jerd.12900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Measurement of the periodontal soft tissue dimension is crucial for clinical decision-making and aesthetic prognosis. However, the effectiveness of different measuring methods remains unclear. This systematic review aimed to explore the diagnostic accuracy of two non-invasive methods (namely CBCT and ultrasound) for gingival thickness measurement at different tooth positions. MATERIALS AND METHODS A systematic search was performed using PubMed (including Medline), PubMed Central, OVID, Cochrane Library, LILACS and OpenGrey. Studies focusing on comparisons between CBCT, ultrasound and direct transgingival probing were included. The means, SDs and correlation coefficients with 95% confidence intervals were extracted and analyzed using Review Manager and R software. RESULTS Twelve studies were selected. No significant difference was found between CBCT measurement and transgingival probing in the anterior and posterior dentition, and a moderate correlation was observed between these two methods (r = 0.41). A weak correlation was found between ultrasound measurement and transgingival probing (r = 0.32), and a slight but statistically significant difference was found when comparing ultrasonic devices and transgingival probing in the posterior area. CONCLUSION CBCT can be considered a relatively reliable method for gingival thickness measurement in both the anterior and posterior areas compared with direct probing. Ultrasonic devices provide limited accuracy in the posterior area but are relatively comparable with direct clinical assessments in the anterior area. CLINICAL SIGNIFICANCE Measurement location may affect the diagnostic accuracy and repeatability of gingival thickness measurements. Appropriate method selection in different clinical scenarios is crucial to aesthetic outcome prediction and decision-making.
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Affiliation(s)
- Jiangyue Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sa Cha
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qing Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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22
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Tianmitrapap P, Srisuwantha R, Laosrisin N. Flapless Er,Cr:YSGG laser versus traditional flap in crown lengthening procedure. J Dent Sci 2022; 17:89-95. [PMID: 35028024 PMCID: PMC8739276 DOI: 10.1016/j.jds.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/08/2021] [Indexed: 10/26/2022] Open
Abstract
Background/purpose Laser technology and minimally invasive therapy has gained attention in many dentistry fields. Er,Cr:YSGG laser is the latest laser type that can be applied on both soft tissue and hard tissue. This study presents periodontal outcome of Er,Cr:YSGG laser flapless crown lengthening procedure compared with traditional technique. Materials and methods Twenty-five participants were divided into two groups: 13 patients were treated with the traditional method of crown lengthening and 12 patients were treated using a flapless Er,Cr:YSGG laser. Their periodontal status were measured and compared at baseline, immediately, one month, and three months after surgery. Results The results showed a significant increase in clinical crown length immediately after surgery in both groups. After a three-month follow-up, the gingival margin of the laser group remained at stable height with 0.17 ± 0.31 mm increase after surgery, while the gingival margin of traditional group showed both recession and rebounding by -0.13 ± 0.63 mm (p > 0.05) average. Conclusion The flapless Er,Cr:YSGG laser crown lengthening with its minimally invasive approach without flap reflection may be an alternative treatment for providing an adequate height of tooth for restoration.
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Affiliation(s)
| | - Rungtiwa Srisuwantha
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Narongsak Laosrisin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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Rodrigues DM, Petersen RL, Montez C, Barboza EP. Tomographic sagittal root position in relation to maxillary anterior bone housing in a Brazilian population. Imaging Sci Dent 2022; 52:75-82. [PMID: 35387099 PMCID: PMC8967500 DOI: 10.5624/isd.20210226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose This cross-sectional study evaluated and categorized the tomographic sagittal root position (SRP) of the maxillary anterior teeth in a Brazilian population. Materials and Methods Cone-beam computed tomographic scans of 420 maxillary anterior teeth of 70 patients (35 men and 35 women, mean age 25.2±5.9 years) were evaluated. The SRP was classified as class I, II, III, or IV. In class I, the root is positioned against the buccal cortical plate; in class II, the root is centered in the middle of the alveolar housing; in class III, the root is positioned against the palatal cortical plate; and in class IV, at least two-thirds of the root engage both the buccal and palatal cortical plates. Results In total, 274 teeth (65.2%) were class I, 39 (9.3%) were class II, 3 (0.7%) were class III, and 104 (24.8%) were class IV. The frequency distribution over the teeth groups was different from the overall analysis. Important differences were found in the frequencies of classes I, II, and IV compared to other populations. Sex was not associated with the SRP classes (P=0.307). Age distribution was significantly different over the classes (P=0.004). Conclusion The findings of this study on the distribution of SRP classes among the Brazilian population compared to other populations demonstrate that the SRP should be analyzed on a case-by-case basis for an accurate treatment plan in the maxillary anterior area.
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Affiliation(s)
| | | | - Caroline Montez
- Post Graduate Program, Federal Fluminense University School of Dentistry, Niterói, Brazil
| | - Eliane Porto Barboza
- Department of Periodontology, Federal Fluminense University School of Dentistry, Niterói, Brazil
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Losev FF, Brailovskaya TB, Kalinin RV. [Use of dental implants in orthopedic rehabilitation of patients in aesthetically important area]. STOMATOLOGIIA 2022; 101:84-88. [PMID: 35184540 DOI: 10.17116/stomat202210101184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The article presents a review of scientific data of Russian and non-Russian works dedicated to the problem of instant dental implantation in the aesthetically important areas, i.e. the upper jaw. The paper considers such anatomical factors of unsatisfactory aesthetic treatment results as presence and thickness of vestibular alveola wall, pathophysiological processes occurring while extracting teeth in this area, presence of odontogenic inflammatory sites and traumatic injuries under root canal and orthopaedic treatment, impact of gum's biotype on the condition of soft tissue in the area of the future orthopaedic prothesis. Data used in the article suggests the necessity of thorough diagnostic with the help of up-to-date technologies such as Cone beam computer tomography (CBCT).
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Affiliation(s)
- F F Losev
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - T B Brailovskaya
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - R V Kalinin
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
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Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
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Anegundi RV, Shenoy SB, Punj A. Gingival biotype as an indicator for the buccal bone thickness - a systematic review of the literature. Evid Based Dent 2021:10.1038/s41432-021-0206-y. [PMID: 34815554 DOI: 10.1038/s41432-021-0206-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/21/2021] [Indexed: 11/08/2022]
Abstract
Introduction A relationship between thin gingiva and thin buccal bone has been proposed but concrete evidence for this is lacking. This study was undertaken to assess the reliability of measuring gingival thickness in estimating the buccal bone thickness.Objectives To answer the following PICO question: do periodontally healthy individuals exhibit any correlation between gingival biotype and buccal/labial/facial bone thickness?Data sources and selection An electronic search was performed in PubMed and Embase databases. English language articles that have met the inclusion and exclusion criteria were selected. Only observational studies were considered. Since the studies have demonstrated heterogeneity, conducting a meta-analysis was not possible, so the results were synthesised using a vote counting method and narrative synthesis.Data synthesis After screening the titles and abstracts, 13 studies which met the study criteria were included in the systematic review. Out of these 13 studies, nine studies assessed only the maxillary anterior/premolars; one study assessed the mandibular anterior, and three studies assessed both maxillary and mandibular anterior/premolars.Conclusions The findings of this systematic review indicated that the gingival biotype may be a reliable indicator for estimating the thickness of buccal bone in maxillary anterior. However, its relation to the buccal bone thickness in mandible is unclear.
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Affiliation(s)
- Raghavendra Vamsi Anegundi
- Postgraduate Student, Department of Periodontics, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, 575018, India
| | - Santhosh B Shenoy
- Additional Professor, Department of Periodontics, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, 575018, India.
| | - Anahita Punj
- Senior Lecturer, Army College of Dental Sciences, Secunderabad, Telangana, India
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Relationship between anterior maxillary tooth sagittal root position and periodontal phenotype: a clinical and tomographic study. Clin Oral Investig 2021; 26:1309-1321. [PMID: 34529147 DOI: 10.1007/s00784-021-04105-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the relationship between the tomographic sagittal root position (SRP) of maxillary anterior teeth and periodontal phenotype (PP). MATERIAL AND METHODS Seventy volunteers (420 teeth) were evaluated. Clinical and photographic exams included the evaluation of gingival phenotype (GP) by transparency of the periodontal probe, keratinized tissue width (KTW), gingival architecture, tooth shape, and papilla height (PH). Soft tissue tomographic scan (ST-CBCT) measurements included the SRP classification, GP, gingival thickness in the tissue zone (GT-TZ) and in the bone zone (GT-BZ), buccal bone thickness (BBT), and the distances from the gingival margin and from cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC). Kruskal-Wallis test and a linear regression analysis model were used. RESULTS The frequency of SRP over the 420 teeth was 65.2% (class I), 9.3% (class II), 0.7% (class III), and 24.8% (class IV). Linear regression analysis showed that SRP is related to PP (p < 0.05). Significantly different measurements of PP parameters were found in SRP classes. The higher and lower GT and BBT were found in classes II and I, respectively. Class IV presented the highest KTW, PH, CEJ-BBC, and GM-BBC. Central incisors (CI) classes I and II were most frequently square-shaped, while 89% of CI Class IV were triangular-shaped. CONCLUSION The SRP of maxillary anterior teeth is related to periodontal phenotype. CLINICAL RELEVANCE Clinical and ST-CBCT individual analysis of PP and SRP may be helpful for an esthetic and functional treatment plan based on soft and hard tissue thickness and tooth positioning.
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Thöne-Mühling M, Kripfgans OD, Mengel R. Ultrasonography for noninvasive and real-time evaluation of peri-implant soft and hard tissue: a case series. Int J Implant Dent 2021; 7:95. [PMID: 34518926 PMCID: PMC8438098 DOI: 10.1186/s40729-021-00375-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The diagnosis of soft and hard tissue at dental implants will be challenging in the future, as high prevalence of mucositis and peri-implantitis were described in the population. Ultrasonography is a promising non-invasive, inexpensive, painless, and radiation-free method for imaging hard and soft tissue at implants, especially an ultrasound device with a 25-MHz probe demonstrating a high correlation between ultrasound, clinical, and radiological measurements. CASE PRESENTATION The following case series demonstrates the use of ultrasonography with high spatial resolution probe in patients with dental implants affected by soft tissue recession and/or crestal bone loss. CONCLUSION These ultrasound images can provide valuable additional information for the assessment of peri-implant soft and hard tissue.
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Affiliation(s)
- Miriam Thöne-Mühling
- Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University Marburg, Georg-Voigt Str. 3, 35039, Marburg/Lahn, Germany
| | - Oliver D Kripfgans
- Department of Radiology, BME, and Appl. Phys., University of Michigan, 3218D Med Sci I, 1301 Catherine Street, Ann Arbor, MI, 48109-5667, USA
| | - Reiner Mengel
- Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University Marburg, Georg-Voigt Str. 3, 35039, Marburg/Lahn, Germany.
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Shafizadeh M, Tehranchi A, Shirvani A, Motamedian SR. Alveolar bone thickness overlying healthy maxillary and mandibular teeth: A systematic review and meta-analysis. Int Orthod 2021; 19:389-405. [PMID: 34366263 DOI: 10.1016/j.ortho.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with gender, age, and smoking. MATERIALS AND METHODS The PubMed, Embase, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched up to July 2020. English articles (sample size≥10) which had used CT or CBCT to measure the ABT at clearly defined reference points were included. The maximum likelihood approach meta-analysis was used to estimate the means (95% CIs). RESULTS A total of 68 articles were included. The meta-analysis results were as follows: In the anterior maxilla, the mean labial plate thickness ranged from 0.42-1.75mm, while it was thicker for the posterior teeth (0.78-4.31mm). The palatal plate thickness ranged from 0.97-8.13mm. In the anterior mandible, the thickness of labial and lingual plates ranged from 0.4-3.71mm and 0.38-5.44mm, respectively. The alveolar bone was thicker for the posterior teeth both at the labial (0.66-6.31mm) and lingual (2.31-7.77mm) sides. Meta-regression revealed a significant relationship between gender and ABT at several points. There was a controversy regarding the association of ABT with age. No significant difference was evidenced between smokers and non-smokers. CONCLUSIONS This study presents a clear image of the alveolar bone structure. Since it has pooled ABT values from various populations, outcomes could be acknowledged as global averages. Therefore, it could provide perspective for several dental procedures, including orthodontic treatments and immediate implant placement.
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Affiliation(s)
- Marziyeh Shafizadeh
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Azita Tehranchi
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Armin Shirvani
- Department of Orthodontics, School of Dentistry, Dental Research Centre, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Saeed Reza Motamedian
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran; Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran.
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Bittencourt TC, Souza Picorelli Assis NM, Ribeiro CG, Ferreira CF, Sotto-Maior BS. Evaluation of the peri-implant tissues in the esthetic zone with prefabricated titanium or zirconia abutments: A randomized controlled clinical trial with a minimum follow-up of 7 years. J Prosthet Dent 2021; 129:573-581. [PMID: 34334178 DOI: 10.1016/j.prosdent.2021.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Long-term clinical studies are lacking on the influence of the type of abutment, titanium or zirconia, on peri-implant tissues. PURPOSE The purpose of this randomized clinical trial was to evaluate peri-implant tissues with titanium or zirconia abutments. MATERIAL AND METHODS A total of 26 single-tooth implant-supported prostheses in 14 participants were analyzed. They received either a titanium abutment with a metal-ceramic crown (TAG) or a zirconia abutment with a ceramic crown (ZAG). Data were collected immediately, at 5 months, and at a minimum of 7 years after crown delivery. The success rate, plaque and bleeding indexes, bleeding on probing, white and pink esthetic scores, and the relationships of the gingival phenotype with the pink esthetic score were analyzed. Statistical analyses were conducted with the t test for paired and independent data (α=.05). RESULTS The mean follow-up time was 95.2 ±2.6 months, showing an implant success rate of 96.7%. No statistically significant differences were found between TAG and ZAG among the time intervals evaluated for plaque or bleeding indexes (P>.05). A statistically significant difference was found for peri-implant probing depths in the mid-buccal sites between the groups at all the time intervals evaluated (TAG, P=.008; ZAG, P=.021): TAG showed an increase between 5 months (3.65 ±0.93 mm) and over 7 years (4.47 ±1.32 mm); and ZAG showed a reduction (5 months=5.22 ±1.71 mm; over 7 years=4.25 ±1.28 mm) in values. For the pink (PES) and white esthetic score (WES), ZAG (PES: immediately=6.33 ±1.41; 5 months=7.44 ±1.81; over 7 years=8.25 ±1.03; WES: immediately=7.67 ±1.50; over 7 years=8.38 ±0.74) showed higher mean values than TAG (PES: immediately=5.94 ±2.35; 5 months=6.53 ±2.15; over 7 years=7.44 ±1.81; WES: immediately=7.00 ±1.17; over 7 years=8.35 ±1.27) (P<.05). Statistically significant differences were found for gingival phenotype and for PES in TAG (P=.031), and the participants with thick phenotype showed higher PES in the 3 time intervals studied. CONCLUSIONS Zirconia abutments exhibited better results than titanium abutments in terms of the peri-implant tissues. Moreover, in those with a thin phenotype, zirconia provided improved gingival esthetics.
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Affiliation(s)
- Thais Camargo Bittencourt
- Master in Comprehensive Dentistry, Department of Prosthodontics, Federal University of Juiz de For a (UFJF) College of Dentistry, Juiz de Fora, Minas Gerais, Brazil.
| | - Neuza Maria Souza Picorelli Assis
- Associate Professor, the Department of Comprehensive Dentistry at the Federal University of Juiz de For a (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Cleide Gisele Ribeiro
- Professor, Maternidade Therezinha de Jesus (HMTJ/JF) and Faculdade de Ciências Médicas e da Saúde Juiz de For a (SUPREMA), Minas Gerais, Brazil
| | - Cimara Fortes Ferreira
- Associate Professor, Director of Implant Dentistry, Department of Periodontics, University of Tennessee (UT) College of Dentistry, Memphis, Tenn
| | - Bruno Salles Sotto-Maior
- Professor, Federal University of Juiz de Fora (UFJF), College of Dentistry, Departament of Restorative Dentistry, Juiz de Fora, Minas Gerais, Brazil
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Bertl K, Al-Hotheiry M, Sun D, Olofsson J, Lettner S, Gotfredsen K, Stavropoulos A. Are colored periodontal probes reliable to classify the gingival phenotype in terms of gingival thickness? J Periodontol 2021; 93:412-422. [PMID: 34309865 DOI: 10.1002/jper.21-0311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT). METHODS Buccal GT in 3 anterior teeth in each of 50 patients was measured by transgingival sounding and classified by 3 different methods by 8 examiners. Specifically, the diagnostic potential of visual judgement and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed. RESULTS GT ranged from 0.57-2.37mm. Using CPP resulted in a medium judgement in 87% of the cases, on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥0.82) to identify thick cases, but also a high false omission rate (≥0.73) indicating that many cases classified as thin were actually thick. Further, 88% of the cases being ≤1mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 64% of the cases being ≤1mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), while visual judgement and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively. CONCLUSION Using CPP resulted in most of the cases in a medium judgement. It seems that CPP cannot distinctly discriminate between "thick" and "very thick" cases and fails to capture the thin high-risk cases. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Mehdi Al-Hotheiry
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden
| | - David Sun
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden
| | - John Olofsson
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden
| | - Stefan Lettner
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Klaus Gotfredsen
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Sweden.,Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Vlachodimou E, Fragkioudakis I, Vouros I. Is There an Association between the Gingival Phenotype and the Width of Keratinized Gingiva? A Systematic Review. Dent J (Basel) 2021; 9:dj9030034. [PMID: 33806934 PMCID: PMC8004949 DOI: 10.3390/dj9030034] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
The concept of gingival phenotype and width of keratinized gingiva influencing the diagnosis and treatment in the periodontal scenario is relatively new. Soft and hard tissue dimensions of oral tissues are considered essential parameters in daily clinical practice. Factors such as the biotype category and the width of the keratinized gingiva help dentists seek the perfect therapy plan for each patient to achieve long-term stability of periodontal health. Several methods have been proposed to categorize phenotypes and each phenotype is characterized by various clinical characteristics. This review aims to discuss the possible association between the gingival phenotype and the width of keratinized gingiva along with the results appeared. After a rigorous search in major electronic databases, the results of the included studies indicated that the width of keratinized gingiva seems to be associated with the periodontal phenotype, with thick biotypes being characterized by a more pronounced keratinized gingival width. However, the heterogeneity of the included studies did not allow to make a conclusion about a direct relationship.
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Fischer KR, Büchel J, Testori T, Rasperini G, Attin T, Schmidlin P. Gingival phenotype assessment methods and classifications revisited: a preclinical study. Clin Oral Investig 2021; 25:5513-5518. [PMID: 33725167 PMCID: PMC8370901 DOI: 10.1007/s00784-021-03860-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Kai R Fischer
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Jasmin Büchel
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tiziano Testori
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giulio Rasperini
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Patrick Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
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Kim YJ, Park JM, Cho HJ, Ku Y. Correlation analysis of periodontal tissue dimensions in the esthetic zone using a non-invasive digital method. J Periodontal Implant Sci 2021; 51:88-99. [PMID: 33913632 PMCID: PMC8090792 DOI: 10.5051/jpis.2003460173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 09/16/2020] [Accepted: 12/30/2020] [Indexed: 11/08/2022] Open
Abstract
Purpose Direct intraoral scanning and superimposing methods have recently been applied to measure the dimensions of periodontal tissues. The aim of this study was to analyze various correlations between labial gingival thickness and underlying alveolar bone thickness, as well as clinical parameters among 3 tooth types (central incisors, lateral incisors, and canines) using a digital method. Methods In 20 periodontally healthy subjects, cone-beam computed tomography images and intraoral scanned files were obtained. Measurements of labial alveolar bone and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0–5 mm from the alveolar crest on the superimposed images. Clinical parameters including the crown width/crown length ratio, keratinized gingival width, gingival scallop, and transparency of the periodontal probe through the gingival sulcus were examined. Results Gingival thickness at the alveolar crest level was positively correlated with the thickness of the alveolar bone plate (P<0.05). The central incisors revealed a strong correlation between labial alveolar bone thickness at 1 and 2 mm, respectively, inferior to the alveolar crest and the thickness of the gingiva at the alveolar crest line (G0), whereas G0 and labial bone thickness at every level were positively correlated in the lateral incisors and canines. No significant correlations were found between clinical parameters and hard or soft tissue thickness. Conclusions Gingival thickness at the alveolar crest level revealed a positive correlation with labial alveolar bone thickness, although this correlation at identical depth levels was not significant. Gingival thickness, at or under the alveolar crest level, was not associated with the clinical parameters of the gingival features, such as the crown form, gingival scallop, or keratinized gingival width.
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Affiliation(s)
- Yun Jeong Kim
- Department of Periodontology, Seoul National University Gwanak Dental Hospital, Seoul, Korea
| | - Ji Man Park
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyun Jae Cho
- Department of Preventive Dentistry and Public Oral Health, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.
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Bednarz-Tumidajewicz M, Sender-Janeczek A, Zborowski J, Gedrange T, Konopka T, Prylińska-Czyżewska A, Dembowska E, Bednarz W. In Vivo Evaluation of Periodontal Phenotypes Using Cone-Beam Computed Tomography, Intraoral Scanning by Computer-Aided Design, and Prosthetic-Driven Implant Planning Technology. Med Sci Monit 2020; 26:e924469. [PMID: 33064673 PMCID: PMC7574361 DOI: 10.12659/msm.924469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/20/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Two clinical parameters, the gingival thickness (GT) and the width of keratinized tissue (WKT), describe the gingival phenotype, which is defined as the 3-dimensional volume of the gingiva. The periodontal phenotype additionally includes the thickness of the labial plate of the alveolar crest (TLPAC). MATERIAL AND METHODS Thirty patients with healthy periodontium on the upper canines and incisors underwent measurements for crestal, supracrestal, free gingival thickness (FGT), the alveolar crest-gingival margin (AC-GM), alveolar crest-cementoenamel junction distance, and the TLPAC at 2, 4, and 8 mm apically from the edge of the alveolar crest using cone-beam computed tomography (CBCT) with computer-aided design and prosthetic-driven implant planning technology. For each tooth, the gingival and periodontal phenotype was evaluated on the basis of the gingival thickness, width of keratinized tissue (WKT), and TLPAC measurements. Each patient's periodontal phenotype was evaluated according to the coronal width/length ratio of both the upper central incisors. RESULTS The dentogingival units had varying average values for the 3 periodontal phenotypes (thin phenotype: FGT 0.65±0.06 mm, WKT 4.85±1.18 mm, AC-GM 3.17±0.64 mm, TLPAC2 0.66±0.28 mm; medium phenotype: FGT 0.87±0.07 mm, WKT 5.49±1.23 mm, AC-GM 3.36±0.65 mm, TLPAC2 0.76±0.37 mm; and thick phenotype: FGT 1.20 mm, WKT 6.00 mm, AC-GM 3.90 mm, TLPAC2 0.90 mm). Positive correlations were seen among WKT, FGT, AC-GM, and TLPAC2. CONCLUSIONS Positive correlations between the FGT and WKT, and the AC-GM distance confirm that measurements using CBCT with computer-aided design and prosthetic-driven implant planning technology can evaluate the gingival phenotype and TLPAC2 for the periodontal phenotype.
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Affiliation(s)
| | | | - Jacek Zborowski
- Department of Periodontology, Wrocław Medical University, Wrocław, Poland
| | - Tomasz Gedrange
- Department of Oral Surgery, Wrocław Medical University, Wrocław, Poland
| | - Tomasz Konopka
- Department of Periodontology, Wrocław Medical University, Wrocław, Poland
| | | | - Elżbieta Dembowska
- Department of Periodontology, Pomeranian Medical University, Szczecin, Poland
| | - Wojciech Bednarz
- Department of Periodontology, Specialist Outpatient Medical Clinic MEDIDENT, Gorlice, Poland
- Department of Periodontology, Wrocław Medical University, Wrocław, Poland
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Chambrone L, Avila-Ortiz G. An evidence-based system for the classification and clinical management of non-proximal gingival recession defects. J Periodontol 2020; 92:327-335. [PMID: 32738056 DOI: 10.1002/jper.20-0149] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 11/11/2022]
Abstract
Gingival recession defect (GRD) may be defined as an apical migration of the gingival margin respective to the cementoenamel junction resulting in partial exposure of the root surface to the oral cavity, which may have important esthetic, functional, and periodontal health implications. A novel system for the classification and management of non-proximal GRDs is proposed in this article. This evidence-based system consists of two essential components: (1) Establishment of the GRD type based on the midbuccal/midlingual attachment level respective to the interproximal bone level, and (2) Assessment of the gingival phenotype according to the width of attached gingiva and gingival thickness. Each category of this new classification system is linked with treatment recommendations substantiated by relevant literature pertaining to the outcomes of validated root coverage procedures in specific scenarios, which can be used as a guide for clinical decision-making in daily practice.
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Affiliation(s)
- Leandro Chambrone
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,MSc Dentistry Program, Ibirapuera University School of Dentistry, São Paulo, Brazil.,Unit of Basic Oral Investigations (UIBO), Universidad El Bosque, School of Dentistry, Bogotá, Colombia
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
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Cha S, Lee SM, Zhang C, Tan Z, Zhao Q. Correlation between gingival phenotype in the aesthetic zone and craniofacial profile-a CBCT-based study. Clin Oral Investig 2020; 25:1363-1374. [PMID: 32648062 DOI: 10.1007/s00784-020-03444-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 07/03/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the correlation between gingival phenotype and craniofacial profile and to evaluate the morphology of periodontal supporting tissues in the maxillary and mandibular anterior zones. MATERIALS AND METHODS A total of 66 patients with 264 central incisors in good periodontal health were included in this cross-sectional study. CBCT images were used to assess gingiva and alveolar bone thickness of the maxillary and mandibular incisors at four vertical levels. Cephalometric analysis was used to assess the sagittal profile of the craniofacial structures. Gingival thickness was compared in patients with different craniofacial profiles based on ANB value. Linear regression coefficients adjusted by age and gender were used to evaluate the correlation between gingival thickness and the cephalometric parameters. RESULTS Individuals with a smaller ANB value (ANB< 2) presented with thinner supporting tissue and a keratinized gingiva width in the anterior zone. Labial gingival thickness on the mandibular incisors at the cementoenamel junction (G1) and at the alveolar bone crest (G2) was positively related to cephalometric measures, indicating a maxillae-mandibular sagittal relationship (ANB value, Wits appraisal, A-NPog value). CONCLUSIONS A moderate correlation was found between mandibular gingival thickness and the sagittal craniofacial profile. Patients with a concave craniofacial profile had a smaller keratinized gingiva width and gingival thickness in the aesthetic zone. CLINICAL RELEVANCE Knowledge of these features on supporting tissue and their correlations with craniofacial morphology will help clinicians to develop a reasonable treatment plan and make decisions to achieve the best aesthetic outcome.
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Affiliation(s)
- Sa Cha
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sueng Min Lee
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chengxiaoxue Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhen Tan
- Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qing Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Abstract
Many soft-tissue grafting solutions are available for reconstruction and restoration of volume and esthetics of keratinized attached mucosa at compromised periodontal and peri-implant interfaces. Presence of healthy soft tissues is crucial for functional and esthetic implant success as well as longevity of natural dentition. The options available each provide unique characteristics with different indications. This article is intended to provide an efficient and comprehensive overview of this topic, covering the essentials of periodontal anatomy and physiology, indications for soft-tissue grafting, and keys in recipient and donor-site preparation, and exploring the available procedural arsenal in soft-tissue grafting.
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Affiliation(s)
- Romeo Minou Luo
- Department of Oral & Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3200 South University Drive, Davie, FL 33328, USA.
| | - David Chvartszaid
- Prosthodontics, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, ON M5G 1G6, Canada
| | - Sang Woo Kim
- Department of Oral & Maxillofacial Surgery, Nova Southeastern University College of Dental Medicine, 3200 South University Drive, Davie, FL 33328, USA
| | - Jason Eli Portnof
- Private Practice, 9980 North Central Park Boulevard Suite 113, Boca Raton, FL 33428, USA
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Yin XJ, Wei BY, Ke XP, Zhang T, Jiang MY, Luo XY, Sun HQ. Correlation between clinical parameters of crown and gingival morphology of anterior teeth and periodontal biotypes. BMC Oral Health 2020; 20:59. [PMID: 32075626 PMCID: PMC7031990 DOI: 10.1186/s12903-020-1040-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 02/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background In this study, we conducted a quantitative analysis of the clinical parameters of crown and gingival morphology (CGM) of the maxillary anterior teeth (MAT). We also analyzed the correlation of these parameters with periodontal biotype (PB), with a view to providing objective standards for PB diagnosis. Methods The three-dimensional (3D) maxillary digital models of 56 individuals were obtained using an intra-oral scanner. The following parameters were measured with the SpaceClaim software: gingival angle (GA), papilla width (PW), papilla height (PH), crown length (CL), crown width (CW), crown width/crown length ratio (CW/CL), bucco-lingual width of the crown (BLW), contact surface width (CSW), and contact surface height/crown length ratio (CS/CL). The PB were determined based on the transparency of the periodontal probe through the gingival sulcus. Independent factors influencing PB were analyzed by logistic regression, and the optimal cutoff values for the independent influencing factors were analyzed using receiver operating characteristic curves (ROC curves). Results There was no significant difference in the parameters of CGM of the MAT at the left and right sides. The thick biotype accounted for 69.6%, and the parameters of GA, PW, PH, CW, CW/CL and CS/CL were significantly correlated with PB (P ≤ 0.2). GA (odds ratio (OR) = 1.206) and PW (OR = 5.048) were identified as independent predictive factors of PB, with areas under the ROC curve (AUC) of 0.807 and 0.881, respectively, and optimal cutoff values of 95.95° and 10.01 mm, respectively. Conclusion The CGMs of the MAT at the left and right side are symmetrical. The thin biotype accounts for a small proportion, and GA and PW are independent influencing factors of PB. GA of 95.95° and PW of 10.01 mm are the optimal cutoff values for categorization of individuals as thick biotype. This indicates that when the GA and PW of the right maxillary central incisor are G ≥ 95.95° and ≥ 10.01 mm, respectively, there is a higher probability that these individuals will be categorized as thick biotype.
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Affiliation(s)
- Xiao-Jie Yin
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China.,Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Bang-Yan Wei
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China
| | - Xiu-Ping Ke
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China
| | - Ting Zhang
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China
| | - Meng-Yang Jiang
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China
| | - Xia-Yan Luo
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China
| | - Hui-Qiang Sun
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, 250012, Shandong, China. .,Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China.
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40
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Tattan M, Sinjab K, Lee E, Arnett M, Oh TJ, Wang HL, Chan HL, Kripfgans OD. Ultrasonography for chairside evaluation of periodontal structures: A pilot study. J Periodontol 2020; 91:890-899. [PMID: 31837020 DOI: 10.1002/jper.19-0342] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The crestal bone level and soft tissue dimension are essential for periodontal diagnosis and phenotype determination; yet, existing measurement methods have limitations. The aim of this clinical study was to evaluate the correlation and accuracy of ultrasound in measuring periodontal dimensions, compared to direct clinical and cone-beam computed tomography (CBCT) methods. METHODS A 24-MHz ultrasound probe prototype, specifically designed for intraoral use, was employed. Periodontal soft tissue dimensions and crestal bone levels were measured at 40 teeth and 20 single missing tooth gaps from 20 patients scheduled to receive a dental implant surgery. The ultrasound images were interpreted by two calibrated examiners. Inter-rater agreement was calculated by using inter-rater correlation coefficient (ICC). Ultrasound readings were compared with direct clinical and CBCT readings by using ICC and Bland-Altman analysis. RESULTS The following six parameters were measured: 1) interdental papilla height (tooth), 2) mid-facial soft tissue height (tooth), 3) mucosal thickness (tooth), 4) soft tissue height (edentulous ridge), 5) mucosal thickness (edentulous ridge), and 6) crestal bone level (tooth). Intra-examiner calibrations were exercised to achieve an agreement of at least 0.8. ICC between the two readers ranged from 0.482 to 0.881. ICC between ultrasound and direct readings ranged from 0.667 to 0.957. The mean difference in mucosal thickness (tooth) between the ultrasound and direct readings was -0.015 mm (95% CI: -0.655 to 0.624 mm) without statistical significance. ICC between ultrasound and CBCT ranged from 0.654 to 0.849 among the measured parameters. The mean differences between ultrasound and CBCT range from -0.213 to 0.455 mm, without statistical significance. CONCLUSION Ultrasonic imaging can be valuable for accurate and real-time periodontal diagnosis without concerns about ionizing radiation.
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Affiliation(s)
- Mustafa Tattan
- Department of Periodontics and Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Eunjee Lee
- Department of Information and Statistics, Chungnam National University, Daejoen, South Korea
| | - Michelle Arnett
- Department of Primary Dental Care, Division of Dental Hygiene, University of Minnesota, Minneapolis, MN, USA
| | - Tae-Ju Oh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA
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Lin G, Curtis DA, Kapila Y, Velasquez D, Kan JY, Tahir P, Avila‐Ortiz G, Kao RT. The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review. J Periodontol 2019; 91:339-351. [DOI: 10.1002/jper.19-0310] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Guo‐Hao Lin
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Donald A. Curtis
- Department of Preventive and Restorative Dental Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Yvonne Kapila
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Diego Velasquez
- Graduate Periodontics Department of Periodontics & Oral Medicine School of Dentistry University of Michigan Ann Arbor MI
| | - Joseph Y.K. Kan
- Department of Restorative Dentistry School of Dentistry Loma Linda University Loma Linda CA
| | - Peggy Tahir
- University of California San Francisco Library CA
| | - Gustavo Avila‐Ortiz
- Department of Periodontics College of Dentistry University of Iowa Iowa City IA
| | - Richard T. Kao
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
- Private Practice Cupertino CA
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Frizzera F, Oliveira GJPLD, Shibli JA, Moraes KCD, Marcantonio EB, Marcantonio Junior E. Treatment of peri-implant soft tissue defects: a narrative review. Braz Oral Res 2019; 33:e073. [PMID: 31576957 DOI: 10.1590/1807-3107bor-2019.vol33.0073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
Abstract
Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to esthetic and functional complaints. Treatments of these defects in implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. This narrative review discusses the proposed treatments for soft tissue defects around implants in the current literature. Several clinical and pre-clinical studies addressed methods to augment the quantity of the peri-implant keratinized mucosa. Autogenous grafts performed better than soft tissue substitutes in the treatment of soft tissue defects, but there is no clinical consensus on the more appropriate donor area for connective tissue grafts. Treatment for facial volume loss, alterations on the mucosa color or texture and shallow peri-implant recessions are more predictable than deep recessions and sites that present loss of papilla. Correction of peri-implant soft tissue defects may be challenging, especially in areas that exhibit larger defects and interproximal loss. Therefore, the regeneration of soft and hard tissues during implant treatment is important to prevent the occurrence of these alterations.
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Affiliation(s)
- Fausto Frizzera
- FAESA Centro Universitário, Dental School, Department of Clinical Dentistry. Vitória, ES, Brazil
| | | | - Jamil Awad Shibli
- Universidade Guarulhos - UnG, Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos, SP, Brazil
| | | | - Eloísa Boeck Marcantonio
- Centro Universitário de Araraquara - Uniara, School of Dentistry, Department of Dentistry , Araraquara, SP, Brazil
| | - Elcio Marcantonio Junior
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Diagnosis and Surgery, , Araraquara, SP, Brazil
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Maxillary bone characteristics between thick and thin gingival biotypes with dentoalveolar protrusion. J World Fed Orthod 2019. [DOI: 10.1016/j.ejwf.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Meng S, Lin YL, Zhao L, Xu Y. [Relationship of orthodontic treatment and periodontal hard tissue health]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:343-349. [PMID: 31512823 DOI: 10.7518/hxkq.2019.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Periodontal tissue, especially the alveolar bone, are closely associated with the progress and efficacy of orthodontic treatment. Prior to and during orthodontic treatment, dentists should fully evaluate the status of periodontal hard tissues to prevent clinical problems. This article aims to discuss bone issues associated with orthodontic treatment, including gingival papilla absence, alveolar bone insufficiency, excessive cortical resistance, and altered passive eruption, etc. The mechanism and prevention methods of these problems are also described.
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Affiliation(s)
- Shu Meng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi-Lan Lin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Eshraghi VT, Malloy KA, Tahmasbi M. Role of Cone-Beam Computed Tomography in the Management of Periodontal Disease. Dent J (Basel) 2019; 7:dj7020057. [PMID: 31159356 PMCID: PMC6631177 DOI: 10.3390/dj7020057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 12/20/2022] Open
Abstract
The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author’s commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one’s own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author’s believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases.
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Affiliation(s)
- V Thomas Eshraghi
- Private Practice, Tualatin, OR 97062, USA.
- Private Practice, Beaverton, OR 97006, USA.
- Department of Periodontology, Oregon Health & Science University, Portland, OR 97201, USA.
| | | | - Mehrnaz Tahmasbi
- Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas, TX 75246, USA.
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Karakış Akcan S, Güler B, Hatipoğlu H. The effect of different gingival phenotypes on dimensional stability of free gingival graft: A comparative 6-month clinical study. J Periodontol 2019; 90:709-717. [DOI: 10.1002/jper.18-0530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/30/2018] [Accepted: 01/06/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Serap Karakış Akcan
- Faculty of Dentistry; Department of Periodontology; Istanbul Aydın University; İstanbul Turkey
| | - Berceste Güler
- Faculty of Dentistry; Department of Periodontology; Kütahya Health Sciences University; Kütahya Turkey
| | - Hasan Hatipoğlu
- Faculty of Dentistry; Department of Periodontology; Kütahya Health Sciences University; Kütahya Turkey
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BORGES SB, ARAÚJO LNMD, GURGEL BCDV. Distribuição das características clínicas do fenótipo gengival em pacientes saudáveis. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.01119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução A determinação do fenótipo gengival possibilita compreender melhor as variações e diferenças clínicas intra e interindividuais dos tecidos periodontais saudáveis. Objetivo O objetivo deste estudo foi determinar os perfis do fenótipo gengival e compará-los em diferentes regiões da cavidade oral, levando em consideração parâmetros clínicos relacionados aos tecidos moles circunjacentes nos dentes anteriores superiores e inferiores. Material e método Noventa e um pacientes com saúde periodontal foram examinados e os parâmetros clínicos profundidade de sondagem (PS), largura de mucosa ceratinizada (MC), espessura gengival em ambos incisivos centrais superiores (EG) e fenótipo gengival (FG) foram coletados nos dentes anteriores superiores e inferiores. Os dados foram analisados estatisticamente pelos testes t-Student pareado e independente, Correlação de Pearson e Qui-quadrado, com um nível de significância de 5%. Resultado O fenótipo gengival espesso predominou nos dentes anteriores superiores (60,5%), enquanto o fenótipo fino foi mais prevalente nos dentes anteriores inferiores (84,6%). Diferenças estatisticamente significativas foram encontradas para os parâmetros largura de mucosa ceratinizada e espessura gengival em relação aos fenótipos gengivais superiores e inferiores (p<0,05). Não houve diferença estatística entre profundidade de sondagem e o fenótipo gengival nos dentes superiores e inferiores. Conclusão Concluiu-se que o fenótipo gengival espesso é mais frequente nos dentes anteriores superiores e que o fenótipo fino é mais comum nos dentes anteriores inferiores, sendo mais frequente em indivíduos do sexo masculino. Os parâmetros largura de mucosa ceratinizada e espessura gengival mostraram-se adequados à determinação do fenótipo gengival.
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Gánti B, Bednarz W, Kőműves K, Vág J. Reproducibility of the PIROP ultrasonic biometer for gingival thickness measurements. J ESTHET RESTOR DENT 2018; 31:263-267. [PMID: 30520211 DOI: 10.1111/jerd.12446] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/10/2018] [Accepted: 10/23/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Gingival thickness (GT) has a great importance in periodontal flap design, gingival recession, and soft tissue esthetic. The aim of this study was to determine the reproducibility of PIROP ultrasonic biometer, which is specially designed for human GT measurements and to compare with the invasive transgingival probing technique. MATERIALS AND METHODS GT was measured in 25 periodontally healthy volunteers both by PIROP and an endodontic spreader on the attached gingiva. Reproducibility was assessed by calculating standrad deviaton (SD) in five repeated measurements and Pearson correlation coefficient (r). Agreement between the two methods was evaluated based on Bland-Altman limits of agreement (LoA). RESULTS No systemic bias in GT was observed between the two methods. The repeatability of the PIROP was better than the spreader method (SD = 0.14 mm vs 0.20 mm, P < 0.001). With five repetitions, the measurement error of the PIROP was halved. The correlation among the repeated observations were strong (r = 0.86) for the ultrasonic, weak (r = 0.34) for the invasive method. The LoA between the two methods was -0.58 to +0.75 mm. CONCLUSION PIROP is a reliable device for GT measurements, but it is recommended to repeat the measurement a few times to improve the precision in individual case. CLINICAL SIGNIFICANCE PIROP ultrasonic biometer could be used in routine practice to reliably measure the GT in noninvasive way. After short learning curve the measurement can be done quickly and conveniently.
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Affiliation(s)
- Bernadett Gánti
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | | | - Karolina Kőműves
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - János Vág
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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Sala L, Alonso-Pérez R, Agustin-Panadero R, Ferreiroa A, Carrillo-de-Albornoz A. Comparative in vitro study of two methods for gingival biotype assessment. J Clin Exp Dent 2018; 10:e858-e863. [PMID: 30386517 PMCID: PMC6203915 DOI: 10.4317/jced.55049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 06/08/2018] [Indexed: 11/05/2022] Open
Abstract
Background The gingival thickness seems to have an important role in different dental treatments. There are different methods of quantifying this thickness, but it is not known which of them can be the most effective. The objective to assess the accuracy of two different methods for gingival thickness measurement: the transgingival needle probing (TGNP) and the tension-free caliper (TFC) in an in vitro model, by comparing them with direct physical measurements (reference standard). Material and Methods Gingival thickness (GT) was evaluated in 27 female pigs with four implant sites 1, 2 and 3mm from the gingival margin with three different methods: 1) transgingival needle probing 2) tension-free caliper and 3) Direct visualization after making a incision in the mucosa and measuring GT with a periodontal probe. Wilcoxon test for paired samples were used with a confident level of 95%. Results A total of 324 points were measured, 59% of the sites presented a thin biotype with DV, it was correctly assessed with the TGNP in 84% of the times and in 86% with the TFC. 41% of the sample presented thick biotype, 76% was the percentage measured with the TGNP and 0% of the sites evaluated with TFC resulted in this biotype. Conclusions Transgingival needle probing constitutes an accurate method when measuring GT at different levels. Tension free caliper is not a good tool for assessing the gingival biotype as long as it is unable to predict thick biotype. Key words:Periodontal Biotype, Gingival Thickness, Periodontal Tissue and Diagnosis.
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Affiliation(s)
- Leticia Sala
- Professor, Department of Periodontology, School of Dentistry, Mississippi Institution of Madrid. Spain
| | - Raquel Alonso-Pérez
- Researcher, Department of Prosthodontics. School of Dentistry, Complutense University of Madrid. Spain
| | - Ruben Agustin-Panadero
- Adjunct professor, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia. Spain
| | - Alberto Ferreiroa
- Associate Professor, Department of Restorative Dentistry and Buccofacial Protheses. School of Dentistry, Complutense University of Madrid. Spain
| | - Ana Carrillo-de-Albornoz
- Associate Professor, Department of Periodontology. School of Dentistry, Complutense University of Madrid. Spain
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