Assessment of Gingival Biotypes in Patients Visiting a Tertiary Care Centre in Eastern Nepal

Evaluation of Gingival Phenotype in the Early Transitional Dentition Phase in Children-Comparison of Three Non-Invasive Methods

Gingival phenotype (GP) is determined based on the thickness and width of the gingival tissue. An evaluation of GP is essential for adequate treatment planning and outcome monitoring, including orthodontic treatments in a paediatric population. The present study aimed to compare the reliability of the visual and TRAN methods with that of the ultrasound biometer measurements in the early transitional dentition phase. One hundred ninety three generally healthy, 7-year-old children were examined. An assessment of GP was performed by a paedodontist and a periodontist. The average thickness of the gingiva was 0.76 ± 0.36 mm, which was classified as a thin GP. The agreement between a visual assessment and the biometric ultrasound measurements reached the highest (94%) level when assessing a very thin GP (Spearman's rank correlation coefficient r = 0.37, p < 0.01). Similarly, 99% agreement in the diagnosis of a thin GP was recorded for the TRAN and ultrasound methods (Spearman's rank correlation coefficient r = 0.49, p < 0.001). In total, 86% of cases diagnosed as having a thick GP using the TRAN method turned out to be thin according to the ultrasound measurements. The dentist's specialization and professional experience in the assessment of GP were irrelevant (Spearman's rank correlation coefficient r = 0.49, p < 0.001). All methods tested in the present study were proven to be easy to perform and well accepted by the children. The visual assessment and TRAN methods, despite the fact that they enabled the diagnosis of a thin GP (crucial for treatment planning), cannot be recommended during the teeth replacement period. A misdiagnosis of thick GP may deprive a young at-risk patient of special supervision, which may develop into mucogingival deformities. A biometric ultrasound, although expensive, allows for reliable assessment of the gingiva thickness when needed.

Effect of the implant-supported provisional restoration on the accuracy of digital peri-implant mucosa replication - a clinical study

OBJECTIVE

This study aimed to quantitatively evaluate the effect of implant-supported provisional restorations (ISPRs) on the accuracy of the intraoral scanned peri-implant soft-tissue profile in the esthetic area.

MATERIALS AND METHODS

Sixteen patients with a single ISPR in the maxillary central incisor's region were recruited for this study. Three impression methods were sequentially used in each patient: (1) an intraoral scanning (IOS) with the ISPR, (2) a conventional impression using the ISPR as impression coping, and (3) a routine IOS without the ISPR. The stereolithography files of the three impression methods obtained from the same patient were superimposed, and the conventional impression method was used as the reference model. Two-dimensional (2D) and three-dimensional (3D) analyses were performed to measure the peri-implant soft-tissue deviation between the reference models and IOS from the groups with or without the ISPR, respectively. Data were presented as the means ± standard deviations. Two-way analyses of variance with post hoc Sidak's multiple comparisons and paired t-tests were performed for 2D and 3D analyses, respectively. The significance level was set at p<0.05.

RESULTS

The peri-implant mucosa without the ISPR immediately collapsed (<20 s), particularly on the palatine side of the labial mucosa and labial side of the palatine mucosa. Consequently, the IOS without the ISPR led to 414.7±116.0 μm of overall dimensional deformation in the cuff-like submucosal region, which was significantly larger (p<0.0001) than that in the IOS with the ISPR (230.6±85.5 μm).

CONCLUSION

ISPRs are important for accurate replication of the intraorally scanned peri-implant soft-tissue profile.