An assessment of different gingival biotypes in individuals with varying forms of maxillary central incisors and canines: A hospital-based study

Abstract

Introduction: The gingival morphology plays an important role in determining the final esthetic outcome. Different gingival biotypes respond differently to inflammation, restorative, trauma, and parafunctional habits. Some gingival features are influenced by tooth shape, position, and size, as well as gender and age. The thick biotype is more resistant to gingival recession and thin gingival biotype is more prone to recession, bleeding, and inflammation. Methods: A total of 220 patients of the age group of 20–50 years with well-aligned dentition and healthy gingival tissues, who agreed to be a subject of the study were included. Gingival biotype (GT) was assessed by a single examiner. Crown width/crown length ratio (CW/CL) of both central incisors and canines was determined according to Olsson and Lindhe. Gingival biotype was evaluated and categorized into thick or thin. Papillary Height (PH) was calculated as the distance from the top of the papilla to a line connecting the midfacial soft tissue margin of the two adjacent teeth, and the mean value was calculated. Results: In this study, 103 males and 117 females had participated. CW/CL ratio of the maxillary central incisors and canines, respectively, was 0.80 and 0.82 in males and 0.82 and 0.79 in females. Males had a short, wide form while females had long, narrow form. Thicker gingival biotype was more common in males. 71.84% of subjects with short, wide tooth form of maxillary central incisors had a thick and 28.16% had thin gingival biotype, whereas 48.72% of long, narrow tooth form of central incisors had thick and 51.28% had thin gingival biotype. Thick gingival biotype (62.20%) was more prevalent in young age group. The mean PH was 4.51 mm in males and 4.04 mm in females. Discussion: The determination of thickness of the gingival tissue plays an important role in treatment planning process for orthodontics, root coverage, extractions, and implant placement, especially in the maxillary anterior area. GT is assessed by an invasive and a noninvasive method. Many studies have emphasized the findings that the thicker biotype prevents mucosal recession, hides the restorative margins, and camouflages the titanium implant shadows. It also prevents biological seal around implants, thus reducing the crestal bone resorption. Conclusion: Our study confirmed that the thicker gingival biotype is more prevalent in males and is associated with short, wider form of teeth while thinner scalloped biotype is more common in females and is associated with long, narrow tooth form. Thick flat biotype is seen in younger individuals while thin scalloped gingival biotype in older age. Decrease in PH is observed with thin biotype.