Abstract

BackgroundThe anatomical features of the gingiva and the clinical crowns and their interrelation, especially in aesthetically and functionally demanding areas, are important in complex dental or implant-retained prosthetic rehabilitations. This observational cross-sectional study was designed to evaluate gender- and age-related differences in the width of attached gingiva (WAG), the clinical crown length (CCL), and their interrelation in the anterior teeth to determine the relationship between the pink and white aesthetics.MethodsEighty (54 females, 26 males) fully dentate Caucasian participants between the ages of 20 and 25 years and 36 probands (23 females, 13 males) between the ages of 45 and 55 years were included in the present study. The CCL of the maxillary and mandibular canines, as well as the central incisors of the maxilla and mandible, were determined with a dental sliding caliper measuring from the middle margin of the gingiva at its deepest point to the incisal edge. The clinical investigation of the WAG was performed by inserting a periodontal probe into the gingival sulcus in the middle of the buccal surface to firstly measure the probing pocket depth. The distance between the gingival margin and mucogingival junction (MGJ) was then measured with a Beerendonk sliding caliper in the middle of the labial curvature, and the clinical WAG was determined by subtraction of the measured probing depth. For the statistical analysis, the Mann–Whitney U test, the Wilcoxon-Test, the Spearman’s rank correlation, and a two-factorial non-parametric analysis were used.ResultsThere was no correlation between the CCL and the WAG in a healthy periodontium. Gender influenced the CCL, with men having significantly longer teeth than women in both maxilla (P ≤ 0.01) and mandible (P ≤ 0.05). Age did not influence the CCL significantly neither in the upper (P = 0.06) nor in the lower jaw (P = 0.33). Gender did not show to have a significant influence on the WAG of maxilla (P = 0.69) and mandible (P = 0.26). But differences in the WAG between young and old participants were observed in both upper (P ≤ 0.01) and lower jaw (P ≤ 0.05).ConclusionThe present observational study demonstrated that the mean values of cohorts with mixed age groups and genders should not be considered when attempting to determine the ideal relationships between the pink and white aesthetics since the statistical analyses showed significant differences between different age groups and genders.

Highlights

  • The anatomical features of the gingiva and the clinical crowns and their interrelation, especially in aesthetically and functionally demanding areas, are important in complex dental or implant-retained prosthetic rehabilitations

  • The quotient between clinical crown length (CCL) and width of attached gingiva (WAG) in the maxilla amounted to 3.10 (SD = 3.30) and 4.67 (SD = 3.68) in the mandible. This resulted in a ratio of 1:3 in the maxilla and Discussion The present findings demonstrate that there is no correlation between the CCL and WAG in a healthy periodontium, meaning that physiologically shorter teeth do not correlate with less or more attached gingiva

  • There is no correlation between the CCL and the WAG in a healthy periodontium

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Summary

Introduction

The anatomical features of the gingiva and the clinical crowns and their interrelation, especially in aesthetically and functionally demanding areas, are important in complex dental or implant-retained prosthetic rehabilitations. An optimum harmonization of the white and pink aesthetics is essential for an aesthetic outcome [1] and is known to influence the social attractiveness of individuals [2] In this context, the “white aesthetic” describes the natural dentition or the restoration of dental hard tissue with suitable materials, whereas the “pink aesthetic” refers to the soft tissue surrounding the teeth, which includes the gingiva and the interdental papilla [3]. Intra- and inter-individual variations exist, with many features of pink aesthetics are genetically defined and have become the subject of considerable interest from therapeutic and epidemiological points of view [5, 6]

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