Gingival biotype revisited-novel classification and assessment tool.

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To evaluate the relationship between gingival biotypes and gingival thickness based on probe transparency through the gingival margin and to assess the sensitivity of a novel classification method. Sixty adult Caucasian subjects were stratified by their gingival biotype (GB) as defined by the transparency of a prototype double-ended periodontal probe through the buccal gingival margin into "thin" (30 subjects), "moderate" (15 subjects), and "thick" (15 subjects) GB. Three additional parameters were also assessed: gingival thickness (GT), probing depth (PD), and gingival width (GW). Median GT was 0.43mm (P 25% 0.32; P 75% 0.58) for thin, 0.74mm (P 25% 0.58; P 75% 0.81) for moderate, and 0.83mm (P 25% 0.74; P 75% 0.95) for thick GB, respectively. GT was statistically significant different for thin versus moderate and thin versus thick, respectively (Kruskal-Wallis test, p<0.05; Dunn's test, thin versus moderate: p=0.002; thin versus thick: p<0.001; moderate versus thick: p=0.089). GW was directly correlated with GT (Spearman correlation p<0.01). The sensitivity of the new classification tool for diagnosing a thin GB was 91.3%. No adverse events or complications were reported. GT differs significantly between the presented GB groups, hence, an alternative classification especially focusing on thin biotypes based on a modified periodontal probe might be advantageous. In addition, the presence of a thick gingiva is associated with a wide band of keratinized tissue. This clinical setting might to be useful to identify high-risk patients with a very thin biotype and, consequently, higher risk for gingival recession after dental treatments.