Gingival Biotype Research Articles

Association of hard and soft tissue factors with gingival recession in orthodontically treated patients: A retrospective study

Orthodontic treatment is thought as a contributory factor in the development of recession. The objective of this study was to determine the factors associated with a gingival recession in patients who underwent orthodontic mechano-therapy. A retrospective chart review of 72 post-orthodontic cases done at the dental clinics of Aga Khan University hospital that were treated from 2009 to 2017. After evaluating dental records patients were recruited based on inclusion and exclusion criteria. Patients were divided into two groups based on the presence or absence of gingival recession on posttreatment photographs. Patients in each group were further assessed on the following factors: (1) Lower incisor inclination (IMPA). (2) Tissue thickness on the facio-lingual dimension. (3) Alveolar bone height. (4) Alveolar bone thickness. The mean age of patients at the start of treatment was 16.56±5.66years. Gingival recession was found in 40.3% of our patients while 59.7% of patients had no recession found after orthodontic treatment. Univariable logistic regression was applied for factors associated with a gingival recession following orthodontic treatment which showed that the odds ratio of gingival recession in thin gingival biotype are 14.4 times more than in thick gingival biotype. Multivariable regression analysis showed that the cases had 10.2 times more recession in thin biotype than those in the thick gingival biotype while adjusting for pre- and posttreatment alveolar heights following orthodontic treatment and with a confidence interval [95% CI=2.69 to 38.40]. It was concluded from this study that 40% of patients developed gingival recession in one or more teeth during orthodontic treatment. Among different factors pre-treatment, gingival biotype of patients and male gender were the factors that were more associated with the development of gingival recession.

Prefabricated zirconia Post; an esthetic option as foundation restoration for ceramic crowns: an in vivo study

Background: The choice of restoring endodontically treated anterior teeth is guided by strength and esthetics. The ultimate shade of post and core definitely affects the translucent ceramic crown systems, which is a matter of concern. The colour of the underlying core influences the definitive esthetic result especially for a highly translucent ceramic crown with a thickness of less than 1.6 mm. In case of a thin gingival biotype the cast posts may also create root discoloration and a blue-gray effect. The gold posts, which is considered as gold standard, exhibit a dull bluish hue and give an unnatural appearance. The utilization of a dissimilar material for post and core buildup often results in failure due to separation between the post and core. When the core and the foundation restoration is of ceramic, post based on ceramic material would ensure better success. The prefabricated zirconia posts are one of the novel alternatives to gold post. Purpose: The mechanical advantage together with the aesthetic gain over the conventional materials has made zirconia the state of art option available for usage in the present day. Materials and Methods: There are only few relative studies, which have reported on aesthetic, clinical survival and patient reported events of endodontically treated teeth with zirconia post. Hence this clinical study is undertaken to evaluate the acceptability of prefabricated zirconia post used in endodontically treated teeth especially in the anterior region with the foundation restoration being all ceramic restorations. Results: Zirconia post is a more aesthetic alternative to fiber post especially in patients with gummy smile and thin biotype with all-ceramic crown to optimize the esthetic effect at the root and maintaining an adequate level of strength. Conclusion: In esthetic zone prefabricated zirconia post is a more simple and viable option to conventional post giving a monoblock (one piece) design. Keywords: Ceramic post, Esthetic post,

Distribution of Gingival Biotypes of Anterior Teeth in Egyptian Adults with Skeletal Class II and Skeletal Class III Jaw Relations and Different Vertical Facial Patterns: A Cross-Sectional Study

Distribution of Gingival Biotypes of Anterior Teeth in Egyptian Adults with Skeletal Class II and Skeletal Class III Jaw Relations and Different Vertical Facial Patterns: A Cross-Sectional Study

Immediate implant placement with or without connective tissue graft: A systematic review and meta-analysis.

To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect following single immediate implant placement (IIP). Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, EMBASE and Cochrane databases as well as a manual search to identify eligible clinical studies up to January 2020. Randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow-up of at least 12months were included for a qualitative analysis. Meta-analyses were performed on data provided by RCTs. Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow-up ranging from 12 to 108months. Only 1 RCT showed low risk of bias. Meta-analysis revealed a significant difference in terms of vertical mid-facial soft tissue change between IIP + CTG and IIP pointing to 0.41mm (95% CI [0.21; 0.61], p<.001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1mm asymmetry in mid-facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p=.002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [-35%; 1%], p=.06). Meta-analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid-facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made. CTG contributes to mid-facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid-facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5mm buccal bone thickness).

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

Evaluation of gingival biotype has become a routine procedure in periodontal examination because the type of gingival biotype can positively or negatively affect the outcome of periodontal, restorative, orthodontic and implant therapy. The aim of the study was to assess the proportion of types of gingival biotypes in patients visiting a tertiary care center in eastern Nepal. Two hundred and fifty patients between 25 to 45 years attending the Periodontology and Oral Implantology were assessed. Gingival biotype of the patents was determined with Probe Transparency technique Results: Out 250 patients assessed, 73 patients (approximately 29.2 %) had thin gingival biotype and remaining 177 patients (approximately 70.8 %) had thick gingival biotype. The number of the male with thin biotype was 31 whereas the number of the male with thick biotype was 82. Similarly, out of 137 female, 42 had thin biotype and remaining 95 female had thick biotype. The types of biotypes were not associated with gender (p=0.67). Thicker gingival biotype was the more common type of gingival biotype in patients attending the tertiary care center of Eastern Nepal. The occurrence of thick gingival biotype was more common in Adivasi Janajati ethnic community compared to Brahmin / Chhetri ethnic community.

Evaluation of Gingival Displacement with Aluminum Chloride and Naphazoline Hydrochloride: A Randomized Controlled Trial.

The objective of this study was to evaluate the use of naphazoline hydrochloride in comparison with aluminum chloride for vertical gingival displacement. The inclusion criteria were: patients with a good general systemic condition; periodontal health; and thick gingival biotype. Moreover, the exclusion criteria were: smoking individuals; canine teeth or central incisors with carious lesions, abrasion, erosion, prosthetic abutments or unsatisfactory restorations; patients with periodontal disease; and users of continuous medication. 72 teeth were included and the Square Block Design was used to randomize the samples. Three measures were obtained from each tooth, and mean vertical gingival displacement was calculated. A descriptive analysis of the average displacement was performed. The normality test used was the Lilliefors' Test and for comparison between treatments, the Kruskal-Wallis Test was used. The Bartlett's Test for homogeneity of variances was used and a 5% (p ⟨ 0.05) significant level was considered. Thus, the Aluminum Chloride and Naphazoline Hydrochloride showed no statistically amount of gingival retraction than the control group (p = 0.3822). The average of gingival vertical displacement in all groups were less than 0,5 mm. The technique used did not allow any amount of horizontal displacement on obtained models.

A 10‐year prospective study on single immediate implants

Aim To evaluate the clinical, aesthetic and radiographical outcome of single immediate implant placement (IIP) after 10 years (a) and to identify putative risk factors for advanced mid-facial recession (b). Material and methods Periodontally healthy patients with a thick gingival biotype and intact buccal bone wall were consecutively treated with a single immediate implant and crown in the aesthetic zone (15-25). Flapless surgery and socket grafting with deproteinized bovine bone mineral were performed. Seven patients received a connective tissue graft (CTG) at 3 months due to obvious alveolar process deficiency (n = 5) or advanced mid-facial recession (n = 2). Clinical, aesthetic and radiographical outcomes at 10 years were compared to those at 5 years and CBCTs were taken at 10 years. Results Twenty-two patients (10 women; mean age 50) were consecutively treated and 18 could be re-examined. Two implants failed and two patients died. None of the parameters differed between the 5- and 10-year re-assessment (marginal bone loss: 0.31 mm; plaque score: 15%; probing depth: 3.4 mm; bleeding on probing: 32%; pink aesthetic score: 10.61; mesial papillary recession: -0.03 mm; distal papillary recession: 0.22 mm; mid-facial recession: 0.58 mm). Six implants (33%) demonstrated ≥1 mm mid-facial recession. Putative risk factors were merely based on descriptive statistics and included buccal shoulder position, no CTG, convex emergence profile and central incisor position. Three implants (17%) had no visible buccal bone on CBCT. One of these was too buccally positioned, another yielded peri-implant mucositis and another demonstrated peri-implantitis. Conclusions Advanced mid-facial recession is common in the long term following IIP. Therefore, caution is required for IIP in the aesthetic zone.

Clinical Evaluation of platelet rich fibrin versus subepithelial connective tissue graft, for soft tissue augmentation around implant in the aesthetic zone: A randomized control clinical trial.

Background: the current study investigated platelet rich fibrin and subepithelial connective tissue graft in preserving crestal bone and soft tissue around delayed implants. Methods: Twelve participants with thin gingival biotype, were randomly assigned in two equal parallel groups. Both received delayed implant, augmented by subepithelial connective tissue graft versus platelet rich fibrin. Crestal bone level was measured at 3, 6 and 9 months. Gingival thickness and keratinized tissue width were measured at baseline, 3 and 6 months, pink esthetic score at 6 months, pain, swelling and patient satisfaction were reported after 7 days and at the end of the follow up period respectively. Results: Both groups showed statistically significant improvement in all clinical outcomes at 3 and 6 months with no statistically significant difference at different observational periods. Subepithelial connective tissue graft showed statistically significant increase in gingival thickness and pink esthetic score compared to platelet rich fibrin after 6 months with no statistically significant difference regarding the crestal bone loss, keratinized tissue width, postoperative pain, swelling and overall patient satisfaction between both groups. Conclusion: Inspite that PRF showed less values of crestal bone loss yet both treatment modalities could not prevent the postsurgical crestal bone loss to occur, with no statistically significant difference between them. Subepithelial connective tissue graft is effective at increasing the gingival thickness around delayed implants. Clinical relevance: Both treatment modalities could be used safely around dental implant. Subepithelial connective tissue graft is more effective in thin phenotype for augmenting gingival thickness.

Rehabilitation Challenge in Patient With a High Smile Line: Case Report and Review of Surgical Protocols

Defects in the maxillary anterior teeth are delicate and difficult to solve because of the esthetic, functional, and psychological impairment that may arise if the rehabilitation treatment does not return the damaged tissues to the naturalness. Esthetic predictability and reduced surgical interventions are some great reasons to simplify dental treatments. During the presurgical evaluation, the clinician should review the implant esthetic risk profile, considering the patient's smile line, the esthetic demands, the hard and soft tissue thickness and width, and the gingival biotype. Thus, achieving long-term esthetic results initiates with a detailed case planning before surgical intervention. The present report described a complex esthetic clinical case involving teeth and dental implant related to a high smile line. The clinical case was solved through immediate implant placement and immediate loading using a personalized prosthetic abutment and finalized with the installation of metal-free prosthetic restorations. The use of a personalized prosthetic abutment helped to achieve a better emergence of the prosthesis under the periodontal tissues. Although it was a challenging esthetic case, especially because of the high smile line, the result was a natural smile while the adjacent soft tissues maintained their esthetics and health.

Gingival Biotype- It’s Significance in Dentistry

This review provides an overview about gingival biotype, its characteristics and various methods availablefor its determination. In recent years, gingival biotype has become a subject of considerable interest inthe era of esthetic-driven dentistry. Gingival biotype is a genetically determined trait that describes thefaciopalatal thickness of gingiva. Various methods for measuring biotype have been suggested. Routinedental procedures subject the gingiva to various insults and the biotypes behave differently to it. Therefore,gingival biotype can provide clinicians with an insight into the precautions that are necessary during tissuehandling to avoid undesirable treatment outcomes.

A 10-year prospective study on single immediate implants.

To evaluate the clinical, aesthetic and radiographical outcome of single immediate implant placement (IIP) after 10years (a) and to identify putative risk factors for advanced mid-facial recession (b). Periodontally healthy patients with a thick gingival biotype and intact buccal bone wall were consecutively treated with a single immediate implant and crown in the aesthetic zone (15-25). Flapless surgery and socket grafting with deproteinized bovine bone mineral were performed. Seven patients received a connective tissue graft (CTG) at 3months due to obvious alveolar process deficiency (n=5) or advanced mid-facial recession (n=2). Clinical, aesthetic and radiographical outcomes at 10years were compared to those at 5years and CBCTs were taken at 10years. Twenty-two patients (10 women; mean age 50) were consecutively treated and 18 could be re-examined. Two implants failed and two patients died. None of the parameters differed between the 5- and 10-year re-assessment (marginal bone loss: 0.31mm; plaque score: 15%; probing depth: 3.4mm; bleeding on probing: 32%; pink aesthetic score: 10.61; mesial papillary recession: -0.03mm; distal papillary recession: 0.22mm; mid-facial recession: 0.58mm). Six implants (33%) demonstrated ≥1mm mid-facial recession. Putative risk factors were merely based on descriptive statistics and included buccal shoulder position, no CTG, convex emergence profile and central incisor position. Three implants (17%) had no visible buccal bone on CBCT. One of these was too buccally positioned, another yielded peri-implant mucositis and another demonstrated peri-implantitis. Advanced mid-facial recession is common in the long term following IIP. Therefore, caution is required for IIP in the aesthetic zone.

Factors Affecting Soft and Hard Tissues Around Two-Piece Transmucosal Implants: A 3-Year Prospective Cohort Study.

This 3-year study aimed to evaluate hard and soft tissue modification around a two-piece implant characterized by a transmucosal hyperbolic neck in healthy consecutive patients with a need for single-tooth replacement. Two-piece implants (n = 66) were placed with a flapless technique in 56 patients (27 men; 29 women; mean age 55 ± 9 years): 16 immediately after root extraction (immediate group), 20 after 8 to 12 weeks (early group), and 30 after 10 or more months (delayed group). The transmucosal hyperbolic neck was exposed 1 to 1.5 mm above gingival level. Customized abutments were positioned 3 months later with the implant-abutment connection located approximately 1 to 1.5 mm above soft tissue level. Provisional cemented resin crowns were designed with the finishing line at the hyperbolic neck and then positioned to avoid excessive compression of soft tissue, to guide gingival contours. Twenty days later, a definitive metal-ceramic crown was cemented. In all patients, the gingival biotype (thin or thick) was also evaluated. The primary outcomes were as follows: 36-month implant survival rate, peri-implant marginal bone level (MBL, in mm) changes observed in single-blind on radiographs at 1, 3, 6, 12, 24, and 36 months (T1, T3, T6, T12, T24, and T36), and pink esthetic score (PES) at T6, T12, and T36 to analyze soft tissue adaptation after loading and crown application. The secondary outcomes were as follows: plaque score and bleeding on probing (BOP). Linear regression models and multilevel mixed logistic regression were used to detect any statistical difference of MBL according to operative parameters. Kruskal-Wallis one-way analysis of variance (ANOVA) on ranks was performed to assess statistical differences of PES at T6, T12, and T36. The survival rate was 100%. The dropout rate was 1.79%. No infections, mucositis, or peri-implantitis were reported. Implants placed in thick-biotype tissues showed a statistically different lower bone loss at 36 months with respect to the thin biotype (P < .05). At 36 months, the early group showed lower bone loss compared with the delayed group (P < .05). Multilevel mixed logistic regression revealed that gingival biotype was the parameter that was most related to MBL variations (P = .025). The PES value (mean ± SD) at T6 was 10.76 ± 1.19 (median: 11; range: 8 to 13; IQR: 10 to 12). The values statistically increased at T12 and T36, where the mean values were 11.76 ± 1.10 (median: 12; range: 9 to 13; IQR: 11 to 12) and 11.83 ± 1.03 (median: 12; range: 9 to 14; IQR: 11 to 13). MBL and soft tissue clinical parameters measured around two-piece hyperbolic-neck implants were stable during the 3-year follow-up and free from complications. The exposure of the hyperbolic neck for 1.0 to 1.5 mm allowed a flapless one-stage surgery, which supported fast adaptation of the soft tissues, evidenced by high PES values and low percentages of BOP. The results from the study imply a new simple approach in the clinical management of gingival and bone tissue.

Gingival Biotype and Its Relationship With the Maxillary Membrane and Lateral Wall Thickness.

The purpose of this study was to analyze the risk of the maxillary sinus lift technique and the correlation between the thickness of the gingiva, maxillary sinus membrane, and the maxillary sinus lateral wall. Cone-beam computerized tomograhy (CBCT) records of 32 adult dentate patients (10 male/22 female) were analyzed. The gingival thickness records of the dental units were compared with the thickness measurements of the membrane and lateral wall of the maxillary sinus. The gingival biotypes varied between 1.1 mm (thin) and 1.6 mm (thick), with a small association with sex. The thickness of the sinus membrane presented a small association between sexes (0.2 mm, female/0.3 mm, male) and gingival biotypes (Cohen d = .52). The lateral wall presented a weak association between the biotypes (1.3 mm, thin/1.1 mm, thick). There was also no correlation between the membrane and lateral wall (r = -.22). The volume dimension related to the graft area of the sinus was 4 mm3 for men and 5 mm3 for women. There was a weak correlation of gingival thickness compared with membrane thickness and lateral wall of the sinus (r = .304/r = -.31). Gingival thickness does not appear to be a reliable thickness predictor of the membrane or lateral wall of the maxillary sinus. The analysis of maxillary sinus anatomical structures through CBCT is the most reliable technique to identify the thickness of the membrane and lateral wall of the maxillary sinus before surgery. We believe that new studies are necessary to confirm our findings.

Measurement and clinical significance of gingival biotype in anterior teeth

Abstract:The morphological characteristics of periodontal tissue and tooth tissue in gingival biotype are one of the indicators reflecting the individual differences of periodontal tissue in patients. Gingival biotypes of anterior teeth are often related to the prognosis of smile aesthetic treatment, which is one of the reference indexes for predicting the success rate of aesthetic treatment such as restoration, implant, periodontal, orthodontic and so on. Gingival biotypes have individual differences, so different gingival biotypes have different responses to different external stimuli. In the current clinical work, the correct evaluation of gingival biotype, especially the accurate measurement of gingival thickness, is the basis of reasonable choice of treatment and prognosis evaluation.

Periodontal biotype: anatomic features and association with surrounding tissue

The high prevalence of periodontal diseases, up to 90%, is an important issue in medicine. The periodontal biotype is one of the most important parameters that determine the course and prognosis of periodontal diseases. Gingival thickness, keratinized tissue, and bone morphology are the main characteristics of the periodontal biotype. This article presents a review of the literature on the characteristics of periodontal biotypes, their response to treatment, and treatment prognosis. A search of electronic databases (Medline, EMBASE, CyberLeninka, Elibrary, and RINC) was performed for the literature review. The article also presents studies about relationships among periodontal biotype, recession, and malocclusion. The thin biotype is a predictive factor of gingival recession. Recessions are characterized by apical migration of marginal gingiva and defects in root coverage. Gingival recession may result from orthodontic movement of teeth, particularly among patients with the thin gingival biotype. The thin and thick biotypes respond differently to inflammation, restorative and surgical effects, and parafunctional habits. A gingival thickness greater than 2 mm can be categorized as the thick biotype and less than 1,5 mm as the thin biotype. Gingival thickness can affect the results of restorative therapy and root coverage procedures. It is necessary to determine the gingival biotype before initiating treatment. Special care must be taken when planning treatment for cases with a thin biotype.

Assessment of oro-dental manifestations in a series of acromegalic patients, the AcroDent study.

Objective:The dental and periodontal impact of GH/IGF-1 hypersecretion has been poorly investigated until now. Our aim is to precisely describe the oro-dental state of acromegalic patients and to study the impact of GH/IGF-1 hypersecretion on patients’ reported oral health-related quality of life (OHRQoL).Methods:After collecting characteristics of their disease, acromegalic patients answered the GOHAI questionnaire assessing their OHRQoL, the AcroQoL questionnaire and then benefited from a complete stomatological and radiological examination (orthopantomogram systematically, retro-alveolar radiography or Cone Beam CT if necessary).Results:In total, 29 patients aged 59.1 ± 16.0 years were included. The average DMFT index (sum of Decayed, Missing and Filled Teeth per patient) was 19.0 ± 7.8. 16/29 patients had a gingivitis and 18/29 a mild to moderate chronic periodontitis, but no case of severe chronic periodontitis was found, probably because the frequency of a protective thick gingival biotype was increased (9/29). No case of generalized gingival hypertrophy or diffuse hypercementosis was observed. According to the Add-GOHAI score, only 8/26 patients had a satisfactory OHRQoL. This parameter was correlated to the acromegaly-specific quality of life according to the AcroQoL score. Interestingly, 11/29 patients had bulky oral bony outgrowths (OBO), such as large maxillary or mandibular tori and multiple vestibular exostosis.Conclusions:The unsatisfactory OHRQoL reported by acromegalic patients contrasts with a rather good objective oro-dental state and annual oral examination seems relevant in this population. Finally, we report that huge OBO could be helpful signposts for the diagnosis of acromegaly.

Gingival Phenotypes Amongst Male Dental Students at Kulliyyah of Dentistry, IIUM, Malaysia

The aim of the present study was to investigate the periodontal phenotypes among young Malay males with different gingival biotypes. Forty-seven systemically and periodontally healthy young Malay males participated in this study, where 25.5% were diagnosed with thin gingival biotype and 74.5% of thick biotype. The periodontal phenotypes were measured through clinical parameters presented by the gingival thickness (GT), gingival width (GW), papilla height (PH), and crown width/crown length ratio (CW/CL). Three clusters were identified through K-means cluster ing analysis based on the parameters of the periodontal phenotypes. Cluster 1 represents narrow crown form and the average CW/CL, GW, PH and PD were 0.69, 2.92, 4.55 and 2.16 mm, respectively. Cluster 2 displayed an average of 0.76, 4.29, 4.96 and 2.14 mm for CW/CL, GW, PH and PD, respectively. Cluster 3 represents wide crown form and the average displayed for CW/CL, GW, PH and PD were 0.80, 4.85, 3.73 and 2.23 mm, respectively. There were significant differences between the three clusters (p&lt;0.05) with respect to the GW, PH and CW/CL. This study demonstrates the difference in gingival phenotypes between young Malay males. The GW has a signiϑicant positive linear correlation (p&gt;&lt;0.05) with CW/CL and negatively correlated with PH.&gt;&lt;0.05) with respect to the GW, PH and CW/CL. This study demonstrates the difference in gingival phenotypes between young Malay males. The GW has a significant positive linear correlation (p&lt;0.05) with CW/CL and negatively correlated with PH.&gt;&lt;0.05) with CW/CL and negatively correlated with PH.

Research progress of the influence of gingival biotype on the prognosis of oral treatment

The gingival biotypes, which were proposed by Ochsenbein, could be divided into thin gingival biotype and thick gingival biotype. There are several methods to judge the gingival biotypes, such as visual methods, periodontal probe transparency and cone-beam CT. Each method has its own characteristics. The gingival biotype is affected by a variety of factors, such as age, gender, crown shape, interdental papillary height, alveolar bone thickness and alveolar bone morphology. In the anterior region, different gingival biotype has different effects on oral aesthetics, and different gingival biotype also has different effects on the prognosis of periodontal, orthodontic and implant treatment. This article mainly reviews the influence of gingival biotype on the prognosis of oral treatment.

КЛИНИКО-РЕНТГЕНОЛОГИЧЕСКИЕ ОСОБЕННОСТИ ТКАНЕЙ ПАРОДОНТА У ПАЦИЕНТОВ С РЕЦЕССИЕЙ ДЕСНЫ

Subject. Gingival recession refers to a form of periodontal disease, which is characterized by a decrease in the free gum without signs of chronic inflammation in the apical direction of the gum and periodontal tissues.&#x0D; The goal is to determine the clinical and radiological features of periodontal tissues in patients with gum recession.&#x0D; Methodology. A comprehensive diagnostic examination was conducted according to a specially developed algorithm of 47 patients aged 20 to 45 years old with a diagnosis of gum recession, which included the collection of anamnestic data, special questionnaires, clinical, radiological and ultrasound examinations of periodontal tissues.&#x0D; Results. According to clinical and radiological data, the diagnosis of gum recession was confirmed in all patients: in 31 (62 %) ― Miller's class I gum recession, in 11 (25 %) ― II, in 5 (11 %) ― III and in 1 (2 %) ― IV. The dependence of the gum recession on the quality of oral hygiene was determined: with satisfactory oral hygiene (OHI-S &lt;2.6), the depth of the gum recession was 1-1.5 mm, with poor (OHI-S&gt; 2.6) ― more than 1,5 mm. In 14 (42.8 %) patients, a concomitant diagnosis of chronic generalized catarrhal gingivitis was established, in 57.2 % of patients with chronic generalized periodontitis. Of the total number of patients, a thin biotype was determined in 30 (63.8 %) patients, and a thick biotype was identified in 17 (36.2 %). A combination of a thin biotype with a small vestibule of the oral cavity, the presence of anomalies of the frenum and strands of the mucous membrane in 23.4 % was revealed.&#x0D; Conclusions. Miller class I gingival recessions have the highest frequency of occurrence (62 %). The ultrasonic research method allowed non-invasive determination of the gingival biotype and gum thickness. A thin biotype of the gum was diagnosed in 63.8 % of patients, which must be taken into account when planning surgical treatment.

Gingival thickness assessment of gingival recession teeth

To evaluate the gingival thickness and gingival biotype of gingival recession teeth of Chinese population. A total of 112 non-molar teeth with gingival recession in 34 patients were included. Direct measurement, cone-beam computerized tomography (CBCT) measurement and periodontal probe method were used to evaluate gingival thickness and biotype. Gingival thickness was measured at 2 mm apical to the gingival margin. Direct measurement was performed with a caliper of 0.01 mm resolution and anesthesia needles attached to silicone disk stops. Gingival biotype was assessed by sulcus probing, if the periodontal probe was visible through the gingival tissue, the gingival biotype was thin; If not visible, the gingival biotype was thick. The differences of gingival thickness among different gingival biotype, tooth site and gingival recession type were analyzed respectively. Besides, the results of CBCT measurement was analyzed compared with the direct measurement. The average gingival thickness of non-molar recession teeth was (1.17±0.41) mm. The average gingival thickness of thick and thin biotype group were (1.38±0.4) mm and (0.97±0.30) mm, respectively, with statistically significant difference (P<0.001). The median of gingival thickness was 1.1 mm. Using 1.1 mm as the cut-off value of thick and thin gingival thickness group, the results matched well with the gingival biotype classification results by periodontal probe method (P=1.000). The average gingival thickness of maxillary teeth was significantly thicker than that of the mandibular teeth. They were (1.39±3.44) mm and (1.01±0.31) mm, respectively (P<0.001). The mean gingival thickness of MillerI, II and III degree gingival recession teeth were (1.15±0.34) mm, (0.83±0.17) mm and (1.26±0.56) mm, respectively, without statistically significant difference (P=0.205). The gingival thickness measurement results between CBCT method and direct measurement were without statistically significant difference (P=0.206). In the non-molar gingival recession teeth, the cut-off value of gingival thickness to classify thick and thin biotype of Chinese population was 1.1 mm. The average gingival thickness of the maxillary teeth was significantly thicker than that of the mandibular teeth. Besides, CBCT measurement was an accuracy method for evaluating facial gingival thickness.