Thin Biotype Research Articles

Esthetic Outcomes of Immediately Placed Implants with Convergent Transmucosal Profile: A Retrospective Single-Cohort Study.

Purpose: Immediate implant placement is a reliable solution to replace hopeless teeth, but this procedure may be associated to an increased risk of soft tissue complications in case of thin biotype. The use of tissue-level implants with a convergent transmucosal profile has been advocated to increase space for soft tissue, contributing to improve their stability and esthetics. The aim of this retrospective study was to evaluate the esthetic outcomes and the Patient-Reported Outcome Measures (PROMs) of immediately placed implants with a convergent transmucosal profile. Materials and methods: This single-cohort, monocentric, retrospective clinical study was conducted on patients treated with an immediately placed implant in the esthetic zone (from premolar to premolar). All the eligible patients were recalled for a clinical and radiographic follow-up visit. Results: This study included 20 patients (8 males, 12 females) with an average age of 55.5± 6.8 years, who received 20 implants, with a mean follow-up of 46.5± 15.3 months. At the time of follow-up, immediately placed implants showed a mean Marginal Bone Loss of 0.42± 0.49 mm, and a statistically significant improvement of the esthetic parameters from baseline to the last available follow-up; in particular, Pink and White esthetic scores (p=.001) and Papilla Index at mesial and distal sites (p<.001). All the patients reported a high satisfaction (VAS>9) both from esthetic and functional point of view. Conclusion: Immediately placed implants with convergent transmucosal profile in the esthetic zone showed good clinical and esthetic outcomes, with stable results over time.

Peri-implant phenotype, calprotectin and MMP-8 levels in cases diagnosed with peri-implant disease

ObjectivesThe purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of non-surgical mechanical treatment (NSMT), along with calprotectin (CLP) and MMP-8(matrix metalloproteinase-8) levels.Materials and methods77 implants from 39 patients were included. The implants were categorized Group-1(peri-implant mucositis), Group-2(peri-implantitis).Baseline (0. Month-PrT) clinical parameters (PD, GI, PI, BOP, CAL) and radiographic bone loss were documented, and peri-implant crevicular fluid (PICF) samples were collected. Various intruments and methodologies were employed to assess PPh components (mucosa thickness, supracrestal tissue height, keratinized mucosa) and peri-implant attached mucosa (AM). NSMT was applied to diseased implant sites. All clinical parameters were reassessed again by taking PICF samples at the 6th month-after treatment (PT). In PICF samples obtained from both groups, MMP-8 and CLP levels were evaluated using the ELISA test.ResultsPrT-PD,PrT-GI,PrT-CAL and PrT-BOP percentage values in Group-2 were significantly higher than Group-1.PrT-PD,PrTPI scores are significantly higher in thin biotype implants. All components of the PPh and AM were significantly lower in thin biotype. Intra-group time-dependent changes of MMP-8 and CLP were significant in both groups (p < 0.05). When the relationship between thin and thick biotype and biochemical parameters was evaluated, the change in PrT-PT didn’t show a significant difference (p > 0.05).ConclusionsPPh plays a role in influencing the severity of peri-implant diseases. However, the impact of phenotype on NSMT outcomes was similar in both groups.Clinical relevanceThe PPh should be considered when planning implant surgery.

Altered Passive Eruption among Patients Visiting Dental Outpatient Department in a Tertiary Care Center: A Descriptive Cross-sectional Study.

The eruption of teeth is considered to be a continuous phenomenon. Two types of eruption are possible namely, active and passive eruption. Failure in passive eruption (by the apical movement of gingiva from the enamel surface) generally results in a clinical condition known as altered passive eruption. It can result in the shortened crown height of a tooth and an esthetically unpleasant situation i.e., excessive gingival display or gummy smile. The main motto of this study was to find out the prevalence of altered passive eruption and associated gingival biotypes in adult patients visiting for dental treatment in tertiary centers along with strategically placed outreach centers. A descriptive cross-sectional study was done in the Department of Dentistry, Dhulikhel Hospital, and four outreach centers of the same hospital. The study was conducted from October 2022 to April 2023 after obtaining the ethical approval. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Among 165 patients, the prevalence of altered passive eruption was 21 (12.72%) (7.62-17.78 at 95% Confidence Interval). Furthermore, among 21 patients, the altered passive eruption was seen in the thick biotype patients in 16 (76.19%) and thin biotype patients in 5 (23.81%). The prevalence of altered passive eruption appeared to be equivalent when compared with the previous studies.

Soft Tissue Response and Determination of Underlying Risk Drivers for Recession and Mucositis after AMSJI Implantation in the Maxilla.

To evaluate the soft tissue response to the placement of additively manufactured subperiosteal jaw implants (AMSJI) in the severely atrophic maxilla and to identify possible risk factors for soft tissue breakdown. An international multicenter study was conducted, and 15 men (mean age: 64.62 years; SD: ± 6.75) and 25 women (mean age: 65.24 years; SD: ± 6.77) with advanced maxillary jaw resorption (Cawood and Howell Class V or more) were included in this study. General patient data were collected, and all subjects were clinically examined. Inclusion criteria were patients who underwent bilateral AMSJI placement in the maxilla at least 1 year prior. Exclusion criteria were patients who did not have patient, surgeon, or dentist consent to participate in the study before their inclusion. A total of 40 patients were enrolled, with a mean follow-up period of 917 days (SD: ± 306.89 days). Primary implant stability was achieved postoperatively in all cases, and all implants were loaded with a final prosthesis. At the time of the study, only 1 patient showed mobility (> 1 mm) of the bilateral AMSJI. Due to mucosal recession, exposure of the framework was seen in 26 patients (65%) and was mainly in the left (21.43% of 26) and right (18.57% of 26) midlateral region. A thin biotype and the presence of mucositis were found to be risk factors (P < .05). Although not significant, smokers had a risk of developing a recession that was nearly seven times (odds ratio: 6.88; P = .08) greater than that of nonsmokers. Twenty-six (65%) patients presented with a recession in one (or more) of the seven regions after oral rehabilitation with bilateral AMSJI placement. Several risk drivers were evaluated. The collapse of soft tissues around the AMSJI that led to caudal exposure of the arms was correlated with a thin biotype and the presence of mucositis.

MODERN VIEW ON ISSUES OF DIAGNOSING GINGIVAL RECESSION

Background. Given that the exposure of the tooth root is not only an aesthetic concern but also leads to dental hypersensitivity, cervical caries, non-carious lesions, and even tooth loss, understanding the causes and characteristics of gum recession, along with its timely detection, is crucial and relevant. The aim of this study is to analyze and consolidate scientific research dedicated to the investigation of factors influencing the development of gum recession, its diagnosis, and the clinical features. This understanding is essential for addressing the challenge dealing with the treatment of this condition. A comprehensive review of scientific publications addressing the specified topics was conducted using library sources and search systems, including PubMed, Web of Science, OUCI (Open Ukrainian Citation Index), and Index Copernicus. The prevalence of gingival recession varies from 9.7% in adolescents to nearly 100% in adults. Most investigators identified a higher number of recession areas on both the upper and lower jaws around the central and lateral incisors, as well as the right first molar. However, conflicting findings exist, with some researchers suggesting that gum recession occurs most frequently in the premolars and canines area. Nevertheless, there is a unanimous agreement among researchers that this disease is polyetiological. Authors assess the significance of different factors provoking recession in varying ways. Moreover, under specific conditions, several factors may combine, with one of them dominating. Despite numerous classification attempts by specialists, efforts to propose a classification that accurately reflects the characteristic features of this pathology, the severity of manifestations, and the prognosis of its treatment are still remaining pressing issues. Thus, among the factors that provoke the development of apical migration of the gingival margin, the leading role is played by the thin biotype of the gums and the peculiarities of the anatomical and morphological structure of the periodontal tissues, inflammatory diseases in the oral cavity, incorrect implementation of hygienic and preventive measures, orthopedic and orthodontic devices that lead to mechanical injury. Despite the large number of existing classifications of gum recession, none of them can fully satisfy dentists, as they are not able to objectively determine all the clinical manifestations of the disease, establish a connection with its etiology, and predict the course.

Інтегральний аналіз клінічних та рентген- антропометричних предикторів тонкого фенотипу тканин пародонту як фактора ризику пародонтальних ускладнень ортодонтичного лікування

Resume: In the article, it was carried out a study of the most clinical predictors of the thin biotype of periodontal tissue, as a consequence of healing in predicting the possible complications of orthodontic treatment. And to itself: I have a mucus alveolar growth with zones of ischemia; small child of an empty company; prominence of roots, lower frontal teeth; short lips ties and tongue tie; manifestations of additional folds of vestibule of the mouth; injection of blood vessels on the alveolar ridge and on the inner surface of the lips and cheek; sharply folded alveolar ridge; change in the height of the interdental papillae and change in the shape of their tops; the presence of wide and narrow recesses is clear. Statistically priming of thin and small X-ray anthropometric predictors of thin biotype of periodontal tissues: thin and long roots of lower cuts; half-moon-like tops of the roots of the cuts and the cleavages of the lower slit; large drawing of trabeculae of spongy cystic tissue; straight, or so, that the roots of the first permanent molars of the lower fissure diverge; a sharp deficit in the height of the body of the lower crack, especially in the vineyards. Key words: periodontal tissue, orthodontic treatment, periodontal tissue biotype, orthopantomography

Estimation of Loss of Crestal Bone Around Dental Implants in Various Tissue Biotypes Using CBCT.

To evaluate the loss of crestal bone height around dental implants placed in various tissue biotypes. 20 patients with single edentulous sites were allocated randomly, with 10 samples in each into Group I (implants were placed in thick tissue biotype) and Group II (implants were placed in thin tissue biotype). Baseline cone-beam computed tomography (CBCT) was performed after implant placement in both groups, and follow-up CBCT was taken at the time of cementation prior to occlusal loading to assess the crestal bone loss around the mesial and distal side of implants in both groups. A significant loss of crestal bone at both the distal and mesial sides of the implants at the time of cementation was observed in both groups but Group II showed more crestal bone loss as compared to Group I. Mean crestal bone loss was more in Group II (thin tissue biotype) in comparison to Group I (thick tissue biotype). The thick biotype causes less crestal bone changes than the thin biotype, which evokes more loss of crestal bone during the period of peri-implant healing.

Photodynamic Therapy with Aminolevulinic Acid Enhances the Cellular Activity of Cells Cultured on Porcine Acellular Dermal Matrix Membranes Used in Periodontology.

This study aims to test a photodynamic protocol based on a gel containing aminolevulinic acid followed by red-LED (ALAD-PDT) irradiation on human gingival fibroblasts (hGFs) and osteoblasts (hOBs) cultured on a porcine acellular dermal matrix membrane (PADMM). In the previous literature, ALAD-PDT showed solid antibacterial activity and proliferative induction on HGFs cultured on plates and HOBs cultured on a cortical lamina. PADMMs are used in dentistry and periodontology to treat gingival recessions and to increase the tissue thickness in the case of a thin biotype without the risks or postoperative discomfort associated with connective tissue grafts. However, one of the possible complications in this type of surgery is represented by bacterial invasion and membrane exposition during the healing period. We hypothesized that the addition of ALAD-PDT to PADMMs could enhance more rapid healing and decrease the risks connected with bacterial invasion. In periodontal surgery, PADMMs are inserted after a full-thickness flap elevation between the bone and the flap. Consequently, all procedures were performed in parallel on hOBs and hGFs obtained by dental patients. The group control (CTRL) was represented by the unexposed cells cultured on the membranes, group LED (PDT) were the cells subjected to 7 min of red LED irradiation, and ALAD-PDT were the cells subjected to 45 min of ALAD incubation and then to 7 min of red LED irradiation. After treatments, all groups were analyzed for MTT assay and subjected to histological examination at 3 and 7 days and to the SEM observations at 3, 7, and 14 days. Different bone mineralization assays were performed to quantify the effects of ALAD-PDT on hOBs: ALP activity, ALP gene expression, osteocalcin, and alizarin red. The effects of ALAD-PDT on hGFs were evaluated by quantifying collagen 1, fibronectin, and MMP-8. Results showed that ALAD-PDT promoted cellular induction, forming a dense cellular network on hOBs and hGFs, and the assays performed showed statistically significantly higher values for ALAD-PDT with respect to LED alone and CTRLs. In conclusion, ALAD-PDT could represent a promising aid for enhancing the healing of gingival tissues after PADMM applications.

Relationship of Gingival Biotype with Schneiderian Membrane Thickness Using Cone Beam Computed Tomography (CBCT)

Aim: To find out the relationship of gingival biotype with schneiderian membrane thickness using cone beam computed tomography (CBCT) in patients at tertiary care dental hospital presenting for routine periodontal care. Methods: In this cross-sectional study, a total of 150 patients were observed in department of Periodontology, Fatima Memorial Hospital College of Medicine and Dentistry Lahore. Patients were clinically evaluated and gingival biotype wasrecorded. Afterthat cone beam computed tomography was performed to assess the patient’s schneiderian membrane thickness from mesial of maxillary 2nd premolar todistal of maxillary 2nd molar due to many anatomical variations of maxillarysinus. Results: In this study the mean age of the patients was 38.75±8.17 years, 70 (46.67%)patients were male. Thin biotype was found in 66(44%) patients and thickbiotype was found in 84 (56%) patients. In thin biotype the mean thickness of schneiderian membrane was 0.58±0.085mm while in thick biotype the mean of schneiderian membrane was1.25±0.07mm (p-value&lt;0.05). Conclusion: The study concluded that there is significant relationship exist between the schneiderian membrane and thickness of biotype. positive correlation of gingival biotype with width of keratinizedgingivainmaxillaryanteriorteeth. Keywords: gingival biotype, schneiderian membrane, Cone Beam Computed Tomography (CBCT), missing teeth

Assessment of gingival biotype in different facial patterns: A cross-sectional study.

The aim of the present study is to evaluate the relationship of gingival biotype in different malocclusions. A total of 157 periodontally healthy subjects (88 males and 69 females) were enrolled in this cross-sectional study. The study participants were divided into three groups of skeletal class I, class II, and class III. The probe transparency method was used to determine the quality and gingival tissue into thick and thin biotype. There was significant difference in gingival biotype among different skeletal malocclusion with high prevalence of thin gingival biotype in class I subjects and more prevalence of thick biotype in class II and class III individuals (P-value: 0.022). Pairwise comparison of gingival biotype in class I versus class II showed significant difference (P-value: 0.032); however in class I versus class III and class II versus class III, the test result was nonsignificant. The overall frequency of thin gingival biotype was significantly less in female subjects with respect to males (P-value: 0.025). A significant relationship is present between skeletal malocclusion and quality of gingival biotype. The prevalence of thick gingival biotype is found more in females as compared to male individuals. The thin gingival biotype is more commonly seen in skeletal class I than class II and class III.

PERIODONTOLOGICAL STATUS OF PATIENTS WITH DENTOMAXIMAL ANOMALIES BEFORE ORTHODONTIC TREATMENT

PERIODONTOLOGICAL STATUS OF PATIENTS WITH DENTOMAXIMAL ANOMALIES BEFORE ORTHODONTIC TREATMENT

Initial assessment of gingival biotype as a potential source of variability in the migration, contraction and gene expression of fibroblasts

ObjectiveGingival biotype refers to the clinical classification of gingiva based on the thickness of the tissue, with thick gingival tissues more resistant to trauma and recession than the thin variant. However, to date there has never been an analysis of whether fibroblasts isolated from different biotypes possess inherent phenotypic differences. We hypothesized that gingival fibroblasts from thick and thin biotype would exhibit differences in migration, contraction and gene expression in vitro in the presence of either transforming growth factor beta one (TGF-β1) or tumor necrosis factor alpha (TNFα), two major cytokines involved in wound repair. DesignMigration was quantified using closure of scratch wound assays, contraction was assessed using attached and detached collagen lattices and extracellular matrix related gene expression using Taqman Realtime polymerase chain reaction. ResultsHuman gingival fibroblasts isolated from both biotypes showed similar rates of closure of scratch wounds, which was not influenced by the addition of TGF-β1 or TNFα. Fibroblasts from both biotypes contracted detached, but not attached, collagen gels to 50 % of their original weight although this contraction was not associated with incorporation of α-smooth muscle actin into stressfibres under any tested culture condition. Analysis of gene expression showed that POSTN, and ACTA2 mRNA levels did not significantly change, but CCN2 and COL1A2 mRNA levels were significantly higher in thick compared to thin fibroblasts in response to TGF-β1. ConclusionWhile supra-cellular factors influence the healing, esthetic outcomes and recession in thin gingival biotypes, differences in gingival fibroblast gene expression in response to growth factors may also play a role and warrants further investigation.

Subepithelial connective tissue graft for thin biotype gingiva on dark root non-vital tooth to enhance the aesthetic area: Case report

Gingival biotype is described as the thickness of the gingiva in the faciopalatal or faciolingual dimension. Aesthetic is highly con-sidered in anterior teeth. A 35-year-old woman came with a complaint that the color of gingiva of her front teeth was slightly dark after root canal treatment 10 years ago. Clinical and radiographic examinations of the upper left lateral incisor showed no signs of inflammation or infection. Biotype evaluation was carried out with a calibrated UNCprobe using the transparency me-thod. Subepithelial connective tissue graft (SCTG) with tunneling technique was performed on the gingiva to thicken the gingi-va around the dark tooth root. SCTG autograft is a stable gingival graft material if the goal of surgery is to thicken the gingiva, so it remains the gold standard in areas that require esthetics.

Intrusion of Maxillary Posterior Teeth by Skeletal Anchorage: A Systematic Review and Case Report with Thin Alveolar Biotype.

This study aimed to review the literature related to the intrusion of maxillary posterior teeth in subjects needing pre-prosthetic restoration or orthodontic treatment due to anterior open bite, and to report a thin alveolar biotype case needing a pre-prosthetic intrusion of maxillary teeth by introducing a novel, personalized method of intrusion measurement. An electronic search was conducted between February 2022 and March 2022 in the following databases: PubMed, Scopus, Embase, Web of Science, and Lilacs; the terms “tooth movement techniques”, “orthodontic anchorage procedures”, “tooth intrusion”, “intrusion”, “molar”, “premolar”, and “human” were surveyed. Eighteen articles were included in this review; the mean amount of intrusion ranged from between 2.1 ± 0.9 mm and 4.57 ± 0.98 mm (being mostly 2–3 mm). The intrusion force varied between 100 and 500 g; 10 articles reported miniscrews (MS), 7 reported zygomatic plates (ZP), and 1 publication reported both anchorage types. The average treatment time was 6.9 months for MS and 7.9 months for ZP. Levelling the occlusal plane by intrusion of the upper posterior teeth can be achieved by skeletal anchorage. The stability of the obtained results, shortening treatment time, and controlling treatment outcome are the main goals for a complex surgical and orthodontic treatment approach.

Buccal soft tissue dehiscence defects at dental implants-associated factors and frequency of occurrence: A systematic review and meta-analysis.

To identify the factors associated with buccal peri-implant soft tissue dehiscences (BSTDs) and their frequency of occurrence. Randomized controlled trials, controlled clinical trials, cohort studies, and case series assessing the frequency of occurrence of BSTD were included. BSTD was defined as an apical migration of the peri-implant soft tissues of ≥1mm from the baseline examination (final restoration) or in comparison with the adjacent or contralateral natural tooth. Frequency distributions of BSTD related to the presence or absence of any surgical, prosthetic, or anatomic factor that may have contributed to the development of BSTD were recorded. Random-effects meta-analyses using odds ratios (OR) were performed to investigate the association of certain factors with the development of BSTD. Twenty-four articles were finally included belonging to 22clinical investigations. Patients at higher risk of developing BSTD were associated with thin biotype (OR=2.85 [1.40, 5.8], n=5, p=.003) and with buccally placed implants (OR=14.37 [4.58, 45.14], n=3, p≤.001). Patients without connective tissue grafting (CTG) had greater odds of developing BSTD (OR=9.00 [3.11, 26.02], n=5, p≤.001), while buccal bone plate thickness of <1mm and immediately placed implants were not associated with greater BSTD (OR=1.29 [0.35, 4.77], n=2, p=.704 and OR=1.56 [0.46, 5.26], n=4, p=.477, respectively). The frequency of occurrence of BSTD varied across the included studies with a range from 0% to 61%. Thin tissue biotype and buccally placed implants were associated with BSTD, whereas CTG seemed to have a protective effect. Thin buccal plates and immediately placed implants did not demonstrate a higher risk of BSTD.

Assessment of the influence of soft tissue biotype on the marginal bone changes around dental implants

Background: Changes in peri-implant hard and soft tissues, as well as restorative and patient-based subjective measures are the most widely used parameters for evaluating the outcomes of implant therapy. The present study was conducted to assess the influence of soft tissue biotype on the marginal bone changes around dental implants. Materials &amp; Methods: 58 patients who received dental implants of both genders were included. In all patients, initial mucosal thickness, marginal bone levels on radiographs, pain, and exudation were evaluated. All these parameters were recorded at the time of implant placement, at the time of cementation of final restoration, 6 months and 12 months post cementation. Results: Out of 58 patients, males were 20 and females were 38. The mean mucosal thickness at baseline, second stage, at cementation, 6 months and 12 months was 2.82, 1.90, 1.54, 2.62 and 3.42 in thick mucosa and 1.65, 0.84, 0.69, 1.14 and 1.62 at thin mucosa. The difference was significant (P&lt; 0.05). The mean pocket depth at cementation was 2.52, at 6 months was 3.20 and at 12 months was 3.24 in thick and 2.12 at cementation, 3.10 at 6 months and 3.16 at 12 months in thin biotype respectively.

Prevention of Post-Gingivectomy Gingival Recession in Fixed Orthodontic Patients with Gingival Enlargement: A Case Report

Background: The use of fixed orthodontic appliances can affect periodontal tissues. It can increase the risk of plaque and calculus accumulation. One of the effects on the periodontal tissue is gingival enlargement. The usual treatment for gingival enlargement is gingivectomy with an external bevel. This treatment carries a risk of gingival recession if the base of the pocket is apical to the cemento-enamel junction (CEJ).&#x0D; Objective: To report the actions to be taken in case of post-gingivectomy gingival recession.&#x0D; Case Report: An 18-year-old woman presented to the Dental and Oral Hospital, Universitas Gadjah Mada Prof. Soedomo, with complaints of swelling of the lower front gums, partially covering the crown of the teeth, sometimes bleeding when brushing her teeth, but no pain. The patient has been in fixed orthodontic treatment since early 2018. The treatment in this case in the form of gingivectomy gave good results which aimed to remove the gingival pocket, form a new gingival anatomy and create a new gingival margin. In addition, a new gingival margin was considered coronal with suturing and fixation on the brackets to prevent recession.&#x0D; Conclusion: The risk of gingival recession after gingivectomy can occur, especially in the gingiva with a thin biotype. Coronally advance flap may be an option to position the gingival margin coronal to the CEJ to prevent gingival recession after gingivectomy procedure.&#x0D; Keywords: gingival enlargement, gingivectomy, fixed orthodontic appliance, coronally advanced flap

Analysis of buccal gingival thickness in maxillary implants and its relation to gingival biotype

Objectives: This study aimed to evaluate vestibular gingival thickness in unitary implants located in the anterior maxilla through a cone beam tomography. Material and methods: After visual classification of the gingival biotype of the 32 patients selected for this study (16 patients with thin biotype and 16 patients with thick biotype) measurements of the vestibular tissue thickness were made at 2, 4 and 6 mm from the gingival margin in the apical direction in the most longitudinal transverse cut of the implant and the contralateral tooth through tomographic cone beam examination for soft tissue. The data of age and gender of the patients, mean buccal wall thickness of the implants and contralateral natural teeth, and the use of connective tissue graft (CTG) were tabulated for descriptive analysis. Results: For thin gingival biotype, mean vestibular gingival thickness varied between 1.26 ± 0.31 mm (teeth) and 2.65 ± 0.93 mm (implant), and for thick biotype varied from 1.77 ± 0.58 mm (teeth) and 3.01 ± 0.96 mm (implant). The use of CTG increased the buccal thickness of thick biotype when compared to thin biotype without CTG. Conclusions: It was not possible to establish a direct relationship between the classification of the gingival biotype of the contralateral teeth and the gingival biotype of the implants installed in the anterior region of the maxilla, but CTG was shown to be efficient in increasing gingival tissue thickness.

Digitalized analysis of the gingival and bone morphology in the maxillary anterior teeth in patient with posterior dental implant

Objective: To explore and analyze the correlation between labial gingival morphology and alveolar bone morphology of maxillary anterior teeth in patients with posterior dental implant, so as to provide reference basis for restoration design and esthetic reconstruction of anterior teeth. Methods: Sixty-four patients [24 males, 40 females (25.6±3.3) years old] who planned to receive posterior dental implant restoration were recruited randomly with the inclusion and exclusion criteria in Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University from May 2020 to May 2021. According to the visibility of periodontal probe through gingival margin, the subjects were divided into thin and thick gingival biotypes, including 29 cases of thin biotype and 35 cases of thick biotype. The 3Shape software was used to perform oral scanning, and cone beam CT (CBCT) was taken for each patient. Geomagic and Mimics software were used to measure and record the labial crown width and length, gingival papilla height, gingival angle, bone papilla height and bone margin angle of maxillary anterior teeth. Results: The crown width length ratios of maxillary central incisors, lateral incisors and canines were 0.85±0.08, 0.80±0.08 and 0.86±0.09 (F=10.71, P<0.01). The height of gingival papilla between maxillary central incisors, between central incisors and lateral incisors, between lateral incisors and canines were (3.93±0.86), (3.47±0.84) and (3.38±0.91) mm respectively (F=7.44, P<0.01), and the height of corresponding bone papilla were (3.44±0.88), (3.12±0.75) and (2.72±0.63) mm respectively (F=14.26, P<0.01). The gingival margin angles of maxillary central incisors, lateral incisors and canines were 88.3°±7.7°, 84.7°±8.9° and 81.2°±6.6° (F=13.15, P<0.01), and the bone margin angles were 103.2°±13.1°, 99.5°±11.2° and 110.6°±13.0° (F=13.25, P<0.01). The crown width length ratio (0.81±0.08), gingival margin angle (82.2°±7.4°) and bone margin angle (99.4°±12.9°) of thin gingival subjects were significantly lower than those of thick gingival subjects (0.85±0.09, 86.5°±8.6°, 108.5°±11.4°) (t=-2.79, 3.63, 5.20, P<0.01). The height of gingival papilla [(3.93±0.81) mm] and bone papilla [(3.43±0.80) mm] in thin gingival subjects were significantly lower than those in thick gingival subjects [(3.34±0.84) and (2.85±0.71) mm, respectively] (t=-4.89, -5.36, P<0.01). The height of labial gingival papilla of upper anterior teeth was positively correlated with that of bone papilla in all patients (r=0.66, P<0.01); the ratio of crown width to length of upper anterior teeth was positively correlated with the angle of bone margin (r=0.42, P<0.01); the height of anterior gingival papilla was negatively correlated with the angle of bone margin (r=-0.58, P<0.01), and the height of bone papilla was negatively correlated with the angle of bone margin (r=-0.82, P<0.01). Conclusions: The crown shape, gingival shape and alveolar bone shape of maxillary anterior teeth were different in different tooth positions. Patients with different periodontal phenotypes had different crown width length ratio, gingival papilla height, bone papilla height, gingival margin angle, and bone margin angle.

Effect of Soft Tissue Condition on Peri-implant Health and Disease: A Retrospective Clinical Study.

This study retrospectively evaluated the effect of soft tissue condition on peri-implant health. Clinical variables (Plaque Index, keratinized tissue width, gingival biotype, and vestibular depth) were recorded. Probing depth, soft tissue recession, bleeding on probing, and radiographic marginal bone loss were assessed in relation to independent variables. Statistical analysis was performed using Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model at the implant level. A total of 139 implants in 43 patients were assessed. Bleeding on probing was recorded at 54.7% sites, which was significantly related to the biofilm accumulation. Gender, history of periodontal disease, patient adherence to recall visits, and the presence of plaque were associated with higher peri-implant probing-depth values. The maximum soft tissue recession was recorded at sites with a thin biotype and shallow vestibular depth (P = .0). The logistic regression analysis revealed that plaque (P = .002) and vestibular depth (P = .043) were significantly associated with peri-implantitis. Within the study limitations, patients with high plaque accumulation and shallow vestibular depth are more prone to peri-implant disease.