Abstract
Objectives
The purpose of this study was to estimate the prevalence of thin and thick gingival phenotype (GPh) in a sample of Dominican subjects and correlate it with clinical parameters.
Materials and methods
One-hundred seven periodontal healthy volunteers in the range of 18–73 years were enrolled in the study. GPh was defined by the transparency of a periodontal probe through the buccal gingival margin on the upper right or left central incisor. Clinical periodontal parameters such as keratinized gingiva width (WKG), attached gingiva width (WAG), probing depth (PD), plaque index (PI), and gingival index (GI) were recorded by a calibrated examiner. Frequency distribution of qualitative variables was calculated. For quantitative variables, Mann-Whitney and Kruskal-Wallis tests were used for comparison of groups.
Results
There was no association between GPh and sex. There were no significant differences between thin and thick GPh regarding age, PD, GI, and interproximal index. The association between tooth morphology and GPh was significant (p = 0.018). Median amount of keratinized gingiva was significantly larger (p = 0.01) in subjects with thin gingival phenotype (median = 6.00 mm) when compared with subjects with thick gingival phenotype (median = 5 mm).
Conclusions
Subjects with thin GPh presented larger WKG. Furthermore, there was an association between tooth morphology and GPh.
Clinical relevance
This is the first study to report the distribution of gingival phenotype and its relationship with different periodontal parameters of a Caribbean population. Our findings can contribute to the clinicians when planning or performing dental procedures.
Similar content being viewed by others
References
Jepsen S, Caton JG, Albandar JM et al (2018) Periodontal manifestations of systemic diseases and development of acquired conditions: consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Periimplant Diseases and Conditions. J Periodontol 89(Suppl 1):237–248
Ochsenbein C, Ross S (1969) A reevaluation of osseous surgery. Dent Clin North Am 13:87–102
Seibert JL, Lindhe J (1989) Esthetics and periodontal therapy. In: Lindhe J (ed) Textbook of Clinical Periodontology, 2nd edn. Munksgaard, Copenhagen, Denmark, pp 477–514
Kahn S, da Rocha Almeida RA, Tavares A, de Pinho Reis WJ, Oliveira M, Taba M Jr (2016) Clinical considerations on the root coverage of gingival recessions in thin or thick biotype. Int J Periodontics Restorative Dent 36:409–415. https://doi.org/10.11607/prd.2249
Hwang D, Wang HL (2006) Flap thickness as a predictor of root coverage: a systematic review. J Periodontol 77:1625–1634
Mallikarjuna DM, Shetty MS, Fernandes AK, Mallikarjuna R, Iyer K (2016) Gingival biotype and its importance in restorative dentistry: a pilot study. J Interdiscip Dentistry 6:116–120
Bittner N, Schulze-Späte U, Silva C et al (2019) Changes of the alveolar ridge dimension and gingival recession associated with implant position and tissue phenotype with immediate implant placement: a randomised controlled clinical trial. Int J Oral Implantol (Berl) 12:469–480
Wang CW, Yu SH, Mandelaris GA, Wang HL (2020) Is periodontal phenotype modification therapy beneficial for patients receiving orthodontic treatment? An American Academy of Periodontology best evidence review. J Periodontol 91:299–310. https://doi.org/10.1002/JPER.19-0037
Lin GH, Curtis DA, Kapila Y et al (2020) The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review. J Periodontol 91:339–351. https://doi.org/10.1002/JPER.19-0310
Kao RT, Curtis DA, Kim DM et al (2020) American Academy of Periodontology best evidence consensus statement on modifying periodontal phenotype in preparation for orthodontic and restorative treatment. J Periodontol 91:289–298. https://doi.org/10.1002/JPER.19-0577
Agudio G, Cortellini P, Buti J, Pini Prato G (2016) Periodontal conditions of sites treated with gingival augmentation surgery compared with untreated contralateral homologous sites: an 18- to 35-year long-term study. J Periodontol 87:1371–1378
Chambrone L, Tatakis DN (2016) Long-term outcomes of untreated buccal gingival recessions: a systematic review and meta-analysis. J Periodontol 87:796–808
Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL (2010) Tissue biotype and its relation to the underlying bone morphology. J Periodontol 81:569–574
Fischer K, Richter T, Friedmann FS (2015) On the relationship between gingival morphotypes and different crown shape assessments in young Caucasians. In: Clin Oral Investig 26:865- 869.DOI 10.1007/s00784-016-1720-8
La Rocca AP, Alemany AS, Levi P Jr, Juan MV, Molina JN, Weisgold AS (2012) Anterior maxillary and mandibular biotype: relationship between gingival thickness and width with respect to underlying bone thickness. Implant Dent 21:507–515
Olsson M, Lindhe J (1991) Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontol 18:78–82
Olsson M, Lindhe J, Marinello CP (1993) On the relationship between crown form and clinical features of the gingiva in adolescents. J Clin Periodontol 20:570–577
Fischer KR, Grill E, Jockel-Schneider Y, Bechtold M, Schlagenhauf U, Fickl S (2013) On the relationship between gingival biotypes and supra-crestal gingival height, crown form and papilla height. Clin Oral Implants Res 00:1–5
Yin XJ, Wei BY, Ke XP et al (2020) Correlation between clinical parameters of crown and gingival morphology of anterior teeth and periodontal biotypes. BMC Oral Health. 20:59. https://doi.org/10.1186/s12903-020-1040-x
Kan JY, Morimoto T, Rungcharassaeng K, Roe P, Smith DH (2010) Gingival biotype assessment in the esthetic zone: visual versus direct measurement. Int J Periodontics Restorative Dent 30:237–243
Kloukos D, Koukos G, Doulis I, Sculean A, Stavropoulos A, Katsaros C (2018) Gingival thickness assessment at the mandibular incisors with four methods: a cross-sectional study. J Periodontol 89:1300–1309. https://doi.org/10.1002/JPER.18-0125
Alves PHM, Alves TCLP, Pegoraro TA, Costa YM, de Bonfante EA, Almeida ALPF (2018) Measurement properties of gingival biotype evaluation methods. Clin Implant Dent Relat Res 20:280–284. https://doi.org/10.1111/cid.12583
DeRouck T, Eghbali R, Collys K, DeBruyn H, Cosyn J (2009) The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 36:428–433
Chou YH, Tsai CC, Wang JC, Ho YP, Ho KY, Tseng CC (2008) New classification of crown forms and gingival characteristics in Taiwanese. Open Dent J 2:114–119
Lee SA, Kim AC, Prusa LA Jr, Kao RT (2013) Characterization of dental anatomy and gingival biotype in Asian populations. J Calif Dent Assoc 41:36–39
Lee WZ, Ong MMA, Yeo AB (2018) Gingival profiles in a select Asian cohort: a pilot study. J Investig Clin Dent 9(1). https://doi.org/10.1111/jicd.12269
Elías-Boneta AR, Toro MJ, Rivas-Tumanyan S, Rajendra-Santosh AB, Brache M, Collins CJR (2018) Prevalence, severity, and risk factors of gingival inflammation in Caribbean adults: a multi-city, cross-sectional study. P R Health Sci J 37:115–123
Gobbato L, Tsukiyama T, Levi PA, Griffin TJ, Weisgold AS (2012) An analysis of the shapes of maxillary central incisors in a Caucasian population. Int J Periodontics Restorative Dent 32:69–78
Slak B, Daabous A, Bednarz W, Strumban E, Maev RG (2014) Assessment of gingival thickness using an ultrasonic dental system prototype: a comparison to traditional methods. Ann Anat 199:98–103
Abraham S, Deepak KT, Ambili R, Preeja C, Archana V (2014) Gingival biotype and its clinical significance: a review. Saudi J Dent Res 5:3–7
Eghbali A, De Rouck T, De Bruyn H, Cosny J (2009) The gingival biotype assessed by experienced and inexperienced clinicians. J Clin Periodontol 36:958–963
Shao Y, Yin L, Gu J, Wang D, Lu W, Sun Y (2018) Assessment of periodontal biotype in a young Chinese population using different measurement methods. Sci Rep 8:11212. https://doi.org/10.1038/s41598-018-29542-z
Shah R, Sowmya NK, Mehta DS (2015) Prevalence of gingival biotype and its relationship to clinical parameters. Contemp Clin Dent 6(Suppl 1):167–171. https://doi.org/10.4103/0976-237X.166824
Peixoto A, Marques TM, Correia A (2015) Gingival biotype characterization - a study in a Portuguese sample. Int J Esthet Dent 10:534–546
Stellini E, Comuzzi L, Mazzocco F, Parente N, Gobbato L (2013) Relationships between different tooth shapes and patient’s periodontal phenotype. J Periodont Res 48:657–662
Egreja AM, Kahn S, Barceleiro M, Bittencourt S (2012) Relationship between the width of the zone of keratinized tissue and thickness of gingival tissue in the anterior maxilla. Int J Periodontics Restorative Dent 32:573–579
Kolte R, Kolte A, Mahajan A (2014) Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol 18:478–481
Kim DM, Bassir SH, Nguyen TT (2020) Effect of gingival phenotype on the maintenance of periodontal health: an American Academy of Periodontology best evidence review. J Periodontol 91:311–338. https://doi.org/10.1002/JPER.19-0337
Müller HP, Heinecke A (2002) The influence of gingival dimensions on bleeding upon probing in young adults with plaque-induced gingivitis. Clin Oral Investig 6:69–74
Müller HP, Könönen E (2005) Variance components of gingival thickness. J Periodontal Res 40:239–244
Cook DR, Mealey BL, Verrett RG et al (2011) Relationship between clinical periodontal biotype and labial plate thickness: an in vivo study. Int J Periodontics Restorative Dent 31:345–354
Fischer KR, Künzlberger A, Donos N, Fickl S, Friedmann A (2018) Gingival biotype revised-novel classification and assessment tool. Clin Oral Investig 22:443–448
Rasperini G, Codari M, Paroni L, Aslan S, Limiroli E, Solís-Moreno C, Suckiel-Papiór K, Tavelli L, Acunzo R (2020) The influence of gingival phenotype on the outcomes of coronally advanced flap: a prospective multicenter study. Int J Periodontics Restorative Dent 40(1):e27–e34. https://doi.org/10.11607/prd.4272
Rasperini G, Acunzo R, Cannalire P, Farronato G (2015) Influence of periodontal biotype on root surface exposure during orthodontic treatment: a preliminary study. Int J Periodontics Restorative Dent 35(5):665–675. https://doi.org/10.11607/prd.2239
Acknowledgements
The authors thank the Health Pastoral Care, Archdiocese of Santo Domingo, and the Regional Metropolitan Health Service (SRSM, by its initials in Spanish) of the Dominican Republic for their support. Also wish to thank all the dentists, community leaders, and patients for their kind cooperation in this study.
Funding
This study was funded by the Caribbean Oral Health Initiative (COHI).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics approval and consent to participate
Ethical approval (No. 042–2016) was obtained from the National Board of Bioethics in Health (CONABIOS). All subjects signed an informed consent before enrollment in the study.
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Collins, J.R., Pannuti, C.M., Veras, K. et al. Gingival phenotype and its relationship with different clinical parameters: a study in a Dominican adult sample. Clin Oral Invest 25, 4967–4973 (2021). https://doi.org/10.1007/s00784-021-03806-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00784-021-03806-x