Beruflich Dokumente
Kultur Dokumente
Department of
Periodontics and Oral
Implantology, National
Dental College and
Hospital, Gulabgarh,
Derabassi, Mohali,
Punjab, India
Abstract:
Background: The gingival morphology of the maxillary anterior region plays an important role in determining
the final esthetic outcome. Knowledge of the periodontal biotype is of fundamental importance because the
anatomical characteristics of the periodontium, such as gingival thickness, gingival width and alveolar bone
morphology, will determine periodontium behavior when submitted to physical, chemical, or bacterial injury or
during periodontal or implant surgical procedures and orthodontic treatment. Materials and Methods: 50 subjects
with healthy periodontal tissues with no loss of attachment and (b) presence of all anterior teeth in both upper and
lower jaw were selected. On clinical examination gingival thickness was recorded based on the transparency of
periodontal probe. Following parameters are recorded from dental cast, i.e., crown length, crown width, papillary
length (PL) and papillary width. Results: There was highly significant correlation between gingival biotype and
crown length and area of papilla with P value 0.002 and 0.013 respectively. Significant correlation was found
between area of crown and PL with P value 0.013 and 0.016. The results of discriminant function analysis
showed that average crown length was the best single determinant of biotype and area of papilla was the next
best choice. Conclusion: Within the limits of the current investigation, the existence and correlation of different
gingival biotypes and dentopapillary complex dimension has been confirmed. These findings can be utilized as
objective guidelines for determining the biotype and response of gingiva to many dental operative procedures.
Key words:
Crown length, crown width, dentopapillary complex, gingival biotype, papillary length, papillary width
DOI:
10.4103/0972-124X.128199
INTRODUCTION
Address for
correspondence:
Dr. Vishakha Grover,
Department of
periodontology and oral
implantology, National
Dental College and
Hospital, Gulabgarh,
Derabassi District, SAS
Nagar, Mohali, Punjab,
India.
E-mail: vishakha_grover@
rediffmail.com
Submission: 15-04-2013
Accepted: 13-05-2013
All the eligible subjects were explained about the study and a
written informed consent was obtained.
Selected subjects were greeted and seated for the appointment
on the dental chair in a comfortable position. Alginate
impressions of selected study participants were made and
poured with dental stone.
Gingival thickness on maxillary anterior teeth was clinically
recorded and was categorized into thick or thin on a site
based level. This evaluation was based on the transparency
of the periodontal probe through the gingival margin
while probing the sulcus at the mid-facial aspect of both
central maxillary incisors. If the outline of the underlying
periodontal probe could be seen through the gingiva, it was
categorized as thin and if not, it was categorized as thick
[Figures 1 and 2]
Dental casts were obtained which is the positive replica
of the whole mouth. Following parameters were recorded
from the dental cast
Crown length (CL)[9] was measured between the incisal edge
of the crown and the free gingival margin, or if discernible,
the cemento-enamel junction
Crown width (CW) [9] i.e., the distance between the
approximal tooth surfaces, was recorded at the border
between the middle and the cervical portion
Papillary height (PH) [9] was assessed to the nearest
0.5 mm using the same periodontal probe at the mesial
and distal aspect of both central incisors. This parameter
was defined as the distance from the top of the papilla to
a line connecting the mid-facial soft tissue margin of the
two adjacent teeth. The mean value will calculated for the
three papilla
Papillary width (PW) was calculated at the base of papilla
between two approximated tooth surfaces
From canine to canine, the area of the facial papilla (AP), the
facial surface area of the anterior tooth (AT), the proportion
of the dento-papillary complex (AP/AT).
The study protocol was duly reviewed and approved from the
institutional ethical committee.
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Figure 3: Mean crown length for thick and thin gingival biotype
Figure 4: Mean crown width for thick and thin gingival biotype
Figure 5: Mean papillary length for thick and thin gingival biotype
Figure 6: Mean papillary width for thick and thin gingival biotype
Figure 7: Mean area of papilla for thick and thin gingival biotype
Figure 8: Mean area of the crown for thick and thin gingival biotype
Figure 9: The ratio between area of papilla/area of the crown for thick and thin
gingival biotype
RESULTS
The study population consisted of 50 periodontally healthy
subjects with a mean age of 35 years. Results showed that the
crown length ranged from 7.9 mm to 12 mm for thin biotype
and for 6 mm to 10.5 mm for thick biotype [Figure 3]. The crown
width ranged from 6 mm to 11.5 for thin biotype and 6 mm
Journal of Indian Society of Periodontology - Vol 18, Issue 1, Jan-Feb 2014
to 9.5 for thick biotype [Figure 4]. The papillary length (PL)
ranged from 3.3 mm to 6 mm for thin biotype and is 3 mm to
6 mm for thick biotype [Figure 5]. The Papillary width (PW)
ranged from 4.3 mm to 7 mm for thin biotype and 3.5-6.3 mm for
thick biotype [Figure 6]. Area of papilla ranged from 13.2 mm
to 36 mm sq and for thick biotype is 12-30 mm sq [Figure 7].
Area of crown ranged from 55.2 mm to 95.6 mm sq for thin
biotype and 42-96 mm sq for thick biotype [Figure 8]. Area of
papilla/area of crown ranged from 0.02 to 0.48 for thin biotype
and for thick biotype is 0.022-6.44 [Figure 9].
DISCUSSION
In recent years, the dimensions of different parts of the
masticatory mucosa, especially gingival thickness, has become
the subject of considerable interest in periodontics from both an
epidemiologic and a therapeutic point of view.[10] Since studies
have concluded that the thickness of the gingiva plays a vital role
in development of mucogingival problems and in the success
45
thin biotype is 5.13 mm and for thick is 4.44 mm. The mean
papillary width for thin biotype is 4.921 mm and for thick
biotype is 4.622 mm. The mean area of papilla for thin biotype
is 25.1004 mm sq and for thick biotype is 24.500 mm sq. The
mean area of the crown for thin biotype is 76.327 mm sq and
for thick biotype is 66.541 mm sq. The mean value of the area
of papilla/area of the crown for thin biotype is 0.3280 and for
thick biotype is 0.5382 [Table 1]. There was highly significant
correlation between gingival biotype and crown length and
area of papilla with P value 0.002 and 0.013 respectively.
Significant correlation was found between area of crown and
PL with P value 0.013 and 0.016. The results of discriminant
function analysis showed that average crown length was the
best single determinant of biotype and area of papilla was the
next best choice. The cut-off value of average crown length was
calculated to be 8.62 [Table 2].
The results of the present study showed that the mean value of
crown length for thin biotype is 9.706 mm and for thick biotype
is 8.478 mm. The mean value of crown width for thin biotype
is 7.844 mm and for thick biotype is 7.87 mm. The mean PL for
Table 1: Comparative analysis of mean values of all the parameters in both study groups
Gingival biotype Crown length Crown width Papillary length Papillary width Area of papilla Area of crown Area of papilla/area
(mm)
(mm)
(mm)
(mm)
(mm)
(mm2)
(mm2)
of the crown
Thin
Thick
P value
9.706
8.478
0.002
7.844
7.87
0.923
5.13
4.44
0.016
4.921
4.662
0.326
25.1004
24.5000
0.006
76.327
66.541
0.013
0.3280
0.5382
0.398
Average crown Average crown Average papilla Average papilla Area of crown Area of papilla Area of papilla/
length (mm)
width (mm)
length (mm)
width (mm)
(mm2)
(mm2)
crown
1
0.011
0.689
0.051
0.786
0.540
0.054
0.011
1
0.080
0.573
0.620
0.303
0.036
0.689
0.080
1
0.100
0.480
0.735
0.019
0.051
0.573
0.100
1
0.384
0.583
0.106
0.786
0.620
0.480
0.384
1
0.598
0.067
0.540
0.303
0.735
0.593
0.598
1
0.94
0.054
0.36
0.019
0.106
0.167
0.094
1
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