DIAGNOSIS OF GINGIVAL BIOTYPE IN THE ANTERIOR MAXILLARY REGION USING DIFFERENT METHODS
DIAGNÓSTICO DO BIOTIPO GENGIVAL NA REGIÃO ANTERIOR DA MAXILA UTILIZANDO DIFERENTES MÉTODOS
DOI:
https://doi.org/10.9771/revfo.v55i1.58032Palavras-chave:
Gingiva. Dental Implantation. Diagnosis.Resumo
Objective: The purpose of this study was to evaluate and compare methods of gingival biotype diagnosis; transparency of the probe, clinical measurement and cone beam computed tomography with removal of soft tissue. Methods: Thirty patients had the gingival thickness assessed in the buccal region of the dental units 11 and 21. Clinical and demographic characteristics such as age, gender, probing depth, gingival marginal position, clinical attachment level and dental morphology (crown width/crown length ratio) were investigated and correlated to gingival thicknesses obtained from the three diagnosis methods: 1) transparency of the periodontal probe through the gingival sulcus; 2) clinical method of transgingival probing through tissue with an endodontic spreader; 3) Cone Beam Computed Tomography with removal of soft tissue. Results: The average gingival thickness of the central incisors obtained by computed tomography was 1.46 mm ± 0.32 mm while the clinical average thickness was 1.32 ± 0.22 mm. Transparency tissue obtained a median of 2 (1.3-1.8, 95% CI), which means that biotype was considered thick in both units 11 and 21. The result of probe transparency was positively and significantly correlated with the thickness determined in tomographic and clinical evaluations. At the same time, the tomography and clinical measurements also showed a significant correlation between measurements. Multiple regression analysis indicated no significant impact of age, crown width/crown length ratio and periodontal parameters on gingival biotype measured by any of the diagnosis methods. Conclusion: It can be concluded that the evaluated diagnosis methods are positively correlated and can be used to determine tissue thickness on central incisors.
Downloads
Referências
Eghbali A, De Rouck T, De Bruyn H, Cosyn J. The gengival biotype assessed by experienced and inexperienced clinicians. J Clin Periodontol. 2009 Nov; 36 (11): 958-63. https://doi.org/10.1111/j.1600-051X.2009.01479.x.
De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontal. 2009 May; 36 (5):428-33. https://doi.org/10.1111/j.1600-051X.2009.01398.x.
Kao RT, Fagan MC, Conte GJ. Thick vs. thin gingival biotypes: A key determinant in treatment planning for dental implants. J Calif Dent Assoc. 2008 Mar; 36 (3):193-8.
Jung RE, Hammerle CHF, Attin T, Schmidlin P. In vitro color changes of soft tissues caused by restorative materials. Int J Periodontics Restorative Dent. 2007 Jun; 27 (3): 251-7.
Sorní-Broker M, Peñarrocha-Diago M, Peñarrocha-Diago M. Factors that influence the position of the peri-implant soft tissues: A review. Med Oral Patol Oral Cir Bucal. 2009 Sep 1; 14 (9): 475-9.
Linkevicius T, Apse P, Grybauskas S, Puisys A. The influence of soft tissue thickness on crestal boné changes around implants: A 1-year prospective controlled clinical trial. Int J Oral Maxillofac Implants. 2009 Jul-aug;24 (4):712-9
Suárez-López Del Amo F, Lin GH, Monje A, Galindo-Moreno P, Wang HL. Influence of Soft Tissue Thickness on Peri-Implant Marginal Bone Loss: A Systematic Review and Meta-Analysis. J Periodontol. 2016 Jun;87(6):690-9. https://doi.org/10.1902/jop.2016.150571.
Fu JH, Lee A, Wang HL. Influence of tissue biotype on implant esthetics. Int J Oral Maxillofac Implants. 2011 May-Jun; 26 (3): 499-508.
Cuny-Houchmand M, Renaudin S, Leroul M, Planche L, Le Guchennec L, Soucidan A. Gingival biotype assessement: visual inspection relevance and maxillary versus mandibular comparison. Open Dent J. 2013; 7: 1-6. https://doi.org/ 10.2174/1874210601307010001.
Goaslind GD, Robertson PB, Mahan CJ, Morrison WW, Olson JV. Thickness of facial gingiva. J Periodontol. 1977 Dec; 48 (12): 768-71. https://doi.org/ 10.1902/jop.1977.48.12.768.
Muller HP, Heinecke A, Schaller N, Eger T. Masticatory mucosa in subjects with different periodontal phenotypes. J Clin Periodontal. 2000 Sep; 27 (9): 621-6. https://doi.org/ 10.1034/j.1600-051x.2000.027009621.x.
Olsson M, Lindhe J. Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontal. 1991 Jan; 18 (1): 78-82. https://doi.org/ 10.1111/j.1600-051x.1991.tb01124.x.
Dvorak G, Arnhart C, Schon P, Heuberer S, Watzek G, Gahleitner A. The “puffed cheek method” to evaluate mucosal thickness: case series. Clin Oral Impl Res. 2013 Jul; 24 (7): 719-2. https://doi.org/10.1111/j.1600-0501.2012.02469.x.
Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin Oral Impl Res. 2008 Apr; 19 (4): 387-92. https://doi.org/10.1111/j.1600-0501.2007.01492.x.
Shah DS, Duseja S, Vaishnav K, Shah RP. Adaptation of gingival biotype in response to prosthetic rehabilitation. Adv Hum Biol. 2017 May-Aug; 7 (2): 85-8. https://doi.org/10.4103/AIHB.AIHB_30_16.
Kinaia BM, Ambrosio F, Lamble M, Hope K, Shah M, Neely AL. Soft tissue changes around immediately placed implants: a systematic review and meta-analyses with at least 12 months of follow-up after functional loading. J Periodontal. 2017 Sep; 8 (9): 876-886. https://doi.org/10.1902/jop.2017.160698.
Casado PL, Bonato LL, Granjeiro JM. Relação entre fenótipo periodontal fino e desenvolvimento de doença peri-implantar: avaliação clínico-radiográfica. Braz J Periodontol. 2013; 23 (1): 68-75.
Kan JYK, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gingival Biotype assessment in the Esthetic Zone: Visual Versus Direct Measurement. Int J Periodontics Restorative Dent. 2010 Jun; 30 (3): 237-43.
Claffey N, Shanley D. Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy. J Clin Periodontal. 1986 Aug; 13 (7): 654-7. https://doi.org/10.1111/j.1600-051x.1986.tb00861.x.
Barriviera M, Duarte WR, Januário AL, Faber J, Bezerra ACB. A new method to assess and measure palatal masticatory mucosa by cone beam computerized tomography. J Clin Periodontal. 2009 Jul; 36 (7): 564-8. https://doi.org/10.1111/j.1600-051X.2009.01422.x.
Yan S, Shi SG, Niu ZY, Pei ZH, Shi SM, Mu C. Soft tissue image reconstruction using cone-beam computed tomography combined with laser scanning: a novel method to evaluate the masticatory mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Dec; 118 (6): 725-731. https://doi.org/10.1016/j.oooo.2014.08.012.
Ueno D, Sato J, Igarashi C, Ikeda S, Morita M, Shimoda S. Accuracy of oral mucosal thickness measurements using spiral computed tomografy. J Periodontol. 2011 Jun; 82 (6): 829-36. https://doi.org/10.1902/jop.2010.100160.
Januário AL, Barriviera M, Duarte WR. Soft tissue cone-beam computed tomography: a novel method for the measurement of gingival tissue and the dimensions of the dentogingival unit. J Esthet Restor Dent. 2008; 20 (6): 366-73; discussion 374. https://doi.org/10.1111/j.1708-8240.2008.00210.x.
Bredesen K, Aalokken TM, Kolbenstvedt A. Ct of the oral vestibule with distended cheeks. Acta radiol. 2001 Jan; 42 (1): 84-87.
Ueno D, Sekiguchi R, Morita M, Jayawardena A, Shinpo S, Sato J, et al. Palatal mucosal measurements in a japonese population using cone-beam computed tomography. J Esthet Restor Dent. 2014 Jan-Fev; 26 (1): 48-60. https://doi.org/10.1111/jerd.12053.
Kan JYK, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: An evaluation of maxillary anterior single implants in humans. J Periodontol. 2003 Apr, 74 (4): 557-62. https://doi.org/10.1902/jop.2003.74.4.557.
Anand V, Govila V, Gulati M. Correlation of gingival tissue biotypes with gender and tooth morphology: A randomized clinical study. Indian J Dent. 2012; 3 (4):190-5. https://doi.org/10.1016/j.ijd.2012.05.006
Lee SP, Kim TI, Kim HK, Shon WJ, Park YS. Discriminant analysis for the thin periodontal biotype based on the data acquired from three-dimensional virtual models of korean young adults. J Periodontol. 2013 Nov; 84 (11): 1638-45. https://doi.org/ 10.1902/jop.2013.120594.
Vandana KL, Savitha B. Thickness of gingiva in association with age, gender and dental arch location. J Clin Periodontol. 2005 Jul; 32 (7): 828-30. https://doi.org/10.1111/j.1600-051X.2005.00757.x.
Cook DR, Mealey BL, Verrett RG, Mills MP, Noujeim ME, Lasho, DJ, et al. Relationship between clinical periodontal biotype and labial plate thickness: an in vivo study. Int J Periodontics Restorative Dent. 2011 Jul-Aug; 31 (4):345-54.
Shah R, Sowmya NK, Mehta DS. Prevalence of gingival biotype and its relationship to clinical parameters. Contemp Clin Dent. 2015 Sep; 6(1): S167-71. https://doi.org/10.4103/0976-237X.166824.
Fischer KR, Grill E, Jockel-Schneider Y, Bechtold M, Schlagenhauf U, Fickl S. On the relationship between gingival biotypes and supracrestal gingival height, crown form and papilla height. Clin Oral Impl Res. 2014 Aug; 25 (8): 894-8. https://doi.org/10.1111/clr.12196.
Amid R, Mirakhori M,Safi Y, Kadkhodazadeh M, Namdari M. Assesment of gingival biotype and facial hard/soft tissue dimensions in the maxillary anterior teeth region using cone beam Computed tomography. Arch Oral Biol. 2017; 79: 1-6. https://doi.org/10.1016/j.archoralbio.2017.02.021.
Anegundi RV, Shenoy SB, Punj A. Gingival biotype as an indicator for the buccal bone thickness - a systematic review of the literature. Evid Based Dent. 2021 Nov 23. https://doi.org/10.1038/s41432-021-0206-y.
Ronay V, Sahrmann P, Bindl A, Attin T, Schmidlin PR. Current status and perspectives of mucogingival soft tissue measurement methods. J Esthet Restor Dent. 2011 Jun; 23 (3): 146-57. https://doi.org/10.1111/j.1708-8240.2011.00424.x.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Revista da Faculdade de Odontologia da UFBA
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.
