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Objective: To compare gingival phenotype assessment methods based on soft tissue transparency on different backgrounds and assessor experience levels., Methods: For this purpose, 24 gingival specimens were retrieved from pig jaws with tissue thicknesses from 0.2 to 1.25 mm. Three methods were assessed: periodontal probe PCP12 (thin/thick), double-ended periodontal probe DBS12 (thin/moderate/thick) and colour-based phenotype probe CBP (thin/moderate/thick/very thick). Each sample was photographed with each probe underneath and categorized whether the probe was visible or not using different coloured backgrounds. To measure experience level influence, dentists, dental undergraduate students and laypersons (n = 10/group) performed the evaluation., Results: PCP12 probe showed a threshold between 0.4 and 0.5 mm. To distinct between thin and moderate thick gingiva, a comparable range for DBS12 was found while moderate thickness was between 0.5 and 0.8 mm and for thick above 0.8 mm. CBP also showed a comparable threshold of 0.5 mm for thin versus moderate as compared with the other methods; above 0.8 mm, predominantly a very thick tissue was measured. In general, the background colour had a minor impact on PCP12 and DBS12, and investigator experience showed no clear influence on GP assessment., Conclusion: Based on probe transparency and within the limitation of a preclinical study, we suggest GP differentiation into three entities: thin (< 0.5 mm; high risk), moderate (0.5-0.8 mm; medium risk) and thick (> 0.8 mm; low risk)., Clinical Relevance: All three GP assessment methods are easy to perform and seem to have a high predictive value with a three entities classification for DBS12 and CBP., (© 2021. The Author(s).)

Objectives: To evaluate the relationship between gingival biotypes and gingival thickness based on probe transparency through the gingival margin and to assess the sensitivity of a novel classification method., Material and Methods: Sixty adult Caucasian subjects were stratified by their gingival biotype (GB) as defined by the transparency of a prototype double-ended periodontal probe through the buccal gingival margin into "thin" (30 subjects), "moderate" (15 subjects), and "thick" (15 subjects) GB. Three additional parameters were also assessed: gingival thickness (GT), probing depth (PD), and gingival width (GW)., Results: Median GT was 0.43 mm (P 25% 0.32; P 75% 0.58) for thin, 0.74 mm (P 25% 0.58; P 75% 0.81) for moderate, and 0.83 mm (P 25% 0.74; P 75% 0.95) for thick GB, respectively. GT was statistically significant different for thin versus moderate and thin versus thick, respectively (Kruskal-Wallis test, p < 0.05; Dunn's test, thin versus moderate: p = 0.002; thin versus thick: p < 0.001; moderate versus thick: p = 0.089). GW was directly correlated with GT (Spearman correlation p < 0.01). The sensitivity of the new classification tool for diagnosing a thin GB was 91.3%. No adverse events or complications were reported., Conclusion: GT differs significantly between the presented GB groups, hence, an alternative classification especially focusing on thin biotypes based on a modified periodontal probe might be advantageous. In addition, the presence of a thick gingiva is associated with a wide band of keratinized tissue., Clinical Relevance: This clinical setting might to be useful to identify high-risk patients with a very thin biotype and, consequently, higher risk for gingival recession after dental treatments.

Objectives: The objective of this study was to determine the relationship between crown length as well as crown width and gingival morphotypes (primary aim) and their correlation with tooth shape and papilla height (secondary aim)., Material and Methods: Thirty-six adult subjects were evaluated in this clinical study according to their gingival morphotype (GM) defined by transparency of a periodontal probe through the buccal gingival margin. Eighteen subjects comprised the thin entity group and 18 the control group thick entity, respectively. Besides crown length (CL) and crown width (CW), two different methods to assess crown shape (CW/CL ratio) were compared and analysis of their relation to papilla height was performed., Results: Nineteen female and 17 male volunteers were enrolled in this study, with a mean age of 24.9 years (±3.4; minimum 18, maximum 35). A statistical significant difference for the crown length could be detected between both groups (p < 0.05) but not for crown width. No significant difference was found for apical or coronal CW/CL ratio besides on tooth 22., Conclusion: Within the limitations of this study and within this young Caucasian study population, only crown length seems to have an association with different gingival morphotypes. Furthermore, papilla height and crown shape do not have a clear correlation on tooth level., Clinical Relevance: Crown shape seems to be not a strong parameter in assessing the gingival morphotype.

Objectives: The aims of this study were to determine the quality of life of periodontally compromised patients after implant treatment (primary aim) and their satisfaction with the restoration and treatment approach (secondary aim)., Material and Methods: In this study, 61 adult subjects were evaluated following non-surgical periodontal treatment, under regular maintenance and implant therapy with a fixed restoration. Oral health-related quality of life (OHQoL) was assessed using the German short form of the Oral Health Impact Profile (OHIP-G14). Patient satisfaction with the restoration and treatment procedure was investigated applying a self-designed questionnaire focusing on social-psychological aspects. Statistical analysis of the collected data was performed using Kruskal-Wallis and Man-Whitney U test for the relationship between OHIP score and number of implants, patient age and level of education., Results: The average OHIP-G14 score of the examined study population was 2.78 (SD ±4.2), while the item pain had the biggest influence on the number of points. No statistical significance was detected between the relationship of OHIP-G14 score and the number of placed implants (p = 0.98). Furthermore, there was no statistically significant correlation between OHIP-G14 score and patient age (p = 0.67) or for level of education (p = 0.39). The questionnaire focusing on patient satisfaction showed a high level of contentment in this study population. All patients declared that they would repeat the treatment and most (98.4%) would recommend it to their friends. Furthermore, a high level of satisfaction with aesthetics, stability, cleanability and speech comprehension was reported., Conclusion: The examined study population showed a quality of life after implant therapy comparable to pre-existing reference values of a healthy non-restored population. There was no statistical significance between OHIP-G 14 score and the number of implants, patients' age and education level. Analysis of the satisfaction with the realized implant therapy provided consistently positive results., Clinical Relevance: When restoring periodontally compromised patients, implant treatment should be considered to achieve potentially higher oral health-related quality of life compared to for example removable dentures. This needs to be investigated in randomized controlled clinical trials.

Objectives: The aim of this study is to compare wound healing and patient pain perception of single-incision (single-incision, modified single-incision) and trap-door surgical techniques to harvest subepithelial connective tissue grafts from the palate., Material and Methods: Thirty-six patients were selected for root coverage procedures with subepithelial connective tissue grafts and randomly assigned to two single-incision groups or a trap-door group (n = 12/group). One week after surgery, a modified early-wound healing index (EHI), patient pain and painkiller intake were recorded. Follow-up was performed until complete epithelialization was achieved., Results: Single-incision techniques showed significantly improved early healing over trap-door approaches. Specifically, the mean EHI was 2.50 ± 1.14 for single-incision techniques, as compared to 3.33 ± 1.30 for trap door. The incidence of secondary healing was significantly lower in the single-incision groups. Concomitantly, the cumulative dosage and duration of painkiller intake were significantly reduced, as compared to the trap-door group., Conclusion: Within the limits of this trial, single-incision techniques can lead to improved early healing and reduced patient pain after subepithelial connective tissue graft harvesting than trap-door techniques., Clinical Relevance: Avoiding trap-door incisions for harvesting of connective tissue grafts may reduce patient morbidity.

Objectives: The objective of this study is to compare tissue reduction following papilla-sparing and sulcular incisions in oral surgical indications., Material and Methods: Five beagle dogs were used. Three months after tooth extraction of P2-M1, notches were prepared at the height of the interproximal gingiva into M2 and P1. Papilla-sparing and sulcular incisions were randomly performed, full-thickness flaps elevated and flaps repositioned. Three months postoperatively, tissue reduction was assessed using a digital calliper, mean values were calculated per group and analysed using a Wilcoxon matched-pair rank test., Results: Papilla-sparing incisions revealed significantly less (p < 0.05) tissue reduction than sulcular incision techniques., Conclusion: Papilla-sparing incisions seem to induce less tissue response following flap surgery compared to sulcular incisions in oral surgical indications. Nevertheless, tissue reduction was seen in both groups., Clinical Relevance: For surgical approaches without the necessity of direct access to the root surface (i.e., implantology, oral surgery), papilla-sparing incisions may be superior compared to sulcular incisions.