Search

Objective: To measure the three-dimensional morphology of the labial supraosseous gingiva (SOG) and the thickness of related labial bone in maxillary anterior teeth of periodontally healthy Han nationality youth using soft tissue indirect imaging cone-beam computed tomography (CBCT)., Methods: Twenty-five periodontally healthy subjects (11 males and 14 females) with 150 maxillary anterior teeth were involved in this study. A special impression with radiopaque material including the maxillary teeth was made, then a CBCT scan with the elastomeric matrix in position was taken for each subject. The imaging data were generated and transferred to a volumetric imaging software in which three-dimensional reconstruction was conducted and the image analyses were carried out. Measurements were made at the site of labial center of the maxillary anterior teeth. The height of the SOG, the distance between cemento-enamel junction (CEJ) and bone crest, the gingival thickness at the CEJ, and the thickness of bone 2 mm below the labial bone crest were measured and the correlation analysis between the parameters was made. All the data analyses were performed using SPSS 22.0. The data were analyzed with ANVOA and Pearson correlation tests with the significance level at α =0.05., Results: The mean SOG values were (3.49±0.70) mm, (3.48±0.81) mm, and (3.54±0.67) mm for central incisors, lateral incisors and canines, respectively. There were no statistically significant differences among the different sites ( P > 0.05). The mean gingival thickness values were (1.45±0.23) mm, (1.13±0.24) mm, (1.14±0.22) mm for central incisors, lateral incisors and canines, respectively. The gingival thickness of the central incisors was the largest among the maxillary anterior teeth with statistically significant difference ( P < 0.05). No correlation was found between the SOG and gingival thickness among the maxillary anterior teeth ( P > 0.05)., Conclusion: The gingival thickness of central incisors was the largest and the supraosseous gingival height had no correlation with gingival thickness among the periodontally healthy maxillary anterior teeth.

Gingival papilla deficiency may cause dental plaque stagnation and food impaction, and may also affect the appearance and pronunciation when occurs in the upper anterior teeth. It has become a common concern of patients and doctors. The aetiological factors of gingival papilla deficiency were complex. Various surgical or non-surgical treatments have been reported. This paper reviews and analyzes the current research progress on the factors and treatment methods of gingival papilla deficiency in domestic and foreign studies, summarizes the factors associated with the gingival papilla deficiency and summarizes the corresponding treatment strategy, so as to provide reference for clinical and research works.

For ideal implant rehabilitation, an adequate bone volume, optical implant position, and stable and healthy soft tissue are required. The reduction of alveolar bone and changes in its morphology subsequent to tooth extraction will result in insufficient amount of bone and adversely affect the ability to optimally place dental implants in edentulous sites. Preservation of alveolar bone volume through ridge preservation has been demonstrated to reduce the vertical and horizontal contraction of the alveolar bone crest after tooth extraction and reduce the need for additional bone augmentation procedures during implant placement. In this case, a patient presented with a mandible molar of severe periodontal disease, the tooth was removed as atraumatically as possible and the graft material of Bio-Oss was loosely placed in the alveolar socket without condensation and covered with Bio-Gide to reconstruct the defects of the alveolar ridge. Six months later, there were sufficient height and width of the alveolar ridge for the dental implant, avoiding the need of additional bone augmentation and reducing the complexity and unpredictability of the implant surgery. Soft tissue defects, such as gingival and connective tissue, played crucial roles in long-term implant success. Peri-implant plastic surgery facilitated development of healthy peri-implant structure able to withstand occlusal forces and mucogingival stress. Six months after the implant surgery, the keratinized gingiva was absent in the buccal of the implant and the vestibular groove was a little shallow. The free gingival graft technique was used to solve the vestibulum oris groove supersulcus and the absence of keratinized gingiva around the implant. The deepening of vestibular groove and broadening of keratinized gingiva were conducive to the long-term health and stability of the tissue surrounding the implant. Implant installation and prosthetic restoration showed favorable outcome after six months.

Objective: To explore a crown form classification method for upper central incisor which is more objective and scientific than traditional classification method based on the standardized photography technique. To analyze the relationship between crown form of upper central incisors and papilla filling in periodontally healthy Chinese Han-nationality youth., Methods: In the study, 180 periodontally healthy Chinese youth ( 75 males, and 105 females ) aged 20-30 (24.3±4.5) years were included. With the standardized upper central incisor photography technique, pictures of 360 upper central incisors were obtained. Each tooth was classified as triangular, ovoid or square by 13 experienced specialist majors in prothodontics independently and the final classification result was decided by most evaluators in order to ensure objectivity. The standardized digital photo was also used to evaluate the gingival papilla filling situation. The papilla filling result was recorded as present or absent according to naked eye observation. The papilla filling rates of different crown forms were analyzed. Statistical analyses were performed with SPSS 19.0., Results: The proportions of triangle, ovoid and square forms of upper central incisor in Chinese Han-nationality youth were 31.4% (113/360), 37.2% (134/360) and 31.4% (113/360 ), respectively, and no statistical difference was found between the males and females. Average κ value between each two evaluators was 0.381. Average κ value was raised up to 0.563 when compared with the final classification result. In the study, 24 upper central incisors without contact were excluded, and the papilla filling rates of triangle, ovoid and square crown were 56.4% (62/110), 69.6% (87/125), 76.2% (77/101) separately. The papilla filling rate of square form was higher (P=0.007)., Conclusion: The proportion of clinical crown form of upper central incisor in Chinese Han-nationality youth is obtained. Compared with triangle form, square form is found to favor a gingival papilla that fills the interproximal embrasure space. The consistency of the present classification method for upper central incisor is not satisfying, which indicates that a new classification method, more scientific and objective than the present one, is to be found.

Objectives: This study aimed to classify the dynamic smile and to quantify the gingival line (GL), as well as apico-coronal displacement of the gingival zenith (GZ), in the maxillary anterior dentition in a young Chinese population., Methods: Two-hundred young Chinese subjects (100 men and 100 women; 20-35 years of age) with healthy dentogingival tissue were recruited. The dynamic smile process was captured using a digital camera. The smile type, GL type, the vertical distance of the GZ between the canine and the central incisor on the same side and the GZ of the lateral incisor-GL relationship were measured using a self-developed smile-analysis method. The kappa statistics was used to examine the reliability of the data recorded by the rater. The Pearson chi-square test was used to analyse the differences between subjects regarding the frequencies of smile type and GL type at α = 0.05., Results: Data revealed that 45.5% of subjects had a high smile and 45.5% had an average smile; 58.2% of the subjects presented an upwards GL. The GZ of canine teeth was 0.33 mm apical to the corresponding central incisor and no significant difference between both sides of the GZ was observed. The GZ of the lateral incisor was located coronal to the GL in 87.9% of samples. The vertical distance between the GZ of the lateral incisor and the GL was 0.59 mm and no statistically significant difference was detected., Conclusions: The most common findings were a high or average smile type, combined with an upward GL. In the majority of subjects, the GZ of the lateral incisor is coronal to the GL. The apico-coronal displacement of the GZ showed bilateral symmetry., (© 2015 FDI World Dental Federation.)

Objectives: To develop a novel technique to visualize dentogingival profiles by using cone beam computed tomography (CBCT) and to evaluate the accuracy of mucogingival tissue thickness measurements with CBCT, as compared with direct measurements in vitro., Methods: A silicone matrix loaded with radiopaque impression material was prepared before performing CBCT on a patient. Two dry cadaver mandibles with simulated mucogingival tissue and six segmental cadaver jaws were used to assess the accuracy of mucogingival tissue thickness measurements directly and radiographically with CBCT images. Paired t tests were used to evaluate the intra- and interexaminer reliability and to compare the data between direct and CBCT imaging measurements at α = 0.05., Results: No statistically significant differences were observed between direct and CBCT imaging measurements of simulated mucogingival tissue thickness in mandibular models and in cadaver jaws (P > .05). Results of direct measurements with simulated mucogingival tissue thickness indicated good intra- and interexaminer reliability., Conclusions: A novel technique was developed to obtain mucogingival tissue thickness data on the use of radiopaque impression materials and CBCT imaging. This new method provides a reliable visual dentogingival profile and a means to objective measurements., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: To investigate the features of the fill of interdental spaces by gingival papillae and the associated factors., Methods: Fifteen volunteers with healthy gingiva were involved in this study. The height and thickness on the alveolar crest level of 62 maxillary anterior papilla were measured radiographically with cone-beam computed tomography (CBCT) scans. A standardized periodontal probe with Williams markings was used for measurements of the papilla width on the alveolar crest level., Results: When the papilla was complete fill interdentally, the mean height of papillary tissue on the alveolar crest level (equal to contact point-bone crest) was (3.67 ± 0.51) mm. The mean thickness of papilla on the alveolar crest level was (8.38 ± 0.75) mm. The papilla height had a positive correlation with papilla thickness (r = 0.433, P < 0.001)., Conclusions: The cone-beam computed tomography can be used for clear visualization of the papilla profile and the measurements of papilla height and thickness. Thicker and wider tissue was associated with an increased likelihood of having a complete papilla fill.

Objective: To establish the relationship of the gingival crest, the gingival curve characteristic point (inflection point, IP) and the contact points and to use it as reference to design the location of contact area in anterior teeth restoration to form the natural papillae., Methods: Two-dimensional gingival curve morphology analysis based on standardized digital images was done to measure the value of different points in the upper anterior teeth for 120 young Chinese., Results: In the maxillary anterior teeth, the average mesial papilla heights(MPH) of central incisors(CI), lateral incisors(LI), canines(CA) were (4.49 ± 0.86) mm, (3.64 ± 0.77) mm and (4.12 ± 0.92) mm; the average distal gingival papilla heights(DPH) were (4.09 ± 0.72) mm, (3.48 ± 0.83) mm and (4.13 ± 0.94) mm . The relationship of the gingival curve inflection points of maxillary anterior teeth with the gingival zenith and the contact points were determined in horizontal and vertical ways. In the CI, the mesial IP in X and Y axis were 0.61±0.10 and 0.26±0.07, in distal were 0.57±0.10 and 0.25±0.07. In the LI, the mesial IP in X and Y axis were 0.50±0.10 and 0.23±0.08, in distal were 0.56±0.11 and 0.26±0.08. In the CA, the mesial IP in X and Y axis were 0.52±0.09 and 0.23±0.07, the distal IP were 0.60±0.12 and 0.26±0.08., Conclusion: The upper anterior teeth papillae shapes of the different teeth and gingival curves are determined with certain characteristics, and the gingival curve inflection points have some mathematical relationship with the gingival crest and the contact points.

Objective: To develop a novel method for obtaining the clear visualization of the gingival profile by cone-beam computed tomography (CBCT) that consistently allows the measurements of gingival thickness and use it to explore the relationship between the gingival thickness and gingival biotype, and the gingival thickness and underlying alveolar bone thickness in the maxillary anterior region., Methods: In this study, 15 volunteers with healthy gingiva in the maxillary anterior teeth were involved, and a special preparation was done before CBCT scans including making impression with the contrast agent. The tissue biotypes were assessed clinically with the probe, The thickness of both gingiva and bone and the gingival thickness of the cemento-enamel junction (CEJ) were measured radiographically with cone-beam computed tomography scans. All data analyses were performed using SPSS 16.0., Results: The CBCT image showed clear visualization of the gingival profile. The average gingival thickness of the CEJ was (1.22±0.32) mm. A correlation was observed between the tissue biotypes and the gingival thickness (r=0.449,P<0.05). The labial gingival thickness was negative associated with the underlying bone thickness measured with CBCT in the maxillary anterior region (r=-0.31, P=0.021)., Conclusion: A method was established for measuring gingival thickness based on cone-beam computed tomography. The gingival biotypes had a positive correlation with gingival thickness of the CEJ.

Objective: To establish a convenient, objective and applicable method to assess gingival biotype using periodontal probing., Methods: A total of 66 maxillary anterior teeth from 14 volunteers (6 males, 8 females) with healthy gingiva, aged from 20 to 30 years, were recruited in this study. The gingival biotypes were evaluated by whether or not the outline of the periodontal probe was clear inside the gingiva. Gingival thickness of the cemento-enamel junction (CEJ) in upper anterior teeth was measured by cone-beam CT (CBCT)., Results: The method of periodontal probing-assessed gingival biotype had good consistency and repeatability. The result of probing-assessed gingival biotype was consistent with that obtained by CBCT. The mean thickness of gingiva in thin, compromised and thick gingival biotype was (1.02 ± 0.20), (1.28 ± 0.25) and (1.46 ± 0.25) mm. These differences were significant for all three comparisons (P = 0.001, respectively)., Conclusions: Periodontal probing-assessed gingival biotype is a simple, relatively objective and suitable method for clinical examination.

Objective: To measure the width of keratinized gingiva and attached gingiva of anterior dental arch in order to establish reference guidance for periodontal surgery., Methods: A total of 120 healthy Chinese Han-nationality volunteers aged 20 - 30 years with healthy gingival tissue were recruited. The width of anterior labial dental arch, keratinized gingiva of gingival zenith, depth of gingival sulcus, and the width of coronal-apical keratinized gingiva of interdental papilla were measured respectively and the data were statistically analyzed., Results: The width of keratinized gingiva and attached gingiva at gingival zenith varied for each individual and tooth location, ranging up to (5.6 ± 1.3) mm in the anterior maxillary region and (4.5 ± 1.1) mm in the anterior submandibular region. The width decreased over the canine and first premolar and increased slightly over the second premolar. The width of keratinized gingiva at interdental papilla ranged from (6.2 ± 1.3) mm to (8.9 ± 1.4) mm in the maxilla and from (5.8 ± 1.0) mm to (7.6 ± 0.9) mm in the mandible. The narrowest width of keratinized gingiva at interdental papilla was located over central incisors., Conclusions: There is a variation of width on labial keratinized gingiva of anterior dental arch of Han nationality youth among different individuals and tooth locations.