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Purpose: The present study aimed to evaluate and compare the management of Jump space (JS) in immediate implants with and without Demineralised freeze-dried bone allograft (DFDBA) with flapless approach. Materials and Methods: The present study included 40 sites with immediate implant placement in the maxillary anterior region. Group 1 patients were treated without augmentation while Group 2 patients with DFDBA in the JS. Both the groups were further subdivided according to the horizontal dimensions as JS less (G1S1, G2S1) or more than 2mm (G1S2, G2S2). Plaque index (PI), Gingival Index (GI), Probing depth (PD), Testori esthetic score (TS), VAS score, Crestal Bone height (CBH), Ridge width (RW), Vertical distance (VD) and radiolucent area (RA) were evaluated radiographically with CBCT at baseline and 12 months' post therapy. Results: Significant differences were observed in CBH in the midfacial region in G1S1-G2S1 with the mean of 0.34±0.19mm and G1S2 --G2S2 with 0.75±0.26 mm at 12 months. Significant differences in TS were observed in G1S1 and G2S1 with mean value of 0.55±0.53 while G1S2 and G2S2 exhibited value of 1.33±0.82. Conclusion: DFDBA shows better CBH preservation in midfacial region, reduction in RA indicating greater resolution of JS thereby leading to better hard and soft tissue healing. [ABSTRACT FROM AUTHOR]

Background: The present study aims to evaluate and compare the effects of 1% melatonin gel plus platelet‐rich fibrin (PRF) and PRF alone in treatment of furcation defects, clinically and radiographically using cone‐beam computed tomography. Methods: This split‐mouth clinical trial included 23 patients with 46 bilateral Grade II furcation defects in first or second maxillary or mandibular molars. Control group was treated with PRF alone while the test group was treated with 1% melatonin gel and PRF. Clinical attachment level (CAL) and horizontal probing depth (HPD) were primary outcome parameters while secondary outcome parameters were pocket probing depth (PPD) and defect volume (DV) assessed at 3 and 6 months postoperatively. Results: Significantly greater mean reduction of PPD, HPD, and CAL gain was observed in test group (2.23 ± 0.41, 2.36 ± 0.68, and 2.97 ± 0.62 mm, respectively) in comparison with control group (2.83 ± 0.78, 2.85 ± 0.67, and 3.21 ± 0.86 mm, respectively) at 6 months. A significant reduction in the mean DV was exhibited radiographically in test group (1.06 ± 0.5 mm3) as compared with control group (3.94 ± 1.32 mm3) at the end of 6 months. Both the groups showed improvements in assessed parameters. Conclusions: In Grade II furcation defects the combination therapy of 1% melatonin + PRF shows a statistically significant degree of bone fill within the periodontal tissues and also better results in terms of decrease in PPD, HPD, and a greater CAL gain. [ABSTRACT FROM AUTHOR]

Objectives: The present study evaluated hard- and soft-tissue changes in immediate implants using flapless approach with and without demineralized freeze-dried bone allograft (DFDBA) clinically and radiographically using cone-beam computed tomography (CBCT). Materials and Methods: Thirty-two sites in patients requiring immediate implants in the maxillary anterior region including the premolars were grouped according to the treatment provided with (test group) or without (control group) DFDBA. Plaque index, probing depth, soft-tissue assessment using Testori Esthetic Score (TS), and ridge width were recorded at baseline and postoperatively at 6 and 12 months, while crestal bone height (CBH), buccal bone thickness (BBT), jump space (JS), and gingival thickness were evaluated using CBCT at baseline and 12 months. Results: Considerable differences among the different time lines and the groups in favor of the test group were prominently seen on the midfacial aspects at 12 months, with CBH values of -0.28 ± 0.17 mm in the test group as compared to -0.78 ± 0.34 in the control group (P < 0.0001). The JS was maximum on the buccal aspects being 1.42 ± 0.87 mm in the test group and 1.12 ± 0.81 mm in the control group which reduced at 12 months to 0.13 ± 0.35 mm and 0.73 ± 0.79 mm, respectively. Conclusion: Immediate implants with DFDBA augmentation using a flapless protocol demonstrated reduced CBH with resolution of JS and increased BBT, especially at the coronal aspects which influence the tissue stability and overall esthetics. [ABSTRACT FROM AUTHOR]

Background: This study was designed to assess the influence of non‐surgical periodontal therapy (NSPT) on gingival crevicular fluid (GCF) levels of semaphorin‐4D (SEMA‐4D), peptidylarginine deiminase‐2 (PAD‐2), and matrix metalloproteinase‐8 (MMP‐8) levels in periodontally healthy, Stage III periodontitis non‐smoker and smoker patients. Methods: Sixty patients were equally divided into three groups, Group I: Periodontally healthy, Group II: Non‐smokers with Stage III periodontitis, and Group III: Smokers with Stage III periodontitis. The patients underwent NSPT with clinical and biochemical parameters examined at baseline and 3 months post therapy. GCF was collected for levels of SEMA‐4D, PAD‐2, and MMP‐8 through enzyme‐linked immunosorbent assay (ELISA). Results: Greater values of PPD (8.06 ± 0.19 mm), CAL (8.94 ± 0.19 mm), PI (2.58 ± 0.19) while lower PBI (1.39 ± 0.19%) and GI (1.72 ± 0.19) scores were seen in Group III as compared to Group II, which reduced significantly from baseline to 3 months in both the groups after NSPT. Minimum values of SEMA‐4D, PAD‐2, and MMP‐8 levels in GCF were seen for Group I, which increased incrementally to Group II and III. Also, among Group II and III the SEMA‐4D, PAD‐2, and MMP‐8 levels in GCF reduced from baseline to 3 months indicating a favorable response within the tissues. Conclusion: Greater levels in GCF of Levels of SEMA‐4D, PAD‐2, and MMP‐8 in Group II and III, which reduced significantly post NSPT, implied that these biomarkers play a pivotal role in the inflammatory process and can be utilized for early diagnosis. [ABSTRACT FROM AUTHOR]

The present randomized controlled study was undertaken to evaluate and compare peri-implant hard and soft tissue changes between implants restored with multiple disconnections and reconnections of the abutment (control group) vs implants restored with a definitive abutment (test group). Twenty edentulous sites from 13 systemically healthy participants were selected for the study. The recorded clinical parameters were bleeding on probing (BOP) and peri-implant pocket depth (PIPD). The measured radiographic parameter was peri-implant marginal bone loss (PMBL). Two parameters were measured both clinically and by CBCT: distance from the cementoenamel junction to the alveolar crest and alveolar ridge width. At the time of surgery, sites were randomly assigned to either the control or test group. At 6 months, (1) BOP was absent in both groups, (2) PIPD increased in both groups and was significantly greater in the control group, and (3) the mean PMBL was significantly higher in the control group than the test group. Thus, it can be concluded that the use of implants with a definitive abutment could be more beneficial in achieving better maintenance of marginal peri-implant tissue health. [ABSTRACT FROM AUTHOR]

Objectives: The present retrospective study assessed the width of keratinized mucosa (WKM) and vestibular depth (VD) adjacent to dental implants subsequent to vestibular extension procedure in patients exhibiting inadequate WKM. A correlation between these two parameters with peri-implant soft tissue stability and the incidence of peri-implant soft tissue dehiscence (PSTD) was also examined. Method and materials: The study included 36 patients (age range 30 to 50 years) with implant restoration. The patients with an inadequate WKM and VD underwent vestibular extension procedure in areas of implant placement. The Modified Plaque Index, Gingival Index, Sulcus Bleeding Index, WKM, VD, and the peri-implant probing depth were measured and compared at baseline, 3 months, and after 1 and 2 years post vestibular extension procedure. Results: A significant enhancement was observed in VD dimensions for both men and women from baseline (1.73 ± 1.10 mm and 1.57 ± 0.98 mm, respectively) to 2 years posttherapy (6.93 ± 0.88 mm and 7.95 ± 1.12mm, respectively). Similarly, there was an increase in WKM of 4.14 ± 0.24 mm in men and 4.84 ± 0.14 mm in women. However, a weak and insignificant negative correlation was observed between WKM, VD, and PSTD after 2 years. Conclusion: The results of the present study indicate that the vestibular extension procedures around dental implants enable the clinician to achieve greater WKM and VD posttherapy, which is maintainable for a considerable time. The peri-implant soft tissue stability achieved thereafter ensures proper oral hygiene at the site and also negatively correlates with the PSTD. [ABSTRACT FROM AUTHOR]

Background: To evaluate and compare efficacy of pinhole surgical technique (PST) alone and with advanced platelet rich fibrin (A‐PRF) in the management of bilateral multiple adjacent gingival recession defects (MAGRD). Methods: One hundred and sixty five MAGRD were randomly assigned to control group (treated with PST) and test group (PST with A‐PRF). Clinical parameters of gingival recession depth (GRD), gingival recession width (GRW), width of keratinised gingiva (WKG), complete root coverage (CRC) and gingival thickness (GT) on ST‐CBCT was measured at 2, 4 and 6 mm apically from the gingival margin. Also, root coverage aesthetic score and patient satisfaction ratings were recorded at baseline, 6 and 12 months postoperatively. Results: Substantial reduction in GRD (Test: 1.29 ± 0.69 mm and Control 0.98 ± 0.30 mm) (p < 0.001) and GRW (Test: 2.03 ± 0.90 mm and control 1.73 ± 0.99 mm) (p < 0.05) with associated gain in WKG and GT was observed (p < 0.001). Mean GT values were increased in both the groups at 2, 4 and 6 mm from the crest. Comparison of Test and Control groups yielded significant reductions in GRD (−0.17 ± 0.56 mm) and WKG (0.73 ± 1.07 mm) favoring the Test group (p < 0.05). Similar increase in GT was observed with better results in Test than control group. (p < 0.001). Conclusion: Both groups exhibited sound clinical outcomes with test group offering better resolution of MAGRD in comparison to control group. Also, it enhances clinical and therapeutic end results in terms of attaining reduction in GRD and GRW along with greater gain in KTW and GT. Clinical Significance: PST as a minimally invasive approach has numerous benefits, some of which include the absence of scarring and improved aesthetics linked to faster wound healing. The addition of A‐PRF enhances the intended therapy outcomes, which is beneficial for both patients and professionals in the field of periodontics. [ABSTRACT FROM AUTHOR]

Aim: The harmonious existence of the extraorai and intraoral attributes are critical and capable of enhancing smiie esthetics. Therefore, the present study was planned as a gender-based evaluation and correlation of interpupillary width (IPW) and intercommisural width (ICOW) with the combined width of the maxillary central incisors and anterior teeth and gingival thickness (GT) in periodontaiiy heaithy patients. Materials and methods: A total of 120 patients within an age range of 20 to 40 years were divided equally into two groups based on gender. The extraoral parameters were recorded on digitized photographs, the intraoral parameters on a stone cast with dental floss and a digital caliper, and the GT clinically. Results: The mean values of IPW and GT in males and females were 63.95 ± 4.40 mm and 60.55 ± 2.43 mm, and 2.14 ± 0.37 mm and 1.07 ± 0.21 mm, respectively. Similarly, the mean combined width of the maxillary central incisors and anterior teeth in males and females differed significantly, being 18.69 ± !.16 mm and 17.86 ± 1.09 mm, and 55.70 ± 3.14 mm and 51.46 ± 2.18 mm, respectiveiy. Conclusions: Although the correlations between the parameters in the present study were found to be weak and positive, they can be accepted as preiiminary findings that may require further exploration. The gender variability of the extraoral and intraoral parameters such as IPW, GT, combined width of the maxillary anterior teeth (CMA), and combined width of the maxillary central incisors (CMI) provide valuable guidelines that can be implemented in restorative procedures in the maxillary anterior sextant. (Int J Esthet Dent 2023;18:378-388) [ABSTRACT FROM AUTHOR]

Objectives: The retrospective study was undertaken to assess the peri-implant tissue stability in premolar and molar sites clinically and radiographically for implants 7 years after loading. Method and materials: 408 implants placed in 275 patients from 2012 to 2020 and following a regular recall protocol were assessed for Modified Plaque Index (MPI), Sulcus Bleeding Index (SBI), pocket probing depth (PPD), and the peri-implant soft tissue dehiscence (PSTD) clinically and mesial bone loss (MBL) and distal bone loss (DBL) radiographically. Results: Significant differences were found in MPI, SBI, and PPD amongst both men and women in the premolar and molar regions. The mean MBL and DBL were substantially greater in women than in men and marginally more in the maxilla than in the mandible. Maximum mean bone loss on either aspect of the premolar and molar implants was 2.80 ± 1.54 mm and 2.97 ± 0.96 mm for women. Implant success of 96.82% at 7 years was achieved and the patient satisfaction levels of 94.55% and 95.50% in the mandibular and maxillary arches, respectively, implied that patients were satisfied with the treatment. Conclusion: Women exhibited greater marginal bone loss on the mesial and distal aspects than men, with premolar implant sites demonstrating greater propensity for marginal bone loss than molar implant sites. [ABSTRACT FROM AUTHOR]

Objective: The present study was formulated as a gender-based evaluation of the vertical apicocoronal (VAC), horizontal mesiodistal (HMD), and horizontal faciopalatal (HFP) dimensions of the interproximal area and their influence on the presence of interdental papillae and gingival thickness (GT) n maxillary anterior teeth. Materials arid methods: A total of 120 patients in an age range of 20 to 40 years, divided equally into two groups based on gender, were evaluated for interproximal VAC, HMD, and HFP dimensions through radio-visiographic (RVG) images. Additionally, the existence of interdental papillae and GT were assessed clinically in the maxillary anterior sextant. Results: The overall mean VAC dimensions in between the central incisors were greater in females than in males, with maximum mean values of 5.91 + 0.33 mm and 5.03 + 0.23 mm, respectively. The mean..yalues~ for HMD and HFP showed a reverse trend, being greater in males than in females, with the differences being statistically significant. Similarly, the mean GT Was greater in males than in females (P < 0.0001). It was also shown that as the VAC dimension increased, the existence of complete papillae in the interproximal areas reduced. Conclusions: The gender variability of intraoral characteristics such as VAC and GT dimensions and their influence on the existence of interdental papillae provide valuable guidelines that can be 'implemented in procedures in the maxillary anterior sextant. The associations between HMD and HFP dimensions and interdental papillae were not clearly evident, and further exploration in participants of different age groups would be useful and informative, (Int J Esthet Dent 2023;18:128-140) [ABSTRACT FROM AUTHOR]

The systematic review and meta-analysis aimed to evaluate the efficacy of Metformin (MF) with Platelet Rich Fibrin (PRF) over PRF alone in the treatment of periodontal osseous defects. An extensive electronic search for articles published up to September 2021 was conducted on 'Embase', 'PubMed' and other library databases accompanied with manual searching. Randomized controlled trials (RCTs), comparing MF plus PRF Vs PRF alone in periodontal osseous defects were identified in which periodontal pocket depth (PPD), Clinical attachment level (CAL) and Intrabony defect depth (IBD Depth) were the outcome measures. Four studies compared MF plus PRF vs.PRF alone in periodontal osseous defects. Meta-analysis was carried out for PPD reduction, CAL gain and IBD Depth changes. A standardized mean difference (SMD) of 1.86 for PPD reduction, 1.95 for CAL gain and 1.31 for IBD Depth reduction in all the studies was observed and the findings were statistically significant favouring test group. The systematic review indicates supplemental benefits of combination therapy of MF + PRF over monotherapy in resolving periodontal osseous defects. In our quest to achieve maximum regeneration in periodontal osseous defects, combination therapies such as MF + PRF have reported to be better treatment choices over other modalities. [ABSTRACT FROM AUTHOR]

The aim of present study was to evaluate the efficacy of demineralized freeze-dried bone allograft (DFDBA) alone and in combination with chorion membrane (CM) in the treatment of Grade II furcation defects using cone beam computed tomography (CBCT). Sites were randomly assigned to Group I (DFDBA) and Group II (DFDBA + CM). Probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), and horizontal probing depth (HPD) were evaluated at 3 and 6 months and defect volume at 6 months. DFDBA + CM led to significant improvement in all parameters, indicating additional benefits of combination therapy. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the relationship between periodontal disease and general health status in adults using the serum albumin concentration. Materials and Methods: A total of 100 patients of both genders with age range of 40 to 70 years were included in the study. Patients were divided into the following two groups: clinically healthy subjects and patients with periodontitis, that is, loss of attachment ≥5 mm. Dental examinations were carried out at baseline and clinical attachment levels were measured at four sites. Serum albumin concentration was estimated by bromocresol green albumin method. Results: The mean serum albumin levels for Group I was 4.47 g/dl with standard deviation (SD) of 0.276 and for Group II, the mean value of serum albumin was 4.61 g/dl with SD of 0.273. Using Student′s unpaired ′t′ test, the difference between the serum albumin levels in Group I and Group II were found to be statistically significant (P=0.020). The mean body mass index values for Group I was 22.63 with a SD of 3.85, whereas the same for Group II was 22.23 with a SD of 4.21, which were on comparison, found to be nonsignificant (P=0.462). Conclusion: The findings of the clinical trial suggest an inverse relationship between the serum albumin concentration and chronic periodontal disease.

The use of autologous platelet concentrates (PC) in addition to bone graft (BG) in open flap debridement (OFD) has been investigated to improve the efficacy and outcomes of regenerative therapy for furcation defects. This systematic review evaluated efficacy of added benefits of PC to bone grafts in treatment of grade II furcation defects. A thorough literature search on PubMed, Cochrane Library and Google Scholar databases was conducted. Data on outcomes were extracted only from randomized controlled clinical trials on humans with a minimum follow up of 6 months comparing BG alone and BG + PC in treatment of mandibular grade II furcation defect. 36 of the 518 screened articles and abstracts were read in full-text, nine of which have been included in the meta-analysis. The addition of PC to BG has resulted in improvement in PD, GR (with smaller effect); V-DBD and H-DBD showed smaller change in experimental group whereas VCAL and HCAL exhibited overall larger changes with smaller effect. Bone regeneration in terms of defect fill with the addition of platelet concentrates to bone graft remains debatable considering the minimal benefits in the treatment of grade II mandibular furcation defect. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate the gender-based association of gingival exhibit with lip dimensions, intercommissural width (ICW), interdental smile line (ISL), and gingival smile line (GSL) in periodontally healthy patients. Materials and methods: 120 patients aged between 20 and 40 years were divided equally into two groups based on gender. The parameters of lip length (LL) at rest and on smiling, ICW, and the intraoral parameters of gingival exhibit in ISL and GSL were measured on digitized photographs in the maxillary anterior teeth. Results: The LL positions at rest and on smiling differed significantly: 23.50 ± 3.31 mm and 19.89 ± 1.91 mm, and 16.53 ± 2.94 mm and 13.91 ± 1.93 mm for males and females, respectively. The gingival exhibit of the interdental papillae in ISL was 3.01 ± 1.85 mm for males and 4.26 ± 1.85 mm for females, while the mid-facial exhibit in GSL was 0.62 ± 1.01 mm for males and 1.24 ± 1.44 mm for females; both the differences were statistically significant. Conclusion: The gender variability in LL, the interdental papillae exhibit in ISL, and the midfacial exhibit in GSL can provide constructive guidelines that can be implemented in the esthetic zone. [ABSTRACT FROM AUTHOR]

Objective: The gingival tissues surrounding the maxillary anterior teeth play a pivotal role in fostering a beautiful smile. The gingival zenith position (GZP) and its spatial orientation in the mesiodistal and apicocoronal direction can provide a valuable reference point. The present study was undertaken to evaluate the GZP and gingival zenith line (GZL) in maxillary anterior teeth in different age groups and genders. Method and Materials: The study population comprised 124 periodontally healthy patients equally divided into 21 to 40 years (Group I) and 41 to 60 years (Group II) age groups and gender distribution. The parameters of vertically bisected midline (VBM), GZP, and GZL were evaluated for all the teeth. Results: The GZP was distally placed in 54.68% and 78.12% of the central incisors for males and females in Group I, while in Group II it was 65.62% and 75.00% respectively. The majority of lateral incisors and canines had coincidence of the GZP and VBM. The GZL was found to be at an apical position with reference to the GZP of lateral incisors. Conclusion: A distal deviation of GZP was observed for central incisors, while the GZP coincided with the VBM for lateral incisors and canines. The GZL was apically placed in relation to the GZP of lateral incisors. These elements can be taken up as reference points in periodontal and restorative procedures. [ABSTRACT FROM AUTHOR]

The presence of interdental papilla between the maxillary central incisors has a considerable influence on harmonizing esthetics and biologic functions. Preliminary investigations indicate an association between tooth shapes and periodontal characteristics. This study aimed to evaluate the prevalence of morphologic variation in maxillary central incisors and its influence on gingival characteristics. It was determined that varied crown forms have a definite influence on gingival characteristics, which could act as a valuable guideline in periodontal, restorative, and anterior implant placement procedures. [ABSTRACT FROM AUTHOR]

Objective: Interdental soft tissues play a critical role in pink esthetics. The presence and preservation of the interdental papillae in the esthetic zone is as crucial as the shape and contour of the anterior teeth in achieving an esthetically pleasing smile. The present study determines the association of central papilla recession with gingival and interdental smile line in periodontally healthy patients of different age groups. Method and Materials: The present study included 200 patients equally divided into 21 to 40 years and 41 to 60 years age groups. The clinical and photographic evaluation of the central papilla, with midfacial gingiva and its relationship with the vermilion border was performed. Results: In total, 137 patients exhibited presence of central papilla, whilst 63 patients had central papilla recession with variable extent. The male patients predominantly had presence of central papilla in both the age groups, with 86% and 64%, compared with 74% and 50% in females, respectively. High gingival smile line was seen in the majority of the patients (62%) and this trend was similar to high interdental smile line (82% of the patients). Conclusion: Esthetics is affected in individuals having papilla recession along with high gingival smile line and interdental smile line as compared to individuals with low or cupid bow gingival smile line and interdental smile line. [ABSTRACT FROM AUTHOR]

Volumetric changes were evaluated to assess the regenerative efficacy of demineralized freeze-dried bone allograft (DFDBA) with and without amnion membrane (AM) in Grade II furcation defects both clinically and radiographically using cone beam computed tomography (CBCT). Sites were randomly assigned to Group I (DFDBA) and Group II (DFDBA + AM). Clinical parameters such as probing pocket depth, clinical attachment level, gingival recession, and horizontal probing depth were assessed at baseline, 3 months, and 6 months. Radiographic dimensions of the defect height, width, depth, and volume were assessed at baseline and 6 months postoperatively. DFDBA used with AM resulted in significant improvement in clinical and radiographic parameters when compared with DFDBA alone. The mean reductions in radiographic volume of the defect were 11.15 ± 6.39 mL for Group I and 17.02 ± 10.86 mL for Group II. Greater reduction in volume indicated a greater amount of healed regenerated tissue in Group II patients. [ABSTRACT FROM AUTHOR]

Background: The present study was aimed to evaluate and compare the effects of 1% MF plus PRF over PRF alone in treatment of Grade II furcation defects, clinically and radiographically by using cone-beam computed tomography.Methods: This split-mouth clinical trial randomly allotted 21 patients with 42 bilateral Grade II furcation defects into two groups. Group I was treated with PRF alone while Group II with 1% MF gel and PRF. The primary outcome parameters were clinical attachment level (CAL) and horizontal probing depth (HPD) while the secondary outcome parameters were probing depth (PD) and defect volume (DV). The clinical parameters were evaluated at 3, 6, and 12 months and the radiographic parameters at 12 months.Results: Both the study groups yielded improvements in assessed parameters; however, significantly greater mean reduction of PD, HPD, and CAL gain was observed in Group II (3.90 ± 0.78 mm, 2.94 ± 0.80 mm, and 3.42 ± 0.93 mm) in comparison with Group I (3.23 ± 0.90 mm, 1.96 ± 0.80 mm, and 2.67 ± 0.88 mm) at 12 months, respectively. A significant reduction of DV was exhibited radiographically in Group II (12.61 ± 4.01 mm3 ) as compared with Group I (9.14 ± 4.31 mm3 ) at the end of 12 months.Conclusions: Better clinical and radiographic findings in terms of reduction in PD, HPD, CAL gain, and significant reduction in DV in Group II patients indicated that the combination therapy of 1% MF + PRF promotes regenerative ability within the periodontal tissues in Grade II furcation defects to a greater extent. [ABSTRACT FROM AUTHOR]

In 60 healthy subjects, 720 interdental papilla sites in maxillary anterior teeth were investigated. Interdental papilla heights were measured from the gingival zenith along the clinical crown lengths. Radiovisiography was used to measure the relative bone length. Percentage of papilla height to crown length and radiographic bone length to crown length were computed and defined as papilla proportion (PP) and crestal papilla proportion (cPP), respectively. The overall mean mesial PP was 44.95 ± 6.80% and distal PP was 45.70 ± 7.87%. The total mean mesial cPP was 54.12 ± 9.50% and distal cPP was 54.95 ± 9.28%. Taken together, the cPP was around 55% and the PP was around 45% for all tooth groups. [ABSTRACT FROM AUTHOR]

Objective: Proportionate existence of the lip framework and gingival scaffold have a critical role in smile esthetics. So, the present study was conducted to assess and correlate the nasolabial angle (NLA) and lip length (LL) with gingival smile line (GSL) and interdental smile line (ISL). Materials and methods: One hundred and twenty periodontally healthy patients with an age group 20 to 40 years were equally divided based on gender into two groups. The parameters of NLA, LL, GSL, ISL, amount of midfacial gingiva, and interdental papilla display were recorded in the maxillary anterior sextant. Results: The mean values of NLA and LL at rest and on smiling were found to be higher in males. Majority of study population exhibited Low GSL (LGSL) and High ISL (HISL). On correlation of LL with GSL, the difference in the mean values between males and females for LGSL were highly significant, for HGSL and Cupid's bow the values were significant. The mean values of midfacial gingiva and interdental papilla visible in females was greater than males. Conclusion: The NLA and LL influence the quantum of gingival exhibit in maxillary anterior teeth with a definitive sexual dimorphism and this can be considered a valuable reference point in smile designing procedures. Clinical significance: The quantum of gingival exhibit on smiling is an important feature in periodontal, implant, restorative, and smile designing procedures in patients possessing HGSL and HISL category of GSL and ISL. It is indicated that the lip length is correlated with the amount of gingival tissue display both in midfacial as well as interdental region and which needs to be considered by the clinician. [ABSTRACT FROM AUTHOR]