Periodontal Biotype: Gingival Thickness as It Relates to Probe Visibility and Buccal Plate Thickness

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Abstract

Probe visibility is the clinical gold standard to discriminate thick from thin biotype but is prone to subjective interpretation. The primary objective of this study is to determine at what objective gingival thickness the probe becomes invisible through the tissue. A secondary objective is to compare mean buccal plate thickness between thick and thin biotypes as determined by probe visibility.

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Most cited references 14

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The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering.

Alan H Morris, S Ochi, C. W. Black … (2000)

Various causes of facial bone loss around dental implants are reported in the literature; however, reports on the influence of residual facial bone thickness on the facial bone response (loss or gain) have not been published. This study measured changes in vertical dimension of facial bone between implant insertion and uncovering and compared these changes to facial bone thickness for more than 3,000 hydroxyapatite (HA)-coated and non-HA-coated root-form dental implants. Subjects were predominantly white males, 18 to 80+ years of age (mean 62.9 years), who were patients at 30 Department of Veterans Affairs Medical Centers and two university dental clinics. Alveolar ridges ranged from normal to resorbed with intact basal bone. Following preparation of the osteotomy site, direct measurements with calipers were made of the residual facial bone thickness, approximately 0.5 mm below the crest of the bone. The distance from the top of the implants to the crest of the facial bone was also measured using periodontal probes. Implants were uncovered between 3 to 4 months in the mandible and 6 to 8 months in the maxilla after insertion. Facial bone response was the difference between the height of facial bone at Stage 1 (insertion) and Stage 2 (uncovering). The mean facial bone thickness after osteotomies were made was 1.7 +/- 1.13 mm. When a mean facial bone thickness of 1.8 +/- 1.41 mm or larger remained after site preparation, bone apposition was more likely to occur. The mean facial bone response for 2,685 implants was -0.7 +/- 1.70 mm. For implants integrated at uncovering, the mean bone response was -0.7 +/- 1.69 mm, and -2.8 +/- 1.57 mm for implants mobile at uncovering. Bone quality-4 had the least facial bone response, -0.5 +/- 2.11 mm. Bone responses were similar for both HA-coated and non-HA-coated implants. Significantly greater amounts of facial bone loss were associated with implants that failed to integrate. As the bone thickness approached 1.8 to 2 mm, bone loss decreased significantly and some evidence of bone gain was seen. There was no statistically or clinically significant difference in bone response between HA-coated and non-HA-coated implants.

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Flap thickness as a predictor of root coverage: a systematic review.

Debby Hwang, Hom-Lay Wang (2006)

Thick gingival tissue eases manipulation, maintains vascularity, and promotes wound healing during and after surgery. A few recent case reports correlate greater flap thickness to mean and complete root coverage after mucogingival therapy for recession defects. The aim of this systematic review is to appraise the current literature on this subject and to combine existing data to verify the presence of any association between gingival thickness and root coverage outcomes.

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Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series.

D Saletta, G Pini Prato, P Cortellini … (1999)

This clinical study was designed to determine whether the thickness of the flap can influence root coverage when gingival recessions associated with traumatic toothbrushing are treated using a coronally advanced flap (CAF). Nineteen patients, aged from 25 to 57 years, with high levels of oral hygiene (full-mouth plaque scores or =2 mm were treated. After local anesthesia and before flap elevation, the exposed root surface was planed with a sharp curet. A trapezoidal full- and partial-thickness flap was then elevated, displaced coronally, and sutured to cover the treated root surface. Before suturing, flap thickness was measured in the alveolar mucosa with a gauge. After surgery, all patients were recalled for control and professional prophylaxis once a week during the first month and monthly up to the third month. The mean initial recession depth was 3.0+/-0.9 mm. Mean flap thickness (FT) was 0.7+/-0.2 mm. Three months later, mean recession depth was 0.6+/-0.6 (P 0.8 mm was associated with 100% of root coverage. The results of this study indicate that there is a direct relation between flap thickness and recession reduction (P <0.0001).