Background
Historically and until today, two different gingival biotypes (GB) were described in literature: a thick and a thin biotype (Müller and Eger, 1997, Weisgold, 1977, Seibert and Lindhe, 1989). Recently, more studies focusing on the influence of gingival biotypes on implant treatment were published (Fu et al., 2011, Cosyn et al., 2011, Kan et al., 2003, Nisapakultorn et al., 2010). In a systematic review, Cosyn et al. (2012b) came to the conclusion, that a thick gingival biotype may contribute to minimize the frequency of advanced recession following immediate implant treatment. Lately, our group showed the shortfall of this dichotomous classification and proposed to introduce a classification and clinical tool to differentiate between more than two biotype groups. For example, the SAC-Assessment tool also discriminates between a thin, moderate and thick GB, however, there is no easy-to-use clinical tool available today (Dawson et al., 2009).
Aim/Hypothesis
Primary Outcome Measure: Main objective of this investigation was to determine the association between clinically estimated gingival biotype (thin versus moderate versus thick) and clinically measured gingival thickness Secondary Outcome Measure: Additionally, the association between gingival biotype and gingival width was analysed. Inter-examiner agreement, sensitivity and specificity of this novel method was calculated. Thereby, the concept of using probe transparency for biotype evaluation was also re-assessed.
Material and Methods
60 adult Caucasian subjects were stratified by their gingival biotype (GB), as defined by 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 assessed: gingival thickness (GT), probing depth (PD) and gingival width (GW).
Results
Average subject age was 23 years (min: 19; max: 37). 39 women and 21 men participated in this investigation. PD was not statistically different between all groups with an average value of 1.8 mm. GT was 0.46 mm for thin, 0.69 mm for moderate and 0.86 mm for thick GB, respectively. GT was statistically significant different between all three groups (Kruskal-Wallis Test, p < 0.05; Dunn`s Test, thin vs moderate: p < 0.01; thin vs thick: p < 0.001; moderate vs thick: p ≥ 0.05). GW (mean: 4mm; min: 2mm; max: 9mm) 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.
Conclusions and clinical implications
Our data support the idea of differentiating GB in more than two different entities, hence, an alternative classification into ‘thick’, ‘moderate’ and ‘thin’ biotypes based on the presented modified periodontal probe might be advantageous. In addition, it seems that a thick gingiva is associated with a wide band of keratinized tissue. The presented tool seems to be a highly reliable tool to identify high-risk patients.
Background
Historically and until today, two different gingival biotypes (GB) were described in literature: a thick and a thin biotype (Müller and Eger, 1997, Weisgold, 1977, Seibert and Lindhe, 1989). Recently, more studies focusing on the influence of gingival biotypes on implant treatment were published (Fu et al., 2011, Cosyn et al., 2011, Kan et al., 2003, Nisapakultorn et al., 2010). In a systematic review, Cosyn et al. (2012b) came to the conclusion, that a thick gingival biotype may contribute to minimize the frequency of advanced recession following immediate implant treatment. Lately, our group showed the shortfall of this dichotomous classification and proposed to introduce a classification and clinical tool to differentiate between more than two biotype groups. For example, the SAC-Assessment tool also discriminates between a thin, moderate and thick GB, however, there is no easy-to-use clinical tool available today (Dawson et al., 2009).
Aim/Hypothesis
Primary Outcome Measure: Main objective of this investigation was to determine the association between clinically estimated gingival biotype (thin versus moderate versus thick) and clinically measured gingival thickness Secondary Outcome Measure: Additionally, the association between gingival biotype and gingival width was analysed. Inter-examiner agreement, sensitivity and specificity of this novel method was calculated. Thereby, the concept of using probe transparency for biotype evaluation was also re-assessed.
Material and Methods
60 adult Caucasian subjects were stratified by their gingival biotype (GB), as defined by 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 assessed: gingival thickness (GT), probing depth (PD) and gingival width (GW).
Results
Average subject age was 23 years (min: 19; max: 37). 39 women and 21 men participated in this investigation. PD was not statistically different between all groups with an average value of 1.8 mm. GT was 0.46 mm for thin, 0.69 mm for moderate and 0.86 mm for thick GB, respectively. GT was statistically significant different between all three groups (Kruskal-Wallis Test, p < 0.05; Dunn`s Test, thin vs moderate: p < 0.01; thin vs thick: p < 0.001; moderate vs thick: p ≥ 0.05). GW (mean: 4mm; min: 2mm; max: 9mm) 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.
Conclusions and clinical implications
Our data support the idea of differentiating GB in more than two different entities, hence, an alternative classification into ‘thick’, ‘moderate’ and ‘thin’ biotypes based on the presented modified periodontal probe might be advantageous. In addition, it seems that a thick gingiva is associated with a wide band of keratinized tissue. The presented tool seems to be a highly reliable tool to identify high-risk patients.
Background
Historically and until today, two different gingival biotypes (GB) were described in literature: a thick and a thin biotype (Müller and Eger, 1997, Weisgold, 1977, Seibert and Lindhe, 1989). Recently, more studies focusing on the influence of gingival biotypes on implant treatment were published (Fu et al., 2011, Cosyn et al., 2011, Kan et al., 2003, Nisapakultorn et al., 2010). In a systematic review, Cosyn et al. (2012b) came to the conclusion, that a thick gingival biotype may contribute to minimize the frequency of advanced recession following immediate implant treatment. Lately, our group showed the shortfall of this dichotomous classification and proposed to introduce a classification and clinical tool to differentiate between more than two biotype groups. For example, the SAC-Assessment tool also discriminates between a thin, moderate and thick GB, however, there is no easy-to-use clinical tool available today (Dawson et al., 2009).
Aim/Hypothesis
Primary Outcome Measure: Main objective of this investigation was to determine the association between clinically estimated gingival biotype (thin versus moderate versus thick) and clinically measured gingival thickness Secondary Outcome Measure: Additionally, the association between gingival biotype and gingival width was analysed. Inter-examiner agreement, sensitivity and specificity of this novel method was calculated. Thereby, the concept of using probe transparency for biotype evaluation was also re-assessed.
Material and Methods
60 adult Caucasian subjects were stratified by their gingival biotype (GB), as defined by 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 assessed: gingival thickness (GT), probing depth (PD) and gingival width (GW).
Results
Average subject age was 23 years (min: 19; max: 37). 39 women and 21 men participated in this investigation. PD was not statistically different between all groups with an average value of 1.8 mm. GT was 0.46 mm for thin, 0.69 mm for moderate and 0.86 mm for thick GB, respectively. GT was statistically significant different between all three groups (Kruskal-Wallis Test, p < 0.05; Dunn`s Test, thin vs moderate: p < 0.01; thin vs thick: p < 0.001; moderate vs thick: p ≥ 0.05). GW (mean: 4mm; min: 2mm; max: 9mm) 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.
Conclusions and clinical implications
Our data support the idea of differentiating GB in more than two different entities, hence, an alternative classification into ‘thick’, ‘moderate’ and ‘thin’ biotypes based on the presented modified periodontal probe might be advantageous. In addition, it seems that a thick gingiva is associated with a wide band of keratinized tissue. The presented tool seems to be a highly reliable tool to identify high-risk patients.
Background
Historically and until today, two different gingival biotypes (GB) were described in literature: a thick and a thin biotype (Müller and Eger, 1997, Weisgold, 1977, Seibert and Lindhe, 1989). Recently, more studies focusing on the influence of gingival biotypes on implant treatment were published (Fu et al., 2011, Cosyn et al., 2011, Kan et al., 2003, Nisapakultorn et al., 2010). In a systematic review, Cosyn et al. (2012b) came to the conclusion, that a thick gingival biotype may contribute to minimize the frequency of advanced recession following immediate implant treatment. Lately, our group showed the shortfall of this dichotomous classification and proposed to introduce a classification and clinical tool to differentiate between more than two biotype groups. For example, the SAC-Assessment tool also discriminates between a thin, moderate and thick GB, however, there is no easy-to-use clinical tool available today (Dawson et al., 2009).
Aim/Hypothesis
Primary Outcome Measure: Main objective of this investigation was to determine the association between clinically estimated gingival biotype (thin versus moderate versus thick) and clinically measured gingival thickness Secondary Outcome Measure: Additionally, the association between gingival biotype and gingival width was analysed. Inter-examiner agreement, sensitivity and specificity of this novel method was calculated. Thereby, the concept of using probe transparency for biotype evaluation was also re-assessed.
Material and Methods
60 adult Caucasian subjects were stratified by their gingival biotype (GB), as defined by 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 assessed: gingival thickness (GT), probing depth (PD) and gingival width (GW).
Results
Average subject age was 23 years (min: 19; max: 37). 39 women and 21 men participated in this investigation. PD was not statistically different between all groups with an average value of 1.8 mm. GT was 0.46 mm for thin, 0.69 mm for moderate and 0.86 mm for thick GB, respectively. GT was statistically significant different between all three groups (Kruskal-Wallis Test, p < 0.05; Dunn`s Test, thin vs moderate: p < 0.01; thin vs thick: p < 0.001; moderate vs thick: p ≥ 0.05). GW (mean: 4mm; min: 2mm; max: 9mm) 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.
Conclusions and clinical implications
Our data support the idea of differentiating GB in more than two different entities, hence, an alternative classification into ‘thick’, ‘moderate’ and ‘thin’ biotypes based on the presented modified periodontal probe might be advantageous. In addition, it seems that a thick gingiva is associated with a wide band of keratinized tissue. The presented tool seems to be a highly reliable tool to identify high-risk patients.