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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (2): 339-345. doi: 10.19723/j.issn.1671-167X.2020.02.023

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Gingival thickness assessment of gingival recession teeth

Zi-yuan CHEN1,Jin-sheng ZHONG2,Xiang-ying OUYANG2,△(),Shuang-ying ZHOU2,Ying XIE2,Xin-zhe LOU2   

  1. 1. Second Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100101, China;
    2. Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2019-09-23 Online:2020-04-18 Published:2020-04-18
  • Contact: Xiang-ying OUYANG E-mail:kqouyangxy@bjmu.edu.cn

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Abstract:

Objective: To evaluate the gingival thickness and gingival biotype of gingival recession teeth of Chinese population.Methods: A total of 112 non-molar teeth with gingival recession in 34 patients were included. Direct measurement, cone-beam computerized tomography (CBCT) measurement and periodontal probe method were used to evaluate gingival thickness and biotype. Gingival thickness was measured at 2 mm apical to the gingival margin. Direct measurement was performed with a caliper of 0.01 mm resolution and anesthesia needles attached to silicone disk stops. Gingival biotype was assessed by sulcus probing, if the periodontal probe was visible through the gingival tissue, the gingival biotype was thin; If not visible, the gingival biotype was thick. The differences of gingival thickness among different gingival biotype, tooth site and gingival recession type were analyzed respectively. Besides, the results of CBCT measurement was analyzed compared with the direct measurement.Results: The average gingival thickness of non-molar recession teeth was (1.17±0.41) mm. The average gingival thickness of thick and thin biotype group were (1.38±0.4) mm and (0.97±0.30) mm, respectively, with statistically significant difference (P＜0.001).The median of gingival thickness was 1.1 mm. Using 1.1 mm as the cut-off value of thick and thin gingival thickness group, the results matched well with the gingival biotype classification results by periodontal probe method (P=1.000). The average gingival thickness of maxillary teeth was significantly thicker than that of the mandibular teeth. They were (1.39±3.44) mm and (1.01±0.31) mm, respectively (P＜0.001). The mean gingival thickness of MillerⅠ, Ⅱ and Ⅲ degree gingival recession teeth were (1.15±0.34) mm, (0.83±0.17) mm and (1.26±0.56) mm, respectively, without statistically significant difference (P=0.205). The gingival thickness measurement results between CBCT method and direct measurement were without statistically significant difference (P=0.206).Conclusion: In the non-molar gingival recession teeth, the cut-off value of gingival thickness to classify thick and thin biotype of Chinese population was 1.1 mm. The average gingival thickness of the maxillary teeth was significantly thicker than that of the mandibular teeth. Besides, CBCT measurement was an accuracy method for evaluating facial gingival thickness.

Key words: Gingival thickness, Gingival biotype, Gingival recession

CLC Number: 

  • R781.4

Figure 1

CBCT scan with a plastic lip retractor"

Figure 2

Clear gingival margin on the CBCT image B, bottom; T, top, T: 0.15 mm, the images were reconstructed with the voxel of 0.15 mm."

Figure 3

Measurement of the buccal gingival thickness in the sagittal view Yellow line: 2 mm from the gingival margin; red line: the distance from the gingival surface to the root surface is 1.3 mm. B, bottom; T, top, T: 0.15 mm, the images were reconstructed with the voxel of 0.15 mm."

Table 1

Gingival thickness of different gingival biotype$\bar{x}±s $/mm"

Gingival
biotype		 n Rec PD WKT GTDM
Thick 55 2.46±1.00 1.60±0.56 3.11±1.66 1.38±0.42
Thin 57 2.44±0.99 1.58±0.53 2.69±1.50 0.97±0.30
P 0.895a 0.839a 0.233b <0.001c

Table 2

Gingival biotype assessment (frequency distribution)"

Gingival biotype
probe method		 Cut-off 1.0 mm Cut-off 1.1 mm
Thick
(>1.0 mm)		 Thin
(≤1.0 mm)		 Thick
(>1.1 mm)		 Thin
(≤1.1 mm)
Thick (55) 43 12 41 14
Thin (57) 21 36 15 42
Predictive value 43/55
(78.20%)		 36/57
(63.20%)		 42/55
(76.40%)		 42/57
(73.70%)
P 0.164 1.000

Table 3

Gingival thickness of different tooth site and tooth type $\bar{x}±s $/mm"

Tooth site n Rec PD WKT GTDM
Maxillary 48 2.34±0.96 1.71±0.54 3.42±1.66 1.39±0.44
Incisors 15 1.57±0.60 1.87±0.64 4.67±1.14 1.27±0.44
Canines 11 2.64±0.78 1.55±0.52 3.27±1.21 1.18±0.28
Premolars 22 2.73±0.96 1.68±0.48 2.64±1.68 1.57±0.46
Mandibular 64 2.53±1.02 1.50±0.54 2.44±1.38 1.01±0.31
Incisors 22 2.52±0.98 1.41±0.50 3.43±1.49 0.93±0.31
Canines 13 2.04±0.72 1.46±0.52 2.23±0.88 1.04±0.25
Premolars 29 2.76±1.11 1.59±0.57 1.74±0.97 1.06±0.33
P 0.326a 0.045a 0.001a <0.001b

Table 4

Gingival thickness of different gingival recession type $\bar{x}±s $/mm"

Gingival
recession		 n Rec PD WKT GTDM
Miller Ⅰ 77 2.35±0.92 1.56±0.55 2.88±1.29 1.15±0.34
Miller Ⅱ 3 2.83±1.04 2.00±0.00 0 0.83±0.17
Miller Ⅲ 32 2.66±1.15 1.63±0.55 3.19±1.96 1.26±0.56
Total 112 2.45±1.00 1.59±0.55 2.89±1.58 1.17±0.41
P 0.189a 0.305b 0.012b 0.205b
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