logo logo
[A pilot study on the consistency of biological widths measured by periodontal probe and cone-beam CT]. Xu L M,Wang M Y,Liu L X,Chen X,Wang Q T Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology To compare the consistency of the biological widths measured by using cone-beam CT (CBCT) and periodontal probe in patients with two different gingival biotypes. Totally 27 patients [13 males, 14 females, (37.6±13.7) years old], who planned to receive the crown lengthening surgery, were recruited under the inclusion and exclusion criteria in Department of Periodontology, School of Stomatology, The Fourth Military Medical University during November 2017 to June 2018. A total of 40 teeth (14 front teeth, 26 posterior teeth) were involved in this study. The patients were divided into two groups according to their gingival biotypes: thin gingival biotype [5 males, 8 females, (40.2±15.0) years old, 21 teeth] and thick gingival biotype [8 males, 6 females, (35.1±11.9) years old, 19 teeth]. All the teeth were checked before crown lengthening procedures by using CBCT, and the biological widths and sulcus depths were measured during the surgery by using periodontal probes (Hu-Friedy, U S A). The data were recorded and statistically analyzed. There were no significant differences of the biological widths between the two measuring methods amongst all of the 40 teeth [periodonial probe: (1.64±0.26) mm; CBCT: (1.69±0.20) mm], amongst 21 thin gingival biotype teeth [periodontal probe: (1.49±0.19) mm; CBCT: (1.57±0.12) mm] and amongst 19 thick gingival biotype teeth [periodontal probe: (1.80±0.21) mm; CBCT: (1.87±0.18) mm] (0.05). There were no significant differences of the biological widths [anterior teeth: (1.59±0.15) mm, posterior teeth: (1.67±0.29) mm, 0.42] and of the sulcus depths [anterior teeth: (2.00±0.28) mm, posterior teeth: (2.11±0.43) mm, 0.44] between anterior teeth and posterior teeth. The difference of biological widths, measured by two methods respectively, between thin and thick gingival biotype groups was statistically significant (0.01). There were significant differences of the sulcus depths, measured by the periodontal probes, between the thin [(1.93±0.28) mm] and thick [(2.24±0.41) mm] gingival biotype groups (0.01). The biological widths measured by CBCT is consistent with those measured by using periodontal probes. The biological widths and the depths of the sulcus of thin and thick gingival biotypes are different. 10.3760/cma.j.issn.1002-0098.2019.04.005
Surgical crown lengthening: evaluation of the biological width. Lanning Sharon K,Waldrop Thomas C,Gunsolley John C,Maynard J Gary Journal of periodontology BACKGROUND:Previous surgical crown lengthening studies have investigated positional changes of the free gingival margin but not the biological width. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biological width. However, very little work has been done in humans. Therefore, the purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown lengthening in human subjects. METHODS:Twenty-three (23) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent teeth with adjacent and non-adjacent sites: plaque and gingival indexes, free gingival margin, probing depth, attachment level, bone level, direct bone level, and biological width. During surgery, the bone level was reduced based on the future prosthetic margin and predetermined biological width; flaps were placed at the bony crest. Patients were examined at baseline and at 3 and 6 months postoperatively. RESULTS:Eighteen patients completed the study. Overall, the amount of bone resected was 1 to 5 mm. At 90% of treated sites, > or = 3 mm of bone was removed. At 3 months, the apical displacement of the free gingival margin at non-adjacent, adjacent, and treated sites was 2.46 +/- 0.25 mm, 2.68 +/- 0.20 mm, and 3.07 +/- 0.16 mm, respectively. There was no significant change in the position of the free gingival margin from 3 to 6 months. The biological width at all sites was smaller at 3 and 6 months compared to baseline (P<0.05) except for the treated sites, which were not significantly different from baseline at 6 months. CONCLUSIONS:During surgical crown lengthening, the bone level was lowered for placement of the prosthetic margin and reestablishment of the biological width. The biological width, at treated sites, was reestablished to its original vertical dimension by 6 months. In addition, a consistent 3 mm gain of coronal tooth structure was observed at the 3- and 6-month examinations. 10.1902/jop.2003.74.4.468
Digital scanning is more accurate than using a periodontal probe to measure the keratinized tissue width. Lee Jung-Seok,Jeon Yoon-Sun,Strauss Franz-Josef,Jung Hoi-In,Gruber Reinhard Scientific reports This study aimed to compare the accuracy and reliability of digital versus conventional clinical measurements of the width of keratinized tissue. To this end, the keratinized tissue width was measured at 110 tooth sites in 5 pig jaws. The measurements were made at each site using three-dimensional (3D) scanned images and a periodontal probe. The actual keratinized tissue width was subsequently measured on histologic slides prepared from the same sites, and differences between the histologic slides and the digital and clinical measurements were analyzed to determine their accuracy in two measurement rounds. Furthermore, intrarater and interrater reliabilities were evaluated using the intraclass correlation coefficient (ICC). Here we show that the mean differences (and lower/upper limits of agreement) between the histologic and the digital/clinical measurements were 0.10 mm (-1.34/1.54 mm) and 1.11 mm (-0.69/2.92 mm), respectively, in the first round of measurements (p < 0.01), and 0.04 mm (-1.52/1.59 mm) and 1.05 mm (-0.37/2.48 mm) in the second round of measurements (p < 0.01). Moreover, we found that the intrarater reliability was higher for the digital measurements (ICC = 0.97, confidence interval [CI] = 0.96-0.97) than for the clinical measurements (ICC = 0.87, CI = 0.86-0.89; p < 0.01). Taken together, our results demonstrate that digital measurements of the keratinized tissue width using 3D scanned images can replace conventional clinical measurements using a periodontal probe since they are more accurate and reliable. 10.1038/s41598-020-60291-0
Comparison of the Clinical Biological Width with the Published Standard Histologic Mean Values. Hamasni Fatme Mouchref,El Hajj Fady Journal of International Society of Preventive & Community Dentistry AIMS AND OBJECTIVES:Biologic width (BW) as defined by Cohen is the part of the supracrestal gingival tissues that occupy the space between the base of the gingival crevice and the alveolar crest; it includes the junctional epithelium and the connective tissue element. Interactions between dental crowns and the marginal periodontal tissues analyzed in many review papers concluded that the recognition of the BW, in terms of crown margin placement, is beneficial for periodontal health. Therefore, knowledge of the dimensions of the sum of the junctional epithelium and connective tissue attachment as well as the sulcus depth (SD) is of clinical relevance. The aim of the study is to compare the average SD and BW clinically measured around teeth with the standard application of a mean value of 0.69 mm and 2.04 mm, respectively, found by Gargiulo .in a histological study on cadavers. MATERIALS AND METHODS:Forty-two healthy patients with age ranging from 20 to 50 years presented to the Multidisciplinary Department at the Lebanese University. A total of 504 tooth sites of 126 teeth were selected and measured by two periodontists. All measurements were done on teeth requiring infiltration anesthesia for surgical, restorative, or endodontic procedures on neighboring tooth/teeth, which eliminate any ethical concerns. The SD and the distance from gingival margin to bone crest at four sites per tooth; mesial, midbuccal, distal, and midlingual/palatal were measured. Clinical, BW was calculated by subtracting SD from the distance between gingival margin to bone crest. STATISTICAL ANALYSIS:Friedman's ANOVA test, independent samples -tests, and one-sample -tests were applied. The IBM SPSS statistics 20.0 statistical package was used to carry out all statistical analyses. RESULTS:The BW is statistically significantly lower than the value stated by Gargiulo . (2.04 mm) with a mean value of 1.13 mm, whereas the SD is statistically significantly greater than the value stated by Gargiulo . (0.69 mm) with a mean value of 1.96 mm. CONCLUSION:It can be concluded that there is a need to create a patient/site-specific distance from the proposed margin of the restoration to the bone crest when restoring subgingivally fractured or carious teeth. This leads to more stable and healthy tissues when performing crown lengthening procedures. Therefore, using the term clinical, BW is more reliable and it should be used to reestablish stability and integrity of periodontal tissues around restored teeth. 10.4103/jispcd.JISPCD_261_17
The biological width around implant. Zheng Zheng,Ao Xiaogang,Xie Peng,Jiang Fan,Chen Wenchuan Journal of prosthodontic research PURPOSE:The concept of biological width has been proposed and widely used in oral implantation. This review aimed to summarize the biological width around implant in detail. STUDY SELECTION:An electronic search of the literature prior to March 2019 was performed to identify all articles related to biological width in periimplant soft tissue. The search was conducted in the MEDLINE (National Library of Medicine) database accessed through PubMed with no date restriction. The following main keywords were used: "implant", "biological width", "soft tissue", "junctional epithelium", "peri-implant epithelium", "connective tissue", "gingiva", "mucosa" (connecting multiple keywords with AND, OR). RESULTS:The identified researches focused on several aspects related to biological width in oral implantation, namely the concept, formation, remodeling, dimension, structure and function. CONCLUSIONS:Based on of the reviewed literature, the concept, formation, remodeling, structure, dimension, and functional significances of periimplant biological width are explored in this narrative review. The formation of biological width around implant is a complex process after several weeks of healing. The biological width around implant is a 3-4mm distance from the top of the peri-implant mucosa to the first bone-to-implant contact or the stabilized top of the adjacent bone, consisting of sulcular epithelium, junctional epithelium and fibrous connective tissue between the epithelium and the first bone-to-implant contact or the stabilized top of the adjacent bone. The biological width forms a biological barrier against the bacteria, influences the remodeling of soft and hard tissue around implant and has implications for clinical aspects of dental implantation. 10.2186/jpr.JPOR_2019_356