Trueness and precision of an intraoral scanner on abutments with subgingival vertical margins: An in vitro study.

OBJECTIVES: This study aimed to evaluate the accuracy of an intraoral scanner (IOS - Medit i700) on tooth abutments with vertical preparations at 2 depths below the free gingival margin, and to determine if the IOS can reproduce the area beyond the finish surface of the tested preparation geometry. METHODS: Two abutments for a maxillary first molar were designed by means of CAD software, with vertical preparations set at 1 and 2 mm below the gingiva. These abutments were subsequently printed in resin and placed on a reference model. The reference files consisted of scans made using a metrological machine on these abutments. Ten scans were made with the tested IOS on each sample, resulting in two study groups. The scans from the experimental groups were labeled "V-1″ for vertical preparation at 1 mm below the gingival margin and "V-2″ for 2 mm below. The analysis of these scans was performed using Geomagic Control X (3D SYSTEMS) to assess their trueness and precision in µm. Descriptive statistics with a 95 % confidence interval were employed, alongside independent sample tests, to ascertain any differences between the groups (α=0.05). RESULTS: Statistically significant differences were not found both for trueness (p=.104) and precision (p=.409), between the tested geometries. The mean values for trueness were V-1 = 37.5[31.4-43.6]; V-2 = 32.6[30.6-34.6]. About the precision, the mean values were V-1 = 20.5[8.4-32.5]; V-2 = 18.4[8.2-28.5]. In both the study groups, it was possible to detect the surface beyond the finish area. CONCLUSIONS: Within the limitations of this study, vertical preparation design allows for registration of the tooth anatomy beyond the finish area with IOS. Moreover, the mean accuracy values were clinically acceptable at both 1 and 2 mm below the gingival margin.

Thermographic examination of gingival phenotypes: correlation between morphological and thermal parameters.

OBJECTIVES: To evaluate the clinical and thermographic aspects of the gingival phenotype (GP) in healthy subjects. MATERIALS AND METHODS: The study sample examined 264 teeth, upper and lower incisors, comprising 132 central incisors (CI) and 132 lateral incisors (LI), in 33 healthy volunteers. Four periodontal parameters were recorded systematically: ratio of width to length of the dental crown (CW/CL), height of the gingival attachment (KGW), probing depth (PD), and gingival transparency (GT). The temperatures of the attached gingiva (KGW temp) and the free gingival margin (FGM Temp) were also recorded by way of infrared thermography (IRT). RESULTS: The average age of the sample was 30.70 ± 7.65 years. Of the 264 teeth evaluated, 76.1% had a thin GP. There was a significant association between CW/CL (p < 0.001), KGW (p < 0.001), PD (p < 0.007), and FGM Temp (p < 0.006) with the tooth groups. The results show a significant and inversely proportional correlation between clinical parameters and gingival temperature (p < 0.05). A significant association was found between CW/CL (p < 0.026); KGW (p < 0.001); and GP. CONCLUSION: CW/CL, KGW, PD, and FGM Temp vary according to tooth group. The majority of the sample presented with the thin GP, which was more prevalent in the lower LIs and CIs. No significant association could be observed between thermographic parameters and GP. CLINICAL RELEVANCE: Knowledge of the temperature of the gingival tissues can be useful in helping to diagnose and plan periodontal treatments. Moreover, our findings will help future studies evaluate the use of IR as an auxiliary diagnostic method in dentistry, eliminating GP as a confounding factor, since it does not seem to influence the temperature of the gingival tissues.

Clinical and histologic evaluation of heterotopic mucosa transpositioning at teeth and dental implants.

AIM: To investigate the healing after heterotopic mucosa transpositioning at dental implants and teeth. MATERIALS AND METHODS: One hemimandible per dog (n = 4) was allocated to receive 3 implants (test), whereby 3 premolars on the contralateral side served as controls. After osseointegration, a Z-plasty was performed on the buccal aspect of the test and control sites to heterotopically move the zone of keratinized tissue (KT) into a region with non-keratinized tissue (nKT) and vice versa. Clinical measurements were performed before (T0) and at 12 weeks following heterotopic transposition (T1). Thereafter, specimens were processed for histological analysis. RESULTS: Clinical measurements revealed that at T1, a band of KT was reestablished at teeth (mean: 2.944 ± 1.866 mm), whereas at implants, the transpositioned nKT resulted in a mucosa without any signs of keratinization (mean: 0 mm; p < .0001). At implant sites, the probing attachment level loss was more pronounced compared to tooth sites (-1.667 ± 1.195 mm and -1.028 ± 0.878 mm, respectively; p = .0076). Histologically, the transpositioned nKT, was accompanied by the formation of KT at the tooth but not at implant sites. The supracrestal soft tissues were statistically significantly higher at tooth compared to implant sites (2.978 ± 0.483 mm and 2.497 ± 0.455 mm, p = .0083). The transpositioned KT remained mostly unaltered in its morphological characteristics. CONCLUSIONS: The findings of this study indicate that: (a) transpositioned KT may retain its morphological characteristics; and (b) transpositioned nKM was accompanied by the formation of KT at the tooth but not at implant sites.

Histological Techniques for the Study of the Dentogingival Junction: A Scoping Review Using the Anatomical Quality Assurance Checklist (AQUA) / Técnicas Histológicas para el Estudio de la Unión Dentogingival: Una Revisión de Alcance Utilizando el Anatomical Quality Assurance Checklist (AQUA)

SUMMARY: The dentogingival junction (DGJ) is an adaptation of the oral mucosa composed of epithelial and connective tissues intimately related with the mineralised tissues of the tooth. The histological evidence available is mainly based on studies in animals, separate evaluations of hard and soft tissues, and studies using conventional histological techniques that eliminate the enamel from preparations. The aim of this study was to carry out a review of the existing evidence on histological techniques available for study of the tooth and periodontium in conjunction in humans. A scoping review was carried out of the available literature referring to study of the tooth and the periodontium in conjunction in humans, in the Web of Science (WoS), EMBASE, Scopus and SciELO databases, using the terms "Histological Techniques"[Mesh]) and "Epithelial Attachment"[Mesh]. One hundred and fifty-nine articles were found, of which 54 were selected for full- text reading. Ten were finally included in the qualitative synthesis, and we applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the selected articles. The results showed that the only articles with a low risk of bias in all five domains according to the AQUA criteria corresponded to Silva et al. (2011) and Agustín-Panadero et al. (2020). Finally, we conclude that the quality of the histological sections to observe tissues that simultaneously contain the tooth and the periodontium, is conditioned by the selected technique and by the care required in certain specific tasks during the histological processing of the samples.

La unión dentogingival (DGJ) es una adaptación de la mucosa oral compuesta por tejidos epitelial y conectivo íntimamente relacionados con los tejidos mineralizados del diente. La evidencia histológica disponible se basa principalmente en estudios en animales, evaluaciones separadas de tejidos duros y blandos y estudios utilizando técnicas histológicas convencionales que eliminan el esmalte de las preparaciones. El objetivo de este estudio fue realizar una revisión de la evidencia existente sobre las técnicas histológicas disponibles para el estudio del diente y el periodonto en conjunto en humanos. Se realizó un scoping review de la literatura disponible referente al estudio del diente y el periodonto en conjunto en humanos, en las bases de datos Web of Science (WoS), EMBASE, Scopus y SciELO, utilizando los términos "Histological Techniques"[Mesh]) y "Epithelial Attachment"[Mesh]. Se encontraron 159 artículos, de los cuales 54 fueron seleccionados para lectura de texto completo. Diez fueron finalmente incluidos en la síntesis cualitativa, y se aplicó la lista de verificación Anatómica Quality Assurance (AQUA) para el análisis de la calidad metodológica de los artículos seleccionados. Los resultados mostraron que los únicos artículos con bajo riesgo de sesgo en los cinco dominios según los criterios AQUA correspondían a Silva et al. (2011) y Agustín-Panadero et al. (2020). Finalmente, concluimos que la calidad de los cortes histológicos para observar los tejidos que contienen simultáneamente el diente y el periodonto, está condicionada por la técnica seleccionada y por el cuidado requerido en ciertas tareas específicas durante el procesamiento histológico de las muestras.

The buccal corridor as a possible morphological risk indicator for sleep disordered breathing.

OBJECTIVE: To explore a possible morphological relationship between buccal corridor, gingival display, transpalatal molar width, palatal height, and a cephalometric measurement (PV-A Line) as a risk indicator for sleep-disordered breathing. MATERIALS AND METHODS: Thirty subjects were enrolled. Full face maximum smile images and CBCT scans were taken. A Pearson correlation coefficient was used to identify any relationships between the variables. RESULTS: No correlations were identified between any of the variables investigated in this study as they relate to risk factors for sleep-disordered breathing. CONCLUSIONS: The amount of buccal corridor space in relation to a patient's smile and the amount of gingival display does not appear to be a reliable metric in identifying certain morphological risk factors for sleep-disordered breathing. CLINICAL SIGNIFICANCE: Assessing the amount of buccal corridor space in relation to a smile does not appear to be a reliable predictor of morphological risk for certain risk factors of sleep-disordered breathing. In addition, utilizing the amount of gingival display in a patient's maximum smile does not appear to relate directly to risks in sleep-disordered breathing. Other tests and discovery may be necessary to identify these types of patients.

Morphological changes in alveolar bone thickness and height after orthodontic proclination or labial movement combined with autogenous soft tissue grafting: a CBCT evaluation.

BACKGROUND: Autogenous soft tissue grafting is indicated in thin gingival biotypes before orthodontic proclination or labial movements to increase the keratinized gingiva and prevent gingival recession. However, its effect on local alveolar bone remodeling is unclear. The aim of this study was to investigate the effects of autogenous soft tissue grafting on local alveolar bone after orthodontic proclination or labial movements. METHODS: Sixteen patients with a thin scalloped gingival biotype, narrow keratinized gingiva, or thin cortical bone requiring orthodontic proclination or labial movement of teeth were included. Cone-beam computed tomography (CBCT) images were obtained before grafting and at least 6 months after surgery. Sixty mandibular teeth were included, and the vertical bone level and horizontal labial bone thickness were measured. The results were compared using paired t-tests or Wilcoxon signed-rank test. RESULTS: The horizontal labial bone thickness increased, especially at 6 mm below the cementoenamel junction (CEJ) in the mandibular central and lateral incisors (P < 0.05). The total alveolar bone area of the canines, first premolars, and second premolars increased at 3, 6, and 9 mm below the CEJ, respectively, and the differences were statistically significant (P < 0.05). Additionally, vertical bone height increased minimally on the labial side, but the differences were not statistically significant (P > 0.05). CONCLUSIONS: New bone regeneration was observed on the labial (pressure) side after autogenous soft tissue grafting, which may represent a mechanism to effectively prevent gingival recession and maintain periodontal health. IRB APPROVAL: All the experimental procedures involving humans in this study were approved by the Medical Ethics Committee of Xiangya Stomatological Hospital, Central South University ( No. 20190048).

Clinical and computed tomographic evaluations of periodontal phenotypes in a Chinese population: a cross-sectional study.

OBJECTIVES: To investigate the diagnostic value of probe transparency related to gingival thickness (GT) and keratinized gingival width (KGW) at individual and site levels and explore the relationship of buccal bone plate thickness (BT) with GT and KGW. MATERIALS AND METHODS: A total of 1,606 teeth from 167 patients with periodontally healthy maxillary anterior region were included. GT was measured with probe transparency and transgingival probing. KGW was measured directly. BTs were assessed at the level 1 mm apical to the alveolar crest (BT1) and midpoint of the root (BT2) and evaluated at individual and tooth levels along with their mutual associations. RESULTS: The prevalence of thick gingiva was 53% with probe transparency measurement and 51% with transgingival probing. The cutoff gingival thickness was 0.8 mm, which correlated moderately with a Cohen's kappa of 0.386. The mean GT, KGW, and BTs (BT1 and BT2) in the maxillary anterior region were 0.97 ± 0.46, 5.51 ± 1.62, 0.85 ± 0.31, and 0.79 ± 0.32 mm, respectively. GT and KGW correlated mildly (r = 0.261), and GT and BTs correlated moderately (BT1: r = 0.298; BT2: r = 0.338). GT and BTs differed significantly between men and women and among different tooth sites. CONCLUSIONS: GT and BTs correlated positively in the maxillary anterior region and varied within and among individuals. Sex was a factor influencing the gingival phenotype and bone morphotype. CLINICAL RELEVANCE: GT measured with transgingival probing, with a cutoff of 0.8 mm, could serve as an objective measure to distinguish different gingival phenotypes.

Association of gingival exhibit with lip dimensions, intercommissural width, and gingival and interdental smile lines - a gender-based evaluation.

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 midfacial 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.

[Digitalized analysis of the gingival and bone morphology in the maxillary anterior teeth in patient with posterior dental implant].

Objective: To explore and analyze the correlation between labial gingival morphology and alveolar bone morphology of maxillary anterior teeth in patients with posterior dental implant, so as to provide reference basis for restoration design and esthetic reconstruction of anterior teeth. Methods: Sixty-four patients [24 males, 40 females (25.6±3.3) years old] who planned to receive posterior dental implant restoration were recruited randomly with the inclusion and exclusion criteria in Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University from May 2020 to May 2021. According to the visibility of periodontal probe through gingival margin, the subjects were divided into thin and thick gingival biotypes, including 29 cases of thin biotype and 35 cases of thick biotype. The 3Shape software was used to perform oral scanning, and cone beam CT (CBCT) was taken for each patient. Geomagic and Mimics software were used to measure and record the labial crown width and length, gingival papilla height, gingival angle, bone papilla height and bone margin angle of maxillary anterior teeth. Results: The crown width length ratios of maxillary central incisors, lateral incisors and canines were 0.85±0.08, 0.80±0.08 and 0.86±0.09 (F=10.71, P<0.01). The height of gingival papilla between maxillary central incisors, between central incisors and lateral incisors, between lateral incisors and canines were (3.93±0.86), (3.47±0.84) and (3.38±0.91) mm respectively (F=7.44, P<0.01), and the height of corresponding bone papilla were (3.44±0.88), (3.12±0.75) and (2.72±0.63) mm respectively (F=14.26, P<0.01). The gingival margin angles of maxillary central incisors, lateral incisors and canines were 88.3°±7.7°, 84.7°±8.9° and 81.2°±6.6° (F=13.15, P<0.01), and the bone margin angles were 103.2°±13.1°, 99.5°±11.2° and 110.6°±13.0° (F=13.25, P<0.01). The crown width length ratio (0.81±0.08), gingival margin angle (82.2°±7.4°) and bone margin angle (99.4°±12.9°) of thin gingival subjects were significantly lower than those of thick gingival subjects (0.85±0.09, 86.5°±8.6°, 108.5°±11.4°) (t=-2.79, 3.63, 5.20, P<0.01). The height of gingival papilla [(3.93±0.81) mm] and bone papilla [(3.43±0.80) mm] in thin gingival subjects were significantly lower than those in thick gingival subjects [(3.34±0.84) and (2.85±0.71) mm, respectively] (t=-4.89, -5.36, P<0.01). The height of labial gingival papilla of upper anterior teeth was positively correlated with that of bone papilla in all patients (r=0.66, P<0.01); the ratio of crown width to length of upper anterior teeth was positively correlated with the angle of bone margin (r=0.42, P<0.01); the height of anterior gingival papilla was negatively correlated with the angle of bone margin (r=-0.58, P<0.01), and the height of bone papilla was negatively correlated with the angle of bone margin (r=-0.82, P<0.01). Conclusions: The crown shape, gingival shape and alveolar bone shape of maxillary anterior teeth were different in different tooth positions. Patients with different periodontal phenotypes had different crown width length ratio, gingival papilla height, bone papilla height, gingival margin angle, and bone margin angle.

Digitalized analysis of the gingival and bone morphology in the maxillary anterior teeth in patient with posterior dental implant / 中华口腔医学杂志

Objective: To explore and analyze the correlation between labial gingival morphology and alveolar bone morphology of maxillary anterior teeth in patients with posterior dental implant, so as to provide reference basis for restoration design and esthetic reconstruction of anterior teeth. Methods: Sixty-four patients [24 males, 40 females (25.6±3.3) years old] who planned to receive posterior dental implant restoration were recruited randomly with the inclusion and exclusion criteria in Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University from May 2020 to May 2021. According to the visibility of periodontal probe through gingival margin, the subjects were divided into thin and thick gingival biotypes, including 29 cases of thin biotype and 35 cases of thick biotype. The 3Shape software was used to perform oral scanning, and cone beam CT (CBCT) was taken for each patient. Geomagic and Mimics software were used to measure and record the labial crown width and length, gingival papilla height, gingival angle, bone papilla height and bone margin angle of maxillary anterior teeth. Results: The crown width length ratios of maxillary central incisors, lateral incisors and canines were 0.85±0.08, 0.80±0.08 and 0.86±0.09 (F=10.71, P<0.01). The height of gingival papilla between maxillary central incisors, between central incisors and lateral incisors, between lateral incisors and canines were (3.93±0.86), (3.47±0.84) and (3.38±0.91) mm respectively (F=7.44, P<0.01), and the height of corresponding bone papilla were (3.44±0.88), (3.12±0.75) and (2.72±0.63) mm respectively (F=14.26, P<0.01). The gingival margin angles of maxillary central incisors, lateral incisors and canines were 88.3°±7.7°, 84.7°±8.9° and 81.2°±6.6° (F=13.15, P<0.01), and the bone margin angles were 103.2°±13.1°, 99.5°±11.2° and 110.6°±13.0° (F=13.25, P<0.01). The crown width length ratio (0.81±0.08), gingival margin angle (82.2°±7.4°) and bone margin angle (99.4°±12.9°) of thin gingival subjects were significantly lower than those of thick gingival subjects (0.85±0.09, 86.5°±8.6°, 108.5°±11.4°) (t=-2.79, 3.63, 5.20, P<0.01). The height of gingival papilla [(3.93±0.81) mm] and bone papilla [(3.43±0.80) mm] in thin gingival subjects were significantly lower than those in thick gingival subjects [(3.34±0.84) and (2.85±0.71) mm, respectively] (t=-4.89, -5.36, P<0.01). The height of labial gingival papilla of upper anterior teeth was positively correlated with that of bone papilla in all patients (r=0.66, P<0.01); the ratio of crown width to length of upper anterior teeth was positively correlated with the angle of bone margin (r=0.42, P<0.01); the height of anterior gingival papilla was negatively correlated with the angle of bone margin (r=-0.58, P<0.01), and the height of bone papilla was negatively correlated with the angle of bone margin (r=-0.82, P<0.01). Conclusions: The crown shape, gingival shape and alveolar bone shape of maxillary anterior teeth were different in different tooth positions. Patients with different periodontal phenotypes had different crown width length ratio, gingival papilla height, bone papilla height, gingival margin angle, and bone margin angle.

Three-dimensional measurement and analysis of botulinum toxin A injection for improving the aesthetic appearance of upper lip.

This study evaluated the efficacy of botulinum toxin A (BTX A) in improving the aesthetic appearance of lips. Twenty-four outpatients with clinical evidence indicating decreased fullness of lips or gummy smile were selected and received BTX A injection on the orbicularis oris. We observed a significant decrease in wrinkles and improvement in gummy smile in all patients 4 weeks after the injection. Aesthetic lines also changed significantly. Local injection of BTX A on the orbicularis oris could simultaneously achieve mild lip enhancement, improvement in fine wrinkles around lips, and mild gummy smile.

Is interdental papilla filling using hyaluronic acid a stable approach to treat black triangles? A systematic review.

PURPOSE: To evaluate the stability of interdental papilla filling using hyaluronic acid (HA) to treat black triangles in esthetic regions. METHODS: The protocol was registered in PROSPERO. Six databases (PubMed, Scopus, Embase, Lilacs, SciELO, and Web of Science) were used as primary search sources, and OpenGrey and OpenThesis were used to capture the "gray literature." Only before-after studies were included. The JBI Checklist assessed the risk of bias. Only four studies met the inclusion criteria and were considered for the analyses. The studies were published from 2010 to 2016. All studies presented a low risk of bias. Considering the studies do not have control groups, a weighted average by sample size was calculated to obtain a general estimate of the percentage of papillary filling after 6 months and the number of HA applications. RESULTS: The studies showed the percentage of papillary reconstruction after 6 months of application, the weighted average by sample size was 77.41% (SD = 20.68), with an average number of applications of 3.17 (SD = 0.31). CONCLUSION: The application of HA may be used to repair anesthetic defects in the papilla. CLINICAL SIGNIFICANCE: Interdental papilla reconstruction with injectable HA is an option of nonsurgical treatment for interdental papilla deficiencies. However, there is still concern about the quality of the evidence available, considering that studies with different experimental designs can produce contradictory results. Moreover, further understanding is required on the stability of tissue gain promoted by HA in black triangles.

Determinación de parámetros estéticos gingivales y dentarios en dientes anterosuperiores / Determination of gingival and dental esthetic parameters in anterosuperior teeth

La odontología estética no es una disciplina especial o área de la odontología en sí misma, pero con consideraciones funcionales y biológicas, representa uno de los objetivos de las intervenciones de tratamiento dental, que abarca todas las áreas de especialidad, desde la odontología preventiva y restaurativa hasta la prostodoncia, ortodoncia, periodoncia, como, así como la cirugía oral y maxilofacial. El cénit gingival es un importante componente de la sonrisa y su estudio sigue siendo muy relevante en la odontoestética internacional. En el presente trabajo se determinaron distancias del cenit al eje longitudinal y se correlacionaron con otros parámetros gingivales, se establecieron diferencias en las alturas de las papilas interdentales y se correlacionaron los datos métricos de las piezas dentarias anteriores de la población estudiada y los datos conocidos con el fin de obtener datos estadísticos relevantes. Los datos mesurables fueron obtenidos de pacientes de ambos sexos, (18 ­ 25) años, con piezas dentarias del grupo anterior y superior a saber: incisivos centrales, incisivos laterales y caninos superiores, normalmente implantados, libres de lesiones o restaruración, ausencia de enfermedad gingivoperiodontal y sin tratamientos ortodoncicos. El trabajo observacional, descriptivo y tranversal arrojó resultados basados en la estadística preponderante. Provee dimensiones y proporciones de dientes maxilares que pueden adaptarse a pacientes individuales en relación con parámetros establecidos en la odontoestética. Estos datos pueden ser pautas útiles para el diagnóstico y la planificación del tratamiento (especialmente cirugía periodontal) en la dentición maxilar (AU)

A esthetic dentistry is not a special discipline or area of dentistry itself, but with functional and biological considerations, it represents one of the objectives of dental treatment interventions, which covers all areas of specialty, from preventive and restorative dentistry up to prosthodontics, orthodontics, periodontics, as well as oral and maxillofacial surgery. The gingival cenith is an important component of the smile and its study remains very relevant in international dentistry. In this work, distances from the cenith to the longitudinal axis were determined and correlated with other gingival parameters, differences in the heights of the interdental papillae were established and the metric data of the anterior teeth of the studied population were correlated and the known data with in order to obtain relevant statistical data. The measurable data were obtained from patients of both sexes, (18 - 25) years, with teeth of the anterior and superior group, namely: central incisors, lateral incisors and upper canines, normally implanted, free of lesions or restoration, absence of disease gingivoperiodontal and without orthodontic treatments. The observational, descriptive and transverse work produced results based on the preponderant statistics. It provides dimensions and proportions of maxillary teeth that can be adapted to individual patients in relation to parameters established in odontoesthetics. These data can be useful guidelines for diagnosis and treatment planning (especially periodontal surgery) in the maxillary dentition (AU)

Assessment of Gingival Biotypes in Patients Visiting a Tertiary Care Centre in Eastern Nepal.

BACKGROUND: Evaluation of gingival biotype has become a routine procedure in periodontal examination because the type of gingival biotype can positively or negatively affect the outcome of periodontal, restorative, orthodontic and implant therapy. The aim of the study was to assess the proportion of types of gingival biotypes in patients visiting a tertiary care center in eastern Nepal. METHODS: Two hundred and fifty patients between 25 to 45 years attending the Periodontology and Oral Implantology were assessed. Gingival biotype of the patents was determined with Probe Transparency technique Results: Out 250 patients assessed, 73 patients (approximately 29.2 %) had thin gingival biotype and remaining 177 patients (approximately 70.8 %) had thick gingival biotype. The number of the male with thin biotype was 31 whereas the number of the male with thick biotype was 82. Similarly, out of 137 female, 42 had thin biotype and remaining 95 female had thick biotype. The types of biotypes were not associated with gender (p=0.67). CONCLUSIONS: Thicker gingival biotype was the more common type of gingival biotype in patients attending the tertiary care center of Eastern Nepal. The occurrence of thick gingival biotype was more common in Adivasi Janajati ethnic community compared to Brahmin / Chhetri ethnic community.

Depth of Gingival Sulcus in Healthy Children with Erupting Permanent Teeth.

INTRODUCTION: Measuring the gingival sulcus depth in children while their permanent teeth erupt is rather difficult especially if using reference norms for adults for a base. AIM: Assessment of the depth of the gingival sulcus during the period of tooth eruption in healthy children. MATERIALS AND METHODS: Thirty children were included in the study (age range 6 - 14 yrs). The children had good oral hygiene and no history of systemic disease. They were clinically examined - their dental statuses were taken, stages of permanent teeth eruption (up to 1/3 of the clinical crown, between 1/3 and 2/3, over 2/3, in occlusion contact), and their gingival sulcus depth was measured at 6 distovestibular, vestibular, mesiovestibular, mesiolingual, lingual, and distolingual sites using an electronic probe Parometer (Orange). It was concluded that the one with the highest value would be considered the maximum depth of the sulcus. RESULTS: The gingival sulcus depth in fully erupted teeth is very similar to that in healthy adults (2.20 - 0.49 mm). The change of sulcus depth in incisors and canines has a variation of 1.5 mm, which at the end of eruption is close to those in adults. Maximum sulcus depth for molars, premolars and incisors was measured distovestibularly, and for canines - mesiovestibularly. CONCLUSION: At the various stages of eruption, the depth of the gingival sulcus plausibly decreases in all tooth types, and by the end of eruption it reaches a depth similar to that of the adult standard. Most indicative in regard to depth are the vestibular probing point.

Effect of Hyaluronic Acid Filler Injection on the Interdental Papilla in a Mouse Model of Open Gingival Embrasure.

The black triangle resulting from interdental papilla (IDP) loss is associated with poor aesthetics and difficulty in pronunciation and food impaction. There is limited knowledge of gingival tissue inflammatory response to hyaluronic acid (HA) filler injection, a minimally invasive IDP reconstruction method. This study aimed to examine the morphological and histological changes in IDP and the inflammatory cytokine localization to the IDP post-HA filler injection using an open gingival embrasure (OGE) mouse model. Mice from the control, sham, and OGE groups were attached with reference, inactive, and activated wires for 5 days, respectively. The degree of IDP loss was determined based on the spring-papilla distance (SPD). Morphological and histological changes in the OGE group injected with phosphate-buffered saline (PBS) or HA fillers were examined on days 2 and 7 post-injection. Immunohistochemical analysis was performed to determine the localization patterns of tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, IL-6, myeloperoxidase (MPO), and Ki67. Five days post-wire attachment, the control and OGE groups exhibited a significantly higher SPD than the sham group (p < 0.0167). The SPD of the HA filler injection group was significantly lower than that of the PBS injection group on days 2, 4, and 7 post-injection (p < 0.05). The IDP of the OGE group was wide and flat. HA filler was stable in the connective tissue underlying the epithelial tissue even on day 7 post-injection. TNF-α, IL-1ß, IL-6, MPO, and Ki67 were highly localized to the connective tissue surrounding the filler on day 2, which decreased on day 7 post-injection. Thus, HA filler can safely and successfully reconstruct the IDP in cases of OGE.

Branching Patterns of Mental Nerve in Newborns.

In classical textbooks of Anatomy, the mental nerve is considered to be the terminal or main branch of the inferior alveolar nerve, especially trifurcate with no designated names as soon as it emerges from the mental foramen. The textbooks define the innervation area of the mental nerve regionally without naming its terminal branches. Nomina Anatomica designates 3 terminal branches of mental nerve as "labial, gingival, and mental branch" but offers no description about their distribution on the mandible. In the present study, bilateral dissections were performed on the lower lip specimens of 20 newborns for 40 mental nerves to determine the branching types of mental nerve. Although anatomy textbooks indicate that mental nerve divides into 3 branches, the authors noted that mental nerve branched into 1, 2, or 3 branches at or right after its exit from the mental foramen. Branching patterns were typed in 13 different subclasses under 3 main groups (Form I-II-III). Moreover, the branching patterns that could not be included in one of these 3 main groups were defined as "Complex Form." The most common type of branching that the authors observed was Form II, which had 2 terminal branches with an incidence of 41.9% (16 specimens). The next frequently encountered type was Form III, having 3 terminal branches, and it was detected in 32.0% of patients (12 specimens). The least common form was Form I, which had 1 terminal branch with a frequency of 15.8% (6 specimens). The unclassified group, Complex Form, was found 10.5% (4 specimens).