Journal of Oral Implantology June 2013 - (Page 308)

RESEARCH An Exploratory Study on Assessment of Gingival Biotype and Crown Dimensions as Predictors for Implant Esthetics Comparing Caucasian and Indian Subjects Ratnadeep Patil, BDS1* Ralph van Brakel, DDS2 Kavita Mahesh, BDS1 Cornelius de Putter, DDS, PhD2 Marco S. Cune, DDS, PhD2,3 Gingival biotype and crown dimensions may be important predictors for the esthetic outcome of surgical procedures. However, the visual distinction between ‘‘thick’’ and ‘‘thin’’ biotype may not be a suitable predictive parameter of surgical outcome. Intraoral photographs of 73 Indian and Dutch subjects were matched with respect to age and gender and were used to determine the gingival biotype (subjective assessment) and crown dimensions (objective assessment). Intraobserver and interobserver agreement was determined for subjective measurements (Cohen’s kappa), and the error of the method was calculated for the objective measurements (Dahlberg formula). Intraobserver agreement for the subjective assessment of gingival biotype was adequate (j ¼ 0.49–0.60), but interobserver agreement was poor (j ¼ 0.10), whereas the error of the method for objective assessment of crown dimensions was small. The mean crown width-length angle is smaller in Dutch as compared to Indian subjects in this sample (P , .05). Crown dimensions may be a more quantitative approach and could become a future norm to predict outcomes of implant restorative and surgical procedures, bearing in mind that cross-cultural differences may be present. Key Words: gingival biotype, gingiva, crown height-width ratio, crown angle, implant esthetics INTRODUCTION C omplete reconstruction of tooth and gingiva-related esthetics has become the primary objective of contemporary (implant) dentistry, especially in the esthetic zone. In some instances, it can be very difficult to achieve.1 It requires adequate bone volume, proper soft tissue thickness, as well as 1 Department of Clinical Dentistry, Smile Care, Mumbai, India. Rijksuniversiteit Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Fixed and Removable Prosthodontics, Groningen, The Netherlands. 3 Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital, Nieuwegein, The Netherlands. * Corresponding author, e-mail: ratnadeeppatil@gmail.com DOI: 10.1563/AAID-JOI-D-10-00194 2 308 Vol. XXXIX /No. Three / 2013 esthetic-appearing restorations.2,3 With modern day ceramics, the tooth shade and tooth surface structure are controlled factors. However, the same cannot be said about the hard and soft tissues. It is a popular notion that gingival response to surgery is particularly difficult to predict.4 The chance of esthetic success depends on the amount of tissue loss present at the initiation of treatment.1 Just as bone volume is crucial to ideal positioning of the implant, soft tissue volume may predict the ideal emergence profile and esthetics of the eventual implant restoration. The attached gingiva, which is attached firmly to the underlying buccal and lingual alveolar bone, varies in thickness between individuals and between teeth. It has been hypothesized that gingival biotype is one of several

Table of Contents for the Digital Edition of Journal of Oral Implantology June 2013

Congratulations to Duke Heller, DDS, MS—Pioneer, Teacher, and Mentor
In Vitro Analysis of Resistance to Cyclic Load and Preload Distribution of Two Implant/ Abutment Screwed Connections
Mandibular Implant-Supported Overdenture: An In Vitro Comparison of Ball, Bar, and Magnetic Attachments
An Exploratory Study on Assessment of Gingival Biotype and Crown Dimensions as Predictors for Implant Esthetics Comparing Caucasian and Indian Subjects
A New Approach to the All-on-Four Treatment Concept Using Narrow Platform NobelActive Implants
Regular and Switching Platform: Bone Stress Analysis With Varying Implant Diameter
Comparison Between Immediate and Delayed Laser-Treated Implants Surface With Switching Platform: A Clinical Retrospective Study
Effect of a Multiporous Beta–Tricalicum Phosphate on Bone Density Around Dental Implants Inserted Into Fresh Extraction Sockets
The Effect of Varying Implant Position in Immediately Loaded Implant-Supported Mandibular Overdentures
Bone Regeneration Around Immediate Implants Utilizing a Dense Polytetrafluoroethylene Membrane Without Primary Closure: A Report of 3 Cases
Socket Preservation and Sinus Augmentation Using a Medical Grade Calcium Sulfate Hemihydrate and Mineralized Irradiated Cancellous Bone Allograft Composite
Implant Placement and Immediate Loading With Fixed Restorations in Augmented Sockets. Five-Year Results. A Case Report
Immediate Placement and Provisionalization With Buccal Plate Preservation: A Case Report of a New Technique
Clinical Importance of Recipient Site Characteristics for Vertical Ridge Augmentation: A Systematic Review of Literature and Proposal of a Classification
Postextraction Implant in Sites With Endodontic Infection as an Alternative to Endodontic Retreatment: A Review of Literature
Letter to the Editor

Journal of Oral Implantology June 2013