Biotip gingive – komparativna analiza različitih metoda ispitivanja
Sažetak
Uvod/Cilj. Biotip gingive može imati značajan uticaj na ishod parodontalnih terapijskih postupaka i predvidljivost njihovog estetskog ishoda. Postoji visoka korelacija između biotipa i potencijalne recesije gingive nakon restaurativnih, parodontalnih i implantoloških hirurških zahvata. Stoga je tačna identifikacija biotipa gingive, pre započinjanja ovih postupaka, jedan od značajnih prediktivnih faktora njihovog uspeha. Cilj rada bio je da se proceni pouzdanost određivanja biotipa gingive primenom vizuelne metode i metoda parodontalnog i transgingivalnog sondiranja u odnosu na direktnu metodu merenja. Metode. Prospektivnom studijom obuhvaćena su 33 pacijenta kod kojih je bila indikovana resekcija vrha korena zuba u interkaninom sektoru gornje vilice. Identifikacija gingivalnog biotipa izvršena je kod svih pacijenata primenom: 1) vizuelne metode; 2) tehnike parodontalnog sondiranja; 3) tehnike transgingivalnog sondiranja i 4) direktnog merenja nakon odizanja režnja. Statistička analiza dobijenih podataka izvršena je radi procene dijagnostičke tačnosti vizuelne metode, parodontalnog sondiranja i transgingivalnog sondiranja u odnosu na direktnu metodu, koja se koristi kao zlatni standard u cilju evaluacije biotipa gingive (tanak nasuprot debelom). Rezultati. Ukupna tačnost testiranih dijagnostičkih postupaka u određivanju biotipa gingive, u poređenju sa metodom direktnog merenja, bila je: vizuelna metoda – 66,7%; parodontalno sondiranje – 78,8%; transmukozno sondiranje – 97,0%. Zaključak. Parodontalna metoda sondiranja može se preporučiti za određivanje biotipa gingive kao rutinska metoda, s obzirom da je njena senzitivnost i ukupna tačnost veća u odnosu na vizuelnu metodu. U pogledu senzitivnosti i sveobuhvatne tačnosti, transgingivalna metoda se gotovo u potpunosti poklapa sa direktnom metodom, ali je invazivnija u poređenju sa metodom parodontalnog sondiranja i mora se sprovesti uz prethodnu primenu lokalne anestezije.
Reference
Kan JYK, Rungcharassaeng K, Morimoto T, Lozada JL. Facial gin-gival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: Consecu-tive case report. J Oral Maxillofac Surg 2009; 67(11 Suppl): 40‒8.
Kan JYK, Rungcharassaeng K. Site development for anterior sin-gle implant esthetics: The dentulous site. Compend Contin Educ Dent 2001; 22(3):221‒6, 228, 230‒1; quiz 232.
De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gin-gival biotype revisited: Transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 2009; 36(5): 428‒33.
Ochsenbein C, Ross S. A reevaluation of osseous surgery. Dent Clin North Am 1969; 13(1): 87‒102.
Seibert JL, Lindhe J. Esthetics and periodontal therapy. In: Lindhe J, editor. Textbook of Clinical Periodontology. 2nd ed. Denmark, Copenhagen: Munksgaard; 1989. p. 477‒514.
Müller HP, Eger T. Gingival phenotypes in young male adults. J Clin Periodontol 1997; 24 (1): 65‒71.
Kan JY, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gin-gival biotype assessment in the esthetic zone: visual versus di-rect measurement. Int J Periodontics Restorative Dent 2010; 30(3): 237‒43.
Joshi N, Agarwal MC, Madan E, Gupta S, Law A. Gingival bio-type and gingival biofilm: determining factors for periodontal disease progression and treatment outcome. Int J Sci Study 2016; 4(3): 220‒5.
Ahmadi RS, Tavassoli R, Sayar F, Ghaffari K, Sarlati F. Gingival thickness assessment: Visual versus direct measurement. J Is-lam Dent Assoc Iran (JIDAI) 2016; 28(4): 149‒54.
Olsson M, Lindhe J, Marinello CP. On the relationship between crown form and clinical features of the gingival in adolescents. J Clin Periodontol 1993; 20(8): 570‒7.
Kan JYK, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: An evaluation of maxillary anterior sin-gle implants in humans. J Periodontol 2003; 74(4): 557‒62.
Alves PHM, Alves TCLP, Pegoraro TA, Costa YM, Bonfante EA, de Almeida ALPF. Measurement properties of gingival biotype evaluation methods. Clin Implant Dent Relat Res. 2018; 20(3): 280‒4.
Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue re-placement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014; 41 Suppl 15: S123‒42.
Linkevicius T, Puisys A, Svediene O, Linkevicius R, Linkeviciene L. Radiological comparison of laser-microtextured and plat-formswitchedimplants in thin mucosal biotype. Clin Oral Im-plants Res 2015; 26(5): 599‒605.
Goaslind GD, Robertson PB, Mahan CJ, Morrison WW, Olson JV. Thickness of facial gingiva. J Periodontol 1977; 48(12): 768‒71.
Esfahrood ZR, Kadkhodazadeh M, Talebi Ardakani MR. Gingival biotype: a review. Gen Dent 2013; 61(4): 14‒7.
Kydd WL, Daly CH, Wheeler JB 3rd. The thickness measure-ment of masticatory mucosa in vivo. Int Dent J 1971; 21(4):430‒41.
Slak B, Daabous A, Bednarz W, Strumban E, Maev RG. Assess-ment of gingival thickness using an ultrasonic dental system prototype: A comparison to traditional methods. Ann Anat 2015; 199: 98‒103.
Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL. Tissue biotype and its relation to the underlying bone mor-phology. J Periodontol 2010; 81(4): 569‒74.
Lindhe J, Lang N, Karring Th. Clinical Periodontology and Im-plant Dentistry. 5th ed. Hoboken: Wiley-Blackwell; 2008; pp 69‒71.
Kolte R, Kolte A, Mahajan A. Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol 2014; 18(4): 478‒81.
Cosyn J, Sabzevar MM, De Bruyn H. Predictors of inter-proximal and midfacial recession following single implant treatment in the ante¬rior maxilla: a multivariate analysis. J Clin Periodontol 2012; 39(4): 895‒903.
Muller HP, Eger T, Sorb A. Gingival dimensions after root coverage with free connective tissue grafts. J Clin Periodontol 1998; 25(5): 424‒30.
Bengazi F, Wennström JL, Lekholm U. Recession of the soft tis-sue margin at oral implants. A 2-year longitudinal prospective study. Clin Oral Implants Res 1996; 7(4): 303‒10.
Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res 2008; 19(1): 73‒80.
Hwang D, Wang HL. Flap thickness as a predictor of root cov-erage: a systematic review. J Periodontol 2006; 77(10): 1625‒34.
Baldi C, Pini-Prato G, Pagliaro U, Nieri M, Saletta D, Muzzi L, et al Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series. J Periodontol 1999; 70(9): 1077‒84.
Kahn S, Almeida RA, Dias AT, Rodrigues WJ, Barceleiro MO, Taba MJr. Clinical Considerations on the Root Coverage of Gingival Recessions in Thin or Thick Biotype. Int J Periodon-tics Restorative Dent 2016; 36(3): 409‒15.