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Effect of gingival phenotype on the maintenance of periodontal health: an american academy of periodontology best evidence review.

BACKGROUND
Gingival thickness, keratinized tissue width and bone morphotype are three important parameters used to categorize periodontal phenotypes. These elements all play an important role in the maintenance of periodontal health. The aim of this review was to explore the importance of converting thin phenotype into a thick phenotype for periodontal health maintenance.


METHODS
Three clinically relevant focus questions were defined to understand the role of gingival phenotype around teeth. 1) What are the factors affecting gingival phenotype (Ex. age, gender, dental arch, race, crown forms, etc.)? 2) Is there difference between thin versus thick gingival phenotype in terms of gingival health? 3) Does the conversion of gingivae from a thin to thick gingival phenotype in sites without mucogingival defects helps with periodontal health maintenance?


RESULTS
Extensive electronic and manual literature search identified a total of 1,129 citations. After title, abstract and full-text screenings, 30 articles were included in the present review. Twenty-five studies met the inclusion criteria and provided data for focus question 1. It was found that periodontal phenotype varies among different individuals and different areas of the mouth within the same individual. Asian individuals tend to have thinner gingival phenotype compared to Caucasian subjects. Eleven studies met the inclusion criteria for the focus question 2. Prevalence and severity of gingival recession was higher at the sites with thin gingiva compared to the sites with thicker gingiva. No studies provided data for the focus question 3.


CONCLUSIONS
Available evidence indicates that subjects with thin and narrow gingiva tend to have more gingival recession compared to those with thick and wide gingiva. Currently, there is no published evidence to support conversion of thin to thick gingival phenotype in sites without gingival recession or mucogingival deformity. This article is protected by copyright. All rights reserved.