OBJECTIVETo investigate the correlation among the morphology of crown, alveolar ridge crest and gingiva in maxillary anterior region of adults and to provide anatomical basis for clinical implant esthetics.

METHODSSixty Han-Chinese with healthy peridontium were selected in this study. The curvature of labial alveolar crest, the length and height of inter-proximal bone were measured on 3-D model reconstructed from cone-beam CT (CBCT) images, and the curvature of free gingiva, the width and height of inter-dental papilla and central incisor crown were evaluated on casts. The ratio of crown width to height was ranked and the 10 ranked highest were categorized as group Short-Wide (SW), the 10 ranked lowest were selected as group Long-Narrow (LN).

RESULTSIn maxillary anterior region, the curvature angle of both alveolar crest and marginal gingiva were significantly different among different tooth regions, but the alveolar and gingival curvature was significantly correlated in the same region (P < 0.05). The morphology of inter-proximal bone and papilla was significantly correlated (P < 0.01), except the region between central and lateral incisors (P = 0.625, P > 0.05). Compared to group SW, group LN formed a pronounced scalloped contour of gingival margin (P = 0.002) and slender inter-dental papilla (P = 0.000).

CONCLUSIONSThe free gingival curvature and inter-dental papillary morphology are significantly correlated with the morphology of crown and alveolar ridge crest in maxillary anterior region of Han-Chinese. Individuals with long-narrow crown, pronounced scalloped marginal gingiva and slender inter-dental papilla are susceptible to risk implant esthetics.

Alveolar Process ; diagnostic imaging ; Crowns ; Gingiva ; anatomy & histology ; Humans ; Incisor ; anatomy & histology ; Maxilla ; Radiography ; Tooth Crown ; anatomy & histology

OBJECTIVETo measure the width of keratinized gingiva and attached gingiva of anterior dental arch in order to establish reference guidance for periodontal surgery.

METHODSA total of 120 healthy Chinese Han-nationality volunteers aged 20 - 30 years with healthy gingival tissue were recruited. The width of anterior labial dental arch, keratinized gingiva of gingival zenith, depth of gingival sulcus, and the width of coronal-apical keratinized gingiva of interdental papilla were measured respectively and the data were statistically analyzed.

RESULTSThe width of keratinized gingiva and attached gingiva at gingival zenith varied for each individual and tooth location, ranging up to (5.6 ± 1.3) mm in the anterior maxillary region and (4.5 ± 1.1) mm in the anterior submandibular region. The width decreased over the canine and first premolar and increased slightly over the second premolar. The width of keratinized gingiva at interdental papilla ranged from (6.2 ± 1.3) mm to (8.9 ± 1.4) mm in the maxilla and from (5.8 ± 1.0) mm to (7.6 ± 0.9) mm in the mandible. The narrowest width of keratinized gingiva at interdental papilla was located over central incisors.

CONCLUSIONSThere is a variation of width on labial keratinized gingiva of anterior dental arch of Han nationality youth among different individuals and tooth locations.

Adult ; China ; Dental Arch ; anatomy & histology ; Ethnic Groups ; Gingiva ; anatomy & histology ; Humans ; Incisor ; Mandible ; Maxilla ; Young Adult

OBJECTIVETo observe the results of surgical crown lengthening procedure and the factors which affected the success of the surgery.

METHODSCrown lengthening surgery was performed on 27 teeth. The distance between margin of tooth and bone crest (MT-B) was obtained greater than 4 mm during the surgeries on 10 teeth which were considered as satisfying group. The other 17 teeth were as temporized group with MT-B < or = 3 mm. The position of the tooth margin was evaluated before surgery, immediately after suturing, and at 4 - 6 weeks after surgery. The occlusal force and tooth mobility were measured immediately after restoration, at 3 and 6 months after surgery.

RESULTSMT-B was obtained > or = 4 mm and all margins and sites of the teeth were exposed in satisfying group (10/10). At least 1 site with MT-B < 3 mm in temporized group in which there still were 11 sites (16%) in 5 teeth (29%) with subgingival tooth margin at 4 - 6 weeks after surgery. There were more teeth showing increased mobility in temporized group (12/17) than in satisfying group (1/10) after surgery (P < 0.05). The occlusal force of the teeth after surgery and restoration in temporized group was significantly lower than that of their counterpart teeth (P < 0.01), but it was not the case in satisfying group (P > 0.05).

CONCLUSIONSIt is suggested that ideal exposure of tooth margin could be obtained if 4 mm from tooth margin to alveolar crest could be created during the crown lengthening surgery. The teeth both with 4 - 5 mm subgingival margin sites and factors limiting surgical performance are not the suitable indications for the surgical crown lengthening.

Alveolectomy ; Crown Lengthening ; methods ; Follow-Up Studies ; Gingiva ; anatomy & histology ; Humans ; Periodontium ; anatomy & histology ; physiology ; Prospective Studies ; Tooth Crown ; pathology

OBJECTIVETo investigate the features of the fill of interdental spaces by gingival papillae and the associated factors.

METHODSFifteen volunteers with healthy gingiva were involved in this study. The height and thickness on the alveolar crest level of 62 maxillary anterior papilla were measured radiographically with cone-beam computed tomography (CBCT) scans. A standardized periodontal probe with Williams markings was used for measurements of the papilla width on the alveolar crest level.

RESULTSWhen the papilla was complete fill interdentally, the mean height of papillary tissue on the alveolar crest level (equal to contact point-bone crest) was (3.67 ± 0.51) mm. The mean thickness of papilla on the alveolar crest level was (8.38 ± 0.75) mm. The papilla height had a positive correlation with papilla thickness (r = 0.433, P < 0.001).

CONCLUSIONSThe cone-beam computed tomography can be used for clear visualization of the papilla profile and the measurements of papilla height and thickness. Thicker and wider tissue was associated with an increased likelihood of having a complete papilla fill.

Adult ; Alveolar Process ; anatomy & histology ; diagnostic imaging ; Cone-Beam Computed Tomography ; Esthetics, Dental ; Female ; Gingiva ; anatomy & histology ; diagnostic imaging ; Humans ; Incisor ; anatomy & histology ; diagnostic imaging ; Male ; Maxilla ; Odontometry

OBJECTIVETo evaluate Beijing college students' concern and preference for maxillary anterior tooth esthetic factors.

METHODSSeveral images about lip and tooth were made through computer. A questionnaire was sent out to students in ten colleges and then collected. There were five factors to be evaluated: relationship of maxillary incisors and lower lip, numbers of tooth exposed, shape of centric incisor, crown width-length ratio, gingival margin. Concern of the beauty of anterior tooth, ie. tooth shape, tooth arrangement, shape of gingiva and so on, were then analyzed.

RESULTSThere were 408 responses collected, and 47.5% (194/408) of them preferred light contact between upper incisors and lower lip; 49.5% (202/408) preferred 8 tooth exposed when smile; 69.1% (282/408) preferred oval crown shape; 52.5% (214/408) preferred 0.85 as a crown width-length ratio; 49.5% (202/408)of responses chose the curve of gingiva runs horizontal. The average score of concern for male was 52.6% (100/190), for female was 59.6% (130/218).

CONCLUSIONSMost results from this study accord with the classical principles of tooth esthetics. Sex affects the concern and preferences of maxillary anterior tooth esthetics factors.

Adult ; China ; Esthetics, Dental ; Female ; Gingiva ; anatomy & histology ; Humans ; Incisor ; anatomy & histology ; Lip ; anatomy & histology ; Male ; Maxilla ; anatomy & histology ; Odontometry ; methods ; Patient Preference ; Sex Factors ; Smiling ; Surveys and Questionnaires ; Tooth Crown ; anatomy & histology ; Young Adult

OBJECTIVETo analyze smile features in maximum lip-dynamic in Chinese.

METHODSSixty-two Han-Chinese, travelling in Germany, with a mean age of 28.5 years were enrolled and photographed. Standardized digital photos were made to measure the height of displayed maxillary gingiva, papilla and tooth during an enjoyment smile. Statistical analysis was performed using Mann-Whitney-U Test and non-parametric analysis.

RESULTSThe mean height of tooth display for the central incisors was 10 mm, with no significant difference between the gender (P > 0.05). The mean height of gingival display was 1.3 mm and the mean papilla height was 3.4 mm. There was no significant difference between the genders (P > 0.05). 31% (19/62) of the subjects belonged to high smile line type, 50% (31/62) to medium smile line type and 19% (12/62) to low smile line type.

CONCLUSIONSThe red esthetics is a paramount factor for Chinese men and women in the esthetic restoration. 81% of the Chinese studied showed various degree of gingival exposure from central incisor to the premolars, which defined the esthetic area for Chinese people. Papilla is a critical parameter for esthetic evaluation and treatment design. The ratio of high smile line in Chinese may be higher than that in Caucasian.

Adult ; Asian Continental Ancestry Group ; ethnology ; Bicuspid ; anatomy & histology ; Cephalometry ; methods ; Dental Papilla ; anatomy & histology ; Esthetics, Dental ; Female ; Gingiva ; anatomy & histology ; Humans ; Incisor ; anatomy & histology ; Male ; Maxilla ; anatomy & histology ; Photography, Dental ; methods ; Smiling ; Young Adult

During smile evaluation and anterior esthetic construction, the anatomic and racial variations should be considered in order to achieve better matching results. The aims of this study were to validate an objective method for recording spontaneous smile process and to categorize the smile and upper lip curvature of Chinese Han-nationality youth. One hundred and eighty-eight Chinese Han-nationality youths (88 males and 100 females) ranged from 20 to 35 years of age were selected. Spontaneous smiles were elicited by watching comical movies and the dynamics of the spontaneous smile were captured continuously with a digital video camera. All subjects' smiles were categorized into three types: commissure, cuspid and gummy smile based on video editing software and final images. Subjects' upper lip curvatures were also measured and divided into three groups: upward, straight and downward. Reliability analysis was conducted to obtain intra-rater reliabilities on twice measurements. The Pearson Chi-square test was used to compare differences for each parameters (α=0.05). In smile classification, 60.6% commissure smile, 33.5% cuspid smile and 5.9% gummy smile were obtained. In upper lip measurement, 26.1% upward, 39.9% straight and 34.0% downward upper lip curvature were determined. The commissure smile group showed statistically significant higher percentage of straight (46.5%) and upward (40.4%) in upper lip curvatures (P<0.05), while cuspid smile group (65.1%) and gummy smile group (72.7%) showed statistically significant higher frequency in downward upper lip curvature (P<0.05). It is evident that differences in upper lip curvature and smile classification exist based on race, when comparing Chinese subjects with those of Caucasian descent, and gender.
Adult ; Cephalometry ; methods ; China ; ethnology ; Cuspid ; anatomy & histology ; Ethnic Groups ; Female ; Gingiva ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; methods ; Lip ; anatomy & histology ; Male ; Smiling ; Video Recording ; methods ; Young Adult

OBJECTIVETo investigate the smile esthetic elements of Chinese Han-nationality female based on high definition (HD) digital camera with computer-image measuring technique.

METHODSHD digital camera was used to capture spontaneous smile process combined with computer-image measuring technique to establish the analysis method of smile. Ninety-nine Han-nationality female with normal gingiva, aged from 20 to 30 years were recruited. The lip-incisor edge distance, gingival display were measured. The data was statistically analyzed.

RESULTSA standard and objective method to analyze spontaneous smile was established. Forty-three percent (43/99) of the subjects studied were classified as having a high smile and average smile respectively, 13% (13/99) as having a low smile. Gingival display accounted for (1.34 ± 0.98) mm in high smile type.

CONCLUSIONSAverage smile and high smile type were most common in the Chinese Han-nationality female studied.

Adult ; Analysis of Variance ; Asian Continental Ancestry Group ; Cephalometry ; methods ; Esthetics, Dental ; Female ; Gingiva ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; methods ; Incisor ; anatomy & histology ; Lip ; anatomy & histology ; Smiling ; Young Adult

OBJECTIVETo analyze and find factors affecting the height of adjacent gingival papilla of maxillary central incisor single implant in human in order to promote the esthetic result of dental implants.

METHODSSixteen maxillary central incisor single implants of 16 patients and 30 sites of adjacent tissues and prosthesis were evaluated. Data on the height of adjacent gingival papilla of dental implant and relative factors were obtained from clinical parameters, photographs, research models, and X radiographs.

RESULTSThe mean and standard deviation of adjacent gingival papilla height of maxillary central incisor single implant were (4.01 +/- 1.85) mm. Statistical analysis revealed that factors affecting the height of adjacent gingival papilla of implant were as following from strong to weak: vertical distance between contact point and gingival margin, vertical distance between proximal bone level of natural tooth and implant abutment, vertical distance between proximal bone level of natural tooth and contact point, proximal protruding degree of crown, horizontal distance between abutment and root, length ratio of the crown and fixture, vertical distance between proximal bone level of implant and abutment, lip-side protruding degree of crown, probing depth.

CONCLUSIONSMultiple factors affected the height of adjacent gingival papilla of maxillary central incisor single implant in human.

Adult ; Aged ; Dental Implants, Single-Tooth ; Esthetics, Dental ; Female ; Gingiva ; anatomy & histology ; Humans ; Incisor ; surgery ; Linear Models ; Male ; Maxilla ; surgery ; Middle Aged ; Young Adult

OBJECTIVETo establish a convenient, objective and applicable method to assess gingival biotype using periodontal probing.

METHODSA total of 66 maxillary anterior teeth from 14 volunteers (6 males, 8 females) with healthy gingiva, aged from 20 to 30 years, were recruited in this study. The gingival biotypes were evaluated by whether or not the outline of the periodontal probe was clear inside the gingiva. Gingival thickness of the cemento-enamel junction (CEJ) in upper anterior teeth was measured by cone-beam CT (CBCT).

RESULTSThe method of periodontal probing-assessed gingival biotype had good consistency and repeatability. The result of probing-assessed gingival biotype was consistent with that obtained by CBCT. The mean thickness of gingiva in thin, compromised and thick gingival biotype was (1.02 ± 0.20), (1.28 ± 0.25) and (1.46 ± 0.25) mm. These differences were significant for all three comparisons (P = 0.001, respectively).

CONCLUSIONSPeriodontal probing-assessed gingival biotype is a simple, relatively objective and suitable method for clinical examination.

Adult ; Cone-Beam Computed Tomography ; Female ; Gingiva ; anatomy & histology ; diagnostic imaging ; Humans ; Male ; Periodontal Index ; Periodontics ; instrumentation ; Tooth Cervix ; diagnostic imaging ; Young Adult