"Accuracy of Cone Beam Computed Tomography for Evaluation of Gingival Biotypes in maxillary esthetic zone" (Prospective study)

Abstract

Gingival biotype is one of the key elements for deciding a successful treatment outcome in many dental procedures. . The bulky and slightly scalloped marginal gingiva with thickness more than 1.5 ml is classified as thick biotype and the highly scalloped marginal gingiva with thickness less than 1.5 ml is classified as thin biotype. This study was conducted as an attempt to evaluate the accuracy of cone beam computed tomography (CBCT) in evaluation of gingival biotypes in maxillary esthetic zone. Forty-six patients (21 males and 25 females) were scanned by one CBCT machine) while wearing customized radiographic stent and measurements obtained from two sites mesial and distal to edentoulous area then they under gone clinical trans gingival method. We included the patients with clinically healthy gingiva and missing one tooth in esthetic zone. Pregnant females and patients under medications or diseases, which can induce gingival enlargement as leukemia and epileptic patient were excluded from the study. We examined the gingival thickness at two regions of interest (ROI), mesial and distal to the edentoulous area at the maxillary aesthetic zone. In order to investigate the gingival thickness at each specific area using CBCT volume, we had to choose an accurate method for standardization.so we use the linear measurement tool to get the distance between the radiographic markers and the external tooth surface from the corrected sagittal view. The aim of our study is to evaluate the reliability of CBCT assessment of gingival biotype at the maxillary aesthetic zone as anon-invasive technique. As reported by Wallner et al., (2018) that aesthetic outcome of dental implants was based on the integrity and thickness of the papilla which indicates the gingival biotype and considered a crucial factor in the stability of crestal bone. Recently, few studies had investigated CBCT as a reliable method for soft tissue assessment similar to a study done by Le (2012) after comparing results had been obtained from CBCT with that from periodontal probing assessment method. Also another study by Lok Lau et al., (2016) evaluated the accuracy of gingival thickness measurements using CBCT in comparison with that obtained from direct clinical method. From the current study the following conclusions are offered:- 1- CBCT is a reliable method to measure the gingival thickness and evaluate gingival biotype. 2- There was no Statistical significant difference between genders noticed regarding the assessment of gingival biotype using cone beam computed tomography (CBCT). 3- Also there was no Statistical significant difference noticed regarding the aspect either mesial or distal.