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AIM: To assess the correlation between the periodontal phenotype (PP) and sinus membrane thickness (SMT) in humans. METHODS: This review was conducted according to the PRISMA guidelines. Two reviewers independently carried out electronic and manual literature searches of studies published in English, German, and Spanish, from 1970 to September 2022 in four electronic databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, in addition to gray literature. Studies that assessed the correlation between PP and SMT in adults (aged 18 years) were included. Methodological quality was evaluated using the Appraisal Tool for Cross-Sectional Studies (AXIS) for articles that met the eligibility criteria. RESULTS: Six studies, including 510 patients, were considered for qualitative analysis. All included studies were cross-sectional, and the correlation between the PP and SMT was evaluated, finding a positive and high correlation in 83.3% of them, based on a value of ≥0.7. All the included studies were assessed with a high overall risk of bias. CONCLUSIONS: Periodontal phenotype and sinus membrane thickness are likely correlated. Nevertheless, further standardized studies are required to draw definitive conclusions.

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OBJECTIVES: To evaluate the correlation between smile type (ST) and the periodontal phenotype (PP). MATERIAL AND METHODS: Clinical and photographic examinations of 164 participants (48 men and 116 women, mean age 22.9 ± 4.6 years) were performed, including an evaluation of ST (high, average, and low), gingival phenotype (GP) by transparency of the periodontal probe (TRAN), keratinized tissue width (KTW), gingival architecture (GA), tooth shape (TS), and papilla height (PH). A subgroup of 70 participants underwent soft-tissue cone-beam tomographic examinations (ST-CBCT), in which GP, gingival thickness (GT), buccal bone thickness (BBT), and the distances from the gingival margin and cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC) were evaluated. The data were analyzed using one-way ANOVA, Student's t-test, and chi-square tests, with the level of significance set at 0.05. RESULTS: High, average, and low STs were found in 31.7%, 56.7%, and 11.6% of the participants, respectively. Sex (p=0.001), GP evaluated using TRAN (p=0.021) and ST-CBCT scans (p=0.009), GA (p<0.001), and TS (p=0.001), were associated with STs. The prevalence of thin GP was: 63% in low, 50% in average, and 38% in high smile types. KTW (p=0.004), PH (p<0.001), GT at different landmarks (p<0.05), CEJ-BBC (p=0.017), and GM-BBC (p=0.001) were significantly different among STs. The highest GT and KTW were found in the high-smile group, average-smile presented the higher CEJ-BBC while GM-BBC and PH, were higher in low-smile group. CONCLUSION: Periodontal phenotype components presented important difference over the smile types. CLINICAL RELEVANCE: A detailed examination of smile types is an essential part of treatment planning, especially when the patient has high esthetic demands. Clinical and tomographic individual analysis of periodontal phenotypes over the smile types may be helpful for a case-by-case approach, and for the development of well-defined treatment protocols.

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OBJECTIVES: To evaluate the relationship between the tomographic sagittal root position (SRP) of maxillary anterior teeth and periodontal phenotype (PP). MATERIAL AND METHODS: Seventy volunteers (420 teeth) were evaluated. Clinical and photographic exams included the evaluation of gingival phenotype (GP) by transparency of the periodontal probe, keratinized tissue width (KTW), gingival architecture, tooth shape, and papilla height (PH). Soft tissue tomographic scan (ST-CBCT) measurements included the SRP classification, GP, gingival thickness in the tissue zone (GT-TZ) and in the bone zone (GT-BZ), buccal bone thickness (BBT), and the distances from the gingival margin and from cementoenamel junction to the buccal bone crest (GM-BBC and CEJ-BBC). Kruskal-Wallis test and a linear regression analysis model were used. RESULTS: The frequency of SRP over the 420 teeth was 65.2% (class I), 9.3% (class II), 0.7% (class III), and 24.8% (class IV). Linear regression analysis showed that SRP is related to PP (p < 0.05). Significantly different measurements of PP parameters were found in SRP classes. The higher and lower GT and BBT were found in classes II and I, respectively. Class IV presented the highest KTW, PH, CEJ-BBC, and GM-BBC. Central incisors (CI) classes I and II were most frequently square-shaped, while 89% of CI Class IV were triangular-shaped. CONCLUSION: The SRP of maxillary anterior teeth is related to periodontal phenotype. CLINICAL RELEVANCE: Clinical and ST-CBCT individual analysis of PP and SRP may be helpful for an esthetic and functional treatment plan based on soft and hard tissue thickness and tooth positioning.

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A técnica do implante imediato juntamente com a coroa provisória imediata tornou-se uma opção bastante segura para a reabilitação oral. Possui vantagens de manter a arquitetura gengival periimplantar; reduzir o tempo e custo de trabalho, pois reduz os procedimentos cirúrgicos e reduzir a perda em altura e largura do osso alveolar. Entretanto, existe uma divergência sobre essas vantagens com um estudo realizado sobre cães, que demonstrou que a técnica de implante imediato não foi capaz de impedir a remodelação óssea após a exodontia. A coroa provisória imediata favorece a manutenção dos tecidos duro e mole da região e tem o papel de vedar o tecido duro que recebeu o implante, formando uma barreira benéfica ao sucesso dos casos. As presentes imagens ilustram a resolução de um único dente perdido na região da maxila anterior (dente 21), através de implante imediato pós-exodontia sem retalho e estética imediata através de coroa provisória imediata. Concluiu-se que o biótipo gengival tem grande influência na estética no tratamento com implantes, sendo o mais fino com maior susceptibilidade a recessão gengival; o uso de restaurações provisórias é importante durante reabilitações orais com implantes, pois além de devolver a função de mastigação, fonética e estética do paciente, também colaboram com a saúde e manutenção dos tecidos periodontais; a técnica do implante imediato à extração dentária é bastante viável e vantajosa, desde que bem planejada e cuidadosamente executada e o uso de coroa provisória imediatamente após a instalação de implante imediato proporciona bem-estar psicológico, representando uma solução reabilitadora para a perda de dente unitário anterior.(AU)

Immediate Provisionalization After Installation Of Immediate Implant In Aeshetic Area - Literature Review The immediate implant technique along with the immediate provisional crown has become a fairly safe option for oral rehabilitation. It has advantages of maintaining the gingival architecture periimplantar; reduce the time and cost of labor as it reduces surgical procedures and reduces loss of height and width of the alveolar bone. However, there is a disagreement about these advantages with a study on dogs, which demonstrated that the immediate implant technique was not able to prevent bone remodeling after the exodontia. The temporary provisional crown favors the maintenance of the hard and soft tissues of the region and has the role of sealing the hard tissue that received the implant, forming a beneficial barrier to the success of the cases. The present case report describes the resolution of a single missing tooth in the region of the anterior maxilla (tooth 21), through immediate post-exodontic implant without flap and immediate aesthetic through immediate provisional crown. It was concluded that the gingival biotype has a great influence on aesthetics in the treatment with implants, being the finest one with greater susceptibility to gingival recession; the use of temporary restorations is important during oral rehabilitations with implants, since in addition to returning the chewing, phonetic and aesthetic function of the patient, they also collaborate with the health and maintenance of the periodontal tissues; the technique of immediate implant to dental extraction is quite feasible and advantageous, since well planned and carefully executed and the use of temporary crown immediately after the installation of immediate implant provides psychological well-being, representing a rehabilitative solution for the loss of tooth unit previous.(AU)

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O objetivo deste estudo clínico foi avaliar a freqüência dos biótipos periodontais, considerando os diferentes formatos geométricos dos incisivos centrais superiores, através de parâmetros anatômicos dentários e gengivais. Quarenta voluntários foram agrupados de acordo com a forma dos incisivos centrais superiores (ICS, n = 10): retangular (grupo 1), triangular (grupo 2), quadrado (grupo 3) ou oval (grupo 4). Para cada voluntário, foi determinado o biótipo periodontal através de consenso entre 3 examinadores calibrados e foram medidos: o comprimento (CC) e a largura (LC) da coroa; a razão entre a largura e o comprimento da coroa (PLC); a altura do ponto de contato entre os ICS (APC); a distância entre os zênites gengivais dos ICS (ZG1); a distância entre os zênites gengivais do incisivo central e do incisivo lateral superiores (ZG2); a altura da papila entre os ICS (AP1); e a altura da papila entre o incisivo central e o incisivo lateral superiores (AP2). Os dentes quadrados obtiveram os menores valores de comprimento coronário (9,36 ± 0,97, p = 0,0012) e a maior proporção entre a largura e o comprimento da coroa (0,93 ± 0,06, p = 0,0001), quando comparados aos dos demais grupos. Os dentes triangulares apresentaram significativamente a maior distância (8,44 ± 0,89, p = 0,0438) considerando o parâmetro ZG2. O biótipo periodontal fino/festonado foi predominante no total de voluntários desse estudo (60%), e mais freqüente em indivíduos com dentes retangulares. Voluntários com dentes quadrados apresentaram maior freqüência de periodonto plano e espesso (60%), embora o teste exato de Fisher não tenha encontrado diferenças estatisticamente significantes entre os grupos.

The aim of this clinical study was to evaluate the frequency of periodontal phenotypes among different geometric forms of maxillary central incisors. Some clinical parameters such as tooth and papillae dimension, localization of contact points and distances between gingival vertices were also evaluated. Forty patients were selected and divided into 4 groups (n=10) according to geometric form of maxillary central incisors: rectangular (group 1), triangular (group 2), squared (group 3) or ovoid (group 4). Squared teeth showed the lowest coronal length values (9.36±0.97; p=0.0012 and the highest coronal width/length ratio (0.93±0.06; p=0.0001), when compared to the other groups. Thin and scalloped gingival phenotype was predominant in this clinical study (60%), and was frequent in groups 1, 2 and 4. In contrast, squared teeth (group 3) presented predominantly thick and plan gingiva. Nevertheless, Fisher’s exact test did not found any statistical difference among groups.

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