Digital assessment of supracrestal tissue attachment and its correlation with dentogingival components

Hesham H Abdulkarim; Nathan M Antoine; Mary Ying-Fang Wang; Elio Reyes Rosales; D Douglas Miley

doi:10.1002/cap.10280

Digital assessment of supracrestal tissue attachment and its correlation with dentogingival components

Clin Adv Periodontics. 2024 Feb 13. doi: 10.1002/cap.10280. Online ahead of print.

Authors

Hesham H Abdulkarim¹, Nathan M Antoine², Mary Ying-Fang Wang³, Elio Reyes Rosales⁴, D Douglas Miley⁴

Affiliations

¹ Department of Advanced Periodontics & Dental Implant Care, A.T. Still University, Missouri School of Dentistry & Oral Health, Saint Louis, Missouri, USA.
² Private Practice, Reno, Nevada, USA.
³ Department of Research Support, A.T. Still University, Kirksville, Missouri, USA.
⁴ Department of Periodontics, Saint Louis University, Center of Advanced Dental Education, Saint Louis, Missouri, USA.

PMID: 38348934
DOI: 10.1002/cap.10280

Abstract

Background: The aim of this study is to measure, in vivo, the supracrestal tissue attachment dimensions (STADs) by means of a noninvasive digital method and to investigate the association between STADs and gingival thickness (GT), tooth position, tooth length, tooth width, keratinized tissue width (KTW), buccal bone thickness (BBT), and bone crest (BC) level.

Methods: Nineteen periodontally healthy subjects who previously received full mouth periodontal charting, cone beam computed tomography, and intraoral scan for the purpose of implant planning were included in the study. A digital imaging software was used for the superimposition of Digital Imaging and Communications in Medicine and stereolithography files, along with hard and soft tissue measurements. Pearson's correlation and ANOVA statistical analyses were used to investigate potential trends between STADs and other dentogingival components.

Results: A total of 203 teeth were assessed, with an average STADs of 2.05 mm (±0.99 mm). STADs were larger in mandibular than maxillary teeth (p-value <0.001) and decreased from anterior to posterior teeth. STADs exhibited an inverse relationship with BBTs and GTs (p-value <0.001) and the KTW (p-value = 0.05). Positive correlations were found between GT and BBT (p-value <0.001), whereas both were negatively correlated with the distance between the cementoenamel junction and BC (p-values 0.019 and 0.006, respectively) and positively correlated with KTW (p-value <0.001).

Conclusions: This study highlighted the dynamic nature of STA relative to tooth position. Additionally, it explored the intricate relationships of STADs with various dentogingival components.

Key points: To the best of the authors' knowledge, this study represents the first application of CBCTs, intraoral scans, and clinical probe depths for noninvasive supracrestal tissue attachment measurements. This study advocates for a personalized assessment of supracrestal attachments, incorporating tooth position and other dentogingival components. The study emphasizes the importance for practitioners to consider the specific patient gingival phenotypes during restorative or surgical planning to avoid adverse outcomes.

Keywords: alveolar bone; cone beam computed tomography; gingival thickness.