Gingival biotype assessment in the esthetic zone: visual versus direct measurement

Int J Periodontics Restorative Dent. 2010 Jun;30(3):237-43.


This study evaluated the reliability of assessing visually the facial gingival biotype of maxillary anterior teeth with and without the use of a periodontal probe in comparison with direct measurements. Forty-eight patients (20 men, 28 women) with a single failing maxillary anterior tooth participated in this study. Three methods were used to evaluate the thickness of the gingival biotype of the failing tooth: visual, periodontal probing, and direct measurement. Prior to extraction, the gingival biotype was identified as either thick or thin via visual assessment and assessment with a periodontal probe. After tooth extraction, direct measurement of the gingival thickness was performed to the nearest 0.1 mm using a tension-free caliper. The gingival biotype was considered thin if the measurement was =or<1.0 mm and thick if it measured>1.0 mm. The assessment methods were compared using the McNemar test at a significance level of a=.05. The mean gingival thickness obtained from direct measurements was 1.06+/-0.27 mm, with an equal distribution (50%) of sites with gingival thicknesses of =or<1 mm and >1 mm. The McNemar test showed a statistically significant difference when comparing the visual assessment with assessment using a periodontal probe (P=.0117) and direct measurement (P=.0001). However, there was no statistically significant difference when comparing assessment with a periodontal probe and direct measurement (P=.146). Assessment with a periodontal probe is an adequately reliable and objective method in evaluating gingival biotype, whereas visual assessment of the gingival biotype by itself is not sufficiently reliable compared to direct measurement.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Weights and Measures / instrumentation*
  • Female
  • Gingiva / anatomy & histology*
  • Humans
  • Incisor
  • Male
  • Maxilla
  • Middle Aged
  • Periodontics / instrumentation*
  • Reproducibility of Results
  • Statistics, Nonparametric
  • Tooth Socket / anatomy & histology
  • Visual Perception*
  • Young Adult