Objective To compare gingival phenotype assessment methods based on soft tissue transparency on different backgrounds and assessor experience levels. Methods For this purpose, 24 gingival specimens were retrieved from pig jaws with tissue thicknesses from 0.2 to 1.25 mm. Three methods were assessed: periodontal probe PCP12 (thin/thick), double-ended periodontal probe DBS12 (thin/moderate/thick) and colour-based phenotype probe CBP (thin/moderate/thick/very thick). Each sample was photographed with each probe underneath and categorized whether the probe was visible or not using different coloured backgrounds. To measure experience level influence, dentists, dental undergraduate students and laypersons (n = 10/group) performed the evaluation. Results PCP12 probe showed a threshold between 0.4 and 0.5 mm. To distinct between thin and moderate thick gingiva, a comparable range for DBS12 was found while moderate thickness was between 0.5 and 0.8 mm and for thick above 0.8 mm. CBP also showed a comparable threshold of 0.5 mm for thin versus moderate as compared with the other methods; above 0.8 mm, predominantly a very thick tissue was measured. In general, the background colour had a minor impact on PCP12 and DBS12, and investigator experience showed no clear influence on GP assessment. Conclusion Based on probe transparency and within the limitation of a preclinical study, we suggest GP differentiation into three entities: thin (< 0.5 mm; high risk), moderate (0.5–0.8 mm; medium risk) and thick (> 0.8 mm; low risk). Clinical relevance All three GP assessment methods are easy to perform and seem to have a high predictive value with a three entities classification for DBS12 and CBP.

Objectives: To evaluate the relationship between gingival phenotype and tooth location based on selected index teeth ("Ramfjord") and assess possible differences between women and men.Material and Methods: Thirty-six women and 20 men voluntarily participated in this investigation with an average age of 23 years (min: 19; max: 37). Gingival phenotypes (GP) were assessed by transparency of a periodontal probe through the buccal gingival margin.Results: A comparable and similar GP on all index teeth was only found in seven out of the 56 subjects, that is, thin or thick only: Five participants (three male/two female) showed a uniform and constantly thick and two females a constantly thin GP. While the majority of molars (94.6%; p = 0.006) showed a thick GP, premolars (61.6%; p = 0.09) as well as incisors (70.5%; p = 0.046) were predominantly categorized as thin. In addition, significantly thicker GP was in general observed for maxillary teeth (p = 0.001) but without differences between genders (p = 0.722). Conclusion:No constant GP can be expected within one dentition. The use of the "Ramfjord teeth" may serve as a quick overview and reliable method to screen GP distribution.

Objectives To measure the efficiency of three cleaning modalities on two implant designs with similar diameters but different thread depths as well as the presence of titanium particles. Methods Sixty dyed implants (30 × 4.8 apically tapered (ATAP) and 30 × 5.0 fully tapered (FTAP)) were fixed in plastic models. The horizontal bone defects were surrounded with porcine soft tissue. Three instrumentation modalities were used to clean for 150 s: Curette (CUR), ultrasonic scaler (US), and air powder waterjet device (APWJ) with erythritol powder. Afterward, implants were photographed and scanning electron microscopic (SEM) images were taken. Titanium in the soft tissues was quantified in dissolved samples and histologically confirmed. Results For ATAP and FTAP implants, the percentage of the cleaned surface was 26.4 ± 3.0 and 17.1 ± 2.4% for CUR, 33.7 ± 3.8% and 28.1 ± 2.3% for US, and 45.5 ± 4.1% and 24.7 ± 3.8% for APWJ, respectively. SEM images showed significant implant surface changes, especially after instrumentation with CUR and US, whereas APWJ had little to no effect. Most titanium residues were found after cleaning ATAP implants with CUR (152.0 ± 75.5), followed by US (89.5 ± 73.8) and APWJ (0.3 ± 0.8). For the FTAP implants, respective values accounted for 129.5 ± 58.6 μg and 67.0 ± 14.4 μg for CUR and US, respectively. No titanium residues were detected on ATAP with APWJ. Conclusion Based on in vitro data, erythritol‐powered APWJ still appears to be the most efficient and gentle cleaning method. All three instruments, however, were found to have unprocessed areas depending on different implant designs, hence, clinical relevance for non‐surgical approaches remains challenging and warrants further improvement.

Background : Soft tissue thickness can have a major impact on treatment outcomes in implant dentistry, periodontology and fixed prosthodontics. Consequently, different methods to assess the gingival phenotype have been introduced. Distinction based on probe transparency through the gingival sulcus is the clinically most common technique. Aim/Hypothesis : To compare ex-vivo three different gingival phenotype assessment methods based on soft tissue transparency on different backgrounds and different experience levels to distinguish between low and high risk cases. Materials and Methods : Three different probes have been assessed: 1) traditional periodontal probe PCP12, dichotomous classification (thin vs. thick; Hu-Friedy); 2) double-ended periodontal probe DBS12, differentiation in thin/moderate/thick (Deppeler); 3) colour-based phenotype probe CBP, four subgroups (very thin/thin/thick/very thick; Hu-Friedy). Overall, 24 gingival pieces were retrieved from ten upper pig jaws with tissue thickness ranging from 0.2 to 1.25 mm. Each soft tissue sample was photographed with each probe underneath and categorised whether the probe is visible through the tissue or NO-visible. Trying to mimic an everyday clinical setting, different backgrounds were made of dental composite in colours A2, A3 as well as A4 and pictures were taken with a digital mirror-reflex camera with a 300 mm working distance. To assess the influence of multiple experience levels, dentists, dental undergraduate students and laypersons (n = 10), respectively, were asked to categorize all pictures (n = 432). Results : The dichotomous differentiation using a PCP12 probe showed a threshold level around 0.5 mm. For distinction between thin and moderate, a similar border was found for the double-ended phenotype probe DBS12 while soft tissue range for moderate thickness was between 0.5-0.8 mm and for thick above 0.8 mm, respectively. Again, CBP showed the same threshold around 0.5 mm for very thin versus thin as seen with the other probes, however, above 0.8 mm predominantly very thick was chosen. Hence, distinction between thick versus very thick seems to be hardy possible based on this color based method. Background colour and investigator experience seemed to have no to only minimal impact. Further statistical analysis will be performed. Conclusions and Clinical Implications : Based on these preliminary descriptive results, differentiation in more than thin vs. thick seems clinically preferable, especially, if gingival thickness will have a major impact on treatment outcome as reported for immediate implant placement or recession coverage procedures. If more than three categories are necessary seems questionable since only minor differences were found above 0.8 mm tissue thickness for the tested methods.

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