For many years, clinicians described gingival tissue simply
as “thin” or “thick.” Today, this view has expanded into the broader concept of
the periodontal phenotype, which considers not only gingival thickness but also
the width of keratinised tissue and the underlying bone structure. This
evolution reflects growing recognition that soft tissue dimensions are not just
anatomical features—they play a critical role in determining periodontal
stability, aesthetic outcomes, and the risk of complications across preventive,
surgical, restorative, orthodontic, and implant therapies.
Individuals with a thin phenotype are more prone to gingival
recession, whether triggered by inflammation or mechanical trauma. They also
face greater challenges after surgery, with marginal tissue changes and a
higher chance of aesthetic compromise when restorative or implant materials
show through delicate tissue. In contrast, a thick phenotype generally offers
more resilience: improved resistance to recession, better wound stability, and
enhanced ability to conceal restorative components.
Importantly, phenotype is not a fixed trait. Advances in
mucogingival and peri-implant soft tissue augmentation now allow clinicians to
increase gingival thickness and keratinised tissue dimensions, reducing risks
and improving long-term stability.
This review brings together current knowledge on
definitions, diagnostic methods, biological mechanisms, and clinical
implications of gingival biotype and periodontal phenotype. It emphasises
practical decision-making and the value of interdisciplinary planning. Evidence
from clinical studies and systematic reviews supports phenotype-based
personalisation, particularly in mucogingival surgery and peri-implant care,
where tissue thickness strongly influences early remodelling and the stability
of soft tissue outcomes. At the same time, areas where evidence remains
indirect are highlighted, along with the promise of emerging digital diagnostic
workflows that may help standardise phenotype assessment in everyday practice.
Author(s) Details
Padmaja V. Deshpande
Department of Periodontology and Implantology, CSMSS Dental College and
Hospital, Chh. Sambhajinagar, India.
Niraj Chaudhari
Department of Periodontology and Implantology, CSMSS Dental College and Hospital,
Chh. Sambhajinagar, India.
Maya Mhaske
Department of Periodontology and Implantology, CSMSS Dental College and
Hospital, Chh. Sambhajinagar, India.
Anup Cholepatil
Department of Periodontology and Implantology, CSMSS Dental College and
Hospital, Chh. Sambhajinagar, India.
Nisha Salvi
Department of Periodontology and Implantology, Govt. Dental College and
Hospital Jalgaon, India.
Please see the book here :- https://doi.org/10.9734/bpi/msup/v6/7115
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