Digital Analysis of Dentogingival Factors Influencing the Gingival Margin Position in the Esthetic Zone

Objectives: To investigate the correlation between gingival thickness (GT) and buccal bone thickness (BBT), as well as the effects of GT, BBT, bone crest level (BC), and tooth position on the buccal gingival margin location of maxillary teeth in the esthetic zone.

Materials and methods: Periodontally healthy subjects with prior cone beam computed tomography and intraoral scans for dental implant planning were included. The hard and soft tissue measurements were retrospectively analyzed digitally. Pearson's correlation and ANOVA were used to evaluate the correlations between clinical/anatomical crown height ratios (CCH/ACH), gingival and buccal bone thicknesses, and the distance between the CEJ and BC (CEJ-BC).

Results: Forty-two subjects with 252 teeth were analyzed. A positive correlation was found between GT and BBT (p < 0.001). GT and BBT were negatively correlated with CCH/ACH (p = 0.006 and p = 0.004, respectively), while CCH/ACH showed a positive correlation with CEJ-BC (p < 0.001).

Conclusions: Within the limitations of our study, we concluded that gingival and buccal bone thicknesses were positively correlated. A thicker gingival phenotype and higher coronal bone crest were linked to a more coronal gingival margin in the esthetic zone.