J Clin Periodontol 1997: 24: 65-71 Copyright C Munksgaard 1997

Primed in Denmark . Ali rights reserved

dinical penodoiitDiojiy
ISS^ 0303-6979

Gingival phenotypes in young Hans-Peter Miiller^ and

Thomas Eger'

male adults
Departments of, 'Operaiive Dentistry and
Pariodontology, University of Heidelberg and,
^Dentistry, German Armed Forces Central
Hospital, Koblenz, Germany

Muller HP, Eger T: Gingival phenotvpes in young male adults. J Clin Feriodontol
1997: 24: 65-71. © Mutiksgaard, 1997.

Abstract. In a previous study on 42 young adult, periodontally healthy stjbjects

without any attrition, abrasion or crown restoratiort, gingival thickness (GTH)
was determined al facial aspects of premolars, catiirtes and incisors by a novel
ultrasonic device, GTH strongly depended on periodonta! probing depth, width of
gingiva (WG), and tooth type. Whereas the ratio of crown width to its length
(CW/CL) was not identified as an explanatory variable, a significant influence of
the subject was ascertained. The aim of the present study was to extend these
analyses in order to identify subjects with different morphological characteristics
of gingiva, i,e,, gingival phenotypes. When employing cluster analysis on stan-
dardized parameters mean GTH, WG and CW/CL of upper canines, lateral
and central incisors, 3 clusters were identified. Cluster A comprised 2.3 of sub-
jects, displaying "normal" GTH, WG and CW./CL. Cluster B (n=9. 21 %j had a
significantly thicker and wider gingiva, and a more quadratic form of upper front
teeth. A 3rd cluster (cluster C, « = 5, 12%) was identified showing "nornfiar'
GTH, high CW/CL, but a narrow zone of keratinized tissue. Some characteristics
of gingival phenotype of the upper front tooth region were also found at upper
premolars {WG, CW/CL) but in general not at mandibular teeth. Present results Key words: gingival phenotype; tootti shape:
clearly indicate evidence for the existence of different gingival phenotypes. Clin- ultrasonic method; cluster analysis
ical relevance of these observations bas to be tested in longitudinal studies. Accepted for publication 11 March 1996

It has been long known that clinical ap-
pearance of healthy marginal periodon-
tium differs from subject to subject and
even among different tooth types.
Many features are directly genetically
determined, others seem to be influ-
enced by tooth size, shape and position,
and biological phenomena such as
growth or aging (Schluger et al. 1990),
While after tooth eruption, e.g., mel-
anin pigmentation, or presence of a gin-
gival groove seem to be stable features
throughout life, if present, the extent of
stippling of the attached gingiva in-
creases in density from early childhood
to adulthood (Schroeder 1986), The
width of the keratinized tissue appears
to increase with age, due to attrition
and continuous eruption of teeth while
the mucogingival border is assumed to
be stable (Ainamo et al. 1981), ln a pre-
vious study we demon,strated that the
mean value of gingival thickness at dif-
ferent teeth does not undergo alter-
ations with increasing age (Eger et al,
1996), In a young adult population with
healthy periodontal conditions, gingival
thickness was determined at facial as-
pects of premolars, canines and incisors
by a novel ultrasonic device. It was ob-
served that gingival thickness strongly
depended on periodontal probing
depth, width of gingiva, and tooth type.
Whereas the ratio of crown width to its
length was not identified as an explana-
tory variable, a significant influence of
the subject was ascertained (Eger et al,
1996), The aim of the present study was
to extend these analyses in order to
identify subjects with different morpho-
logical characteristics of gingiva, i.e.,
gingival phenotypes.
Material and Methods
The study population has been de-
scribed in detail elsewhere (Eger et al,
1996). Briefly, 42 medically healthy, Cau-
casian, male volunteers, 20—25 years
old, gave their informed consent to par-
ticipate in the present study. Inclusion
criteria for participation were (i) no
crown attrition or abrasion nor (ii) arti-
ficial crowTi restoration of premolars,
canines and incisors; (iii) no medi-
cation, at present or in the past, of
drugs known to increase the risk for
gingival enlargement (Seymour & Heas-
man 1988), as calcium channel block-
ers, cyclosporin A or phenytoin; (lv) no
periodonta] treatment with the excep-
tion of regularly performed prophy-
laxis; (V) healthy gingivae OT mild gingi-
vitis with no periodontal probing depth
(PPD) in excess of ,^ mm. Subjects were
provided with one session of oral hy-
giene instruction including interdental
flossing. If present, supragingival calcu-
lus was removed and tooth surfaces
polished. After 1-2 weeks, clinical
examination of premolars, catiines and
incisors of the upper and lower jaws was
66 Mailer & Eger

Table 1. Clinical characteristics of gingiva and tooth form in 42 young male subjects
Gingivai thickness Width of gingiva Ratio width to length Periodontal probing Gingivai recession
Tooth (mm) (mm) of crown depth (mm) (mm)
I5,'25 mean (s,d,) 1,08 (0,38) 4,28(1,20) 0,79(0,12) 1,56(0,47) 0,01 (0,08)
range 0,55-2,35 2,05-7,20 0,55-1,05 !,00-2,50 0,00-0,50
14/24 mean (s,d,) 1,05 (0,28) 3,79(1,10) 0,73(0,11) 1,37 (0,46) 0,06 (0,26)
range 0,50-1,65 1,65-6,45 0,50-0,95 1,00-2,50 0,00-1,45
13/23 mean (s,d,) 0,90 (0,29) 4,21 (1,34) 0,71 (0,10) 1,45 (0,49) 0,07 (0,27)
range 0,55-1,80 1,80-7,65 0,50-0,90 1,00-2,50 0,00-1,35
12/22 mean (s,d,) 1,15 (0,33) 4,80(1,49) 0,72 (0,09) 1,58 (0,51) 0,03(0,12)
range 0,50-1,75 1,45-7,45 0,55-0,90 1,00-2,50 0,00-0,60
11/21 mean (s,d,) 1,28(0,37) 4,44(1,41) 0,81 (0,08) 1,56 (0,55) 0,03 (1,12)
range 0,70-2,35 1,25-7,45 0,60-1,00 1,00-3,00 0,00-0,60
31/4J mean (s,d,) 0,89 (0,27) 4,04(1,32) 0,56(0,10) 1,36 (0,45) 0,15(0,61)
range 0,50-1,60 1,10-7,35 0,40-0,90 1,00-2,50 0,00-3,40
32/42 mean (s,d,) 0,91 (0,30) 4,18 (1,24) 0,59 (0,09) 1,37(0,46) 0,08 (0,32)
range 0,50-1,25 1,10-6,95 0,45-0,80 1,00-2,50 0,00-1,65
33/43 mean (s,d,) 0,84 (0,24) 3,59(1,02) 0,61 (0,07) 1,49(0,64) 0,05 (2,00)
range 0,50-1,55 1,45-6,50 0,50-0,80 1,00-3,00 0,00-0,95
34/44 mean (s,d,) 0,76(0,14) 3,21 (0,98) 0,71 (0,08) 1,41 (0,50) 0,06 (2,50)
range 0,50-1,05 1,80-6,20 0,50-0,95 1,00-2,50 0,00-1,45
35,'45 mean ( s d ) 0,94 (0,22) 3,81 (0,84) 0,78 (0,09) 1,54(0,45) 0,08 (0,26)
range 0,60-1,55 2,00-5,85 0,60-0,95 1,00-2,50 0,00-1,20

Table 2. Clinical characteristics of gingiva and tooth form (mean and standard deviation) in clusters A-C, Cluster analysis based on mean
gingivai thickness, width of gingiva and ratio of width to length of tooth of upper canines, lateral incisors and central incisors: maxillary
teeth: cluster-discriminating features demarcated and bold faced
Gingivai thickness Width of gingiva Ratio width to length Periodontal probing Gingivai recession
Tooth (mm) (mm) of crown depth (mm) (mm)
15/25
Cluster ,A (n=28) 1,07 (0,39) 3,98 (0,80) 0,75 (0,10) 1,50 (0,47) 0,02 (0,09)
Cluster B (n=9) 1,11 (0,39) 5,64(1,56) 0,81 (0,11) 1,67(0,50) 0,00 (0,00)
Cluster C (n=5) 1,04 (0,31) 3,53 (0,37) 0,92 (0,08) 1,70 (0,45) 0,00 (0,00)
P n.s. <0,001 <0,01 n.s. n,s.
14/24
A 1,03 (0,29) 3,53 (0,86) 0,68 (0,08) 1,30(0,44) 0,07 (0,29)
B 1,21 (0,25) 4,86(1,37) 0,79 (0,12) 1,56(0,53) 0,08 (0,25)
C 0,90(0,18) 3,35 (0,52) 0,84(0,10) 1,40 (0,42) 0,00 (0,00)
P n,s. <0,01 <0,01 n,s. n,s.
13/23
A 0.81 (0.19) 3,73 (0.88) 0.67 (0,08) 1,41 (0,49) 0,10(0,33)
B 1.24 (0.35) 6.(»(1.16) 0.78 (0.09) 1,44(0,46) 0,00 (0,00)
C 0.75 (0.17) 3.47 (0.58) 0.83 (0,03) 1,70(0,57) 0,00 (0,00)
P <0.001 <D.OO! <0.001 n,s. n,s.
12/22
A 1.12 (0.31) 4.59 (1.25) 0.68 (0.08) 1,55(0,46) 0,04(0,15)
B 1.31 (0.26) 6.41 (0.88) 0.77 (0.08) 1,50(0,61) 0,00 (0,00)
C 1.03 (0.53) 3.04 (0.83) 0.82 (0.05) 1,90(0,55) 0,00 (0,00)
P n.s. <0.001 <0.001 n,s. n,s.
U/21
A 1.13 (0.26) 4.18 (1.04) 0.78 (0,07) 1,48(0,50) 0,04(0,15)
B 1,79 (0.31) 6.22 (0.91) 0,86 (0.06) 1,72(0,76) 0,00 (0,00)
C 1.23(0.10) 2,75 (0,48) 0.8«(O.I0) 1,70(0,45) 0,00 (0,00)
P <0.00I <0,001 <0.01 n,s. n,s.

carried out, PPD was measured at the Germany), Width of gingiva (WG) and mm, Gingivai thickness (GTH) at facial
buccal aspect of the tooth to the next gingiva! recession were measured mid- aspects was assessed atraumatically
mm (PCP 11, Aesculap, Tuttlingen, buccaliy with a caliper to the next 0,1 with a novel ultrasonic device (SDM®,
 Gingival phenotypes 67

Table 3. Clinical characteristics of gingiva and tooth form (mean and standard deviation) in clusters A-C. Cluster analysis based on mean
gingival thickness, width of gingiva and ratio of width to length of tooth of upper canines, lateral incisors and central incisors; mandibular
teeth
Gingival thickness Width of gingiva Ratio width to length Periodontai probing Gingival recession
Tooth iinm) (mm) of crown depth Imm) (mm)
35/45
Cluster A («=28) 0.95 (0,20) 3,75(0.72) 0.75 (0.08) 1,52(0.50) 0.08 (0.26)
Cluster B («=9) 1.01 (0,26) 4.08(1.12) 0.78 (0,09) 1,50(0.35) 0.11 (0,33)
Cluster C (n = 5) 0.78(0.15) 3.69 (0,95) 0.89 (0,06) 1.70(0.27) 0,00 (0.00)
P n.s. n,s. <0,01 n.s. n.s.
,14/44
A 0.77(0.15) 3.22(1.22) 0.69 (0,07) 1.34 (0.51) 0.09 (0,30)
B 0.76(0.13) 3.09 (0.61) 0.71 (0,04) 1.39 (0.49) 0,00 (0.00)
C 0.67 (0.09) 3.38 (0.74) 0,83 (0.09) 1.80(0,27) 0,00 (0.00)
P n,s. n,s. <0.01 n,s. n.s.
33/43
A 0,80(0.21) 3.51 (0,14) 0.60(0.07) 1.52(0.63) 0.08 (0.24)
B L03 (0,26) 4.03 (0.68) 0.61 (0.07) 1.39(0.78) 0,00 (0.00)
C 0,71 (0.20) 3.26 (0.65) 0.65 (0,04) 1.50(0,50) 0,00 (0.00)
P <0,05 n,s. n.s. n.s. n.s.
32/42
A 0.89 (0.33) 4.06(1,25) 0.57 (0,08) 1.41 (0.43) 0.10 (0.37)
B 1,02(0.16) 4.98 (L14J 0.63 (0,10) L17(0,35J 0,06 (O.i8)
C 0,88 (0.36) 3.41 (0.58) 0.64(0,10) 1,50 (0.71) 0,00 (0.00)
P n.s. <0.05 n,s. n,s. n.s.
31/41
A 0.83 (0.23) 3.90 (1.29) 0.55(0.11) 1.32(0.41) 0.16(0.66)
B 0.99(0.16) 4,89(1.35) 0.58 (0.04) 1.28(0,44) 0,21 (0,63)
C 1.04(0,52) 3,25(0.71) 0.62(0.13) 1.70(0,57) 0.00 (0,00)
P <0.05 n.s. n.s. n.s. n,s.

Krupp, Essen, Germany) to the next 0,1
mm. The edge of the transducer probe
of the SDIVI* was placed at a midbuccal
location at the level of the PPD. Excel-
lent validity and reliability of the meas-
urement device has been presented else-
where (Eger et al. 1996),
The ratio of the width of Ihe crown
to its length (CW/CL) was calculated
according to Olsson & Lindhe (1991).
CL was defined as the distance between
the gingival margin or, if discernible,
the cemento-enamel junction, and the
buccal cuspid or incisal edge of the
crown. The length of the crown was di-
vided into 3 portions of equal hight;
cervical, middle, and incisal. The dis-
tance between the approximal tooth
surfaces (CW) was measured at the bor-
derline between the cervical and middle
portion (Olsson & Lindhe 1991), Meas-
urements were made on stone model
casts.
An analytical approach to objectively
divide a given population into easier to
survey fractions may be cluster analysis.
The Euklidean distance of 9 parameters
was used as a measure of distance;
mean GTH, WG and CW/CL of upper
central incisors, lateral incisors, and
canines. An initial partition of the 42
subjects into 3 clusters was iteratively
improved by non-hierarchical disjunct
cluster analysis with A-means algorithm
(Hartigan & Wong 1979) in order to re-
duce the within-group stim of squares.
Analysis of variance was applied to
search for differences among clusters.
No attempt was made to adjust for
multiple testing. All analyses were done
on an IBM-PC with SYSTAT for Win-
dows, version 5 (SYSTAT Evanstone,
[L, USA).
Results
Table 1 presents some clinical charac-
teristics of gingiva and shape of teeth
in 42 young adult male subjects. Mean
(±standard deviation) GTH ranged be-
tween 0,76±0,14 mm at lower ist pre-
molars and l,28±0,37 mm at upper
central incisors. Coefficients of vari-
ation (standard deviation/mean; CVs)
ranged between l$% (lower 1st pre-
molars) and 35% (upper 2nd pre-
molars). Mean WG was greatest at
upper lateral incisors (4,80±l,49 mm),
whereas a relatively narrow band of
keratinized tissue was found at lower
1st premolars (3,21 ±1,02 mm). There
was considerable variation between
subjects with regard to WG, In general,
CVs of about 30% were calculated.
Mean CW/CL ranged between
0.56±0,10 (lower central incisors) and
0.81 iO.08 (upper central incisors) with
relatively low CVs of about 15"''o. Ir-
respective of tooth type, mean PPD was
about 1.5 mm whereas gingival re-
cession was an uncommon finding with
3,8% teeth being affected (Table 1).
Cluster analysis based on facial
width and thickness of keratinized
tissues and tooth form of upper incisors
and canines revealed, among 42 young
adult male subjects, 3 clusters with dis-
tinct clinicai features (Table 2). In two
thirds of the subjects (cluster A, n=28),
mean GTH of cluster-determining
upper front teeth of about 1 mm and
mean WG of about 4 mm was ascer-
tained, whereas CW/CL ranged be-
tween 0.67 (canines) and 0.78 (central
incisors). Cluster B was comprised of 9
subjects with considerably thicker
(mean 1,24 to 1,79 mm) and wider gin-
giva (mean >6 mm), whereas a more
quadratic shape of teeth was apparent.
Five subjects (cluster C) could be iden-
tified with similar GTH and WG as ob-
served in cluster A, However, shape of
tooth was, on average, even more quad-
68 Muller & Eger
ratic than in cluster B subjects (Table
2), Because of intentionally assorting
stibjects to clusters with similar clinical
features at maxillary front teeth (i,e,,
decreasing within-cluster sum of
squares), most of the differences were
highly significant (p<0,001). Interest-
ingly, when regarding WG and CW./CL,
significant differences among clusters
were also found at upper premolars
(Table 2). In contrast, with a few excep-
tions, in mandibuiar teeth clinical fea-
tures were quite similar in different clus-
ters (Table 3), PPD and gingival re-
cession did not discriminate between
clusters, in general. However, gingival
recession was found at 5,4% teeth in
cluster A subjects. 1.1% teeth in cluster
B and not in cluster C subjects (/^(2)=
11,2, /)<0,01), 3-D scatterplots pre-
sented in Figs, 1-3 may provide an im-
pression of spatial distribution of sub-
jects in clusters A-C, Maxillary incisor
regions of representative subjects in dif-
ferent clusters are presented in Fig, 4,
An attempt was made, to use the
same clinical features in the mandibuiar
Fig. I. 3-D scatterplot presentation of subjects in dusters A-C, Gingival thickness, width of
gingiva and ratio of crown width to length at upper central incisors.
front teeth segment to define clusters.
The analysis failed to create distinct
clusters. Instead. 2 individuals (i.e,. out-
liers) were seperately split off the popu-
lation.
Discussion
The gingiva (i,e,, the marginal peri-
odontium) is that portion of the oral
mucous membrane which, in a com-
plete posteruptive dentition of a healthy
individual, surrounds and is attached to
the teeth and the alveolar processes.
Clinical appearance of normal gingival
tissue in part reflects the underlying
structure of the epithelium and lamina
propria. Because of considerable vari-
ability of the architecture of the papil-
lary body, the irregular patterns of the
epithelium-connective tissue interface
are in part due to large within and be-
tween subject variation of clinical fea-
tures. The particular shape, topo-
graphical distribution and width of the
gtngiva are clearly functions ofthe pres-
ence and position of erupted teeth
11/21
(Schroeder 1986), Moreover, tooth
shape itself seems lo have an important
impact on the clinica! features of the
surrounding gingiva and probably also
the underlying tooth supporting peri-
odontal tissues. These and other often
cited overall clinical impressions de-
scribing the variation of morphological
characteristics of marginal periodon-
tium and rather rare scientific data have
been reviewed in detail by Olsson et al,
(1993). These authors mentioned, as
proposed by Seibert & Lindhe (1989).
the term periodontal biotype to desig-
nate distinct features ("flat-thick" or
"scalloped-thin") of the periodontium,
including the underlying alveolar bone.
Instead, in the present paper, the more
customary term phenotype is used to
describe features of the marginal peri-
odontium that are influenced by both
genetic and environmental factors.
In the present study, cluster analysis
based on clinical features of the maxil-
lary from teeth segment was performed
in order to objectively divide a given
population of healthy young men into
fractions with different gingival pheno-
types. Based on evidence, obtained in
an analysis of covariance, of the subject
as an important factor determining
GTH (Fger et al, 1996). it was pre-
sumed that there exist groups with dif-
ferent combinations of dimensions of
gingiva and crown form. Since cluster
analysis is an interactive process, a
number of different solutions were
evaluated. An initial partition of the
population into 3 clusters (shallow-thin
gingiva, slender crown form; wide-thick
gingiva. quadratic crown form; an un-
known combination) seemed most
reasonable and was iteratively improved
by non-hierarchical disjunct cluster
analysis. It should be noted that a dis-
tinct cluster comprising subjects with
an explicit slender tooth shape, low
GTH and a narrow band of gingiva was
not identified. Rather. 2/3 of subjects
were grouped in cluster A. representing
"normal" thickness and width of gin-
giva as well as "normal" ratio of crown
width to length. Nine subjects (cluster
B) had significantly thicker and wider
gingiva and a more quadratic form of
upper front teeth. Surprisingly. 5 sub-
jects (cluster C) displayed "normal"
GTH. a comparably narrow band of
keratinized tissue at facial aspects and
the highest CW/CL. Some character-
istics of gingival phenotypes defined by
the conditions observed in upper front
tooth region were also found at upper
 Gingivai phenotypes 69

fig, 2. Clinical characteristics at upper lateral incisors of subjects in clusters A-C, Fig, 4. Clinical appearance of maxillary lat-
eral and centra! incisor segments representa-
tive for (a) cluster A: "normal" width and
length of teeth: "normal" width and thick-
ness of keratinized tissue (GTH 13 23: 0,60
mm; 12/22: 1,05 mm; U,'21: 1,15 mm): (b)
cluster B: more quadratic shape of central
and lateral incisors: wide and thick gingiva
(GTH 13/23: 1,,35 mm: 12^22: 1,60 mm: 11/
13/23 21: 1,45 mm): (c) cluster C: quadratic shape
of central and lateral incisors, narrow band
of keraiinized tissue, thin gingira (GTH 13/
23: 0,60 nun: 12/22: 0,60 mm: 11/21: 0,90
mm).

premolars (e,g,, width of keratinized

tissue, ratio of width of crown to
length), but by and large not at man-
dibular teeth. Accordingly, the attempt
of defining similar clusters considering
mandibular front teeth failed. Instead.
2 seperate outliers were split off the
study population.
By intention, cluster anaiysis may be
performed as an initial search for in-
tuitively reasonable structure. Validity
of the resulting partition of a popula-
tion into clusters must be tested in sub-
sequent investigations or considering
data from the literature, Olsson et al,
(1993) identified in 96 volunteers, 16-19
years old. 10 subjects with, at maxillary
centra! incisors, highest (mean±
Fig. 3. Clinical characteristics at upper canines of subjects in clusters A-C, standard deviation 0,89±0,03) and 10
 70 Muller & Eger
with lowest CW/CL (0.65 ±0.03). They
reported significant wider keratinized
tissue at facial aspects, a lower papilla
height, a higher gingival angle of the
crown, but no significant difference in
GTH at short-wide as compared with
long-narrow central incisors. Similarly,
when considering the same data as in
the present study and applying an
analysis of covariance with the subject
as factor, Eger et ai, (1996) failed to ob-
serve a meaningful influence of CW/CL
on GTH, In a recent attempt to test the
hypothesis that a highly scalloped gin-
giva (often associated with a slender
crown form) may respond to peri-
odontal therapy in a different way than
a more flat gingival morphotype (as-
sociated with a wide and short crown of
tooth), Kocher et al, (1995) were not
able to find any statistically significant
differences in a large population of 78
patients with periodontal disease 5
years after completion of active therapy.
They concluded that the results of their
retrospective analysis of stone model
casts did not support the hypothesis
that crown form has a major impact on
the outcome of periodontal therapy
However, when considering our present
results, one should not infer from crown
form of upper central incisors to GTH
and vice versa. Obviously, there were at
least 2 different phenotypes being as-
sociated with a wide-short type of
crown at the upper anterior segment,
one with a "normal" thickness and nar-
row band of keratinized tissue and one
with thick and wide gingiva. It is con-
ceivable that presence of these pheno-
types at least in part accounts for insig-
nificant results in the above mentioned
investigations. It should also be stressed
that, in the present study, cluster A sub-
jects ("normal" conditions) yielded a
mean CW/CL of 0.78±0,07, a figure
20°/<i iarger than the mean vaiue ob-
tained in the 10 subjects with the most
slender upper central incisors of the
study by Olsson et al, (1993), Neverthe-
iess, similar to observations made by
Olsson & Lindhe (1991), in the present
study gingival recession was mainly
found in subjects with a comparably
slender form of upper front teeth, i.e.,
cluster A subjects. Since the present
findings seem to be valid only in this
male, young adult, Caucasian popula-
tion, it would be of some interest to ex-
tend these investigations in order to
confirm the existence of the proposed
gingiva! phenotypes and to' determine
prevalence in different gender, physical
constitutional and racial groups. Clin-
ical relevance of different gingival
phenotypes has to be tested in sub-
sequent longitudinal studies.
Acknowledgement
The opinions expressed in this article
are those of the authors and cannot be
construed as reflecting the views of the
German Armed Forces' Medical Ser-
vice, the German Armed Forces at large
nor the German Ministry of Defence,
Zusammenfassung
Gingivaie Fiidnotypen hei Jugendlichen nidnn-
lichen Geschlechts
In einer frilheren Studie an 42 parodontal ge-
sunden. Jugendiichen Probanden ohne .Attri-
tion, Abrasion oder Kronenersatz, wurde der
Gingivaquerschnitt (GTH) bei Pramolaren,
Eckzahnen und Inzisiven in faziaJem Aspekt
mit einem neuartigen Ultraschallgerat be-
stimmt. Der GTH war weitgehend von der
parodontalen Sondiertiefe, der Gingivabreite
|WG) utid dem Zahntyp abhangig. Wahrend
das Verhaltnis Kronenbreite/Lange (CW/CL)
ats eriauternde Variable nicht in Frage kam,
ermittelte man einen bedeutenden EinfluB
des Phanotyps der Versuchsperson. Mit der
vorliegenden Arbeit wurde beabsichtigt, diese
,A.nalysen zu erweitern, um Personen mit un-
terschiedlichen morphologischen Merkmalen
der Gingiva, m. a. Worten gingivalen phano-
typen, identifizieren zu konnen. Wird die
Clusteralyse bei standardisierten Parame-
tern, wie den mittleren Werten des GTH, der
WG und des CW/CL oberer Eckzahne, sowie
seitlicher und mittlerer Inzisiven angewandt,
werden 3 Cluster identifiziert. Der Cluster A
erfaBte 2/3 der Probanden. GTH, WG und
CW/CL waren "normal". Bei dem Cluster B
(«=9,21%) war die Gingiva erheblich dicker
und breiter. Die oberen Frontzahne hatten
eine deutlicher ausgepragte, quadratische
Form. Weiterhin wurde ein 3. Cluster (Clu-
ster C, n = 5, 12V<j) erkannt, bei dem "norma-
ler" GTH, hohes CW/CL aber eine schmale
Zone keratinisierten Gewebes vorlag. Einige
Kennzeichen des gingivalen Phanotyps der
oberen Frontzahnregion (WG, CW/CL) wur-
den auch bei oberen Pramolaren angetrofTen,
im allgemeinen aber nicht bei Unterkiefer-
zahnen. Die vorliegenden Ergebnisse weisen
eindeutig darauf hin, dafi unterschiedliche
Phanotypen der Gingiva bestehen. Die klini-
sche Rclevanz diser Beobachtungen muO je-
doch anhand von Verlaufssttidien geklarl
werden.
Resume
Fhenotypes gingivaux chez ies Jeunes hommes
Dans une etude precedente effectuee aupres
de 42 jeunes adultes avec parodonte sain,
sans attrition, abrasion ou restauration pro-
thetique, I'epaisseur de la gencive a ete deter-
minee au niveau vestibulaire des premolaires,
canines et incisives a I'aide d'un nouveau sys-
teme utilisant les ultra-sons. L'epaisseur gin-
givale dependait fortement de la profondeur
de poche au sondage, de la largeur de la gen-
cive et du type de dent considere. Bien que le
rapport largeur de la couronne vis-a-vis de ia
longueur de la couronne n'a pas ete identifie
comme variable pouvant justifier le pheno-
mene, une influence significative du sujet a
ete trouvee. Le but de I'etude presente a ete
d'etendre ces analyses atin d'identifier les in-
dividus avec differentes caracteristiques mor-
phologiques de la gencive c.-a-d. les phenoty-
pes gingivaux. En utiiisanl l'analyse par
groupe sur des parametres standardises au
niveau des incisives et canines superieures, la
moyenne de l'epaisseur gingivale, de la lar-
geur gingivale et de la fraction largeur de la
couronne vis-a-vis de sa longueur, trois grou-
pes ont ete mis en evidence. Le groupe A
comprenait 2 tiers des sujets ayant une epais-
scur gingivale, une largeur gingivale et une
fraction largeur de la couronne vis-a-vis de
sa longueur estimees norma)es. Le groupe B
(n=9, 21%) avait une gencive significalive-
ment plus epaisse et plus Earge, et une forme
plus carree des dents supero-anterieures. Le
troisieme groupe C (n=5, 12"/;,) comportait
une epaiseur de gencive normale. un rapport
largeur de la couronne vis-a-vis de sa lon-
gueur eleve mais une zone etroile de tissu ke-
ratinise. Quelques caracteristiques de pheno-
type gingival de la region dentaire antero-
superieure ont egalement ele trouvees au ni-
veau des premolaires superieures (largeur de
la gencive et fraction largeur de la couronne
vis-a-vis de sa longueur) mais en general pas
au niveau des dents inferieures. Les resultats
presents mettent en evidence I'existence de
differents phenotypes gingivaux. La signifi-
cation clinique de ces obser\'ations doit en-
core etre testee dans des etudes longitudi-
nales.
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