Gingival Biotype Assessement: Visual Inspection Relevance And Maxillary Versus Mandibular Comparison

Madline Cuny-Houchmand 2, Stéphane Renaudin 2, Mustapha Leroul 2, Lucie Planche 4, Laurent Le Guehennec 3, Assem Soueidan 1, *
1 Department of Periodontology, U 791, UIC Odontologie, School of Dentistry, Nantes, France
2 Department of Orthodontics, School of Dentistry, Nantes, France
3 Department of Prosthodontics, School of Dentistry, Nantes, France
4 Cellule de Promotion de la Recherche Clinique, CHU, Nantes, France

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© Cuny-Houchmand et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the UFR Odontologie de Nantes, 1, place Alexis Ricordeau, 44042 NANTES Cedex / France; Tel: 02 40 41 29 23; Fax: 02 40 20 18 67; E-mail:



This clinical study was aimed at evaluating the accuracy of gingival visual inspection procedures during clinical examination and determining whether differences existed between the maxillary and mandibular gingival biotypes.

Materials and Methods:

The study included 53 patients and 124 clinicians. The clinicians were asked to assign to each subject, using photographic documents, one of three biotypes: thin-scalloped, thick-scalloped, or thick-flat gingival biotype. A total of 19716 responses were collected for statistical analysis.


Identification accuracy of the gingival biotype and the intra-examiner repeatability presented poor highlighting of the limited relevance of visual inspection. In addition, the percent of agreement between classifications based on the global view of both the maxilla and mandible and the classification based on the individual mandibular or maxillary anterior teeth was not statistically significant.


Based on the above results, it can be concluded that a simple visual inspection is not effective for the identification of gingival biotype. Furthermore, evidence suggests that a difference of biotype between the maxilla and the mandible in the same patient is conceivable. Therefore, orthodontic clinical examination should incorporate a reproducible method of determining the individualized gingival biotype for each group of teeth that will be moved.

Keywords: Clinical examination, gingival biotype, maxilla, mandible, visual inspection.