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Quick Review #224 - #dental #dentist #dentistry #dentalstudent #dentalschool #teeth #cavity #wisdomteeth #extraction #oralsurgery #oralsurgeon #biologicalwidth #dentalimplant #teeth

The biological width in dentistry refers to the vertical space of soft tissue that exists between the base of the gingival sulcus and the alveolar bone crest. This space is composed of the epithelial attachment and the connective tissue attachment, and it serves as a protective barrier for the underlying periodontal structures. It is critical for maintaining periodontal health and protecting against inflammation, bone loss, and potential damage to the tooth or implant.

Biological Width in Natural Teeth:

For natural teeth, biological width is composed of two main components:

1. Epithelial Attachment: The layer of epithelial cells that attaches the gingiva to the tooth surface. This creates a barrier to prevent bacterial invasion.

2. Connective Tissue Attachment: The fibers of connective tissue that attach the gingiva to the cementum of the tooth and the underlying alveolar bone.

The biological width for natural teeth is typically around 2 mm, which includes about 1 mm of epithelial attachment and 1 mm of connective tissue attachment. This width, though relatively consistent, may vary slightly among individuals depending on their anatomy.

Biological Width Around Dental Implants:

The concept of biological width also applies to dental implants, but the soft tissue attachment around implants is different from that around natural teeth. While the peri-implant soft tissues also consist of an epithelial seal and connective tissue attachment, there are structural differences:

1. Epithelial Seal: A junctional epithelium forms around the implant, creating a protective seal similar to that seen in natural teeth.

2. Connective Tissue: Unlike the connective tissue in natural teeth, which inserts perpendicularly into the cementum, the connective tissue fibers around implants are generally aligned parallel to the implant surface. These fibers do not insert into the implant surface, which affects the strength and quality of the soft tissue attachment.

The biological width around implants is generally similar in dimension to that of natural teeth, around 2-4 mm. However, the parallel orientation of the connective tissue fibers makes the soft tissue around implants more susceptible to peri-implant inflammation and bone loss compared to natural teeth.

References:

1. Yoo, H.-S., Kang, S.-N., Jeong, C.-M., Yun, M.-J., & Huh, J.-B. (2012). Effects of implant collar design on marginal bone and soft tissue. The Journal of Korean Academy of Prosthodontics, 50(1), 21-28

2. Kois, J. C. (1996). Altering gingival levels: The restorative connection. Part I: Biologic variables. Journal of Esthetic and Restorative Dentistry, 8(1), 3-9. https://lnkd.in/evtefk_g

3. ChatGPT. 2024.

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