The Effect of Periodontal Health on Smile (EPHS)

Investigation of the Effect of Periodontal Health on Smile Parameters: a Cross-Sectional

Anamnesis was taken from 108 patients aged 18-33 who applied to the clinic and met the inclusion criteria. Photographs of the patients' smiles were taken without any measurement. Plaque , gingival index , bleeding on probing, pocket depth measurements, clinical attachment, and gingival recession levels were measured, respectively. Patients were divided into two groups: peri-implant health and gingivitis. Gingival thickness and keratinized gingival width were also measured. In addition, the smile aesthetic index, style, type, and stage were also determined using the smile classification system. Gingival visibility was measured in mm from the photographs taken.

Study Overview

• Status: Completed
• Conditions: Gingival Diseases; Smiling
• Intervention / Treatment: Other: Periodontal health and gingivitis

• Study Type: Observational
• Enrollment (Actual): 108

Contacts and Locations

Study Locations

• Turkey
  • Bolu, Turkey, 14030
    • Bolu Abant İzzet Baysal Üniversity

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

108 systemically healthy individuals between 13 and 33 years of age

Description

Inclusion Criteria:

• No systemic disease

Exclusion Criteria:

• Active smoking,
• Ongoing or past orthodontic treatment,
• Pregnancy,
• Nursing,
• Individuals who have drug-induced gingival hyperplasia, hereditary gingival fibromatosis, permanent or removable prostheses in the upper front area, or missing teeth in the front region

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Periodontal health; It includes gingival healthy individuals without any periodontal disease.	Other: Periodontal health and gingivitis; The presence or absence of periodontal disease in the gingiva was determined.
Gingivitis; It includes individuals with gingivitis.	Other: Periodontal health and gingivitis; The presence or absence of periodontal disease in the gingiva was determined.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Keratinized gingival thickness	Keratinized gingival thickness refers to the vertical measurement of the gingival tissue that extends from the free gingival margin to the mucogingival junction, characterized by a keratinized epithelial layer which provides enhanced protection and stability to the underlying periodontal structures.	Baseline
Keratinized gingival width	Keratinized gingival width refers to the horizontal dimension of the gingival tissue that is keratinized, measured from the free gingival margin to the mucogingival junction.	Baseline
Gingival display	The gingival displays were measured by measuring the distances from the zenith points to the vermilion border	Baseline
Smile esthetic index	. The aforementioned factors were assigned a number (0 or 1) depending on their presence or absence, and the total of the assigned numbers indicates the subject's SEI (which ranges from 0 for very poor to 10 for very good)	Baseline
Smile clasificatain system	Smile style (Commissura smile, sharp smile, and complex smile), stage (Stage I, Stage II, Stage III, and Stage IV), and type (Type 1, Type 2, Type 3, and Type 4) were analyzed with the smile classification system	Baseline
Gingival phenotype	The visible end of the periodontal probe in the sulcus represents a thin gingival phenotype, while the invisible end corresponds to a thick gingival phenotype	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bleeding on probing	Bleeding, leading sign of inflammation inside the connective tissue, is a critical factor for pocket depth measurements, and with other variable factors prevents making reproducible measurements.	Baseline
Plaque index	The plaque index assesses the amount of dental plaque visible on the vestibular and lingual surfaces of all teeth	Baseline
Clinical attachment level	CAL is calculated by subtracting the gingival margin level from the probing depth.	Baseline
Gingival index	This measurement is based on the presence or absence of bleeding on gentle probing	Baseline
Gingival recession depth	Gingival recession is the apical migration of the gingival margin away from the cemento-enamel junction (CEJ), resulting in the exposure of the root surface of a tooth.	Baseline
Periodontal pocket depth	A pathologically deepened gingival sulcus around a tooth at the gingival margin.	Baseline

Collaborators and Investigators

• Sponsor: Abant Izzet Baysal University

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2023
• Primary Completion (Actual): May 15, 2023
• Study Completion (Actual): June 25, 2023

Study Registration Dates

• First Submitted: August 11, 2024
• First Submitted That Met QC Criteria: August 11, 2024
• First Posted (Actual): August 15, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 2, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: gingivitis; periodontal health; smile
• Additional Relevant MeSH Terms: Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Gingival Diseases
• Other Study ID Numbers: AIBU-DH-TS

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No