Fenótipo periodontal: classificação e relevância clínica

RESUMO

Na última década, várias pesquisas sugeriram que o fenótipo gengival fino ou espesso responde de maneira diferente aos variados tratamentos odontológicos. Objetivo: discutir, com base em uma revisão narrativa da literatura, os diferentes métodos para classificação do fenótipo gengival e/ou periodontal, bem como a relevância clínica do diagnóstico. Material e métodos: através de uma pesquisa realizada no PubMed, foram selecionados artigos que comparavam pelo menos dois métodos para classificar o fenótipo gengival, com vantagens e desvantagens, facilidade na reprodutibilidade e confiabilidade dos mesmos. Resultados: os trabalhos científicos sugerem que dois métodos para classificação do fenótipo gengival são praticados pela maioria dos clínicos: o visual e o da transparência à sondagem. Embora recomendado, o método de classificação através da transparência à sondagem ainda é subjetivo, podendo gerar confusão nesse diagnóstico. Existe uma grande relevância clínica no diagnóstico correto do fenótipo gengival, pelo impacto que isso pode causar no resultado de um tratamento em Implantodontia. Conclusão: com base nessa revisão, embora os métodos clínicos de avaliação do fenótipo gengival sejam os mais utilizados na prática diária, as medições nas tomografias de feixe cônico com afastamento de lábio têm um papel fundamental para determinação do fenótipo periodontal, já que sua atual definição é baseada no fenótipo gengival (espessura gengival), faixa de gengiva queratinizada e espessura da tábua óssea vestibular (morfologia óssea).

Palavras-chave – Fenótipo gengival; Fenótipo periodontal; Biotipo gengival; Biotipo periodontal; Classificação do fenótipo gengival; Espessura gengival.

ABSTRACT

In the last decade, several studies have suggested that thin or thick gingival phenotypes respond differently to varied dental treatments. Objective: to discuss, based on a narrative literature review, the different methods for classifying the gingival and/or periodontal phenotype, as well as the clinical relevance of the diagnosis. Material and methods: a search in PubMed selected articles that compared at least two methods to classify the gingival phenotype, with advantages and disadvantages, ease of reproducibility and reliability. Results: scientific works suggests that two methods for classifying the gingival phenotype are practiced by most clinicians; visual and probe transparency. Although recommended, the transparency approach is still subjective and can generate confusion. There is great clinical relevance in correctly diagnosing the gingival phenotype due to the impact this can have on the result of an implant dentistry treatment. Conclusion: based on this review, although clinical methods for evaluating the gingival phenotype are the most used in daily practice, measurements on cone beam tomography with lip retaction have a crucial role in determining the periodontal phenotype, since its current definition It is based on gingival phenotype (gingival thickness), range of keratinized gingiva, and thickness of the buccal bone plate (bone morphology).

Key words – Gingival phenotype; Periodontal phenotype; Gingival biotype; Periodontal biotype; Phenotype classification; Gingival thickness.

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