Current landmarks for gingival thickness evaluation in maxillary anterior teeth: a systematic review

ObjectivesTo identify and report the current landmarks used for measuring gingival thickness (GT) in healthy maxillary anterior teeth.Material and methodsThe protocol of this Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review was registered in PROSPERO. A literature search was conducted to identify articles that met the eligibility criteria published up to 2022. The methods of assessing gingival thickness and the landmarks adopted on the studies were described. Primary outcomes were identified, and the frequency of reporting in the selected articles was calculated. Additionally, risk-of-bias assessments were performed for individual articles.ResultsFifty-eight articles (34 with low risk of bias and 24 with medium risk of bias) were selected. A total of 3638 individuals had their gingival thickness measured. Thirty-nine different landmarks were adopted in the studies. Fifty-six articles with 22 landmarks were included in the meta-analysis. A higher heterogeneity was found between the studies (GT ranged from 0.48 to 2.59 mm, mean GT 1.074; 95% CI: 1.024-1.104). The 3 most used landmarks were 2 mm from gingival margin (10 studies, mean GT 1.170 mm, 95% CI: 1.085-1.254), bone crest (9 studies, mean GT 1.01 mm; 95% CI: 0.937-1.083), and cemento-enamel junction (7 studies, mean GT 1.172 mm; 95% CI: 1.105, 1.239).ConclusionsWithin the limits of this study, a large heterogeneity in GT was found, and there was no consensus on the ideal landmark for GT measurement.

Automated summary

This study aimed to identify the current landmarks used for measuring gingival thickness in healthy maxillary anterior teeth. A total of 58 articles were selected, involving 3638 individuals. It was found that 39 different landmarks were adopted, with the most commonly used being 2 mm from the gingival margin, bone crest, and cemento-enamel junction. The results showed a large heterogeneity in gingival thickness, and there was no consensus on the ideal landmark for measurement.