Evaluation of Width and Thickness of Attached Gingiva and Its Association with Age, Gender and Arch Location in Nepalese Population

Evaluation of Width and Thickness of Attached Gingiva and Its Association with Age, Gender and Arch Location in Nepalese Population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of Width and Thickness of Attached Gingiva and Its Association with Age, Gender and Arch Location in Nepalese Population Arjun Hari Rijal, Bhageshwar Dhami, Anju Khapung, Pratistha Ghimire This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3681725/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose The width and thickness of attached gingiva are important clinical parameters. Considerable variations exist in the same as well as in different individuals. This study aimed to assess the width and thickness of the attached gingiva and its relationship with age, gender, and arch location in the Nepalese patients. Methods An observational cross-sectional study was conducted among 120 individuals visiting periodontics department who were categorized into three age-groups with equal distribution of gender in each group. The width of attached gingiva (WAG) was determined using University of North Carolina − 15 probe after locating the mucogingival junction. Data were gathered, entered in excel sheet version 19 and SPSS version 20 was used for further analysis. Mean and standard deviation were calculated. Independent t-test, One-way ANOVA was used to find out the significant difference between variables. Correlation between dependent and independent variables was discovered with the help of Pearson correlation test. The significance level was set at 5% with a 95% confidence level. Results 120 individuals with 1440 teeth were examined to measure the WAG with equal distribution of gender. The maximum WAG was found on maxillary right lateral incisor and minimum width on mandibular left first premolar. The average WAG was greater in the upper arch (3.19 mm) than in the lower (2.71 mm). Maximum thickness (1.728 mm) of attached gingiva was found on the mandibular left first molars and minimum width (0.667 mm) on mandibular left first premolars. Conclusions As individuals age, there is a reduction in gingival thickness, accompanied by an increase in the WAG across both dental arches. In terms of gender differences, females exhibit a higher thickness of attached gingiva (TAH) in comparison to male counterpart. Dentistry Figures Figure 1 INTRODUCTION Orban defined the “attached gingiva” as: “The part of the gingiva which is firmly attached to the underlying tooth and bone and is stippled on the surface” [ 1 ]. WAG extends from the mucogingival junction (MGJ) and to the free gingival groove. It is characterized by firmness, density, stippling, and a tight connection to the periosteum, tooth, and osseous structure. This clinical parameter holds significance in dental assessments. Seibert and Lindhe presented the term “periodontal biotype” to categorize the thickness of gingiva as “thick flat” and “thin scalloped” [ 2 ]. The facio-palatal dimension of the gingiva has been used to describe the thickness (gingival biotype) in and is influenced by the genetic trait. While the shape of the gingiva, thickness of keratinized gingiva in faciolingual direction, WAG, form and thickness of buccal bone, and crown shape are included within the term “periodontal biotype” [ 3 ]. Various techniques have been introduced to measure gingival biotype: histological study on cadaver jaws, [ 4 ] modified caliper, [ 5 ] injection needle, [ 6 ] direct measurements/bone sounding or transgingival probing, [ 7 ] visual examination, probe transparency, histological section, [ 8 ] ultrasonic devices, [ 9 ] cone beam computed tomography. [ 6 ] Differences in the clinical presentation of a healthy marginal periodontium are observed among various subjects and tooth morphologies. Numerous characteristics are inherited through genetics, while others appear to be shaped by factors like tooth shape, size, and alignment. Additionally, biological factors like age, gender, and growth can also play a role in determining these features [ 10 ]. Typically, there are differences in the biotypes of the facial gingiva at both the intra-individual and inter-individual levels [ 2 , 11 ]. This suggests the possibility of different gingival phenotypes existing within any given adult population [ 12 ]. An adequate WAG helps in maintaining aesthetics and improved control of dental plaque. [ 13 ] In routine periodontal and plastic surgeries, it is very important to restore an adequate WAG. Desirable TAH is essential, as a thin gingival margin may result in recession following trauma, surgery, or inflammatory damage. [ 14 ] Many previous studies focused either on assessing the thickness of the palatal mucosa on palate or on individuals who were edentulous [ 12 ] So, this study aimed to assess the width and thickness of the attached gingiva and its relationship with age, gender, and arch location in the Nepalese patients. MATERIALS AND METHOD The descriptive cross-sectional study was conducted at Kantipur Dental College, Kathmandu, Nepal. The study population were patients attending in Periodontics department who fulfilled the inclusion and exclusion criteria. Individuals with all indexed teeth in the both jaws, maintained oral hygiene status, periodontal tissues that are clinically healthy, exhibiting no loss of attachment in the indexed teeth (16,14,12,21,24,26,36,34,32,41,44,46), well-aligned teeth in the both arches were included in the present study. The individuals with gingival recession in indexed teeth, hospitalized patients, females with pregnancy and breast feeding, patients using any medications or hormonal replacement therapy possibly affecting the periodontal tissue, extensive restorations including cervical restoration, fixed partial denture, etc., history of periodontal plastic surgery, patient with history of or undergoing fixed or removable orthodontic therapy, physically disabled and mentally unstable patients were not included in the study. The research proposal was submitted and gave consent to conduct the study by the Institutional Review Committee (IRC No: 2018/Th-05), Kantipur Dental College. Before participating in the research, each participant provided informed consent in a written form. The research sample was selected according to non- probability convenient sampling. The study population selected was between 16 to 50 years of age and were assured that the data collected from them will be kept confidential. The research took place from October 2018 to January 2021. The calculation of the sample size was according to the findings from the research conducted by Jacob et al. [ 15 ] by using the following formula, Minimum of 57 subjects in each group i.e., 57 females and 57 males so altogether 114 patients was enrolled in the study. To obtain a rounded figure, the study included a total of 120 participants. The participants were subsequently categorized into three age groups. Equal gender distribution was maintained in each age group. The presence of plaque was recorded using the modified plaque index (Loe in 1967). The condition of gingiva was assessed with gingival index (GI) as given by Loe and Silness (1963). Periodontal examinations included measurement of WAG, probing sulcus depth, TAH and number of teeth present. Gingival index and plaque index assessments were conducted prior to initiating the periodontal examination. The individuals with healthy gingiva without bleeding on probing and with no visible plaque were included in the study. Further measurements were done on those individuals. A single examiner conducted the entire procedure to reduce the interobserver variability. Standardized instruments were used for the study. The clinical procedures followed along with the armamentarium used are shown in Fig. 1 . All measurements were taken at the mid-buccal area of the indexed tooth. The mucogingival junction was identified with the assistance of Lugol’s solution, which was coated to the participant’s gingiva and alveolar mucosa using a cotton pellet and a light-pressure burnishing technique. The measurement of the width of the keratinized gingiva was carried out by using a University of North Carolina-15 probe (Hufriedy Mfg. Co., LLC., Chicago, United States), extending from the gingival margin to the mucogingival junction. The probing depth was then measured with a UNC-15 periodontal probe. The reading was rounded off to the nearest 1 mm. To ascertain the WAG, the measurement involved determining the total width of keratinized tissue and reducing the probing depth from it. For the measurement of gingival thickness, lignocaine spray (Nummit spray 100ml - anesthetic lidocaine topical spray, ICPA, Mumbai, India) was applied on mid-buccal surface and dried with cotton pellet. Endodontic spreader (number 25, Dentsply Sirona) fitted with stopper was inserted perpendicular to the gingival surface. Then reading was measured from tip of spreader to the point below the stopper with the help of digital Vernier’s caliper (Digital Calipers 6 inch/150 mm - Electronic Vernier Caliper with Large LCD Screen, Inch and Millimeter Conversion Measurement, Arura Enterprise, Tamil Nadu 600031, India). Three consecutive measurements were recorded in millimeter and the average was calculated. The intra-examiner reliability was calculated by re-examining the WAG and TAH in 10% of total patients after 1-week interval and was 91%. Statistical analysis Data were gathered and entered in Microsoft Excel version 19. Further data analysis was done using the SPSS version 20. Frequencies, mean, standard deviation & percentage were calculated. The independent t-test was employed to identify any statistical differences between width and thickness of attached gingiva and age, gender and arch location. Likewise, one-way ANOVA was utilized to determine differences between continuous variables. Pearson correlation test was employed to identify the correlation between the variables. The significance level was set at 5% with a 95% confidence level. RESULTS In current study, 120 individuals were examined, with an equal distribution of 60 (50%) males and 60 (50%) females. The participants had a mean age of 31.9 ± 10.72 years. Subjects were categorized into three age groups. Participants were equally distributed in each group i.e. 40 in each group (20 males and 20 female). Considering the ethnicity, 82 (68.3%) were Aryan, 22 (18.3%) were Mongolian and 16 (13.4%) was Mixed. 1440 teeth were examined to measure the WAG. The overall mean width of attached gingiva was 2.956 mm. The average WAG was greater in the maxilla (3.19 mm) comparison with the mandible (2.71 mm). Within the maxilla, the widest width of attached gingiva (4.53 mm) was observed on the right lateral incisor (12), while the narrowest (2.22 mm) was noted on the left first premolar (24). In the mandible, maximum width (3.52 mm) was found on the right central incisor (41) and minimum (1.84 mm) on the left first premolar (34). The average WAG per tooth has been presented in Table 1 . Table 1 Mean width of attached gingiva in maxillary and mandibular arch (mm) n Mean ± SD Over all 1140 2.956 ± 0.419 Maxillary teeth All teeth 3.19 ± 0.49 1.6 120 2.92 ± 0.724 1.4 120 2.31 ± 0.683 1.2 120 4.53 ± 0.934 2.1 120 4.27 ± 0.978 2.4 120 2.22 ± 0.679 2.6 120 2.89 ± 0.818 Mandibular teeth All teeth 2.7194 ± 0.47436 3.6 120 2.60 ± 0.814 3.4 120 1.84 ± 0.661 3.2 120 3.47 ± 0.907 4.1 120 3.52 ± 0.830 4.4 120 1.85 ± 0.603 4.6 120 3.04 ± 0.726 The overall average thickness of attached gingiva (GT-TGP) was 1.101 mm. Maximum thickness (1.728 mm) of attached gingiva was found on mandibular left first molars and minimum thickness (0.667mm) on mandibular left first premolars. The mean TAH was higher in the maxilla (1.131 mm) compared to the mandible (1.070 mm). In the maxilla, maximum thickness of attached gingiva (1.699 mm) was found on the left first molars (26), whereas minimum (0.757 mm) on the right first premolars (14). In the mandible, maximum thickness (1.070 mm) was found on the right first molar (46) and minimum (0.667 mm) on the left first premolar (34). The mean thickness of attached gingiva per tooth is shown in Table 2 . Thickness was classified [ 16 ] as thick (≥ 1.5 mm) and thin (< 1.5 mm), as presented in Table 2 . Table 2 Mean thickness of attached gingiva in maxillary and mandibular arch Teeth N Mean Gingival Thickness - Transgingival probing (GT-TGP) (mm) Gingival Thickness - Transgingival probing (GT-TGP) 1.5 mm n (%) Overall teeth 1440 1.1010 ± 0.15982 1093 (75.90) 347 (24.1) Maxillary arch All teeth 720 1.1317 ± 0.17611 550 (76.38) 170 (23.62) 1.6 120 1.545 ± 0.4632 66 (55) 54 (45) 1.4 120 0.757 ± 0.2941 116 (96.7) 4 (3.3) 1.1 120 0.999 ± 0.2906 109 (90.8) 11 (9.2) 2.1 120 1.022 ± 0.2817 113 (94.2) 7 (5.8) 2.4 120 0.768 ± 0.2602 117 (97.5) 3 (2.5) 2.6 120 1.699 ± 0.4101 29 (24.2) 91 (75.8) Mandibular arch All teeth 720 1.0704 ± .22788 543 (75.41) 177 (24.59) 3.6 120 1.728 ± 1.1973 41 (34.2) 79 (65.8) 3.4 120 0.689 ± 0.3070 118 (98.3) 2 (1.7) 3.1 120 0.811 ± 0.1922 120 (100) - 4.1 120 0.827 ± 0.1879 120 (100) - 4.4 120 0.667 ± 0.1642 120 (100) - 4.6 120 1.701 ± 0.17611 24 (20) 96 (80) The evaluation of mean WAG and TAG in males and females was conducted through an independent sample t-test. The outcomes are presented in Tables 3 and 4 . Females had higher mean WAG (3.00mm) than males (2.91 mm). The mean WAG in the maxillary premolar region was significantly higher in females in comparison to males, with a statistically significant difference (p-value = 0.03). In all others areas, there was no any statistical significance. (Table 3 ) Table 3 Comparison of mean width of attached gingiva among male and female Teeth Male (n = 60) Female (n = 60) p-value All 2.91 ± 0.36 3.00 ± 0.47 0.23 Maxillary All teeth Incisor region Premolar region Molar region 3.12 ± 0.39 4.30 ± 0.62 2.15 ± 0.52 2.92 ± 0.58 3.26 ± 0.57 4.51 ± 0.94 2.38 ± 0.61 2.90 ± 0.60 0.12 0.15 0.03* 0.88 Mandibular All teeth Incisor region Premolar region Molar region 2.69 ± 0.45 3.51 ± 0.77 1.79 ± 0.46 2.79 ± 0.62 2.74 ± 0.50 3.48 ± 0.77 1.90 ± 0.56 2.85 ± 0.67 0.61 0.81 0.25 0.62 Independent Samples t test, p-value < 0.05 statistically significant* Table 4 Comparison of mean thickness of attached gingiva among male and female Teeth Male (n = 60) Female (n = 60) p-value All 1.07 ± 0.13 1.13 ± 0.18 0.04* Maxillary All teeth Incisor region Premolar region Molar region 1.10 ± 0.18 0.99 ± 0.23 0.75 ± 0.21 1.58 ± 0.31 1.16 ± 0.16 1.03 ± 0.29 0.78 ± 0.21 1.67 ± 0.37 0.07 0.32 0.41 0.14 Mandibular All teeth Incisor region Premolar region Molar region 1.04 ± 0.14 0.87 ± 0.17 0.68 ± 0.15 1.57 ± 0.28 1.10 ± 0.29 0.77 ± 0.17 0.67 ± 0.23 1.86 ± 0.80 0.15 0.002* 0.76 0.01* Independent Samples t test, p-value < 0.05 statistically significant* The total TAH was notably greater in females (1.13 mm) compared to males (1.07 mm), with statistical significance (p = 0.04, Table 4 ). Likewise, the statistically significant differences were observed in the mean TAH in the mandibular incisor area (p-value = 0.002) and the molar area (p-value = 0.01). The assessment of variation in TAH and WAG across various age groups was conducted using the One-way ANOVA test. Results are shown in Tables 5 and 6 . The statistically significant difference in the mean TAH in the maxillary molar region among different age groups was observed (p-value = 0.01). Table 5 Comparison of mean width of attached gingiva among different age groups Teeth 16–24 years (n = 40) 25–39 years (n = 40) 40 years and above (n = 40) p-value All 2.70 ± 0.38 3.03 ± 0.44 3.14 ± 0.29 < 0.001* Maxillary All teeth Incisor region Premolar region Molar region 2.96 ± 0.48 3.98 ± 0.89 2.31 ± 0.64 2.59 ± 0.53 3.33 ± 0.52 4.61 ± 0.70 2.29 ± 0.53 3.09 ± 0.55 3.29 ± 0.40 4.63 ± 0.61 2.20 ± 0.55 3.05 ± 0.56 0.001* < 0.001* 0.66 < 0.001* Mandibular All teeth Incisor region Premolar region Molar region 2.45 ± 0.47 3.03 ± 0.78 1.85 ± 0.47 2.46 ± 0.59 2.72 ± 0.46 3.60 ± 0.67 1.75 ± 0.63 2.81 ± 0.63 2.99 ± 0.32 3.85 ± 0.61 1.94 ± 0.41 3.19 ± 0.49 < 0.001* < 0.001* 0.27 < 0.001* One-way ANOVA, p-value < 0.05 statistically significant* Table 6 Comparison of mean thickness of attached gingiva among different age groups Teeth 16–24 years (n = 40) 25–39 years (n = 40) 40 years and above (n = 40) p-value All teeth 1.11 ± 0.15 1.09 ± 0.12 1.09 ± 0.19 0.84 Maxillary All teeth Incisor region Premolar region Molar region 1.16 ± 0.21 1.04 ± 0.27 0.78 ± 0.24 1.66 ± 0.38 1.15 ± 0.18 0.97 ± 0.23 0.75 ± 0.23 1.72 ± 0.33 1.09 ± 0.12 1.03 ± 0.28 0.76 ± 0.15 1.49 ± 0.28 0.23 0.42 0.86 0.01* Mandibular All teeth Incisor region Premolar region Molar region 1.07 ± 0.15 0.82 ± 0.19 0.71 ± 0.26 1.68 ± 0.34 1.05 ± 0.13 0.79 ± 0.16 0.64 ± 0.11 1.69 ± 0.28 1.09 ± 0.35 0.85 ± 0.18 0.68 ± 0.19 1.76 ± 0.98 0.61 0.45 0.34 0.84 One-way ANOVA, p-value < 0.05 statistically significant* The correlation between the mean TAH and WAG was not found to be statistically significant in the maxilla (p-value = 0.09), mandible (p-value = 0.65), and overall (both arches, p-value = 0.29). Correlation was significant between maxillary incisors (p-value = 0.01) and was weak. (Table 7 ) The width of attached gingiva in the maxilla and the mandible were positively correlated, and was statistically significant (p-value < 0.001). The strength of correlation was moderate (r = 0.501). A positive correlation was identified between the thickness of attached gingiva in the maxilla and mandible, and this correlation was statistically significant (p-value = 0.008). The correlation strength was weak (r = 0.240). Table 7 Correlation between mean width and mean thickness of attached gingiva Variables Width of attached gingiva (Mean ± SD) Thickness of attached gingiva (Mean ± SD) Pearson correlation coefficient (r) p-value Maxilla Overall Incisor Premolar Molar 3.19 ± 0.49 4.40 ± 0.79 2.27 ± 0.57 2.91 ± 0.59 1.13 ± 0.18 1.01 + 0.26 0.76 ± 0.21 1.62 ± 0.35 0.155 0.229 0.144 -0.137 0.09 0.01* 0.12 0.13 Mandible Overall Incisor Premolar Molar 2.72 ± 0.47 3.49 ± 0.77 1.85 ± 0.51 2.82 ± 0.64 1.07 ± 0.23 0.82 ± 0.18 0.68 ± 0.19 1.71 ± 0.62 0.042 0.153 0.024 0.005 0.65 0.09 0.79 0.96 Overall (Both arches) 2.96 ± 0.42 1.10 ± 0.16 0.097 0.29 Pearson correlation p-value < 0.05 statistically significant* DISCUSSION The designation 'periodontal phenotype' was introduced by the “2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions” [ 17 ]. This designation is based on both gingival phenotype and bone morphotype [ 17 ]. TAH, WAG, and bone morphotype were three crucial parameters utilized for categorizing biotypes, playing an important role in the development or progression of defects present mucogingival area [ 18 ]. According to its definition, biotype is genetically determined and remains unalterable. It does not consider environmental factors or clinical interventions that might influence the profile of the periodontal tissue [ 17 ]. Researchers have explored the function of keratinized gingiva in preserving periodontal health, serving to prevent gingivitis and stabilize the gingival margin [ 19 , 20 ]. There is ongoing debate concerning the function of attached gingiva in sustaining gingival health. Maintaining optimal plaque control in regions with minimal or no attached gingiva can contribute to the preservation of periodontal health. Some authors have documented inflammation in areas with at least two mm of keratinized gingiva, even when all dental surfaces were free of plaque [ 19 , 20 ]. Kennedy et al. [ 21 ] concluded that their study found no supporting evidence to suggest that a zone with narrow attached gingiva is more susceptible to gingival inflammation compared to a wider area of attached gingiva. When establishing esthetic margins, the existence of attached gingiva is crucial to reduce the risk of gingival recession and facilitate oral hygiene procedures [ 22 ]. But Mehta et al. [ 23 ] disagreed on this statement. There is an ongoing debate regarding the quantity of attached gingiva required to prevent subsequent recession and attachment loss. Bowers GM [ 14 ] mentioned that it is feasible to maintain clinically healthy gingiva even with a very limited area of attachment (< 1 mm). A thin periodontal biotype, non-existence of attached gingiva, and decreased alveolar bone thickness due to malaligned tooth positioning within the jaw are recognized as determinants for the development and progression of gingival recession. The safeguarding of gingival health is primarily contingent on the presence and upkeep of attached gingival tissue [ 20 ]. As per the 1989 World Workshop of Periodontology, various parameters should be taken into consideration when assessing the presence of a sufficient area of attached gingiva and determining the minimum acceptable amount of attached gingiva [ 24 ]. Thus, determining the width of attached gingiva before any periodontal surgical procedure mainly in perio-plastic surgery is important. The WAG and TAH plays a crucial part in influencing the indications and outcomes of various restorative, periodontal, surgical, and implant therapies. The response of a thick gingival biotype varies from that of a thin gingival biotype. Evaluating the gingival biotype prior to dental procedures is essential for attaining a consistent and stable gingival margin position. In this study, thickness of attached gingiva was measured by transgingival probing [ 25 ] which was easy to perform, convenient, cheap and accurate. The mid-buccal region was selected as a standardized landmark, given that this region represents the minimal width of gingiva and for the sake of convenience. Also, gingival index and plaque index were taken in the same teeth. For patient’s and clinician’s convenience and to reduce the examination time, index teeth were selected which are the representative of respective sextant. Due to the absence of distiction between the attached gingiva and palatal mucosa and lingual mucosa, measurements were not taken for the palatal and lingual zones of attached gingiva The mean WAG was higher in the maxilla (3.19 mm) compared to the mandible (2.71 mm), aligning with findings from previous studies done by Bowers et al. [ 14 ], Pradhan et al. [ 26 ], Adesola et al. [ 27 ], Saxena et al. [ 28 ] and Pradeep et al. [ 29 ]. In the current study, maximum WAG in the maxilla (4.53mm) was found on the right lateral incisors, whereas minimum (2.22mm) on the left first premolars. In the mandible, maximum width (3.52 mm) was found on the right permanent central incisor and minimum (1.84 mm) on the left first premolar. WAG ranged from 1 to 7 mm. According to Lee et al. [ 16 ] on Chinese population, the maximum WAG was found on the maxillary central incisors (5.64 ± 1.40 mm), while the lowest width was noted on the mandibular first premolar (3.43 ± 0.89 mm). The mean WAG was larger in the maxilla (5.10 ± 1.41 mm) than in the mandible (4.09 ± 1.05 mm), consistent with the current study. Variations in measurements could be attributed to different techniques for determining the mucogingival junction (functional versus iodine) or potential ethnic differences. In a study by Shaju Jacob et al . [ 15 ], variations in the WAG were identified across various regions of oral cavity, with the widest measurements in the upper central incisors and the narrowest in the lower molars. These outcomes align with the results of our study Subbaiah et al. [ 30 ], Adesola et al. [ 27 ], and Pradeep et al. [ 29 ] discovered that the WAG varied widely, with the highest measurements typically present in the upper incisors and the lowest in the lower premolars. These findings are comparable to the findings of the present study. In a research conducted by Chandulal et al. [ 31 ], variations in the WAG were noted across different oral cavity regions, with the maxillary incisors showing the widest dimension. In the present study, similar variations in the WAG were observed in both arches. Variations in WAG in various studies might be due to different methods used to locate mucogingival junctions (functional versus staining) or possible true ethnical differences [ 10 , 15 , 16 , 31 ]. In this study, participants were categorized into three age groups, and the WAG was measured and compared among these groups. The statistically significant difference in the average WAG among the three age groups was noticed (p-value 40 years group. There was a notable increase in the overall WAG in the group aged > 40 years compared to the other age groups. Kolte et al. [ 12 ], Bhatia et al. [ 32 ], Pradhan et al. [ 26 ], Jennes et al. [ 33 ] suggested an increase in the WAG with age, while Adesola et al. [ 27 ] observed no association between the WAG and age. In a study done by P Shaju Jacob & RM Zade [ 15 ] in Indian population, the maximum WAG was in middle years age group and lowest in older years age group. In contrast to this study, there was progressive increase in the WAG with increase in age in the current study. In the present study, female participants had a higher mean WAG (3.00mm) than males (2.91 mm). The average WAG in the maxillary premolar area was significantly higher in females compared to males, with a significant difference statistically (p-value = 0.03). In all others areas, no statistical significance was seen. (Table 3 ) These results were similar with the studies done by Chandulal et al . [ 31 ], Shaju Jacob P, Zade RM [ 15 ], Pradhan et al. [ 26 ] and Alhajj et al. [ 34 ]. But in the research by Kolte et al. [ 12 ], D Rouck et al. [ 35 ] and Jennes et al. [ 33 ] where female had less WAG. In the present study, the mean TAH was higher in the maxilla (1.131 mm) compared to the mandible (1.070 mm), aligning with the results of the research conducted by Agarwal et al. [ 36 ] In the study carried out by Lee et al. [ 16 ], the average TAH in the upper incisor, premolar, and molar regions was reported as 1.55 ± 0.30 mm, 1.38 ± 0.37 mm, and 2.20 ± 0.64 mm, respectively. Similarly, in mandibular incisor, premolar and molar region was presented to be 1.01 ± 0.31 mm, 1.11 ± 0.36 mm and 2.07 ± 0.40 mm respectively. These measurements exceed those observed in the current study. General anatomical trend of increasing thickness of attached gingiva was consistent in all studies [ 16 , 25 , 37 ], whereas there was a decrease in thickness from incisor to premolar, which increased in molars in the currentt study. Unlike the current study, Vandana et al. [ 13 ] and Kolte et al. [ 12 ] found that the TAH was greater in the lower arch compared to the upper arch. Our findings indicate that gingival thickness was greater in the young adults group and decreased in the older adult group. These observations align with the findings reported by Vandana et al. [ 13 ], such alterations in oral epithelium could be attributed to age-dependent thinning and reduced keratinization. Our study specifically concentrated on measuring the gingival biotype (thickness) on the midfacial aspect, which is considered to be the most appropriate approach. This is because variations may exist between midfacial and interdental measurements due to differences in alveolar bone contours, which could potentially affect soft tissue thickness [ 13 ]. The overall TAH was greater in females (1.13 mm) compared to males (1.07 mm), with statistical significance (p = 0.04, Table 4 ). Comparable results were suggested by Agarwal et al. [ 36 ]. In contrast to the current study, females had thinner attached gingiva as compared to males in the research done by Vandana et al. [ 13 ], Kolte et al. [ 12 ], Manjunath et al. [ 38 ] and Pradeep et al. [ 29 ]. Different researchers have established arbitrary thresholds to distinguish between thick and thin tissues. Few studies utilized one mm, while others suggested one and half mm as the ceiling for thin gingival tissue due to variations in tissue responses to the periodontal therapy [ 5 , 39 , 40 ]. Using this threshold of 1.5 mm, 75% participants had thin gingiva and 24.9% had thick gingiva. In the maxillary arch, 76.38% participants had thin and 23.62% had thick gingival biotype, whereas 75.41% thin and 24.59% thick gingival biotype in the mandibular arch. Lee et al. [ 16 ] concluded that overall, 64.6% had thin and 35.4% had thick gingival biotype, which is comparable with the result obtained in the current study. Similar prevalence of gingival biotype (75.6% thin, 24.6% thick) was obtained in the mandibular arch but higher prevalence (53.2% thin, 46.8% thick) was discovered in the research done by Lee et al. [ 16 ], as compared to the current study. In contrast, Shao et al. [ 41 ], Shah et al. [ 42 ] and Rijal et al. [ 43 ] discovered greater prevalence of thick gingival phenotype. This difference in gingival thickness in different population may be due to racial variation where Asians usually have a thin gingiva as compared to Caucasians [ 16 , 41 , 44 , 45 ]. The correlation between the mean WAG and TAH was not seen statistically significant in the upper arch (p-value = 0.09), lower arch (p-value = 0.65), and overall (both arches, p-value = 0.29). These findings are in consistent with the research carried out by Lee et al. [ 16 ], James et al. [ 46 ], Alkan et al. [ 47 ], Park et al. [ 48 ], Singh et al. [ 49 ], Muhammad et al. [ 50 ] and Adesola et al. [ 27 ], whereas they contradict the study by Kolte et al. [ 12 ]. Similarly, there is an association between gingival width and gingival phenotype. Thick gingival biotype has a more pronounced width of keratinized gingiva [ 18 , 41 , 51 , 52 ]. Correlation was significant between maxillary incisors (p-value = 0.01, however, the correlation is weak. CONCLUSION As age increases, there is a non-statistically significant decrease in gingival thickness, while the WAG increases in both the upper and lower dental arches. In terms of gender differences, females exhibit a greater TAH compared to males. While, the other tooth related components like tooth position, shape of the arch, genetic factors of the individual and religion factors are also likely to affect the measurement, which may be an important parameter for future clinical trials. Additional research is required on periodontally healthy individuals in various populations in Nepal to establish baseline values for the WAG. LIMITATIONS Since this is a cross-sectional study, the level of evidence provided by this study is less as compared to case-control and cohort studies. All the measurements were done with the help of a hand periodontal probe, in which standardization of probing force and probing angulations could not be possible compared to automated probes. The precision of reading was 1mm when the UNC-15 probe was used. Measurement errors may have resulted from difference in the angulation of spreader, change in tissue volume due to infiltration of anesthetic, and difficulty in accessibility/visibility, especially in the posterior regions. The findings of the current research may not be generalizable to the entire Nepali citizens because of ethnic and cultural differences. This sample consisted only of patients visiting the dental college located in Kathmandu, Nepal. Hence, the result cannot be generalized for entire Nepalese population. RECOMMENDATIONS Further studies should be conducted in various populations in Nepal to get reference values for the WAG. Variations due to ethnicity should be studied. A sample size with large population should be considered to explore the correlation among age, gender, and the gingival biotype (width and thickness). Automated probes with high precision should be used in the future studies. Non-invasive methods like Cone-beam computed tomography (CBCT), Ultrasonography (USG) should also be used to measure the TAH. Declarations DATA AVAILABILITY The data used to support the findings of this study can be obtained from the author upon request. CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported . FUNDING STATEMENT This is self-funded study. ACKNOWLEDGEMENTS I would like to acknowledge all the faculties, staffs of the Department of Periodontics, Kantipur Dental College and all the participants who were involved directly or indirectly in this study. References Orban B. Clinical and histologic study of the surface characteristics of the gingiva. Oral Surg Oral Med Oral Pathol. 1948;1(9):827–41. Seibert J, Lindhe J. Esthetics and periodontal therapy. Textbook of Clinical Periodontology 2nd edition Copenhangen, Denmark: Munksgaard. 1989;2:477–514. Becker W, Ochsenbein C, Tibbetts L, Becker BE. Alveolar bone anatomic profiles as measured from dry skulls: Clinical ramifications. J Clin Periodontol. 1997;24(10):727–31. Hirschfeld I. A study of skulls in the American Museum of Natural History in relation to periodontal disease. Journal of Dental Research. 1923;5(4):241–65. Kan JY, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gingival biotype assessment in the esthetic zone: visual versus direct measurement. International Journal of Periodontics & Restorative Dentistry. 2010;30(3):237–243. Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL. Tissue biotype and its relation to the underlying bone morphology. Journal of periodontology. 2010;81(4):569–74. Greenberg J, Laster L, Listgarten MA. Transgingival probing as a potential estimator of alveolar bone level. Journal of periodontology. 1976;47(9):514–7. Östlund SG. The effect of complete dentures on the gum tissues. Acta odontologica scandinavica. 1958;16(1):1–41. Müller HP, Schaller N, Eger T. Ultrasonic determination of thickness of masticatory mucosa: a methodologic study. Oral Surg Oral Med Oral Pathol Oral Radiol. 1999;88(2):248–53. Müller HP, Eger T. Gingival phenotypes in young male adults. Journal of clinical periodontology. 1997;24(1):65–71. Olsson M, Lindhe JJJocp. Periodontal characteristics in individuals with varying form of the upper central incisors. 1991;18(1):78–82. Kolte R, Kolte A, Mahajan A. Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol. 2014;18(4):478–81. Vandana KL, Savitha B. Thickness of gingiva in association with age, gender and dental arch location. Journal of clinical periodontology. 2005;32(7):828–30. Bowers GM. A study of the width of attached gingiva. The Journal of Periodontology. 1963;34(3):201–9. Shaju JP, Zade RM. Width of attached gingiva in an Indian population: A descriptive study. Ban J Med Sci. 2009;8(3):64–7. Lee WZ, Ong MM, Yeo AB. Gingival profiles in a select Asian cohort: A pilot study. J Investig Clin Dent. 2018;9(1):e12269. Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018;45:S219-29. Zweers J, Thomas RZ, Slot DE, Weisgold AS, Van der Weijden FG. Characteristics of periodontal biotype, its dimensions, associations and prevalence: a systematic review. J Clin Periodontol. 2014;41(10):958–71. Agudio G, Cortellini P, Buti J, Pini Prato G. Periodontal conditions of sites treated with gingival augmentation surgery compared with untreated contralateral homologous sites: an 18-to 35‐year long‐term study. J Periodontol. 2016;87(12):1371–8. Kim DM, Neiva RJ. Periodontal soft tissue non–root coverage procedures: A systematic review from the AAP regeneration workshop. J Periodontol. 2015;86:S56-S72. Kennedy JE, Bird WC, Palcanis KG, Dorfman HS. A longitudinal evaluation of varying widths of attached gingiva. J Clin Periodontol. 1985;12(8):667–75. Goldberg PV, Higginbottom FL, Wilson Jr TG. Periodontal considerations in restorative and implant therapy. Periodontol 2000. 2001;25(1):100–9. Mehta P, Lim LP. The width of the attached gingiva—Much ado about nothing?. J Dent. 2010;38(7):517–25. American Academy of Periodontology. Proceedings of the world workshop in clinical periodontics. American Academy of Periodontology; 1989. Müller HP, Heinecke A, Schaller N, Eger T. Masticatory mucosa in subjects with different periodontal phenotypes. J Clin Periodontol. 2000;27(9):621–6. Pradhan S, Shrestha B. Correlation of Width of Attached Gingiva on Oral Hygiene Maintenance and Gingival Health. Journal of Nepalese Society of Periodontology and Oral Implantology. 2020;4(1):5–9. Adesola UK, Okhiabigie AP, Adeola A, Omowunmi AP, Ayodeji TO. Evaluation of the attached gingival width and sulcus depth in an adult nigerian population—A pilot study. J Int Acad Periodontol. 2018;20:78–85. Saxena D, Mamen RA, Jain S, Pandav G, Aggarwal R, Jolly S. Clinical Evaluation of Gingival Thickness and Width according to Dental Arch and Location in Pigmented and Nonpigmented Gingiva. Dental Journal of Advance Studies. 2021;9(01):31–5. Anand PS, Bansal A, Shenoi BR, Kamath KP, Kamath NP, Anil S. Width and thickness of the gingiva in periodontally healthy individuals in a central Indian population: a cross-sectional study. Clinical Oral Investigations. 2022;26(1):751–9. Subbaiah R, Manohar B. Assessment of the width of attached gingiva in different regions of the mouth in an Indian subpopulation. J Indian Dent Assoc. 2012;6:96–8. Chandulal D, Jayshri W, Bansal N. Measurement of the width of attached gingiva in an Indian subpopulation. Indian J Dent Adv. 2016;8(1):14–7. Bhatia G, Kumar A, Khatri M, Bansal M, Saxena S. Assessment of the width of attached gingiva using different methods in various age groups: A clinical study. J Indian Soc Periodontol. 2015;19(2):199–202. Jennes ME, Sachse C, Flügge T, Preissner S, Heiland M, Nahles S. Gender-and age-related differences in the width of attached gingiva and clinical crown length in anterior teeth. BMC Oral Health. 2021;21(1):1–9. Alhajj WA. Gingival phenotypes and their relation to age, gender and other risk factors. BMC Oral Health. 2020;20(1):1–8. De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. Journal of clinical periodontology. 2009;36(5):428–33. Agarwal V, Mehrotra N, Vijay V. Gingival biotype assessment: Variations in gingival thickness with regard to age, gender, and arch location. Indian J Dent Sci. 2017;9(1):12–5. Eger T, Müller HP, Heinecke A. Ultrasonic determination of gingival thickness: subject variation and influence of tooth type and clinical features. J Clin Periodontol. 1996;23(9):839–45. Manjunath RS, Rana A, Sarkar A. Gingival biotype assessment in a healthy periodontium: transgingival probing method. Journal of Clinical and Diagnostic Research: JCDR. 2015;9(5):ZC66. Claffey N, Shanley D. Relationship of gingival thickness and bleeding to loss of probing attachment in shallow sites following nonsurgical periodontal therapy. J Clin Periodontol. 1986;13(7):654–7. Anderegg CR, Metzler DG, Nicoll BK. Gingiva thickness in guided tissue regeneration and associated recession at facial furcation defects. Journal of periodontology. 1995;66(5):397–402. Shao Y, Yin L, Gu J, Wang D, Lu W, Sun Y. Assessment of periodontal biotype in a young Chinese population using different measurement methods. Scientific reports. 2018;8(1):1–8. Shah R, Sowmya NK, Mehta DS. Prevalence of gingival biotype and its relationship to clinical parameters. Contemporary clinical dentistry. 2015;6(Suppl 1):S167. Rijal AH, Dhami B, Pandey N, Aryal D. Prevalence of Gingival Pigmentation and its Association with Gingival Biotype and Skin Colour. Journal of Nepalese Society of Periodontology and Oral Implantology. 2021;5(1):19–25. Chou YH, Tsai CC, Wang JC, Ho YP, Ho KY, Tseng CC. New classification of crown forms and gingival characteristics in taiwanese. The Open Dentistry Journal. 2008;2:114–119. Lee SA, Kim AC, Prusa Jr LA, Kao RT. Characterization of dental anatomy and gingival biotype in Asian populations. Journal of the California Dental Association. 2013;41(1):31–36. Collins JR, Pannuti CM, Veras K, Ogando G, Brache M. Gingival phenotype and its relationship with different clinical parameters: a study in a Dominican adult sample. Clinical Oral Investigations. 2021;25(8):4967–73. Alkan Ö, Kaya Y, Alkan EA, Keskin S, Cochran DL. Assessment of gingival biotype and keratinized gingival width of maxillary anterior region in individuals with different types of malocclusion. Turkish Journal of Orthodontics. 2018;31(1):13. Park JH, Hong JY, Ahn HW, Kim SJ. Correlation between periodontal soft tissue and hard tissue surrounding incisors in skeletal Class III patients. The Angle Orthodontist. 2018;88(1):91–9. Singh J, Rathod VJ, Rao PR, Patil AA, Langade DG, Singh RK. Correlation of gingival thickness with gingival width, probing depth, and papillary fill in maxillary anterior teeth in students of a dental college in Navi Mumbai. Contemporary Clinical Dentistry. 2016;7(4):535. Khattak MU, ahmed I, kumar K, Ahsen MI, Ata K, Ullah ZA. Co-Relation of Gingival Biotype (Periodontal Phenotype) with Width of Keratinized Gingiva in Maxillary Anterior Teeth in Patients Reporting to a Local Tertiary Care Dental Hospital. Vlachodimou E, Fragkioudakis I, Vouros I. Is there an association between the gingival phenotype and the width of keratinized gingiva? A systematic review. Dentistry Journal. 2021;9(3):34. Jing WD, Xu L, Xu X, Hou JX, Li XT. Association between periodontal biotype and clinical parameters: A cross-sectional study in patients with skeletal class III malocclusion. Chin J Dent Res. 2019;22(1):9–19. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3681725","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":254416947,"identity":"1ac8129c-b765-44b5-8b71-f994963c335b","order_by":0,"name":"Arjun Hari Rijal","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIie2RPwrCMBSHXwmky5OuEUq9QqGggqBXCRQ6xRMo/ll0qc4ew8k5UNTFA3QUCh2cBEF0EdMcIO0omG8Iv8Dv4+URAIvlN+HAEXyvU0h1YX5jBduLhFcKNh6FoRShDrXV3lqW96s/RJCXxy2f9hHc7Lg3Kf6FxzuOMTrLzWEgTuphmCS5SWHAY7ULQUJah0hQpTDsmhXvWilzpBTLSHyaKExPyVBBivGqkaKnnJEx2iXjLUNau4snYuedToJRToqHeM4Cz81ORkV9BAcn1YkyfZrrFa4EeOlE7vVti8Vi+Ue+hd4/F/ALMKAAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-2216-5220","institution":"Department of Periodontology and Oral Implantology, Kathmandu University School of Medical Sciences, Kavrepalanchok, Nepal.","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Arjun","middleName":"Hari","lastName":"Rijal","suffix":""},{"id":254416948,"identity":"268a8f80-28a4-4ce7-b3e2-a822707cc963","order_by":1,"name":"Bhageshwar Dhami","email":"","orcid":"https://orcid.org/0000-0002-4363-6995","institution":"Department of Periodontology and Oral Implantology, Kantipur Dental College and Hospital, Kathmandu, Nepal","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Bhageshwar","middleName":"","lastName":"Dhami","suffix":""},{"id":254416949,"identity":"1c868935-0d99-4ec3-a1ae-c059240bde25","order_by":2,"name":"Anju Khapung","email":"","orcid":"https://orcid.org/0000-0002-8741-688X","institution":"Department of Public Health Dentistry, Nepal Medical College, Kathmandu, Nepal","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Anju","middleName":"","lastName":"Khapung","suffix":""},{"id":254416950,"identity":"df2d12fe-904c-4252-b983-6077fb8169f3","order_by":3,"name":"Pratistha Ghimire","email":"","orcid":"https://orcid.org/0000-0002-0230-5903","institution":"Dental Department, Methinkot Hospital, Kavrepalanchok, Nepal","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Pratistha","middleName":"","lastName":"Ghimire","suffix":""}],"badges":[],"createdAt":"2023-11-29 12:45:02","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-3681725/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3681725/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":47385260,"identity":"2d78ae67-92cd-4b70-b36e-bec22c0b6a79","added_by":"auto","created_at":"2023-11-30 17:16:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":948973,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePhotographs of clinical procedures and armamentarium\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3681725/v1/6f659d52f5d80954bb4ed11e.png"},{"id":47385665,"identity":"d8d21e99-7039-41f2-8a9b-e477bcf2a39f","added_by":"auto","created_at":"2023-11-30 17:24:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1258656,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3681725/v1/36eb3c06-ea2a-4a8c-9dc3-f1f45a7dd386.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003e\u003cstrong\u003eEvaluation of Width and Thickness of Attached Gingiva and Its Association with Age, Gender and Arch Location in Nepalese Population\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eOrban defined the \u0026ldquo;attached gingiva\u0026rdquo; as: \u0026ldquo;The part of the gingiva which is firmly attached to the underlying tooth and bone and is stippled on the surface\u0026rdquo; [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. WAG extends from the mucogingival junction (MGJ) and to the free gingival groove. It is characterized by firmness, density, stippling, and a tight connection to the periosteum, tooth, and osseous structure. This clinical parameter holds significance in dental assessments.\u003c/p\u003e \u003cp\u003eSeibert and Lindhe presented the term \u0026ldquo;periodontal biotype\u0026rdquo; to categorize the thickness of gingiva as \u0026ldquo;thick flat\u0026rdquo; and \u0026ldquo;thin scalloped\u0026rdquo; [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The facio-palatal dimension of the gingiva has been used to describe the thickness (gingival biotype) in and is influenced by the genetic trait. While the shape of the gingiva, thickness of keratinized gingiva in faciolingual direction, WAG, form and thickness of buccal bone, and crown shape are included within the term \u0026ldquo;periodontal biotype\u0026rdquo; [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Various techniques have been introduced to measure gingival biotype: histological study on cadaver jaws, [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] modified caliper, [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] injection needle, [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] direct measurements/bone sounding or transgingival probing, [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] visual examination, probe transparency, histological section, [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] ultrasonic devices, [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] cone beam computed tomography. [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eDifferences in the clinical presentation of a healthy marginal periodontium are observed among various subjects and tooth morphologies. Numerous characteristics are inherited through genetics, while others appear to be shaped by factors like tooth shape, size, and alignment. Additionally, biological factors like age, gender, and growth can also play a role in determining these features [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Typically, there are differences in the biotypes of the facial gingiva at both the intra-individual and inter-individual levels [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This suggests the possibility of different gingival phenotypes existing within any given adult population [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAn adequate WAG helps in maintaining aesthetics and improved control of dental plaque. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] In routine periodontal and plastic surgeries, it is very important to restore an adequate WAG. Desirable TAH is essential, as a thin gingival margin may result in recession following trauma, surgery, or inflammatory damage. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] Many previous studies focused either on assessing the thickness of the palatal mucosa on palate or on individuals who were edentulous [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] So, this study aimed to assess the width and thickness of the attached gingiva and its relationship with age, gender, and arch location in the Nepalese patients.\u003c/p\u003e"},{"header":"MATERIALS AND METHOD","content":"\u003cp\u003eThe descriptive cross-sectional study was conducted at Kantipur Dental College, Kathmandu, Nepal. The study population were patients attending in Periodontics department who fulfilled the inclusion and exclusion criteria. Individuals with all indexed teeth in the both jaws, maintained oral hygiene status, periodontal tissues that are clinically healthy, exhibiting no loss of attachment in the indexed teeth (16,14,12,21,24,26,36,34,32,41,44,46), well-aligned teeth in the both arches were included in the present study. The individuals with gingival recession in indexed teeth, hospitalized patients, females with pregnancy and breast feeding, patients using any medications or hormonal replacement therapy possibly affecting the periodontal tissue, extensive restorations including cervical restoration, fixed partial denture, etc., history of periodontal plastic surgery, patient with history of or undergoing fixed or removable orthodontic therapy, physically disabled and mentally unstable patients were not included in the study. The research proposal was submitted and gave consent to conduct the study by the Institutional Review Committee (IRC No: 2018/Th-05), Kantipur Dental College. Before participating in the research, each participant provided informed consent in a written form.\u003c/p\u003e\n\u003cp\u003eThe research sample was selected according to non- probability convenient sampling. The study population selected was between 16 to 50 years of age and were assured that the data collected from them will be kept confidential. The research took place from October 2018 to January 2021.\u003c/p\u003e\n\u003cp\u003eThe calculation of the sample size was according to the findings from the research conducted by \u003cstrong\u003eJacob et al.\u003c/strong\u003e [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e] by using the following formula,\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\" height=\"73\" width=\"93\"\u003e\u003c/p\u003e\n\u003cp\u003eMinimum of 57 subjects in each group i.e., 57 females and 57 males so altogether 114 patients was enrolled in the study. To obtain a rounded figure, the study included a total of 120 participants. The participants were subsequently categorized into three age groups. Equal gender distribution was maintained in each age group.\u003c/p\u003e\n\u003cp\u003eThe presence of plaque was recorded using the modified plaque index (Loe in 1967). The condition of gingiva was assessed with gingival index (GI) as given by Loe and Silness (1963). Periodontal examinations included measurement of WAG, probing sulcus depth, TAH and number of teeth present.\u003c/p\u003e\n\u003cp\u003eGingival index and plaque index assessments were conducted prior to initiating the periodontal examination. The individuals with healthy gingiva without bleeding on probing and with no visible plaque were included in the study. Further measurements were done on those individuals.\u003c/p\u003e\n\u003cp\u003eA single examiner conducted the entire procedure to reduce the interobserver variability. Standardized instruments were used for the study. The clinical procedures followed along with the armamentarium used are shown in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003eAll measurements were taken at the mid-buccal area of the indexed tooth. The mucogingival junction was identified with the assistance of Lugol\u0026rsquo;s solution, which was coated to the participant\u0026rsquo;s gingiva and alveolar mucosa using a cotton pellet and a light-pressure burnishing technique. The measurement of the width of the keratinized gingiva was carried out by using a University of North Carolina-15 probe (Hufriedy Mfg. Co., LLC., Chicago, United States), extending from the gingival margin to the mucogingival junction. The probing depth was then measured with a UNC-15 periodontal probe. The reading was rounded off to the nearest 1 mm. To ascertain the WAG, the measurement involved determining the total width of keratinized tissue and reducing the probing depth from it.\u003c/p\u003e\n\u003cp\u003eFor the measurement of gingival thickness, lignocaine spray (Nummit spray 100ml - anesthetic lidocaine topical spray, ICPA, Mumbai, India) was applied on mid-buccal surface and dried with cotton pellet. Endodontic spreader (number 25, Dentsply Sirona) fitted with stopper was inserted perpendicular to the gingival surface. Then reading was measured from tip of spreader to the point below the stopper with the help of digital Vernier\u0026rsquo;s caliper (Digital Calipers 6 inch/150 mm - Electronic Vernier Caliper with Large LCD Screen, Inch and Millimeter Conversion Measurement, Arura Enterprise, Tamil Nadu 600031, India). Three consecutive measurements were recorded in millimeter and the average was calculated. The intra-examiner reliability was calculated by re-examining the WAG and TAH in 10% of total patients after 1-week interval and was 91%.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStatistical analysis\u003c/h2\u003e\n \u003cp\u003eData were gathered and entered in Microsoft Excel version 19. Further data analysis was done using the SPSS version 20. Frequencies, mean, standard deviation \u0026amp; percentage were calculated. The independent t-test was employed to identify any statistical differences between width and thickness of attached gingiva and age, gender and arch location. Likewise, one-way ANOVA was utilized to determine differences between continuous variables. Pearson correlation test was employed to identify the correlation between the variables. The significance level was set at 5% with a 95% confidence level.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eIn current study, 120 individuals were examined, with an equal distribution of 60 (50%) males and 60 (50%) females. The participants had a mean age of 31.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.72 years. Subjects were categorized into three age groups. Participants were equally distributed in each group i.e. 40 in each group (20 males and 20 female). Considering the ethnicity, 82 (68.3%) were Aryan, 22 (18.3%) were Mongolian and 16 (13.4%) was Mixed.\u003c/p\u003e \u003cp\u003e1440 teeth were examined to measure the WAG. The overall mean width of attached gingiva was 2.956 mm. The average WAG was greater in the maxilla (3.19 mm) comparison with the mandible (2.71 mm). Within the maxilla, the widest width of attached gingiva (4.53 mm) was observed on the right lateral incisor (12), while the narrowest (2.22 mm) was noted on the left first premolar (24). In the mandible, maximum width (3.52 mm) was found on the right central incisor (41) and minimum (1.84 mm) on the left first premolar (34). The average WAG per tooth has been presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean width of attached gingiva in maxillary and mandibular arch (mm)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOver all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.956\u0026thinsp;\u0026plusmn;\u0026thinsp;0.419\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eMaxillary teeth\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.724\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.683\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.934\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.978\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.679\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eMandibular teeth\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7194\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47436\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.814\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.661\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.907\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.830\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.603\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.726\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe overall average thickness of attached gingiva (GT-TGP) was 1.101 mm. Maximum thickness (1.728 mm) of attached gingiva was found on mandibular left first molars and minimum thickness (0.667mm) on mandibular left first premolars. The mean TAH was higher in the maxilla (1.131 mm) compared to the mandible (1.070 mm). In the maxilla, maximum thickness of attached gingiva (1.699 mm) was found on the left first molars (26), whereas minimum (0.757 mm) on the right first premolars (14). In the mandible, maximum thickness (1.070 mm) was found on the right first molar (46) and minimum (0.667 mm) on the left first premolar (34). The mean thickness of attached gingiva per tooth is shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Thickness was classified [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] as thick (\u0026ge;\u0026thinsp;1.5 mm) and thin (\u0026lt;\u0026thinsp;1.5 mm), as presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean thickness of attached gingiva in maxillary and mandibular arch\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean Gingival Thickness - Transgingival probing (GT-TGP) (mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGingival Thickness - Transgingival probing\u003c/p\u003e \u003cp\u003e(GT-TGP)\u0026thinsp;\u0026lt;\u0026thinsp;1.5 mm\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGingival Thickness - Transgingival probing (GT-TGP)\u0026thinsp;\u0026gt;\u0026thinsp;1.5 mm\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1440\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1010\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15982\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1093 (75.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e347 (24.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMaxillary arch\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e720\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1317\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e550 (76.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e170 (23.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.545\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66 (55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e54 (45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.757\u0026thinsp;\u0026plusmn;\u0026thinsp;0.2941\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e116 (96.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.999\u0026thinsp;\u0026plusmn;\u0026thinsp;0.2906\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e109 (90.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (9.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.022\u0026thinsp;\u0026plusmn;\u0026thinsp;0.2817\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113 (94.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 (5.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.768\u0026thinsp;\u0026plusmn;\u0026thinsp;0.2602\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e117 (97.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (2.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.699\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29 (24.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e91 (75.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMandibular arch\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e720\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0704\u0026thinsp;\u0026plusmn;\u0026thinsp;.22788\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e543 (75.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e177 (24.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.728\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (34.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e79 (65.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.689\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e118 (98.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (1.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.811\u0026thinsp;\u0026plusmn;\u0026thinsp;0.1922\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e120 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.827\u0026thinsp;\u0026plusmn;\u0026thinsp;0.1879\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e120 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.667\u0026thinsp;\u0026plusmn;\u0026thinsp;0.1642\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e120 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.701\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e96 (80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe evaluation of mean WAG and TAG in males and females was conducted through an independent sample t-test. The outcomes are presented in Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Females had higher mean WAG (3.00mm) than males (2.91 mm). The mean WAG in the maxillary premolar region was significantly higher in females in comparison to males, with a statistically significant difference (p-value\u0026thinsp;=\u0026thinsp;0.03). In all others areas, there was no any statistical significance. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of mean width of attached gingiva among male and female\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaxillary\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39\u003c/p\u003e \u003cp\u003e4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003cp\u003e2.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003cp\u003e2.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003cp\u003e4.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.94\u003c/p\u003e \u003cp\u003e2.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003cp\u003e2.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003cp\u003e0.15\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.03*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandibular\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45\u003c/p\u003e \u003cp\u003e3.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003cp\u003e1.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003cp\u003e2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003cp\u003e3.48\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003cp\u003e1.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e \u003cp\u003e2.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003cp\u003e0.81\u003c/p\u003e \u003cp\u003e0.25\u003c/p\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eIndependent Samples t test, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 statistically significant*\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of mean thickness of attached gingiva among male and female\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.04*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaxillary\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003cp\u003e0.99\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e \u003cp\u003e1.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16\u003c/p\u003e \u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e \u003cp\u003e1.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003cp\u003e0.32\u003c/p\u003e \u003cp\u003e0.41\u003c/p\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandibular\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e \u003cp\u003e0.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e \u003cp\u003e0.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15\u003c/p\u003e \u003cp\u003e1.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e \u003cp\u003e0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e \u003cp\u003e0.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003cp\u003e1.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.002*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.76\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.01*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eIndependent Samples t test, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 statistically significant*\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe total TAH was notably greater in females (1.13 mm) compared to males (1.07 mm), with statistical significance (p\u0026thinsp;=\u0026thinsp;0.04, Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Likewise, the statistically significant differences were observed in the mean TAH in the mandibular incisor area (p-value\u0026thinsp;=\u0026thinsp;0.002) and the molar area (p-value\u0026thinsp;=\u0026thinsp;0.01). The assessment of variation in TAH and WAG across various age groups was conducted using the One-way ANOVA test. Results are shown in Tables\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e and \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. The statistically significant difference in the mean TAH in the maxillary molar region among different age groups was observed (p-value\u0026thinsp;=\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of mean width of attached gingiva among different age groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u0026ndash;24 years\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u0026ndash;39 years\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 years and above\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaxillary\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e \u003cp\u003e3.98\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e \u003cp\u003e2.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003cp\u003e2.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003cp\u003e4.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003cp\u003e2.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e \u003cp\u003e3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e \u003cp\u003e4.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003cp\u003e2.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003cp\u003e3.05\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.66\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandibular\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/p\u003e \u003cp\u003e3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e \u003cp\u003e1.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/p\u003e \u003cp\u003e2.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003cp\u003e3.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003cp\u003e1.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003cp\u003e2.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.99\u0026thinsp;\u0026plusmn;\u0026thinsp;0.32\u003c/p\u003e \u003cp\u003e3.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003cp\u003e1.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e \u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.27\u003c/p\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eOne-way ANOVA, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 statistically significant*\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of mean thickness of attached gingiva among different age groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeeth\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u0026ndash;24 years\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u0026ndash;39 years\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 years and above\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaxillary\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e \u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.27\u003c/p\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.24\u003c/p\u003e \u003cp\u003e1.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003cp\u003e0.97\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003cp\u003e1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12\u003c/p\u003e \u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e \u003cp\u003e0.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15\u003c/p\u003e \u003cp\u003e1.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.86\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.01*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandibular\u003c/p\u003e \u003cp\u003eAll teeth\u003c/p\u003e \u003cp\u003eIncisor region\u003c/p\u003e \u003cp\u003ePremolar region\u003c/p\u003e \u003cp\u003eMolar region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15\u003c/p\u003e \u003cp\u003e0.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.19\u003c/p\u003e \u003cp\u003e0.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/p\u003e \u003cp\u003e1.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13\u003c/p\u003e \u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16\u003c/p\u003e \u003cp\u003e0.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.11\u003c/p\u003e \u003cp\u003e1.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e \u003cp\u003e0.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003cp\u003e0.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.19\u003c/p\u003e \u003cp\u003e1.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003cp\u003e0.45\u003c/p\u003e \u003cp\u003e0.34\u003c/p\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eOne-way ANOVA, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 statistically significant*\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe correlation between the mean TAH and WAG was not found to be statistically significant in the maxilla (p-value\u0026thinsp;=\u0026thinsp;0.09), mandible (p-value\u0026thinsp;=\u0026thinsp;0.65), and overall (both arches, p-value\u0026thinsp;=\u0026thinsp;0.29). Correlation was significant between maxillary incisors (p-value\u0026thinsp;=\u0026thinsp;0.01) and was weak. (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e) The width of attached gingiva in the maxilla and the mandible were positively correlated, and was statistically significant (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The strength of correlation was moderate (r\u0026thinsp;=\u0026thinsp;0.501). A positive correlation was identified between the thickness of attached gingiva in the maxilla and mandible, and this correlation was statistically significant (p-value\u0026thinsp;=\u0026thinsp;0.008). The correlation strength was weak (r\u0026thinsp;=\u0026thinsp;0.240).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation between mean width and mean thickness of attached gingiva\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWidth of attached gingiva\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eThickness of attached gingiva\u003c/p\u003e \u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePearson correlation coefficient (r)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaxilla\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003cp\u003eIncisor\u003c/p\u003e \u003cp\u003ePremolar\u003c/p\u003e \u003cp\u003eMolar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003cp\u003e4.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79\u003c/p\u003e \u003cp\u003e2.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003cp\u003e1.01\u0026thinsp;+\u0026thinsp;0.26\u003c/p\u003e \u003cp\u003e0.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21\u003c/p\u003e \u003cp\u003e1.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003cp\u003e0.229\u003c/p\u003e \u003cp\u003e0.144\u003c/p\u003e \u003cp\u003e-0.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.01*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.12\u003c/p\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandible\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003cp\u003eIncisor\u003c/p\u003e \u003cp\u003ePremolar\u003c/p\u003e \u003cp\u003eMolar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/p\u003e \u003cp\u003e3.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003cp\u003e1.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e \u003cp\u003e2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e \u003cp\u003e0.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e \u003cp\u003e0.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.19\u003c/p\u003e \u003cp\u003e1.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003cp\u003e0.153\u003c/p\u003e \u003cp\u003e0.024\u003c/p\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003cp\u003e0.09\u003c/p\u003e \u003cp\u003e0.79\u003c/p\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eOverall (Both arches)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003ePearson correlation p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 statistically significant*\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe designation 'periodontal phenotype' was introduced by the \u0026ldquo;2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions\u0026rdquo; [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. This designation is based on both gingival phenotype and bone morphotype [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. TAH, WAG, and bone morphotype were three crucial parameters utilized for categorizing biotypes, playing an important role in the development or progression of defects present mucogingival area [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. According to its definition, biotype is genetically determined and remains unalterable. It does not consider environmental factors or clinical interventions that might influence the profile of the periodontal tissue [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eResearchers have explored the function of keratinized gingiva in preserving periodontal health, serving to prevent gingivitis and stabilize the gingival margin [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. There is ongoing debate concerning the function of attached gingiva in sustaining gingival health. Maintaining optimal plaque control in regions with minimal or no attached gingiva can contribute to the preservation of periodontal health. Some authors have documented inflammation in areas with at least two mm of keratinized gingiva, even when all dental surfaces were free of plaque [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Kennedy et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] concluded that their study found no supporting evidence to suggest that a zone with narrow attached gingiva is more susceptible to gingival inflammation compared to a wider area of attached gingiva. When establishing esthetic margins, the existence of attached gingiva is crucial to reduce the risk of gingival recession and facilitate oral hygiene procedures [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. But Mehta et al. [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] disagreed on this statement.\u003c/p\u003e \u003cp\u003eThere is an ongoing debate regarding the quantity of attached gingiva required to prevent subsequent recession and attachment loss. Bowers GM [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] mentioned that it is feasible to maintain clinically healthy gingiva even with a very limited area of attachment (\u0026lt;\u0026thinsp;1 mm). A thin periodontal biotype, non-existence of attached gingiva, and decreased alveolar bone thickness due to malaligned tooth positioning within the jaw are recognized as determinants for the development and progression of gingival recession. The safeguarding of gingival health is primarily contingent on the presence and upkeep of attached gingival tissue [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs per the 1989 World Workshop of Periodontology, various parameters should be taken into consideration when assessing the presence of a sufficient area of attached gingiva and determining the minimum acceptable amount of attached gingiva [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Thus, determining the width of attached gingiva before any periodontal surgical procedure mainly in perio-plastic surgery is important.\u003c/p\u003e \u003cp\u003eThe WAG and TAH plays a crucial part in influencing the indications and outcomes of various restorative, periodontal, surgical, and implant therapies. The response of a thick gingival biotype varies from that of a thin gingival biotype. Evaluating the gingival biotype prior to dental procedures is essential for attaining a consistent and stable gingival margin position.\u003c/p\u003e \u003cp\u003eIn this study, thickness of attached gingiva was measured by transgingival probing [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] which was easy to perform, convenient, cheap and accurate. The mid-buccal region was selected as a standardized landmark, given that this region represents the minimal width of gingiva and for the sake of convenience. Also, gingival index and plaque index were taken in the same teeth. For patient\u0026rsquo;s and clinician\u0026rsquo;s convenience and to reduce the examination time, index teeth were selected which are the representative of respective sextant. Due to the absence of distiction between the attached gingiva and palatal mucosa and lingual mucosa, measurements were not taken for the palatal and lingual zones of attached gingiva\u003c/p\u003e \u003cp\u003eThe mean WAG was higher in the maxilla (3.19 mm) compared to the mandible (2.71 mm), aligning with findings from previous studies done by \u003cem\u003eBowers et al.\u003c/em\u003e [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], \u003cem\u003ePradhan et al.\u003c/em\u003e [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], \u003cem\u003eAdesola et al.\u003c/em\u003e [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], \u003cem\u003eSaxena et al.\u003c/em\u003e [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] \u003cem\u003eand Pradeep et al.\u003c/em\u003e [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the current study, maximum WAG in the maxilla (4.53mm) was found on the right lateral incisors, whereas minimum (2.22mm) on the left first premolars. In the mandible, maximum width (3.52 mm) was found on the right permanent central incisor and minimum (1.84 mm) on the left first premolar. WAG ranged from 1 to 7 mm. According to \u003cem\u003eLee et al.\u003c/em\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] on Chinese population, the maximum WAG was found on the maxillary central incisors (5.64\u0026thinsp;\u0026plusmn;\u0026thinsp;1.40 mm), while the lowest width was noted on the mandibular first premolar (3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89 mm). The mean WAG was larger in the maxilla (5.10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41 mm) than in the mandible (4.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.05 mm), consistent with the current study. Variations in measurements could be attributed to different techniques for determining the mucogingival junction (functional versus iodine) or potential ethnic differences.\u003c/p\u003e \u003cp\u003eIn a study by \u003cem\u003eShaju Jacob et al\u003c/em\u003e. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], variations in the WAG were identified across various regions of oral cavity, with the widest measurements in the upper central incisors and the narrowest in the lower molars. These outcomes align with the results of our study \u003cem\u003eSubbaiah et al.\u003c/em\u003e [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], \u003cem\u003eAdesola et al.\u003c/em\u003e [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], \u003cem\u003eand Pradeep et al.\u003c/em\u003e [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] discovered that the WAG varied widely, with the highest measurements typically present in the upper incisors and the lowest in the lower premolars. These findings are comparable to the findings of the present study. In a research conducted by \u003cem\u003eChandulal et al.\u003c/em\u003e [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], variations in the WAG were noted across different oral cavity regions, with the maxillary incisors showing the widest dimension. In the present study, similar variations in the WAG were observed in both arches. Variations in WAG in various studies might be due to different methods used to locate mucogingival junctions (functional versus staining) or possible true ethnical differences [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this study, participants were categorized into three age groups, and the WAG was measured and compared among these groups. The statistically significant difference in the average WAG among the three age groups was noticed (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The average WAG in each group was 2.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38 mm in 16\u0026ndash;24 years group, 3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44 mm in 25\u0026ndash;39 years group and 3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29 mm in \u0026gt;\u0026thinsp;40 years group. There was a notable increase in the overall WAG in the group aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years compared to the other age groups. \u003cem\u003eKolte et al.\u003c/em\u003e [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], \u003cem\u003eBhatia et al.\u003c/em\u003e [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], \u003cem\u003ePradhan et al.\u003c/em\u003e [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], \u003cem\u003eJennes et al.\u003c/em\u003e [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] suggested an increase in the WAG with age, while \u003cem\u003eAdesola et al.\u003c/em\u003e [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] observed no association between the WAG and age. In a study done by \u003cem\u003eP Shaju Jacob \u0026amp; RM Zade\u003c/em\u003e [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] in Indian population, the maximum WAG was in middle years age group and lowest in older years age group. In contrast to this study, there was progressive increase in the WAG with increase in age in the current study.\u003c/p\u003e \u003cp\u003eIn the present study, female participants had a higher mean WAG (3.00mm) than males (2.91 mm). The average WAG in the maxillary premolar area was significantly higher in females compared to males, with a significant difference statistically (p-value\u0026thinsp;=\u0026thinsp;0.03). In all others areas, no statistical significance was seen. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) These results were similar with the studies done by \u003cem\u003eChandulal et al\u003c/em\u003e. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], \u003cem\u003eShaju Jacob P, Zade RM\u003c/em\u003e [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], \u003cem\u003ePradhan et al.\u003c/em\u003e [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] \u003cem\u003eand Alhajj et al.\u003c/em\u003e [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. But in the research by \u003cem\u003eKolte et al.\u003c/em\u003e [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], \u003cem\u003eD Rouck et al.\u003c/em\u003e [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] \u003cem\u003eand Jennes et al.\u003c/em\u003e [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] where female had less WAG.\u003c/p\u003e \u003cp\u003eIn the present study, the mean TAH was higher in the maxilla (1.131 mm) compared to the mandible (1.070 mm), aligning with the results of the research conducted by \u003cem\u003eAgarwal et al.\u003c/em\u003e [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn the study carried out by \u003cem\u003eLee et al.\u003c/em\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], the average TAH in the upper incisor, premolar, and molar regions was reported as 1.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30 mm, 1.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.37 mm, and 2.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64 mm, respectively. Similarly, in mandibular incisor, premolar and molar region was presented to be 1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.31 mm, 1.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36 mm and 2.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40 mm respectively. These measurements exceed those observed in the current study. General anatomical trend of increasing thickness of attached gingiva was consistent in all studies [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], whereas there was a decrease in thickness from incisor to premolar, which increased in molars in the currentt study.\u003c/p\u003e \u003cp\u003eUnlike the current study, \u003cem\u003eVandana et al.\u003c/em\u003e [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] \u003cem\u003eand Kolte et al.\u003c/em\u003e [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] found that the TAH was greater in the lower arch compared to the upper arch.\u003c/p\u003e \u003cp\u003eOur findings indicate that gingival thickness was greater in the young adults group and decreased in the older adult group. These observations align with the findings reported by \u003cem\u003eVandana et al.\u003c/em\u003e [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], such alterations in oral epithelium could be attributed to age-dependent thinning and reduced keratinization. Our study specifically concentrated on measuring the gingival biotype (thickness) on the midfacial aspect, which is considered to be the most appropriate approach. This is because variations may exist between midfacial and interdental measurements due to differences in alveolar bone contours, which could potentially affect soft tissue thickness [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe overall TAH was greater in females (1.13 mm) compared to males (1.07 mm), with statistical significance (p\u0026thinsp;=\u0026thinsp;0.04, Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Comparable results were suggested by \u003cem\u003eAgarwal et al.\u003c/em\u003e [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. In contrast to the current study, females had thinner attached gingiva as compared to males in the research done by \u003cem\u003eVandana et al.\u003c/em\u003e [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], \u003cem\u003eKolte et al.\u003c/em\u003e [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], \u003cem\u003eManjunath et al.\u003c/em\u003e [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003cem\u003eand Pradeep et al.\u003c/em\u003e [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDifferent researchers have established arbitrary thresholds to distinguish between thick and thin tissues. Few studies utilized one mm, while others suggested one and half mm as the ceiling for thin gingival tissue due to variations in tissue responses to the periodontal therapy [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Using this threshold of 1.5 mm, 75% participants had thin gingiva and 24.9% had thick gingiva. In the maxillary arch, 76.38% participants had thin and 23.62% had thick gingival biotype, whereas 75.41% thin and 24.59% thick gingival biotype in the mandibular arch. \u003cem\u003eLee et al.\u003c/em\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] concluded that overall, 64.6% had thin and 35.4% had thick gingival biotype, which is comparable with the result obtained in the current study. Similar prevalence of gingival biotype (75.6% thin, 24.6% thick) was obtained in the mandibular arch but higher prevalence (53.2% thin, 46.8% thick) was discovered in the research done by \u003cem\u003eLee et al.\u003c/em\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], as compared to the current study. In contrast, \u003cem\u003eShao et al.\u003c/em\u003e [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], \u003cem\u003eShah et al.\u003c/em\u003e [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003cem\u003eand Rijal et al.\u003c/em\u003e [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] discovered greater prevalence of thick gingival phenotype. This difference in gingival thickness in different population may be due to racial variation where Asians usually have a thin gingiva as compared to Caucasians [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe correlation between the mean WAG and TAH was not seen statistically significant in the upper arch (p-value\u0026thinsp;=\u0026thinsp;0.09), lower arch (p-value\u0026thinsp;=\u0026thinsp;0.65), and overall (both arches, p-value\u0026thinsp;=\u0026thinsp;0.29). These findings are in consistent with the research carried out by \u003cem\u003eLee et al.\u003c/em\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], \u003cem\u003eJames et al.\u003c/em\u003e [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], \u003cem\u003eAlkan et al.\u003c/em\u003e [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], \u003cem\u003ePark et al.\u003c/em\u003e [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], \u003cem\u003eSingh et al.\u003c/em\u003e [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e], \u003cem\u003eMuhammad et al.\u003c/em\u003e [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]\u003cem\u003eand Adesola et al.\u003c/em\u003e [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], whereas they contradict the study by \u003cem\u003eKolte et al.\u003c/em\u003e [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Similarly, there is an association between gingival width and gingival phenotype. Thick gingival biotype has a more pronounced width of keratinized gingiva [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Correlation was significant between maxillary incisors (p-value\u0026thinsp;=\u0026thinsp;0.01, however, the correlation is weak.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eAs age increases, there is a non-statistically significant decrease in gingival thickness, while the WAG increases in both the upper and lower dental arches. In terms of gender differences, females exhibit a greater TAH compared to males. While, the other tooth related components like tooth position, shape of the arch, genetic factors of the individual and religion factors are also likely to affect the measurement, which may be an important parameter for future clinical trials. Additional research is required on periodontally healthy individuals in various populations in Nepal to establish baseline values for the WAG.\u003c/p\u003e"},{"header":"LIMITATIONS","content":"\u003cp\u003eSince this is a cross-sectional study, the level of evidence provided by this study is less as compared to case-control and cohort studies. All the measurements were done with the help of a hand periodontal probe, in which standardization of probing force and probing angulations could not be possible compared to automated probes. The precision of reading was 1mm when the UNC-15 probe was used. Measurement errors may have resulted from difference in the angulation of spreader, change in tissue volume due to infiltration of anesthetic, and difficulty in accessibility/visibility, especially in the posterior regions. The findings of the current research may not be generalizable to the entire Nepali citizens because of ethnic and cultural differences. This sample consisted only of patients visiting the dental college located in Kathmandu, Nepal. Hence, the result cannot be generalized for entire Nepalese population.\u003c/p\u003e"},{"header":"RECOMMENDATIONS","content":"\u003cp\u003eFurther studies should be conducted in various populations in Nepal to get reference values for the WAG. Variations due to ethnicity should be studied. A sample size with large population should be considered to explore the correlation among age, gender, and the gingival biotype (width and thickness). Automated probes with high precision should be used in the future studies. Non-invasive methods like Cone-beam computed tomography (CBCT), Ultrasonography (USG) should also be used to measure the TAH.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDATA AVAILABILITY\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used to support the findings of this study can be obtained from the author upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONFLICT OF INTEREST\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo potential conflict of interest relevant to this article was reported\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING STATEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is self-funded study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI would like to acknowledge all the faculties, staffs of the Department of Periodontics, Kantipur Dental College and all the participants who were involved directly or indirectly in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOrban B. 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J Clin Periodontol. 2000;27(9):621\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePradhan S, Shrestha B. Correlation of Width of Attached Gingiva on Oral Hygiene Maintenance and Gingival Health. Journal of Nepalese Society of Periodontology and Oral Implantology. 2020;4(1):5\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdesola UK, Okhiabigie AP, Adeola A, Omowunmi AP, Ayodeji TO. Evaluation of the attached gingival width and sulcus depth in an adult nigerian population\u0026mdash;A pilot study. J Int Acad Periodontol. 2018;20:78\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaxena D, Mamen RA, Jain S, Pandav G, Aggarwal R, Jolly S. Clinical Evaluation of Gingival Thickness and Width according to Dental Arch and Location in Pigmented and Nonpigmented Gingiva. 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Chin J Dent Res. 2019;22(1):9\u0026ndash;19.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Kantipur Dental College and Hospital","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-3681725/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3681725/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThe width and thickness of attached gingiva are important clinical parameters. Considerable variations exist in the same as well as in different individuals. This study aimed to assess the width and thickness of the attached gingiva and its relationship with age, gender, and arch location in the Nepalese patients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn observational cross-sectional study was conducted among 120 individuals visiting periodontics department who were categorized into three age-groups with equal distribution of gender in each group. The width of attached gingiva (WAG) was determined using University of North Carolina \u0026minus;\u0026thinsp;15 probe after locating the mucogingival junction. Data were gathered, entered in excel sheet version 19 and SPSS version 20 was used for further analysis. Mean and standard deviation were calculated. Independent t-test, One-way ANOVA was used to find out the significant difference between variables. Correlation between dependent and independent variables was discovered with the help of Pearson correlation test. The significance level was set at 5% with a 95% confidence level.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e120 individuals with 1440 teeth were examined to measure the WAG with equal distribution of gender. The maximum WAG was found on maxillary right lateral incisor and minimum width on mandibular left first premolar. The average WAG was greater in the upper arch (3.19 mm) than in the lower (2.71 mm). Maximum thickness (1.728 mm) of attached gingiva was found on the mandibular left first molars and minimum width (0.667 mm) on mandibular left first premolars.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eAs individuals age, there is a reduction in gingival thickness, accompanied by an increase in the WAG across both dental arches. In terms of gender differences, females exhibit a higher thickness of attached gingiva (TAH) in comparison to male counterpart.\u003c/p\u003e","manuscriptTitle":"Evaluation of Width and Thickness of Attached Gingiva and Its Association with Age, Gender and Arch Location in Nepalese Population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-11-30 17:16:13","doi":"10.21203/rs.3.rs-3681725/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8f9249ef-b39c-4c5e-8afb-bfbf728a0726","owner":[],"postedDate":"November 30th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":26865500,"name":"Dentistry"}],"tags":[],"updatedAt":"2023-11-30T17:16:13+00:00","versionOfRecord":[],"versionCreatedAt":"2023-11-30 17:16:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3681725","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3681725","identity":"rs-3681725","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}