Linking facial typology to dental morphology and gingival characteristics: A cross-sectional study

Linking facial typology to dental morphology and gingival characteristics: A cross-sectional study | 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 Linking facial typology to dental morphology and gingival characteristics: A cross-sectional study Zuzanna Oruba, Piotr Stós, Karolina Kukuczka, Anna Chyla, Agata Wieczorkiewicz, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8691966/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 28 Apr, 2026 Read the published version in BMC Oral Health → Version 1 posted 12 You are reading this latest preprint version Abstract Background Contemporary orthodontic planning increasingly recognizes the importance of periodontal soft-tissue morphology. Thin gingiva is more susceptible to recession and may limit safe tooth movement. The evidence regarding the relationship between facial and gingival morphology is inconsistent. The aim of the present study was to investigate the associations between facial typology, gingival and dental characteristics in periodontally healthy young adults. Methodology Facial measurements included facial height (N-Me), facial width (Zy-Zy) and facial index (FI = N-Me/Zy-Zy). Periodontal examination included the determination of gingival phenotype (GP) by periodontal probe visibility method, measurement of the width of attached gingiva (AG) and ultrasonic measurement of gingival thickness (GT). Additionally, crown width (CW) and clinical crown height (CCH) were measured. Results Sixty-one patients (aged 21–30), 43 females and 18 males participated. CW of maxillary and mandibular central incisors demonstrated significant positive correlations with Zy–Zy. GT at teeth 22 and 42 correlated positively with Zy–Zy, while GT at teeth 31 and 32 correlated negatively with FI. A significant positive association was observed between AG at multiple teeth and N–Me. Male sex emerged as an independent predictor of GT at 22 and 42 and AG at 11, 42, 41, 31 and 32, while increasing FI was associated with reduced GT at 31 and 32. Conclusions Individuals with broader faces seem to present wider central incisors and thicker gingival tissues. Subject with greater facial height may present wider zone of attached gingiva at incisors. In males, gingiva may be thicker and of a wider band of attached tissues. facial index facial typology gingival thickness gingival phenotype dental morphology Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Contemporary orthodontic diagnostics should extend beyond dentoalveolar and skeletal relationships and include an assessment of periodontal tissue morphology. This broader approach supports planning of safe orthodontic tooth movements that remain within the anatomical limits of the alveolus and the adaptive capacity of the gingiva, thereby minimizing the risk of bony dehiscence and gingival recession. The clinical relevance of periodontal soft-tissue characteristics is widely recognized. In particular, a thin gingival phenotype is considered more prone to recession development in response to an insults than a thick phenotype, which demonstrates greater resistance and stability [ 1 , 2 ]. Numerous studies have shown that facial typology is associated with alveolar characteristics. In dolichofacial (hyperdivergent) individuals, the mandibular symphysis is slender and narrow and the alveolar process thinner, whereas brachyfacial (hypodivergent) subjects present a shorter and wider symphysis and a thicker alveolus [ 3 – 6 ]. Hypodivergence has been associated with increased thickness of buccal and lingual cortical plates in the maxilla and mandible [ 7 – 9 ]. These observations suggest that vertical craniofacial pattern may influence the biological envelope for orthodontic tooth movement and thereby affect periodontal risk. In contrast to the relatively consistent evidence regarding alveolar bone morphology, the relationship between facial typology and periodontal soft tissues remains unclear. Valletta et al. reported no association between facial typology and gingival phenotype; however, they observed that a reduced lower-to-total facial height ratio was associated with a lower risk of thin gingival phenotype [ 10 ]. Kaya et al. found no differences in gingival thickness in the maxillary and mandibular anterior regions among individuals with different vertical and sagittal growth patterns [ 11 ]. Similarly, Kong et al. identified no correlation between skeletal vertical dimension and gingival thickness or the width of keratinized gingiva, yet reported that a thin gingival phenotype at the mandibular central incisor was more frequent in hypo- and normodivergent subjects [ 12 ]. More recently, using combined CBCT and facial scanning, Lin et al. reported that brachyfacial morphology was associated with thinner gingiva and reduced alveolar bone in the maxillary anterior region and proposed that vertical facial pattern may serve as a predictor of periodontal vulnerability [ 13 ]. In contrast, Salti et al. reported a higher prevalence of gingival recession and attachment loss in individuals with long and narrow faces [ 14 ], whereas Mazurova et al. concluded that facial type does not predict gingival recession development after orthodontic treatment [ 15 ]. These inconsistencies may be explained, at least in part, by variability in study populations, differences in how facial typology is defined, and heterogeneity in gingival assessment methods. Moreover, periodontal soft tissues may be influenced not only by craniofacial morphology, but also by tooth dimensions and crown form. Methods Aim Given the inconsistent evidence and the potential clinical implications, the aim of the present study was to investigate the associations between gingival characteristics (gingival thickness, attached gingiva width, and gingival phenotype) and anatomical parameters related to facial typology and anterior tooth crown morphology in periodontally healthy young adults. Study design and ethics A cross-sectional study was conducted at the Department of Orthodontics, Dental University Clinic in Kraków (Poland) among young adult patients. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and the study protocol was approved by the Research Ethics Committee of the Jagiellonian University Medical College in Kraków, Poland (approval no. 118.0043.1.215.2024). Inclusion and exclusion criteria Young adult patients willing to participate were recruited if all of the following criteria were met: Periodontal health, defined according to the 2017 Classification of Periodontal and Peri-Implant Diseases, i.e., no clinical attachment loss, no radiographic bone loss, probing pocket depth ≤ 3 mm, and bleeding on probing 1 year before study enrolment. Written informed consent. Participants were excluded if any of the following were present: History of periodontal surgery. Gingivitis or periodontitis as defined by the Classification of Periodontal and Peri-Implant Diseases (2017) [ 16 ]. Smoking. Ongoing orthodontic treatment. Extraoral examination: facial measurements Facial measurements were performed with a calliper. Facial height (N–Me) was measured as the distance between soft-tissue nasion (N; the deepest midline point between the forehead and nose) and menton (Me; the lowest point of the soft-tissue contour of the chin in the midsagittal plane). Facial width (Zy–Zy) was measured as the distance between the bilateral zygion points (Zy; most lateral point of the soft-tissue contour of the cheek). The facial index (FI) was calculated as: $$\:FI=\frac{\text{N}-\text{M}\text{e}}{\text{Z}\text{y}-\text{Z}\text{y}}\times\:100$$ Periodontal examination Periodontal measurements were performed using a UNC-15 periodontal probe (Falcon, Poland) and rounded to the nearest millimetre. Measurements were conducted at the maxillary and mandibular central and lateral incisors. Gingival phenotype (GP) Gingival phenotype (GP) was assessed using the periodontal probe visibility (PPV) method [ 17 ]. The probe was inserted into the sulcus at the midfacial aspect of each tooth and probe transparency was evaluated visually. A thin phenotype was recorded when the probe outline was visible through the gingival tissue, and a thick phenotype when it was not visible [Fig. 1 A]. Width of attached gingiva (AG) The width of attached gingiva (AG) was calculated as the difference between the width of keratinized gingiva (distance from the free gingival margin to the mucogingival junction) and sulcus depth at the same site. Gingival thickness (GT) Gingival thickness (GT) was measured using a PIROP ultrasonic device (Echo-Son, Puławy, Poland). The device is equipped with a 1.7 mm diameter probe designed for oral soft-tissue thickness assessment. Measurements were performed by placing the probe perpendicular to the gingival surface at the midfacial aspect of the tooth, 1 mm apical to the free gingival margin. The GT value recorded by the device represents the mean of 10 consecutive measurements [Fig. 1 B]. Dental measurements Dental measurements included mesiodistal crown width (CW) and clinical crown height (CCH) of the maxillary and mandibular central incisors. CW was measured between the mesial and distal line angles at the widest portion of the crown. CCH was measured as the distance from the incisal edge to the gingival margin at the midfacial aspect. The crown height-to-width ratio (CCH/CW) was calculated for maxillary central incisors. Given the substantial variability of lateral incisor morphology, measurements were limited to central incisors. Examiner reliability Inter-examiner reliability was assessed in the first 10 participants, who were examined independently by two investigators (P.S. and J.P.). Agreement for continuous variables was evaluated using intraclass correlation coefficients (ICC) and was excellent for facial/dental distance measurements (ICC = 0.998; 95% CI 0.997–0.999) and good for PIROP measurements (ICC = 0.75; 95% CI 0.556–0.842). Agreement for categorical variables (GP classification) was assessed using Cohen’s kappa (κ = 0.65; 95% CI 0.483–0.794; p < 0.001), indicating substantial agreement. Statistical analysis Quantitative variables were summarized using mean, standard deviation (SD), median, quartiles (Q1–Q3), and range. Qualitative variables were presented as absolute and relative frequencies (N, %). Associations between quantitative variables were evaluated using Spearman’s rank correlation coefficients and presented as heat maps. Multiple linear regression models were built to evaluate the influence of sex, history of orthodontic treatment (yes/no), and FI on GT and AG. Univariate logistic regression was used to assess the influence of facial and dental variables on gingival phenotype (thin vs thick), followed by multivariate logistic regression including sex, orthodontic treatment history, and FI. Statistical significance was set at p < 0.05. All analyses were conducted in R software (version 4.5.1). Results Study population A total of 61 patients aged 21–30 years (mean age 24.15 ± 1.74 years) of Caucasian origin were included in the analysis (43 females and 18 males). Thirty-five participants (57.4%) had undergone orthodontic treatment in the past, whereas 26 (42.6%) had no history of orthodontic treatment. Descriptive statistics for craniofacial, dental, and gingival characteristics are presented in Table 1 , and gingival phenotype distribution is presented in Table 2 . Table 1 Craniofacial, dental and gingival characteristics (quantitative variables) of the study population. Parameter N Mean SD Median Min Max Q1 Q3 Zy-Zy [mm] 61 119.2 7.4 119 103 135 114 125 N-Me [mm] 61 114. 8.4 113 97 136 109 118 FI 61 95.9 8.1 94.5 80.2 116.2 89.6 101.6 CW [mm] Tooth 11 61 8.3 0.8 8 7 10 8 9 Tooth 21 61 8.5 0.8 8.5 7 10 8 9 Tooth 41 61 5 0.6 5 4 6 5 5 Tooth 31 61 5 0.6 5 4 6 5 5.5 CCH [mm] Tooth 11 61 10 1 10 8 12 9 11 Tooth 21 61 10 1.1 10 7 12.5 9.5 11 Tooth 41 61 8.2 1.2 8.5 5.5 11.5 7 9 Tooth 31 61 8.4 1.2 8.5 6 11.5 8 9 CCH/CW ratio Tooth 11 61 1.2 0.2 1.2 0.9 1.6 1.1 1.3 Tooth 21 61 1.2 0.2 1.1 0.9 1.6 1.1 1.3 GT – PIROP measurement [mm] Tooth 12 61 1 0.2 1 0.5 1.4 0.9 1.1 Tooth 11 61 1.2 0.2 1.2 0.7 1.6 1 1.4 Tooth 21 61 1.2 0.2 1.2 0.7 1.5 1 1.4 Tooth 22 61 1.2 0.2 1 0.6 1.5 0.9 1.2 Tooth 42 61 0.8 0.2 0.8 0.4 1.4 0.7 0.9 Tooth 41 61 0.8 0.2 0.8 0.4 1.2 0.7 0.9 Tooth 31 61 0.8 0.2 0.8 0.4 1.4 0.7 0.9 Tooth 32 61 0.8 0.2 0.8 0.4 1.2 0.7 0.9 AG [mm] Tooth 12 61 4.0 1.35 4 1 8 3 5 Tooth 11 61 3.4 1.3 3 1 7 3 4 Tooth 21 61 3.2 1.2 3 1 7 2 4 Tooth 22 61 3.7 1.5 4 1 8 2 5 Tooth 42 61 2.1 1.3 2 0 5 1 3 Tooth 41 61 2 1.3 2 0 5 1 3 Tooth 31 61 1.9 1.4 2 0 6 1 3 Tooth 32 61 2.2 1.3 2 0 6 1 3 SD - standard deviation, Q1 - lower quartile, Q3 - upper quartile Table 2 GP assessed by the periodontal probe visibility (PPV) method. GB Assessment Thin Thick Tooth 12 47 (77.1%) 14 (23%) Tooth 11 36 (59%) 25 (41%) Tooth 21 34 (55.7%) 27 (44.3%) Tooth 22 47 (77.1%) 14 (23%) Tooth 42 61 (100%) 0 (0%) Tooth 41 61 (100%) 0 (0%) Tooth 31 61 (100%) 0 (0%) Tooth 32 59 (96.7%) 2 (3.3%) Associations between facial typology and dental morphology CW of maxillary and mandibular central incisors demonstrated statistically significant positive correlations with Zy–Zy. Additionally, CW of teeth 21 and 31 correlated negatively with FI. The CCH/CW ratio of tooth 21 correlated negatively with Zy–Zy. No significant correlations were identified between CCH of the central incisors and facial typology variables. These relationships are summarized in Fig. 2 . Associations between facial typology and gingival characteristics GT at teeth 22 and 42 correlated positively with Zy–Zy, while GT at teeth 31 and 32 correlated negatively with FI. A significant positive association was also observed between AG at teeth 11, 42, 41, 31, and 32 and N–Me. No significant correlations were identified between N–Me and GT. These results are shown in Fig. 3 . In univariate logistic regression models assessing the relationship between facial typology and GP, none of the facial parameters (Zy–Zy, N–Me, FI) significantly predicted the probability of thin GP for teeth 12, 21, and 22. For tooth 11, N–Me was a significant predictor (OR = 0.932; 95% CI: 0.871–0.997; p = 0.040), indicating that each additional millimetre of N–Me reduced the odds of thin phenotype by 6.8% (Additional file 1). Logistic regression models were not performed for mandibular incisors due to the overwhelming predominance of thin phenotype. Associations between dental morphology and gingival characteristics GT at tooth 21 correlated positively with CW of the same tooth. Beyond this tooth-specific association, multiple statistically significant positive correlations were observed between GT values and CWs across different teeth, as well as negative correlations between GT and the CCH/CW ratio of the maxillary central incisors (Fig. 4 ). AG at 11 and 21 demonstrated significant negative correlations with CCH of the corresponding teeth. AG at tooth 11 also correlated negatively with the CCH/CW ratio of teeth 11 and 21. No analogous associations were identified in mandibular incisors. No significant associations were observed between AG and crown width. In univariate logistic regression models, none of the evaluated dental morphology variables significantly predicted the probability of thin gingival phenotype at any sit Predictors of gingival thickness, attached gingiva, and gingival phenotype Multiple linear regression models including sex, past orthodontic treatment, and FI revealed that none of these variables significantly predicted GT at teeth 12, 11, 21, or 41. It was found that male sex increases GT at the tooth 22 by 0.162 mm (β = 0.162, p = 0.07) and at the tooth 42 by 0.142 mm (β = 0.142, p = 0.012) compared to female sex. In turn, an increase of FI by 1% decreases GT at the teeth 31 and 32 by 0.008 mm (β = 0.008, p = 0.011) and 0.006 mm (β = 0.006, p = 0.046), respectively (significant data presented in Table 3 , all data presented in Additional file 2). Table 3 Multivariable linear regression analysis – predictors of GT and AG for individual teeth. Values are presented as regression coefficients β, 95% CI and p-values. Only variables demonstrating statistically significant effects are reported – all data are presented in Tables 2 and 3 in Additional files. GT Independent variable: Male vs Female Tooth β 95% CI p 22 0.162 0.045 0.279 0.007 42 0.142 0.032 0.252 0.012 Independent variable: FI Tooth β 95% CI p 31 −0.008 −0.014 −0.002 0.011 32 −0.006 −0.011 0.000 0.046 AG Independent variable: Male vs Female Tooth β 95% CI p 11 0.743 0.038 1.448 0.039 42 0.927 0.230 1.624 0.010 41 0.886 0.177 1.596 0.015 31 0.951 0.162 1.740 0.019 32 0.773 0.051 1.495 0.036 For AG, male sex was associated with increased width at tooth 11 by 0.743 mm (β = 0.743; p = 0.039), tooth 42 by 0.927 mm (β = 0.927; p = 0.010), tooth 41 by 0.886 mm (β = 0.886; p = 0.015), tooth 31 by 0.951 mm (β = 0.951 mm; p = 0.019), and tooth 32 by 0.773 mm (β = 0.773; p = 0.036). Orthodontic treatment history and FI were not significant predictors of AG at any site (significant data presented in Table 3 , all data presented in Additional file 3). Multivariate logistic regression models including sex, orthodontic treatment history, and FI identified no significant independent predictors of thin gingival phenotype at any maxillary or mandibular incisor. Discussion In the present cross-sectional study we investigated the interrelationships between facial typology, dental morphology and gingival characteristics in periodontally healthy young adults. Understanding these relationships may be clinically important, because variation in facial typology could be reflected in periodontal soft-tissue dimensions, potentially affecting susceptibility to mucogingival complications. Within the limitations of the study design, several significant associations were identified, suggesting that specific facial and dental characteristics may co-occur with differences in gingival thickness and the width of attached gingiva. A consistent pattern emerging from our results was the involvement of the transverse dimension. Facial width (Zy–Zy) correlated positively with the crown width of maxillary and mandibular central incisors. Such relationships have been frequently described. Alshamri et al. reported that maxillary central incisor width correlated with bizygomatic width in females and with interpupillary distance in both sexes [ 18 ], while Banu et al. observed significant correlations between several transverse facial measurements and the combined mesiodistal width of the maxillary anterior teeth [ 19 ]. Similar associations between transverse facial parameters and transverse dental measures were reported by Wang et al [ 20 ]. In contrast, Ammar and Saker did not confirm such relationships, highlighting that the strength and detectability of these associations may differ across populations and methodological approaches [ 21 ]. Beyond tooth size, transverse facial morphology was also linked to periodontal soft tissues. In our study, facial width was positively associated with gingival thickness at teeth 22 and 42, while the facial index (FI) showed negative correlations with gingival thickness at mandibular incisors 31 and 32. Notably, FI emerged as an independent predictor of gingival thickness at teeth 31 and 32, indicating that individuals with a higher FI (i.e., relatively greater facial height in relation to width) tended to present with thinner gingival tissues at these sites. Although these associations were modest, they suggest that transverse and proportional facial morphology may be reflected in gingival tissue dimensions at selected incisor sites. Several additional correlations were identified between gingival thicknesses and crown widths of various teeth, as well as inverse associations between gingival thicknesses and the CCH/CW ratios of central incisors. Altogether, these findings point that within our study population broader facial morphology might have been modestly associated with wider maxillary and mandibular central incisors and thicker gingival tissues at specific sites. Interpretation of the associations between dental morphology and gingival thickness requires caution because of differences in the assessment methods used across studies. In the present study, gingival thickness was measured quantitatively using an ultrasonic device, while gingival phenotype was assessed qualitatively by periodontal probe visibility. Many earlier studies relied on probe transparency method alone. While this method is valuable clinically, it often provides dichotomous classification rather than continuous measurements, which limits direct comparisons with ultrasonographic evaluation [ 17 ]. Furthermore, radiographic evaluation of gingival thickness has shown lower accuracy compared with ultrasound [ 22 ], whereas transgingival puncture with an endodontic file has demonstrated better agreement with ultrasound-based measurements [ 22 – 24 ]. With respect to tooth morphology, many authors report crown width-to-length ratios (CW/CL), whereas we used the inverse indicator (CCH/CW). Within these methodological constraints, our findings align with several previous reports suggesting that tooth crown shape may be related to gingival thickness. The pattern emerging from our results is that wider crowns (and more “square” crown morphology) tend to be associated with thicker gingival tissues. Similar conclusions were reported by Joshi et al. in a large cross-sectional cohort, where CW/CL ratios were positively correlated with gingival thickness (assessed by TRAN and radiographic method) [ 25 ]. Comparable observations were reported by Stein et al. (who used the same measurement methods as Joshi et al.) [ 26 ] and Gadge (who scored gingival thickness by a TRAN method only) [ 27 ]. In contrast, Kloukos et al., using an ultrasound device, did not find significant associations between gingival thickness and crown width or crown length [ 28 ]. Differences between studies may reflect population-specific characteristics, but they may also be attributable to differences in sampling strategy, measurement location, or the restricted range of variability in a periodontally healthy cohort. In contrast to the transverse findings, the vertical relationships in our study were more nuanced. We did not identify associations between facial height and gingival thickness, nor between facial height and clinical crown height. However, facial height was positively associated with the width of attached gingiva at multiple sites (11, 42, 41, 31 and 32). At the same time, clinical crown height of maxillary central incisors was negatively associated with attached gingiva at those teeth, indicating that longer crowns were linked to a narrower attached gingival band. This is in accordance with the findings of Olssoin et al. who observed a narrower zone of AG in patients with long and narrow crown forms [ 29 ]. On the contrary, Jennes et al. failed to prove an association between clinical crown length and the width of attached gingiva [ 30 ]. It was also found that as the facial height N-Me increases, the likelihood of a thin gingival biotype at tooth 11 decreases, however this may be a chance finding given the fact that we have identified that it is rather the transverse facial dimension that corresponds with GT. Evidence in the literature regarding vertical facial typology and periodontal soft tissues is inconsistent, likely due to differences in measurement approaches. Kaya et al. determined facial typology by the inclination of the mandibular plane and measured gingival thickness by puncturing with the endodontic file and did not find a significant difference between the groups of different vertical growth patterns, which stands in line with our findings [ 11 ]. Similarly Kong et al. did not observe a correlation between skeletal vertical dimension and gingival thickness (measured by ultrasounds), as well as the width of keratinized gingiva [ 12 ]. The latter finding seem to be contradictory with our outcomes, and the discrepancy may be potentially attributed to the fact, that the authors measured the width of the whole band of keratinized gingiva, whereas we have measured the zone of attached gingiva only. The lack of association between vertical facial typology determined by the inclination of mandibular plane and gonial angle and gingival biotype (measured by a TRAN method) was also among the findings of Valletta et al. [ 10 ] which seem to stand in line with our outcomes. However, the authors observed that a decreased lower to total facial height ratio is associated with the lower risk of finding a thin gingival biotype. Again, the inconsistency may be due to the differences in the measurement methodology as Valletta et al. measured the SnMe/NMe while we have measured just the total facial height. Further, the authors did not report on the transverse facial measurements, which might have potentially influenced the results. We did not detect the relationship between facial and dental vertical dimensions, and the results of Ammar et el. partly align with ours. The authors also failed to identify a relationship between vertical facial and incisal dimensions, but also did not observe the transverse associations that were clearly evident in our study [ 21 ]. Quite similarly, Furtado et al. reported no associations between facial height nor width and the shape of the maxillary central incisor [ 31 ]. The differences may be attributed to the study population – Ammar et al examined Syrian population, or measurement methods – Furtado et. al. used lateral and frontal radiographs to determine facial dimensions and determined dental morphology by shape and not by direct measurements. In our study, males had greater gingival thickness at 22 and 42. Although this association was detected for only 2 of the 8 incisors examined, and therefore cautious interpretation is advisable, the literature appears to be consistent. Kolte et al. also found thicker gingiva in males [ 32 ]. Recently, Kloukos et al., found that the gingiva at 31 and 41 was thicker in older patients and in males [ 28 ]. We have also found that male gender was associated with a wider zone of attached gingiva at 11, 42, 41, 31 and 32. Kolte et al. observed wider zone of attached gingiva in males, however, the differences did not reach statistical significance [ 32 ]. On the contrary, Jennes et al. did not find gender related differences in the width of gingival tissues [ 30 ]. Interpretation of these results should consider several limitations. The cross-sectional design precludes causal inference, and the inclusion of only periodontally healthy young adults limits generalizability. Although ultrasound offers reliable quantitative measurements of gingival thickness, differences in methodology hinder direct comparison with studies using qualitative phenotypes. Facial typology was assessed using two-dimensional measures, which may not fully reflect three-dimensional craniofacial complexity. Finally, the sample size and site-specific nature of some findings warrant cautious interpretation. Conclusions Within the limitations of this study, the following conclusions may be drawn: Transverse facial morphology appears modestly related to anterior tooth and gingival characteristics. Greater facial width was associated with wider central incisor crowns and increased gingival thickness at selected sites, suggesting partial coordination between transverse craniofacial dimensions, tooth morphology, and gingival thickness within the studied population. Vertical facial morphology was related to the width of attached gingiva. Greater facial height was associated with a wider zone of attached gingiva, whereas longer maxillary central incisor crowns were associated with a narrower attached gingival band. Sex-related differences were observed. Male sex was associated with thicker gingival tissues at selected incisors and with a wider zone of attached gingiva at multiple sites. Further studies are required. Longitudinal research using standardized facial typology descriptors and quantitative soft-tissue measurements is needed to confirm these relationships and clarify their potential clinical relevance. Abbreviations AG – width of attached gingiva CCH – clinical crown height CW – crown width FI – facial index GP – gingival phenotype GT – gingival thickness N-Me – facial height PPV – periodontal probe visibility method TRAN – transgingival probing Zy-Zy – facia width Declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and the study protocol was approved by the Research Ethics Committee of the Jagiellonian University Medical College in Kraków, Poland (approval no. 118.0043.1.215.2024). All participants provided written informed consent prior to participation in the study. Consent for publication Not applicable. Availability of data and materials The data supporting the findings of this study are available from the corresponding author upon reasonable request. Competing interests The Authors have no conflict of interest to declare. Funding The study had no funding. Authors' contributions Z.O. : 1) conceptualization and design, analysis and interpretation of data, 2) drafting the article 3) final approval of the version to be published. P.S. : 1) concepualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. K.K. : 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. A.C. : 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. A.W. : 1) concepualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. J.P. : 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. A.P. : 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. P.F. : 1) conceptualization and design and interpretation of data, 2) drafting the article and revising it critically for important intellectual content and 3) final approval of the version to be published. Acknowledgements The Authors have no acknowledgements to report. References 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;13:654–7. Malhotra R, Grover V, Bhardwaj A, et al. Analysis of the gingival biotype based on the measurement of the dentopapillary complex. J Indian Soc Periodontol. 2014;18:43. Mangla R, Singh N, Dua V, et al. Evaluation of mandibular morphology in different facial types. Contemp Clin Dent. 2011;2:200. Xiao D, Gao H, Ren Y. Craniofacial morphological characteristics of Chinese adults with normal occlusion and different skeletal divergence. Eur J Orthod. 2011;33:198–204. Molina-Berlanga N, Llopis-Perez J, Flores-Mir C, et al. Lower incisor dentoalveolar compensation and symphysis dimensions among Class I and III malocclusion patients with different facial vertical skeletal patterns. Angle Orthod. 2013;83:948–55. Rajesh R, Gupta S, Chakraborty S et al. Three-Dimensional Assessment of Mandibular Morphology Across Vertical Facial Growth Patterns Using Cone-Beam Computed Tomography: A Cross-Sectional Study. Cureus . Epub ahead of print 27 May 2025. 10.7759/cureus.84895 Horner KA, Behrents RG, Kim KB, et al. Cortical bone and ridge thickness of hyperdivergent and hypodivergent adults. Am J Orthod Dentofac Orthop. 2012;142:170–8. Sadek MM, Sabet NE, Hassan IT. Alveolar bone mapping in subjects with different vertical facial dimensions. Eur J Orthod. 2015;37:194–201. Baysal A, Ucar FI, Buyuk SK, et al. Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography. Korean J Orthod. 2013;43:134. Valletta R, Pango A, Tortora G, et al. Association between Gingival Biotype and Facial Typology through Cephalometric Evaluation and Three-Dimensional Facial Scanning. Appl Sci. 2019;9:5057. Kaya Y, Alkan Ö, Alkan EA, et al. Gingival thicknesses of maxillary and mandibular anterior regions in subjects with different craniofacial morphologies. Am J Orthod Dentofac Orthop. 2018;154:356–64. Kong J, Hartsfield JK, Aps J, et al. Effect of craniofacial morphology on gingival parameters of mandibular incisors. Angle Orthod. 2023;93:545–51. Lin K, Guo Y, Zheng M et al. Three-dimensional craniofacial morphology predicts periodontal tissue dimensions using the facial scanner. J Periodontol 2025; jper.70006. Salti L, Holtfreter B, Pink C, et al. Estimating effects of craniofacial morphology on gingival recession and clinical attachment loss. J Clin Periodontol. 2017;44:363–71. Mazurova K, Renkema A-M, Navratilova Z, et al. No association between gingival labial recession and facial type. Eur J Orthod. 2016;38:286–91. Caton JG, Armitage G, Berglundh T et al. A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. J Periodontol ; 89. Epub ahead of print June 2018. 10.1002/JPER.18-0157 De Rouck T, Eghbali R, Collys K, et al. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol. 2009;36:428–33. Alshamri H, Al Moaleem M, Al-Huthaifi B, et al. Correlation Between Maxillary Anterior Teeth and Common Facial Measurements. Clin Cosmet Investig Dent. 2023;15:289–300. Banu R, Dandekeri S, Shenoy K, et al. An In Vivo study to compare and evaluate the correlation of the facial measurements with the combined mesiodistal width of the maxillary anterior teeth between males and females. J Pharm Bioallied Sci. 2017;9:127. Wang J, Li F-L, Yang H-X, et al. Correlation between different points on the face and the width of maxillary anterior teeth. Heliyon. 2024;10:e27642. Ammar Y, Saker R. The Correlation Between Maxillary Central Incisor Dimensions and Different Points on the Face in a Syrian Population. BioMed Res Int 2024; 2024: 5980986. Bednarz-Tumidajewicz M, Furtak A, Zakrzewska A, et al. Comparison of the Effectiveness of the Ultrasonic Method and Cone-Beam Computed Tomography Combined with Intraoral Scanning and Prosthetic-Driven Implant Planning Method in Determining the Gingival Phenotype in the Healthy Periodontium. Int J Environ Res Public Health. 2022;19:12276. Gánti B, Bednarz W, Kőműves K, et al. Reproducibility of the PIROP ultrasonic biometer for gingival thickness measurements. J Esthet Restor Dent. 2019;31:263–7. Slak B, Daabous A, Bednarz W, et al. Assessment of gingival thickness using an ultrasonic dental system prototype: A comparison to traditional methods. Ann Anat - Anat Anz. 2015;199:98–103. Joshi A. Comparison of Gingival Biotype between different Genders based on Measurement of Dentopapillary Complex. J Clin Diagn Res. Epub ahead of print 2017. 10.7860/JCDR/2017/30144.10575 Stein JM, Lintel-Höping N, Hammächer C, et al. The gingival biotype: measurement of soft and hard tissue dimensions ‐ a radiographic morphometric study. J Clin Periodontol. 2013;40:1132–9. Gadge NP, Chawla R, Ronad S, et al. Correlations of gingival biotype with clinical crown and periodontal parameters in maxillary and mandibular jaws. Clin Adv Periodontics. 2025;15:77–85. Koukos G, Kyriakou E, Malamoudi GA, et al. Association of Gingival Thickness With Incisor Morphological Characteristics and Papilla Height: A Cross-Sectional Study. J Esthet Restor Dent. 2025;37:201–7. Olssoin M, Lindhe J, Marinello CP. On the relationship between crown form and clinical features of the gingiva in adolescents. J Clin Periodontol. 1993;20:570–7. Jennes M-E, Sachse C, Flügge T, et al. Gender- and age-related differences in the width of attached gingiva and clinical crown length in anterior teeth. BMC Oral Health. 2021;21:287. Furtado G, Furtado A, El Haje O, et al. Relationship between the morphology of the maxillary central incisor and horizontal and vertical measurements of the face. Indian J Dent Res. 2014;25:178. Kolte R, Kolte A, Mahajan A. Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol. 2014;18:478. Additional Declarations No competing interests reported. Supplementary Files Additionalfiles.docx Additional files (Tables in text format) Additional file 1. Results of a univariate logistic regression analyzing the relationship between gingival biotype and facial typology characteristics. Additional file 2. Multivariable linear regression analysis – predictors of GT for individual teeth. Values are presented as regression coefficients β (95% CI) and p-values. The reference categories were female sex and no history of orthodontic treatment. Additional file 3. Multivariable linear regression analysis – predictors of AG for individual teeth. Values are presented as regression coefficients β (95% CI) and p-values. The reference categories were female sex and no history of orthodontic treatment. Cite Share Download PDF Status: Published Journal Publication published 28 Apr, 2026 Read the published version in BMC Oral Health → Version 1 posted Editorial decision: Revision requested 02 Apr, 2026 Reviews received at journal 23 Mar, 2026 Reviews received at journal 14 Mar, 2026 Reviewers agreed at journal 13 Mar, 2026 Reviewers agreed at journal 09 Mar, 2026 Reviewers agreed at journal 04 Mar, 2026 Reviewers agreed at journal 26 Feb, 2026 Reviewers invited by journal 24 Feb, 2026 Editor invited by journal 30 Jan, 2026 Editor assigned by journal 28 Jan, 2026 Submission checks completed at journal 28 Jan, 2026 First submitted to journal 25 Jan, 2026 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. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-8691966","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596476234,"identity":"8a3e6af5-b17c-4c00-ab2c-19ad2c121957","order_by":0,"name":"Zuzanna Oruba","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYJADNgaGCgZmIMMAiC2I1XIGrkWCSC2MbWAGfi3yM9Iffi7cYcfAL33G7MHPeYfZGdibt0kw7sCthXFGQrL0zDPJDJJ9OeaGvdsOMzPwHCuTYDyDWwuzRMIBad42ZgaDMzxmErwgLRI5ZhKMbbi1sEkkNv/mbasHa5H8OweoRf4Nfi08EslsQFsOg7VI8zaAbOHBr0WC5xmbNW/bcR7JHrZyY5lj6cxsPGnFFol4/CLfnv74Nm9btRw/D/O2h29qrJP52Q9vvPFxhw1OLXAHwhjJbCAysYGgDgSwA5OMpGgZBaNgFIyC4Q4As19BT67dsBcAAAAASUVORK5CYII=","orcid":"","institution":"Jagiellonian Univeristy Medical College","correspondingAuthor":true,"prefix":"","firstName":"Zuzanna","middleName":"","lastName":"Oruba","suffix":""},{"id":596476235,"identity":"8f1e999c-f8e3-4ef0-a989-5527569de841","order_by":1,"name":"Piotr Stós","email":"","orcid":"","institution":"Jagiellonian University Medical College","correspondingAuthor":false,"prefix":"","firstName":"Piotr","middleName":"","lastName":"Stós","suffix":""},{"id":596476236,"identity":"6442ec44-6aba-4858-9410-28fe7ca86e52","order_by":2,"name":"Karolina Kukuczka","email":"","orcid":"","institution":"Jagiellonian University Medical College","correspondingAuthor":false,"prefix":"","firstName":"Karolina","middleName":"","lastName":"Kukuczka","suffix":""},{"id":596476237,"identity":"eaad7288-96d9-460a-af99-6e837df1ebdd","order_by":3,"name":"Anna Chyla","email":"","orcid":"","institution":"Jagiellonian University Medical College","correspondingAuthor":false,"prefix":"","firstName":"Anna","middleName":"","lastName":"Chyla","suffix":""},{"id":596476238,"identity":"561cebba-cc96-49be-84be-6ed1413907f9","order_by":4,"name":"Agata Wieczorkiewicz","email":"","orcid":"","institution":"Jagiellonian University Medical College","correspondingAuthor":false,"prefix":"","firstName":"Agata","middleName":"","lastName":"Wieczorkiewicz","suffix":""},{"id":596476239,"identity":"88ecd787-851f-44dc-83a9-677f4dbcacd6","order_by":5,"name":"Justyna Prorok","email":"","orcid":"","institution":"Jagiellonian University Medical College","correspondingAuthor":false,"prefix":"","firstName":"Justyna","middleName":"","lastName":"Prorok","suffix":""},{"id":596476240,"identity":"76f46207-c637-497c-b1cf-687bd69d29b8","order_by":6,"name":"Alicja Protoklitov","email":"","orcid":"","institution":"Jagiellonian University Medical College","correspondingAuthor":false,"prefix":"","firstName":"Alicja","middleName":"","lastName":"Protoklitov","suffix":""},{"id":596476241,"identity":"65f9bb37-21e1-4234-a7ef-7fa96d210ef3","order_by":7,"name":"Piotr Fudalej","email":"","orcid":"","institution":"Jagiellonian Univeristy Medical College","correspondingAuthor":false,"prefix":"","firstName":"Piotr","middleName":"","lastName":"Fudalej","suffix":""}],"badges":[],"createdAt":"2026-01-25 11:09:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8691966/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8691966/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12903-026-08417-0","type":"published","date":"2026-04-28T15:58:02+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":103589965,"identity":"dd32e541-143a-485a-9998-4603f7eac7e9","added_by":"auto","created_at":"2026-02-27 12:00:29","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":186257,"visible":true,"origin":"","legend":"\u003cp\u003eA. Gingival phenotype (GP) evaluation based on the periodontal probe visibility (PPV) assessment method. An example of a thick GP determined by the absence of probe transparency through the soft tissues. B. Measurement of gingival thickness with a PIROP ultrasonic device.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8691966/v1/a9fe52f7a25af3c482b6a99f.png"},{"id":103589968,"identity":"5b91f15f-401a-41b9-83f7-ee330a538892","added_by":"auto","created_at":"2026-02-27 12:00:29","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":176624,"visible":true,"origin":"","legend":"\u003cp\u003eHeat map depicting correlations between facial typology and dental morphology. Values of the Spearman’s correlation coefficient (r) are given in the cells. Asterisks indicate correlations which reached statistical significance (p \u0026lt; 0.05).\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8691966/v1/d01beeb02cba868468e93485.png"},{"id":103589966,"identity":"91a87f6c-95de-493a-a664-3ae285ac85e2","added_by":"auto","created_at":"2026-02-27 12:00:29","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":171530,"visible":true,"origin":"","legend":"\u003cp\u003eHeat map depicting correlations between facial typology and gingival characteristics. Values of the Spearman’s correlation coefficient (r) are given in the cells. Asterisks indicate correlations which reached statistical significance (p \u0026lt; 0.05).\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8691966/v1/20534feed25ee1f8933b65e8.png"},{"id":103589969,"identity":"d8816f2b-7212-4ca4-8031-0b64b7761cda","added_by":"auto","created_at":"2026-02-27 12:00:29","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":377353,"visible":true,"origin":"","legend":"\u003cp\u003eHeat map depicting correlations between dental morphology and gingival characteristics. Values of the Spearman’s correlation coefficient (r) are given in the cells. Asterisks indicate correlations which reached statistical significance (p \u0026lt; 0.05).\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8691966/v1/e29f808a9ce932e54a6bce21.png"},{"id":108437688,"identity":"0b387d74-8ba4-4669-9085-0cfcc2042f1c","added_by":"auto","created_at":"2026-05-04 16:02:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1373353,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8691966/v1/ed8afb48-22a4-47b3-85dd-1a5284551e4e.pdf"},{"id":103589967,"identity":"44163e7c-5196-4117-99bf-f3b723e28c54","added_by":"auto","created_at":"2026-02-27 12:00:29","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":21655,"visible":true,"origin":"","legend":"\u003cp\u003eAdditional files (Tables in text format)\u003c/p\u003e\n\u003cp\u003eAdditional file 1. Results of a univariate logistic regression analyzing the relationship between gingival biotype and facial typology characteristics.\u003c/p\u003e\n\u003cp\u003eAdditional file 2. Multivariable linear regression analysis – predictors of GT for individual teeth. Values are presented as regression coefficients β (95% CI) and p-values. The reference categories were female sex and no history of orthodontic treatment.\u003c/p\u003e\n\u003cp\u003eAdditional file 3. Multivariable linear regression analysis – predictors of AG for individual teeth. Values are presented as regression coefficients β (95% CI) and p-values. The reference categories were female sex and no history of orthodontic treatment.\u003c/p\u003e","description":"","filename":"Additionalfiles.docx","url":"https://assets-eu.researchsquare.com/files/rs-8691966/v1/f40e3494b91ed0c0022e3492.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Linking facial typology to dental morphology and gingival characteristics: A cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eContemporary orthodontic diagnostics should extend beyond dentoalveolar and skeletal relationships and include an assessment of periodontal tissue morphology. This broader approach supports planning of safe orthodontic tooth movements that remain within the anatomical limits of the alveolus and the adaptive capacity of the gingiva, thereby minimizing the risk of bony dehiscence and gingival recession. The clinical relevance of periodontal soft-tissue characteristics is widely recognized. In particular, a thin gingival phenotype is considered more prone to recession development in response to an insults than a thick phenotype, which demonstrates greater resistance and stability [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNumerous studies have shown that facial typology is associated with alveolar characteristics. In dolichofacial (hyperdivergent) individuals, the mandibular symphysis is slender and narrow and the alveolar process thinner, whereas brachyfacial (hypodivergent) subjects present a shorter and wider symphysis and a thicker alveolus [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Hypodivergence has been associated with increased thickness of buccal and lingual cortical plates in the maxilla and mandible [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. These observations suggest that vertical craniofacial pattern may influence the biological envelope for orthodontic tooth movement and thereby affect periodontal risk.\u003c/p\u003e \u003cp\u003eIn contrast to the relatively consistent evidence regarding alveolar bone morphology, the relationship between facial typology and periodontal soft tissues remains unclear. Valletta et al. reported no association between facial typology and gingival phenotype; however, they observed that a reduced lower-to-total facial height ratio was associated with a lower risk of thin gingival phenotype [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Kaya et al. found no differences in gingival thickness in the maxillary and mandibular anterior regions among individuals with different vertical and sagittal growth patterns [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Similarly, Kong et al. identified no correlation between skeletal vertical dimension and gingival thickness or the width of keratinized gingiva, yet reported that a thin gingival phenotype at the mandibular central incisor was more frequent in hypo- and normodivergent subjects [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. More recently, using combined CBCT and facial scanning, Lin et al. reported that brachyfacial morphology was associated with thinner gingiva and reduced alveolar bone in the maxillary anterior region and proposed that vertical facial pattern may serve as a predictor of periodontal vulnerability [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In contrast, Salti et al. reported a higher prevalence of gingival recession and attachment loss in individuals with long and narrow faces [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], whereas Mazurova et al. concluded that facial type does not predict gingival recession development after orthodontic treatment [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese inconsistencies may be explained, at least in part, by variability in study populations, differences in how facial typology is defined, and heterogeneity in gingival assessment methods. Moreover, periodontal soft tissues may be influenced not only by craniofacial morphology, but also by tooth dimensions and crown form.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eGiven the inconsistent evidence and the potential clinical implications, the aim of the present study was to investigate the associations between gingival characteristics (gingival thickness, attached gingiva width, and gingival phenotype) and anatomical parameters related to facial typology and anterior tooth crown morphology in periodontally healthy young adults.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design and ethics\u003c/h3\u003e\n\u003cp\u003eA cross-sectional study was conducted at the Department of Orthodontics, Dental University Clinic in Krak\u0026oacute;w (Poland) among young adult patients. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and the study protocol was approved by the Research Ethics Committee of the Jagiellonian University Medical College in Krak\u0026oacute;w, Poland (approval no. 118.0043.1.215.2024).\u003c/p\u003e\n\u003ch3\u003eInclusion and exclusion criteria\u003c/h3\u003e\n\u003cp\u003eYoung adult patients willing to participate were recruited if all of the following criteria were met:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePeriodontal health, defined according to the 2017 Classification of Periodontal and Peri-Implant Diseases, i.e., no clinical attachment loss, no radiographic bone loss, probing pocket depth\u0026thinsp;\u0026le;\u0026thinsp;3 mm, and bleeding on probing\u0026thinsp;\u0026lt;\u0026thinsp;10% [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAge 20\u0026ndash;30 years.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eNo history of orthodontic treatment, or orthodontic treatment completed\u0026thinsp;\u0026gt;\u0026thinsp;1 year before study enrolment.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWritten informed consent.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eParticipants were excluded if any of the following were present:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHistory of periodontal surgery.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eGingivitis or periodontitis as defined by the Classification of Periodontal and Peri-Implant Diseases (2017) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSmoking.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eOngoing orthodontic treatment.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e\n\u003ch3\u003eExtraoral examination: facial measurements\u003c/h3\u003e\n\u003cp\u003eFacial measurements were performed with a calliper. Facial height (N\u0026ndash;Me) was measured as the distance between soft-tissue nasion (N; the deepest midline point between the forehead and nose) and menton (Me; the lowest point of the soft-tissue contour of the chin in the midsagittal plane). Facial width (Zy\u0026ndash;Zy) was measured as the distance between the bilateral zygion points (Zy; most lateral point of the soft-tissue contour of the cheek).\u003c/p\u003e \u003cp\u003eThe facial index (FI) was calculated as:\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:FI=\\frac{\\text{N}-\\text{M}\\text{e}}{\\text{Z}\\text{y}-\\text{Z}\\text{y}}\\times\\:100$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003ePeriodontal examination\u003c/h3\u003e\n\u003cp\u003ePeriodontal measurements were performed using a UNC-15 periodontal probe (Falcon, Poland) and rounded to the nearest millimetre. Measurements were conducted at the maxillary and mandibular central and lateral incisors.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eGingival phenotype (GP)\u003c/h2\u003e \u003cp\u003eGingival phenotype (GP) was assessed using the periodontal probe visibility (PPV) method [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The probe was inserted into the sulcus at the midfacial aspect of each tooth and probe transparency was evaluated visually. A thin phenotype was recorded when the probe outline was visible through the gingival tissue, and a thick phenotype when it was not visible [Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eWidth of attached gingiva (AG)\u003c/h3\u003e\n\u003cp\u003eThe width of attached gingiva (AG) was calculated as the difference between the width of keratinized gingiva (distance from the free gingival margin to the mucogingival junction) and sulcus depth at the same site.\u003c/p\u003e\n\u003ch3\u003eGingival thickness (GT)\u003c/h3\u003e\n\u003cp\u003eGingival thickness (GT) was measured using a PIROP ultrasonic device (Echo-Son, Puławy, Poland). The device is equipped with a 1.7 mm diameter probe designed for oral soft-tissue thickness assessment. Measurements were performed by placing the probe perpendicular to the gingival surface at the midfacial aspect of the tooth, 1 mm apical to the free gingival margin. The GT value recorded by the device represents the mean of 10 consecutive measurements [Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eDental measurements\u003c/h2\u003e \u003cp\u003eDental measurements included mesiodistal crown width (CW) and clinical crown height (CCH) of the maxillary and mandibular central incisors. CW was measured between the mesial and distal line angles at the widest portion of the crown. CCH was measured as the distance from the incisal edge to the gingival margin at the midfacial aspect. The crown height-to-width ratio (CCH/CW) was calculated for maxillary central incisors. Given the substantial variability of lateral incisor morphology, measurements were limited to central incisors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eExaminer reliability\u003c/h2\u003e \u003cp\u003eInter-examiner reliability was assessed in the first 10 participants, who were examined independently by two investigators (P.S. and J.P.). Agreement for continuous variables was evaluated using intraclass correlation coefficients (ICC) and was excellent for facial/dental distance measurements (ICC\u0026thinsp;=\u0026thinsp;0.998; 95% CI 0.997\u0026ndash;0.999) and good for PIROP measurements (ICC\u0026thinsp;=\u0026thinsp;0.75; 95% CI 0.556\u0026ndash;0.842). Agreement for categorical variables (GP classification) was assessed using Cohen\u0026rsquo;s kappa (κ\u0026thinsp;=\u0026thinsp;0.65; 95% CI 0.483\u0026ndash;0.794; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating substantial agreement.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eQuantitative variables were summarized using mean, standard deviation (SD), median, quartiles (Q1\u0026ndash;Q3), and range. Qualitative variables were presented as absolute and relative frequencies (N, %). Associations between quantitative variables were evaluated using Spearman\u0026rsquo;s rank correlation coefficients and presented as heat maps. Multiple linear regression models were built to evaluate the influence of sex, history of orthodontic treatment (yes/no), and FI on GT and AG. Univariate logistic regression was used to assess the influence of facial and dental variables on gingival phenotype (thin vs thick), followed by multivariate logistic regression including sex, orthodontic treatment history, and FI. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. All analyses were conducted in R software (version 4.5.1).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eA total of 61 patients aged 21\u0026ndash;30 years (mean age 24.15\u0026thinsp;\u0026plusmn;\u0026thinsp;1.74 years) of Caucasian origin were included in the analysis (43 females and 18 males). Thirty-five participants (57.4%) had undergone orthodontic treatment in the past, whereas 26 (42.6%) had no history of orthodontic treatment.\u003c/p\u003e \u003cp\u003eDescriptive statistics for craniofacial, dental, and gingival characteristics are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, and gingival phenotype distribution is 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=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCraniofacial, dental and gingival characteristics (quantitative variables) of the study population.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameter\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\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eQ1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eQ3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZy-Zy [mm]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN-Me [mm]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e94.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e80.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e116.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e89.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e101.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eCW [mm]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eCCH [mm]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eCCH/CW ratio\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eGT \u0026ndash; PIROP measurement [mm]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eAG [mm]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eSD - standard deviation, Q1 - lower quartile, Q3 - upper quartile\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=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGP assessed by the periodontal probe visibility (PPV) method.\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\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eAssessment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThick\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (77.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (23%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (41%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (55.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (44.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (77.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (23%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth 32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (96.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAssociations between facial typology and dental morphology\u003c/h2\u003e \u003cp\u003eCW of maxillary and mandibular central incisors demonstrated statistically significant positive correlations with Zy\u0026ndash;Zy. Additionally, CW of teeth 21 and 31 correlated negatively with FI. The CCH/CW ratio of tooth 21 correlated negatively with Zy\u0026ndash;Zy. No significant correlations were identified between CCH of the central incisors and facial typology variables. These relationships are summarized in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eAssociations between facial typology and gingival characteristics\u003c/h2\u003e \u003cp\u003eGT at teeth 22 and 42 correlated positively with Zy\u0026ndash;Zy, while GT at teeth 31 and 32 correlated negatively with FI. A significant positive association was also observed between AG at teeth 11, 42, 41, 31, and 32 and N\u0026ndash;Me. No significant correlations were identified between N\u0026ndash;Me and GT. These results are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eIn univariate logistic regression models assessing the relationship between facial typology and GP, none of the facial parameters (Zy\u0026ndash;Zy, N\u0026ndash;Me, FI) significantly predicted the probability of thin GP for teeth 12, 21, and 22. For tooth 11, N\u0026ndash;Me was a significant predictor (OR\u0026thinsp;=\u0026thinsp;0.932; 95% CI: 0.871\u0026ndash;0.997; p\u0026thinsp;=\u0026thinsp;0.040), indicating that each additional millimetre of N\u0026ndash;Me reduced the odds of thin phenotype by 6.8% (Additional file 1). Logistic regression models were not performed for mandibular incisors due to the overwhelming predominance of thin phenotype.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eAssociations between dental morphology and gingival characteristics\u003c/h2\u003e \u003cp\u003eGT at tooth 21 correlated positively with CW of the same tooth. Beyond this tooth-specific association, multiple statistically significant positive correlations were observed between GT values and CWs across different teeth, as well as negative correlations between GT and the CCH/CW ratio of the maxillary central incisors (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAG at 11 and 21 demonstrated significant negative correlations with CCH of the corresponding teeth. AG at tooth 11 also correlated negatively with the CCH/CW ratio of teeth 11 and 21. No analogous associations were identified in mandibular incisors. No significant associations were observed between AG and crown width.\u003c/p\u003e \u003cp\u003eIn univariate logistic regression models, none of the evaluated dental morphology variables significantly predicted the probability of thin gingival phenotype at any sit\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of gingival thickness, attached gingiva, and gingival phenotype\u003c/h2\u003e \u003cp\u003eMultiple linear regression models including sex, past orthodontic treatment, and FI revealed that none of these variables significantly predicted GT at teeth 12, 11, 21, or 41. It was found that male sex increases GT at the tooth 22 by 0.162 mm (β\u0026thinsp;=\u0026thinsp;0.162, p\u0026thinsp;=\u0026thinsp;0.07) and at the tooth 42 by 0.142 mm (β\u0026thinsp;=\u0026thinsp;0.142, p\u0026thinsp;=\u0026thinsp;0.012) compared to female sex. In turn, an increase of FI by 1% decreases GT at the teeth 31 and 32 by 0.008 mm (β\u0026thinsp;=\u0026thinsp;0.008, p\u0026thinsp;=\u0026thinsp;0.011) and 0.006 mm (β\u0026thinsp;=\u0026thinsp;0.006, p\u0026thinsp;=\u0026thinsp;0.046), respectively (significant data presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, all data presented in Additional file 2).\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\u003eMultivariable linear regression analysis \u0026ndash; predictors of GT and AG for individual teeth. Values are presented as regression coefficients β, 95% CI and p-values. Only variables demonstrating statistically significant effects are reported \u0026ndash; all data are presented in Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e in Additional files.\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=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eGT\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eIndependent variable: Male vs Female\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e95% CI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eIndependent variable: FI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e95% CI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026minus;0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u0026minus;0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eAG\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eIndependent variable: Male vs Female\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eβ\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e95% CI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.743\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.448\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.927\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.624\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.886\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.951\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.740\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.773\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e1.495\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.036\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\u003eFor AG, male sex was associated with increased width at tooth 11 by 0.743 mm (β\u0026thinsp;=\u0026thinsp;0.743; p\u0026thinsp;=\u0026thinsp;0.039), tooth 42 by 0.927 mm (β\u0026thinsp;=\u0026thinsp;0.927; p\u0026thinsp;=\u0026thinsp;0.010), tooth 41 by 0.886 mm (β\u0026thinsp;=\u0026thinsp;0.886; p\u0026thinsp;=\u0026thinsp;0.015), tooth 31 by 0.951 mm (β\u0026thinsp;=\u0026thinsp;0.951 mm; p\u0026thinsp;=\u0026thinsp;0.019), and tooth 32 by 0.773 mm (β\u0026thinsp;=\u0026thinsp;0.773; p\u0026thinsp;=\u0026thinsp;0.036). Orthodontic treatment history and FI were not significant predictors of AG at any site (significant data presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, all data presented in Additional file 3).\u003c/p\u003e \u003cp\u003eMultivariate logistic regression models including sex, orthodontic treatment history, and FI identified no significant independent predictors of thin gingival phenotype at any maxillary or mandibular incisor.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn the present cross-sectional study we investigated the interrelationships between facial typology, dental morphology and gingival characteristics in periodontally healthy young adults. Understanding these relationships may be clinically important, because variation in facial typology could be reflected in periodontal soft-tissue dimensions, potentially affecting susceptibility to mucogingival complications. Within the limitations of the study design, several significant associations were identified, suggesting that specific facial and dental characteristics may co-occur with differences in gingival thickness and the width of attached gingiva.\u003c/p\u003e \u003cp\u003eA consistent pattern emerging from our results was the involvement of the transverse dimension. Facial width (Zy\u0026ndash;Zy) correlated positively with the crown width of maxillary and mandibular central incisors. Such relationships have been frequently described. Alshamri et al. reported that maxillary central incisor width correlated with bizygomatic width in females and with interpupillary distance in both sexes [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], while Banu et al. observed significant correlations between several transverse facial measurements and the combined mesiodistal width of the maxillary anterior teeth [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Similar associations between transverse facial parameters and transverse dental measures were reported by Wang et al [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In contrast, Ammar and Saker did not confirm such relationships, highlighting that the strength and detectability of these associations may differ across populations and methodological approaches [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBeyond tooth size, transverse facial morphology was also linked to periodontal soft tissues. In our study, facial width was positively associated with gingival thickness at teeth 22 and 42, while the facial index (FI) showed negative correlations with gingival thickness at mandibular incisors 31 and 32. Notably, FI emerged as an independent predictor of gingival thickness at teeth 31 and 32, indicating that individuals with a higher FI (i.e., relatively greater facial height in relation to width) tended to present with thinner gingival tissues at these sites. Although these associations were modest, they suggest that transverse and proportional facial morphology may be reflected in gingival tissue dimensions at selected incisor sites.\u003c/p\u003e \u003cp\u003eSeveral additional correlations were identified between gingival thicknesses and crown widths of various teeth, as well as inverse associations between gingival thicknesses and the CCH/CW ratios of central incisors. Altogether, these findings point that within our study population broader facial morphology might have been modestly associated with wider maxillary and mandibular central incisors and thicker gingival tissues at specific sites.\u003c/p\u003e \u003cp\u003eInterpretation of the associations between dental morphology and gingival thickness requires caution because of differences in the assessment methods used across studies. In the present study, gingival thickness was measured quantitatively using an ultrasonic device, while gingival phenotype was assessed qualitatively by periodontal probe visibility. Many earlier studies relied on probe transparency method alone. While this method is valuable clinically, it often provides dichotomous classification rather than continuous measurements, which limits direct comparisons with ultrasonographic evaluation [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Furthermore, radiographic evaluation of gingival thickness has shown lower accuracy compared with ultrasound [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], whereas transgingival puncture with an endodontic file has demonstrated better agreement with ultrasound-based measurements [\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. With respect to tooth morphology, many authors report crown width-to-length ratios (CW/CL), whereas we used the inverse indicator (CCH/CW).\u003c/p\u003e \u003cp\u003eWithin these methodological constraints, our findings align with several previous reports suggesting that tooth crown shape may be related to gingival thickness. The pattern emerging from our results is that wider crowns (and more \u0026ldquo;square\u0026rdquo; crown morphology) tend to be associated with thicker gingival tissues. Similar conclusions were reported by Joshi et al. in a large cross-sectional cohort, where CW/CL ratios were positively correlated with gingival thickness (assessed by TRAN and radiographic method) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Comparable observations were reported by Stein et al. (who used the same measurement methods as Joshi et al.) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] and Gadge (who scored gingival thickness by a TRAN method only) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In contrast, Kloukos et al., using an ultrasound device, did not find significant associations between gingival thickness and crown width or crown length [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Differences between studies may reflect population-specific characteristics, but they may also be attributable to differences in sampling strategy, measurement location, or the restricted range of variability in a periodontally healthy cohort.\u003c/p\u003e \u003cp\u003eIn contrast to the transverse findings, the vertical relationships in our study were more nuanced. We did not identify associations between facial height and gingival thickness, nor between facial height and clinical crown height. However, facial height was positively associated with the width of attached gingiva at multiple sites (11, 42, 41, 31 and 32). At the same time, clinical crown height of maxillary central incisors was negatively associated with attached gingiva at those teeth, indicating that longer crowns were linked to a narrower attached gingival band. This is in accordance with the findings of Olssoin et al. who observed a narrower zone of AG in patients with long and narrow crown forms [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. On the contrary, Jennes et al. failed to prove an association between clinical crown length and the width of attached gingiva [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. It was also found that as the facial height N-Me increases, the likelihood of a thin gingival biotype at tooth 11 decreases, however this may be a chance finding given the fact that we have identified that it is rather the transverse facial dimension that corresponds with GT.\u003c/p\u003e \u003cp\u003eEvidence in the literature regarding vertical facial typology and periodontal soft tissues is inconsistent, likely due to differences in measurement approaches. Kaya et al. determined facial typology by the inclination of the mandibular plane and measured gingival thickness by puncturing with the endodontic file and did not find a significant difference between the groups of different vertical growth patterns, which stands in line with our findings [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Similarly Kong et al. did not observe a correlation between skeletal vertical dimension and gingival thickness (measured by ultrasounds), as well as the width of keratinized gingiva [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The latter finding seem to be contradictory with our outcomes, and the discrepancy may be potentially attributed to the fact, that the authors measured the width of the whole band of keratinized gingiva, whereas we have measured the zone of attached gingiva only. The lack of association between vertical facial typology determined by the inclination of mandibular plane and gonial angle and gingival biotype (measured by a TRAN method) was also among the findings of Valletta et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] which seem to stand in line with our outcomes. However, the authors observed that a decreased lower to total facial height ratio is associated with the lower risk of finding a thin gingival biotype. Again, the inconsistency may be due to the differences in the measurement methodology as Valletta et al. measured the SnMe/NMe while we have measured just the total facial height. Further, the authors did not report on the transverse facial measurements, which might have potentially influenced the results.\u003c/p\u003e \u003cp\u003eWe did not detect the relationship between facial and dental vertical dimensions, and the results of Ammar et el. partly align with ours. The authors also failed to identify a relationship between vertical facial and incisal dimensions, but also did not observe the transverse associations that were clearly evident in our study [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Quite similarly, Furtado et al. reported no associations between facial height nor width and the shape of the maxillary central incisor [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The differences may be attributed to the study population \u0026ndash; Ammar et al examined Syrian population, or measurement methods \u0026ndash; Furtado et. al. used lateral and frontal radiographs to determine facial dimensions and determined dental morphology by shape and not by direct measurements.\u003c/p\u003e \u003cp\u003eIn our study, males had greater gingival thickness at 22 and 42. Although this association was detected for only 2 of the 8 incisors examined, and therefore cautious interpretation is advisable, the literature appears to be consistent. Kolte et al. also found thicker gingiva in males [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Recently, Kloukos et al., found that the gingiva at 31 and 41 was thicker in older patients and in males [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. We have also found that male gender was associated with a wider zone of attached gingiva at 11, 42, 41, 31 and 32. Kolte et al. observed wider zone of attached gingiva in males, however, the differences did not reach statistical significance [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. On the contrary, Jennes et al. did not find gender related differences in the width of gingival tissues [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInterpretation of these results should consider several limitations. The cross-sectional design precludes causal inference, and the inclusion of only periodontally healthy young adults limits generalizability. Although ultrasound offers reliable quantitative measurements of gingival thickness, differences in methodology hinder direct comparison with studies using qualitative phenotypes. Facial typology was assessed using two-dimensional measures, which may not fully reflect three-dimensional craniofacial complexity. Finally, the sample size and site-specific nature of some findings warrant cautious interpretation.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWithin the limitations of this study, the following conclusions may be drawn:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTransverse facial morphology appears modestly related to anterior tooth and gingival characteristics. Greater facial width was associated with wider central incisor crowns and increased gingival thickness at selected sites, suggesting partial coordination between transverse craniofacial dimensions, tooth morphology, and gingival thickness within the studied population.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eVertical facial morphology was related to the width of attached gingiva. Greater facial height was associated with a wider zone of attached gingiva, whereas longer maxillary central incisor crowns were associated with a narrower attached gingival band.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSex-related differences were observed. Male sex was associated with thicker gingival tissues at selected incisors and with a wider zone of attached gingiva at multiple sites.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eFurther studies are required. Longitudinal research using standardized facial typology descriptors and quantitative soft-tissue measurements is needed to confirm these relationships and clarify their potential clinical relevance.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAG \u0026ndash; width of attached gingiva\u003c/p\u003e\n\u003cp\u003eCCH \u0026ndash; clinical crown height\u003c/p\u003e\n\u003cp\u003eCW \u0026ndash; crown width\u003c/p\u003e\n\u003cp\u003eFI \u0026ndash; facial index\u003c/p\u003e\n\u003cp\u003eGP \u0026ndash; gingival phenotype\u003c/p\u003e\n\u003cp\u003eGT \u0026ndash; gingival thickness\u003c/p\u003e\n\u003cp\u003eN-Me \u0026ndash; facial height\u003c/p\u003e\n\u003cp\u003ePPV \u0026ndash; periodontal probe visibility method\u003c/p\u003e\n\u003cp\u003eTRAN \u0026ndash; transgingival probing\u003c/p\u003e\n\u003cp\u003eZy-Zy \u0026ndash; facia width\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was\u0026nbsp;conducted in accordance with the Declaration of Helsinki (as revised in 2013) and the study\u0026nbsp;protocol was approved by the Research Ethics Committee of the Jagiellonian University Medical College in Kraków, Poland (approval no. 118.0043.1.215.2024). All participants provided written informed consent prior to participation in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Authors have no conflict of interest to declare.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study had no funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors' contributions\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eZ.O.\u003c/strong\u003e: 1) conceptualization and design, analysis and interpretation of data, 2) drafting the article 3) final approval of the version to be published. \u003cstrong\u003eP.S.\u003c/strong\u003e: 1) concepualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. \u003cstrong\u003eK.K.\u003c/strong\u003e: 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. \u003cstrong\u003eA.C.\u003c/strong\u003e: 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published.\u0026nbsp;\u003cstrong\u003eA.W.\u003c/strong\u003e:\u0026nbsp;1) concepualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. \u003cstrong\u003eJ.P.\u003c/strong\u003e: 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. \u003cstrong\u003eA.P.\u003c/strong\u003e: 1) conceptualization and acquisition of data, 2) revising the manuscript critically for important intellectual content and 3) final approval of the version to be published. \u003cstrong\u003eP.F.\u003c/strong\u003e: 1) conceptualization and design and interpretation of data, 2) drafting the article and revising it critically for important intellectual content and 3) final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Authors have no acknowledgements to report.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eClaffey 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;13:654\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMalhotra R, Grover V, Bhardwaj A, et al. Analysis of the gingival biotype based on the measurement of the dentopapillary complex. J Indian Soc Periodontol. 2014;18:43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMangla R, Singh N, Dua V, et al. Evaluation of mandibular morphology in different facial types. Contemp Clin Dent. 2011;2:200.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXiao D, Gao H, Ren Y. Craniofacial morphological characteristics of Chinese adults with normal occlusion and different skeletal divergence. Eur J Orthod. 2011;33:198\u0026ndash;204.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMolina-Berlanga N, Llopis-Perez J, Flores-Mir C, et al. Lower incisor dentoalveolar compensation and symphysis dimensions among Class I and III malocclusion patients with different facial vertical skeletal patterns. Angle Orthod. 2013;83:948\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRajesh R, Gupta S, Chakraborty S et al. Three-Dimensional Assessment of Mandibular Morphology Across Vertical Facial Growth Patterns Using Cone-Beam Computed Tomography: A Cross-Sectional Study. \u003cem\u003eCureus\u003c/em\u003e. Epub ahead of print 27 May 2025. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.84895\u003c/span\u003e\u003cspan address=\"10.7759/cureus.84895\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHorner KA, Behrents RG, Kim KB, et al. Cortical bone and ridge thickness of hyperdivergent and hypodivergent adults. Am J Orthod Dentofac Orthop. 2012;142:170\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSadek MM, Sabet NE, Hassan IT. Alveolar bone mapping in subjects with different vertical facial dimensions. Eur J Orthod. 2015;37:194\u0026ndash;201.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaysal A, Ucar FI, Buyuk SK, et al. Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography. Korean J Orthod. 2013;43:134.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eValletta R, Pango A, Tortora G, et al. Association between Gingival Biotype and Facial Typology through Cephalometric Evaluation and Three-Dimensional Facial Scanning. Appl Sci. 2019;9:5057.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaya Y, Alkan \u0026Ouml;, Alkan EA, et al. Gingival thicknesses of maxillary and mandibular anterior regions in subjects with different craniofacial morphologies. Am J Orthod Dentofac Orthop. 2018;154:356\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKong J, Hartsfield JK, Aps J, et al. Effect of craniofacial morphology on gingival parameters of mandibular incisors. Angle Orthod. 2023;93:545\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin K, Guo Y, Zheng M et al. Three-dimensional craniofacial morphology predicts periodontal tissue dimensions using the facial scanner. J Periodontol 2025; jper.70006.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalti L, Holtfreter B, Pink C, et al. Estimating effects of craniofacial morphology on gingival recession and clinical attachment loss. J Clin Periodontol. 2017;44:363\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMazurova K, Renkema A-M, Navratilova Z, et al. No association between gingival labial recession and facial type. Eur J Orthod. 2016;38:286\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCaton JG, Armitage G, Berglundh T et al. A new classification scheme for periodontal and peri-implant diseases and conditions \u0026ndash; Introduction and key changes from the 1999 classification. \u003cem\u003eJ Periodontol\u003c/em\u003e; 89. Epub ahead of print June 2018. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/JPER.18-0157\u003c/span\u003e\u003cspan address=\"10.1002/JPER.18-0157\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Rouck T, Eghbali R, Collys K, et al. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol. 2009;36:428\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlshamri H, Al Moaleem M, Al-Huthaifi B, et al. Correlation Between Maxillary Anterior Teeth and Common Facial Measurements. Clin Cosmet Investig Dent. 2023;15:289\u0026ndash;300.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBanu R, Dandekeri S, Shenoy K, et al. An In Vivo study to compare and evaluate the correlation of the facial measurements with the combined mesiodistal width of the maxillary anterior teeth between males and females. J Pharm Bioallied Sci. 2017;9:127.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang J, Li F-L, Yang H-X, et al. Correlation between different points on the face and the width of maxillary anterior teeth. Heliyon. 2024;10:e27642.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmmar Y, Saker R. The Correlation Between Maxillary Central Incisor Dimensions and Different Points on the Face in a Syrian Population. \u003cem\u003eBioMed Res Int\u003c/em\u003e 2024; 2024: 5980986.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBednarz-Tumidajewicz M, Furtak A, Zakrzewska A, et al. Comparison of the Effectiveness of the Ultrasonic Method and Cone-Beam Computed Tomography Combined with Intraoral Scanning and Prosthetic-Driven Implant Planning Method in Determining the Gingival Phenotype in the Healthy Periodontium. Int J Environ Res Public Health. 2022;19:12276.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eG\u0026aacute;nti B, Bednarz W, Kőműves K, et al. Reproducibility of the PIROP ultrasonic biometer for gingival thickness measurements. J Esthet Restor Dent. 2019;31:263\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSlak B, Daabous A, Bednarz W, et al. Assessment of gingival thickness using an ultrasonic dental system prototype: A comparison to traditional methods. Ann Anat - Anat Anz. 2015;199:98\u0026ndash;103.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJoshi A. Comparison of Gingival Biotype between different Genders based on Measurement of Dentopapillary Complex. J Clin Diagn Res. Epub ahead of print 2017. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7860/JCDR/2017/30144.10575\u003c/span\u003e\u003cspan address=\"10.7860/JCDR/2017/30144.10575\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStein JM, Lintel-H\u0026ouml;ping N, Hamm\u0026auml;cher C, et al. The gingival biotype: measurement of soft and hard tissue dimensions ‐ a radiographic morphometric study. J Clin Periodontol. 2013;40:1132\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGadge NP, Chawla R, Ronad S, et al. Correlations of gingival biotype with clinical crown and periodontal parameters in maxillary and mandibular jaws. Clin Adv Periodontics. 2025;15:77\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoukos G, Kyriakou E, Malamoudi GA, et al. Association of Gingival Thickness With Incisor Morphological Characteristics and Papilla Height: A Cross-Sectional Study. J Esthet Restor Dent. 2025;37:201\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlssoin M, Lindhe J, Marinello CP. On the relationship between crown form and clinical features of the gingiva in adolescents. J Clin Periodontol. 1993;20:570\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJennes M-E, Sachse C, Fl\u0026uuml;gge T, et al. Gender- and age-related differences in the width of attached gingiva and clinical crown length in anterior teeth. BMC Oral Health. 2021;21:287.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFurtado G, Furtado A, El Haje O, et al. Relationship between the morphology of the maxillary central incisor and horizontal and vertical measurements of the face. Indian J Dent Res. 2014;25:178.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKolte R, Kolte A, Mahajan A. Assessment of gingival thickness with regards to age, gender and arch location. J Indian Soc Periodontol. 2014;18:478.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"facial index, facial typology, gingival thickness, gingival phenotype, dental morphology","lastPublishedDoi":"10.21203/rs.3.rs-8691966/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8691966/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eContemporary orthodontic planning increasingly recognizes the importance of periodontal soft-tissue morphology. Thin gingiva is more susceptible to recession and may limit safe tooth movement. The evidence regarding the relationship between facial and gingival morphology is inconsistent. The aim of the present study was to investigate the associations between facial typology, gingival and dental characteristics in periodontally healthy young adults.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFacial measurements included facial height (N-Me), facial width (Zy-Zy) and facial index (FI = N-Me/Zy-Zy). Periodontal examination included the determination of gingival phenotype (GP) by periodontal probe visibility method, measurement of the width of attached gingiva (AG) and ultrasonic measurement of gingival thickness (GT). Additionally, crown width (CW) and clinical crown height (CCH) were measured.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSixty-one patients (aged 21–30), 43 females and 18 males participated. CW of maxillary and mandibular central incisors demonstrated significant positive correlations with Zy–Zy. GT at teeth 22 and 42 correlated positively with Zy–Zy, while GT at teeth 31 and 32 correlated negatively with FI. A significant positive association was observed between AG at multiple teeth and N–Me. Male sex emerged as an independent predictor of GT at 22 and 42 and AG at 11, 42, 41, 31 and 32, while increasing FI was associated with reduced GT at 31 and 32.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIndividuals with broader faces seem to present wider central incisors and thicker gingival tissues. Subject with greater facial height may present wider zone of attached gingiva at incisors. In males, gingiva may be thicker and of a wider band of attached tissues.\u003c/p\u003e","manuscriptTitle":"Linking facial typology to dental morphology and gingival characteristics: A cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-27 12:00:12","doi":"10.21203/rs.3.rs-8691966/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-02T06:57:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-23T21:28:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-14T18:33:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"65512090072160613896991734913353588980","date":"2026-03-13T10:17:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"96350467680568486065531528098476752467","date":"2026-03-09T15:56:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110174456826330218720349531402365004855","date":"2026-03-04T17:42:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"36379596661187400198375172371836885475","date":"2026-02-26T11:45:08+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-24T11:07:58+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-30T12:30:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-29T02:33:18+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-29T02:32:34+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2026-01-25T11:00:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d254f586-b7e0-48ca-b382-339e0370ff54","owner":[],"postedDate":"February 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T16:00:54+00:00","versionOfRecord":{"articleIdentity":"rs-8691966","link":"https://doi.org/10.1186/s12903-026-08417-0","journal":{"identity":"bmc-oral-health","isVorOnly":false,"title":"BMC Oral Health"},"publishedOn":"2026-04-28 15:58:02","publishedOnDateReadable":"April 28th, 2026"},"versionCreatedAt":"2026-02-27 12:00:12","video":"","vorDoi":"10.1186/s12903-026-08417-0","vorDoiUrl":"https://doi.org/10.1186/s12903-026-08417-0","workflowStages":[]},"version":"v1","identity":"rs-8691966","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8691966","identity":"rs-8691966","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}