Contemporary Concepts of Gingival Biotype and Its Assessment Methods

This paper reviews modern literature on gingival anatomy and biotype assessment methods, with the goal of analyzing and systematizing the data. A literature search was performed in PubMed and Elibrary. ru (2005–2025) with the keywords: “gingival biotype”, “periodontal diseases” and “gingival biotype evaluation techniques”. From an initial pool of 258 sources, 90 original studies met the inclusion criteria and were selected for analysis. The gingiva is one of the most important structures of the periodontium, providing trophic, barrier, supportive, stabilizing, shock-absorbing, and sensory functions. As the only visible part of the periodontium that is readily accessible for examination, the gingiva’s morphofunctional status can serve as an indicator of the condition of other periodontal tissues. Gingival thickness is a key criterion of its biotype and significantly influences treatment outcomes for periodontal pathology and dental implantation. The gingiva is classified into two main biotypes (thick and thin), with some studies identifying an intermediate category. Each biotype exhibits distinct inflammatory responses and susceptibility to harmful agents and traumatic injuries. A thick gingival biotype demonstrates considerable keratinized tissue thickness (1,5–2 mm) with squat, wide papillae and subtle curvature of the gingival margin. Conversely, thin biotypes exhibit about 1 mm keratinized tissue, highly scalloped margins, slender tooth crowns, and tall, narrow papillae. The reported prevalence of gingival biotypes varies considerably across studies. The morphological characteristics of gingival tissue are critical for predicting outcomes in periodontal therapy and orthodontic treatment. Different gingival biotypes exhibit distinct responses to inflammation, exposure to aggressive agents, and mechanical trauma. Numerous assessment methods exist for evaluating gingival biotype, including direct measurement, transgingival probing, ultrasonography, periodontal probe transparency technique, cone-beam computed tomography, intraoral and extraoral ultrasonography, and intraoral digital scanning.

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