EVALUATION OF COINCIDENCE OF GINGIVAL ZENITH AND VERTICALLY BISECTED MIDLINE IN ANTERIOR TEETH: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.37762/jgmds.13-1.793Keywords:
Gingival Zenith, Vertically Bisected Midline,, Apico-Coronal Displacement.Abstract
ABSTRACT
OBJECTIVES
This study aimed to evaluate the coincidence and displacement of the gingival zenith in relation to the VBM of maxillary anterior teeth and to examine possible gender differences.
METHODOLOGY
A cross-sectional study was conducted with a non-probability consecutive sampling technique on 100 patients aged 18-30 at the outpatient department of Rehman College of Dentistry. Maxillary impressions were taken and poured in type IV dental stone. A digital caliper measured the gingival zenith and VBM on the casts, along with a pico-coronal displacement of lateral incisors. Data were analyzed using SPSS v22 with appropriate statistical tests (Shapiro-Wilk, t-test/Mann-Whitney U, chi-square), with significance set at p < 0.05.
RESULTS
With mean shifts of 0.70-0.84 mm and no significant gender differences (parametric effect size d = 0.25-0.35; 95% CI; p>0.05), gingival zenith displacement was more prevalent in central incisors (>90%). Minor nonparametric effects were observed in canines and lateral incisors (r < 0.081), with canines most aligned with VBM.
CONCLUSION
Displacement of the gingival zenith is common in maxillary anterior teeth, particularly in central incisors, while canines show the greatest likelihood of coincidence with the VBM. Gender did not influence gingival zenith position. Careful assessment of zenith position is recommended when planning esthetic dental treatments.
Downloads
Metrics
References
REFERENCES
Pham TAV, Nguyen PA. Morphological features of smile attractiveness and related factors influence perception and gingival aesthetic parameters. Int Dent J. 2022 Feb;72(1):67–75. https://doi.org/10.1016/j.identj.2021.08.010. PMID: 34695339 DOI: https://doi.org/10.1016/j.identj.2021.02.001
Koidou VP, Rosenstiel SF, Rashid RG. Celebrity smile esthetics assessment: Smile angulation. J Prosthet Dent. 2017 May;117(5):636–41. https://doi.org/10.1016/j.prosdent.2016.08.014. PMID: 27727040 DOI: https://doi.org/10.1016/j.prosdent.2016.08.008
Patil AS, Ranganath V, Yerawadekar SA, Kumar CN, Sarode GS. Pink esthetics: A study on significant gingival parameters. J Contemp Dent Pract. 2020 Feb 1;21(2):207–10. https://doi.org/10.5005/jp-journals-10024-2753. PMID: 32381829 DOI: https://doi.org/10.5005/jp-journals-10024-2739
Bamusa B, Amal A, Al-Alsheikh M, Alanood A, Altasan Y, Alkhaibari H, et al. Assessment of the gingival zenith positions and levels of the maxillary anterior teeth among the Saudi population: Comparison between males and females. Egypt Dent J. 2018 Jul;64(3):2113–9. https://doi.org/10.21608/edj.2018.77135 DOI: https://doi.org/10.21608/edj.2018.76769
Frizzera F, Tonetto M, Cabral G, Shibli JA, Marcantonio E. Periodontics, implantology, and prosthodontics integrated: The zenith-driven rehabilitation. Case Rep Dent. 2017;2017:1–8. https://doi.org/10.1155/2017/4897360. PMID: 28409130 DOI: https://doi.org/10.1155/2017/1070292
Ganji KK, Alam MK, Alanazi AF, Aldahali M. Facial profile-based evaluation of gingival zenith position in maxillary central incisors among Saudi, Indian, and Bangladeshi populations. Saudi Dent J. 2018 Oct;30(4):342–7. https://doi.org/10.1016/j.sdentj.2018.06.006. PMID: 30319248 DOI: https://doi.org/10.1016/j.sdentj.2018.05.008
Rajaraman V, Abraham A, Dhanraj M, Jain AR. Symmetry of gingival zenith: Defining esthetic outcome. Drug Invent Today. 2018;10(5):865–8. Available from: https://www.ditonline.info/index.php/dit/article/view/123456
Negi A, Amita. Interdisciplinary management of congenitally missing maxillary lateral incisors. J Oral Biol Craniofac Res. 2020 Apr;10(2):184–8. https://doi.org/10.1016/j.jobcr.2019.12.001. PMID: 31890513 DOI: https://doi.org/10.1016/j.jobcr.2020.04.001
Covey DA. Bonded porcelain restorations in the anterior dentition: A biomimetic approach. J Prosthodont. 2003 Sep;12(3):233–4. https://doi.org/10.1016/S1059-941X(03)00018-7. PMID: 14678481 DOI: https://doi.org/10.1016/S1059-941X(03)00133-5
Mattos CML, Santana RB. A quantitative evaluation of the spatial displacement of the gingival zenith in the maxillary anterior dentition. J Periodontol. 2008 Oct;79(10):1880–5. https://doi.org/10.1902/jop.2008.070668. PMID: 18834245
Žagar M, Knezović Zlatarić D, Carek V. A quantitative evaluation of the distal displacement of the gingival zenith in the maxillary anterior teeth. Coll Antropol. 2010 Mar;34(1):225–8. PMID: 20432788
Martins FV, de Santana CM, Magno MB, Maia LC, Fonseca EM, de Santana RB. Gingival zenith level, position, and symmetry: A systematic review and meta-analysis. J Prosthet Dent. 2024 May 3. https://doi.org/10.1016/j.prosdent.2024.03.012 DOI: https://doi.org/10.1016/j.prosdent.2024.03.012
Mattos CML, Santana RB. A quantitative evaluation of the spatial displacement of the gingival zenith in the maxillary anterior dentition. J Periodontol. 2008 Oct;79(10):1880–5. https://doi.org/10.1902/jop.2008.070668. PMID: 18834245 DOI: https://doi.org/10.1902/jop.2008.080053
Appukuttan D, Cholan P, Ashwini C, Swapna S. Assessment of gingival zenith position and distance from vertical bisecting midline in the maxillary anterior dentition – An observational study. J Orofac Sci. 2018;10(1):14–8. https://doi.org/10.4103/jofs.jofs_90_17 DOI: https://doi.org/10.4103/jofs.jofs_32_17
Chu SJ, Tan JH, Stappert CFJ, Tarnow DP. Gingival zenith positions and levels of the maxillary anterior dentition. J Esthet Restor Dent. 2009 Apr;21(2):113–20. https://doi.org/10.1111/j.1708-8240.2009.00242.x. PMID: 19368601 DOI: https://doi.org/10.1111/j.1708-8240.2009.00242.x
Shagufta NS, Agrawal A, Tamuk M. Comparative evaluation of gingival zenith deviation from the vertical bisected midline and apicocoronal displacement of the zenith of lateral incisor from gingival zenith level: A cross-sectional study. Int J Prosthodont Restor Dent. 2021 Sep 30;11(2):88–92. https://doi.org/10.5005/jp-journals-10019-1329 DOI: https://doi.org/10.5005/jp-journals-10019-1317
Gaddale R, Aspalli S, Abraham S, Krishna SGS, Mahapatra P, Monisha V. A trichotomous relation between papilla proportion, gingival zenith, and facial profile. Int J Prosthodont Restor Dent. 2022 Apr 4;11(4):173–7. https://doi.org/10.5005/jp-journals-10019-1456 DOI: https://doi.org/10.5005/jp-journals-10019-1343
Shahiryar A, Anees R, Chaudhary MAG, Shafique S, Anwar P. Gingival zenith variations in maxillary anterior teeth across age and gender in the Pakistani population. Pak J Med Dent. 2025 Apr;14(2):342–52. https://doi.org/10.36283/ziun-pjmd14-2/052 DOI: https://doi.org/10.36283/ziun-pjmd14-2/052
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Dr Sharafat Abdullah, Shafqat Hussain, Dr Sana Gul, Sajid Ali, Sana Murtaza, Izazullah
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
