References

Cohen DW.Washington DC, USA: Walter Reed Army Medical Center; 1962
Gargiulo AW, Wentz FM, Orban B Dimensions and relations of the dentogingival junction in humans. J Periodontol. 1961; 32:261-267 https://doi.org/10.1902/jop.1961.32.3.261
Vacek JS, Gher ME, Assad DA The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent. 1994; 14:154-165
Makigusa K. Histologic comparison of biologic width around teeth versus implant: the effect on bone preservation. J Implant Reconstr Dent. 2009; 1:20-24
Jepsen S. New classification of periodontal and peri-implant diseases and conditions. Guidance for Clinicians.: European Federation of Periodontology. Today; 2019
Padbury A, Eber R, Wang HL. Interactions between the gingiva and the margin of restorations. J Clin Periodontol. 2003; 30:379-385 https://doi.org/10.1034/j.1600-051x.2003.01277.x
Eaton KA, Ower P. Practical Periodontics E-Book. Elsevier Health Sciences. 2015; 179
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; 13:654-657 https://doi.org/10.1111/j.1600-051x.1986.tb00861.x
Jorgic-Srdjak K, Plancak D, Maricevic T Periodontal and prosthetic aspect of biological width part I: violation of biologic width. Acta Stomatol Croat. 2000; 34:195-197
Nevins M, Skurow HM. The intracrevicular restorative margin, the biologic width, and the maintenance of the gingival margin. Int J Periodontics Restorative Dent. 1984; 4:30-49
Wagenberg BD, Eskow RN, Langer B. Exposing adequate tooth structure for restorative dentistry. Int J Periodontics Restorative Dent. 1989; 9:322-331
Misch CE, Perel ML, Wang HL Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent. 2008; 17:5-15 https://doi.org/10.1097/ID.0b013e3181676059
Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited. J Clin Periodontol. 1996; 23:971-973 https://doi.org/10.1111/j.1600-051x.1996.tb00520.x
Misch CE., 2nd edn. : Elsevier; 2015
Hermann JS, Buser D, Schenk RK Biologic width around titanium implants. A physiologically formed and stable dimension over time. Clin Oral Implants Res. 2000; 11:1-11 https://doi.org/10.1034/j.1600-0501.2000.011001001.x
Jepsen S, Caton JG, Albandar JM Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018; 45:S219-S229 https://doi.org/10.1111/jcpe.12951

Supracrestal tissue attachment: an update

From Volume 50, Issue 1, January 2023 | Pages 54-57

Authors

Jaini Shah

Foundation Dentist, Poynters Road Dental Practice, Dunstable

Articles by Jaini Shah

Ewen McColl

BSc(Hons), BDS, MFDS, FDS RCPS, MCGDent, MRD RCS Ed, MClinDent, FDS RCS(Rest Dent), FHEA, FDTF(Ed), , BSc (Hons), FCGDent, FDTFEd, FFD RCSI

Director of Clinical Dentistry; Peninsula Dental School, University of Plymouth

Articles by Ewen McColl

Email Ewen McColl

Michael Daldry

Foundation Dentist, Dental Centre, Bournemouth

Articles by Michael Daldry

Email Michael Daldry

Serena Bhagi

Dental Foundation Trainee, Oraco Dental

Articles by Serena Bhagi

Rob Witton

Director of Community-based Dentistry, Peninsula Dental School, University of Plymouth

Articles by Rob Witton

Abstract

Supracrestal tissue attachment (STA) is a relatively new term that was introduced in 2017 following the World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions, co-sponsored by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP), which included expert participants from all over the world. It has replaced the term biological width, and refers to the junctional epithelium and supracrestal connective tissue. This article provides an updated review of the anatomy of STA, highlights the negative effects of violation and discusses its clinical relevance in restorative dentistry, including the use of crown lengthening. The impact of implants on STA is highlighted, and a summary of the relevance of STA in implant dentistry is also discussed.

CPD/Clinical Relevance: To allow dental practitioners to have more confidence providing adequate function, comfort, and aesthetics in the dentition, while maintaining periodontal health.

Article

In 1962, Cohen introduced the term ‘biological width’, which describes the biological attachment of the soft tissues to the root of the tooth and comprises the junctional epithelium and connective tissue attachment, and this being equivalent to the distance between the base of the gingival sulcus and the alveolar bone crest.1 This term was coined following the work by Gargiulo et al in 1961, in which the width is referred to as the dentogingival junction.2 The dentogingival junction can be divided into two components: the connective tissue attachment and the epithelial attachment.

The term ‘biological width’ was updated in 2017 at the World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions, to ‘supracrestal tissue attachment’ (STA), referring to the junctional epithelium and supracrestal connective tissue. The workshop was co-sponsored by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) and included expert participants from all over the world. This article focuses on the clinical relevance of understanding the STA, particularly in the periodontal and restorative interface of dentistry.

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