The topography of papillary gingiva in health and early gingivitis

Using stereo-images, topographical features within the maxillary papillary gingiva between the lateral and central incisors were investigated in 36 healthy young adults. The features studied were surface stippling, presence of a gingival groove, papillary length and papillary area. The prevalence of stippling was found to be 95%. The intensity of stippling varied considerably between individuals, the mean being 2.6 depressions/mm2. A gingival groove only occurred in 19% of the cases examined. The maximum length of the papilla from the base to its most incisal tip was measured in relation to the length of the crown of the lateral incisor. This ratio was found to be close to 0.5, indicating a healthy papilla reaching about halfway to the incisal edge. The surface area of the papilla was measured in relation to the labial surface area of the lateral incisor. This ratio was close to 0.25, indicating that the papillary surface under healthy conditions amounts to about 1/4 of the labial surface of the lateral incisor crown. Changes resulting from 20 days of plaque accumulation were also investigated. A mean GI of 0.8 was recorded at the end of the experimental period; however, no measurable changes in stippling intensity or papillary shape could be established. These findings suggest that the early stages of gingivitis are characterized mainly by changes in gingival colour, while changes in surface texture and shape are secondary characteristics of clinical inflammation.