THE BIOLOGIC WIDTH

- a Concept in Periodontics and Restorative Dentistry

Introduction
For restoration to survive long term the periodontium must

remain healthy so that teeth are maintained. For the periodontium to remain healthy restoration must be critically maintainedin several area so that they are in harmony with their surrounding periodontal tissue. To maintain and enhance the patients esthetic appearance the tooth-tissue interface must present a healthy natural appearance with gingival tissue framing a restored teeth in a harmonious manner. Defective dental restorationsand anatomical aberration of the teeth often favour plaque accumulation leading to gingival inflammation.

BIOLOGIC WIDTH
The dimension of space that the healthy gingival tissue occupy

above the alveolar bone is identified as Biologic Width.

An average length of 1.07mm of connective tissue attachment

and 0.97mm of epithelial attachment

So on an average biologic width measures 2.04mm.

 Invasion of this space result in inflammation

and crestal resorption of alveolar bone. Invasion of biologic width should be avoided during restoration, in order to prevent attachment loss and persist gingival inflammation The more common finding with subgingival margin placement is that the

Evaluation of Biologic Width

Radiographic interpretation can identify interproximal

violation of biologic width. If patient is having discomfort when restorative margins level are being assessed with a periodontal probe it is a good indicaton that the margin extends into the attachment and that a biologic width violation has occurred. More positive assessment can be made clinically by measuring the distance between the bone and margin. The probe is pushed through the anesthetized attachment tissue from the sulcus to the underlying bones. If the distance is less than 2mm at one or more location, a diagnosis of biologic width violation can be confirmed.

 Assassment is completed circumferentially around

the tooth. The biological or attachment, width can be identified for each individual patient by probing under anesthesia to the bone level and substracting the sulcus depth from the resulting measurement. This measurement must be performed on teeth with healthy gingiva tissue and should be repeated more than one tooth for accurate measurement. The information obtained is then used for definitive diagnosis of biologic width.