Aesthetic restorations are designed to create morphological and color harmony with natural teeth, gingiva, lips and face. Disciplines including Prosthodontics, Periodontology and dental technology are involved in accomplishing the treatment goals. To achieve an optimal aesthetic result, the dentist must be familiar with characteristics such as tooth shape, color and gingival aesthetic features as important elements involved in creating aesthetic smile. As gingival levels have direct impact on aesthetics, there is no doubt that establishing the correct one for each individual tooth is the key in the creation of harmonious smile those evaluation is the f irst step in oral rehabilitation. Periodontal therapy plays a great role in correcting gingival defects. It provides the opportunity to recreate a harmonious gingival architecture and correct Zenith location with reference to normal anatomy. In addition, it offers more retention for the restoration by increasing the prepared tooth surface which is beneficial for etention.

T he success of esthetic restorations depends not only on teeth arrangement but also gingival biotype. This fact makes gingival thickness a subject of considerable interest and its evaluation essential in treatment planning. Therefore, when the clinician receives a new patient with aesthetic desire, he must be aware and have knowledge not only regarding teeth but also gingiva. Identifying each gingival biotype, using reliable methods, is important because they present different healing tendencies and it has been shown that differences in gingival and osseous architecture present a significant impact on the outcome of restorative [1,2]. Clinicians face difficulty associated with the correct identification and categorizing of the patient’s gingival biotype because of several classifications that have been established. Theses classifications are depending on numerous observations and measurements, such as the height of keratinized tissue, the bucco lingual thickness and various invasive and non invasive methods are available to measure this thickness. In the same context, placing a periodontal probe in the gingival sulcus and observing the transparency seems to be the simplest method to evaluate/determine tissue thickness.

One of the critical manifestations of periodontal diseases is the sequel of mobility that results from such a clinical situation. Mobility, as extremely slowly developing phenomenon, leads to drastic consequences (especially tooth migration and occlusal trauma) that can be corrected.Depending on clinical conditions, tooth mobility can be treated by combination of several treatment modalities, such as periodontal and restorative therapeutics. T he periodontic therapy is directed toward the etiologic factors including plaque, and calculus. Root planning and subgingival debridement are performed to help to reduce inflammation, and bleeding. A few months after initial debridement, the tissue response is assessed. The periodontist will determine if the periodontal statue is stable enough to proceed with restorative treatment (splinting).

The objective of this research was to determine the relationship between periodontal disease and obesity as calculated by BMI in a retrospective population of patients at the University Of Pittsburgh School Of Dental Medicine.

Background: Obesity is a major global public health problem affecting both developed and developing societies. Obesity is an individual health condition with a societal component and any reduction in the epidemic would have worldwide public health benefits. Obesity is a complex multifactorial chronic disease arising from an interaction of genotype and the environment. Being overweight as an individual is an established predisposing risk factor for many chronic systemic conditions. Our understanding of how and why obesity develops is incomplete, but involves the integration of social, behavioral, cultural, physiological, metabolic, and genetic factors.

Materials and Methods: Data for 3058 patients regarding the relationship between BMI and periodontal condition were extracted from the electronic health record maintained by the University of Pittsburgh School of Dental Medicine. For each patient record, variables including age, gender, BMI, smoking history, diabetes condition, and periodontal condition were extracted and categorized.

Results: Logistic regression was used to control for age, sex, race, diabetes condition, and smoking condition. Patients with Body Mass Index ≥ 30 were 1.22 times more likely to develop periodontal disease. Controlling for all variables except gender and periodontal condition, male patients have a higher chance for periodontal disease than females have. (p< 0.01).

Conclusion: Findings further establish the positive correlation between periodontal disease and obesity as measured by Body Mass Index (BMI). Obese patients, BMI ≥ 30, had a greater chance of developing periodontal disease (p<0.01), with the probability increasing for male patients. The prevalence of periodontal disease in the presence of obesity likewise increased with age