Digital assessment of gingival thickness changes after initial periodontal treatment: comparison of central and interdental areas in the anterior maxillary region

Abstract

To develop digital parameters for direct evaluation of gingival thickness changes (GTC) and to test their correlations with standard periodontal parameters. Ten Stage III/IV periodontitis patients were treated with conventional debridement protocol using ultrasonic scaler (PiezoLED, KaVo) and Gracey curettes (Hu-Friedy). Before recording baseline and 3-months re-evaluation probing pocket depth (PPD) and gingival recession (REC) with Williams probe (POW6, Hu-Friedy), patients underwent intraoral scanning (CEREC Omnicam AC, Dentsply Sirona). Digital assessment (GOM Inspect 2017) was made on superimposed digital models of 3-mm wide gingival margin region of maxillary incisors and canine for evaluation of GTC. The GTC was evaluated in the central region (C) and interdental buccal region (INT). For different differences in REC (diffREC) points, GTC distribution was plotted on a Box diagram. Correlations were calculated between diffPPD, diffREC and GTC for C and INT regions. The median GTC in C and INT regions was -0.24 mm (range: -0.18 mm to -0.38 mm) and -0.50 mm (range: -0.30 mm to -0.72 mm), respectively (Mann-Whitney, p < 0.001). Wider variability of GTC distribution at neutral diffREC value in INT than in C region was also apparent on color–coded superimposed models. GTC in INT region correlated with diffPPD (Spearman rho = 0.57, p < 0.0001). The proposed digital parameters revealed dimensional changes after initial periodontal treatment undetected by standard periodontal parameters. As clinically significant changes were detected in aesthetically important regions of interdental papillae, new parameters can be recommended for the evaluation of different periodontal treatment modalities.