Evaluation of the accuracy of soft tissue thickness measurements with three different methodologies: An in vitro study
Affiliations
Affiliations
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
- AlAmiri Dental Center, Kuwait City, Kuwait.
- Department of Oral Pathology, Medicine, and Radiology, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
Abstract
Background: Soft tissue thickness (STT) influences esthetics, peri-implant, and periodontal health. Non-invasive methods of STT evaluation include cone-beam computed tomography (CBCT) with Digital Imaging and Communications in Medicine (DICOM) files and registration of DICOM files with an intraoral scan or Standard Tessellation Language (STL) files. This study compares three methodologies: bone sounding, DICOM data alone, and DICOM and STL registration to absolute histomorphologic values.
Methods: Five human maxillas, including teeth numbers 6 to 11, provided 90 sites for analysis. For standardization, reference grooves were placed at the cervical margin and the long axis of each tooth. Direct measurements with a no. 25 K-file were completed at the facial soft tissues at 3.00, 5.00, and 7.00 mm from the apical marginal reference. Indirect measures were performed with implant planning software. Histological measurements were rendered with imaging software. One-way analysis of variance (ANOVA) was used to compare the three techniques for the differences from histologic measurements (α = 0.05).
Results: Seventy-two sites were included for final analysis. The overall mean histological STT (mSTT) was 0.73 ± 0.31 mm. Bone sounding overestimated mSTT, 0.22 ± 0.20 mm (P < 0.001); whereas, DICOM alone underestimated mSTT, -0.23 ± 0.19 mm (P < 0.001). DICOM and STL registration had non-statistically significant differences, -0.04 ± 0.21 mm (P = 0.429). Intraclass correlation coefficient (ICC) of DICOM and STL registration achieved the highest agreement with histology (ICC: 0.74).
Conclusions: DICOM and STL file registration had the highest agreement with histological STT supporting the use of DICOM and STL registration for the evaluation of STT.
Keywords: histology; imaging; periodontal phenotype; phenotype; radiology.
Similar articles
Jamjoom FZ, Kim DG, McGlumphy EA, Lee DJ, Yilmaz B.J Prosthet Dent. 2018 Sep;120(3):367-374. doi: 10.1016/j.prosdent.2017.11.019. Epub 2018 Apr 25.PMID: 29703673
Jamjoom FZ, Yilmaz B, Johnston WM.Clin Oral Implants Res. 2019 Aug;30(8):826-832. doi: 10.1111/clr.13490. Epub 2019 Jun 14.PMID: 31161678
Lee CY, Ganz SD, Wong N, Suzuki JB.Implant Dent. 2012 Aug;21(4):265-71. doi: 10.1097/ID.0b013e31825e5739.PMID: 22814549
Jamjoom FZ, Kim DG, Lee DJ, McGlumphy EA, Yilmaz B.Clin Implant Dent Relat Res. 2018 Jun;20(3):300-307. doi: 10.1111/cid.12582. Epub 2018 Feb 5.PMID: 29399999
Rungrojwittayakul O, Kan JY, Shiozaki K, Swamidass RS, Goodacre BJ, Goodacre CJ, Lozada JL.J Prosthodont. 2020 Feb;29(2):124-128. doi: 10.1111/jopr.13107. Epub 2019 Sep 9.PMID: 31498957 Review.
Cited by
Rodrigues DM, Chambrone L, Montez C, Luz DP, Barboza EP.Clin Oral Investig. 2023 Apr;27(4):1363-1389. doi: 10.1007/s00784-023-04898-3. Epub 2023 Feb 14.PMID: 36786957
KMEL References
References
-
- Lee A, Fu JH, Wang HL. Soft tissue biotype affects implant success. Implant Dent 2011;20:e38-e47.
-
- Thoma DS, Muhlemann S, Jung RE. Critical soft-tissue dimensions with dental implants and treatment concepts. Periodontol 2000 2014;66:106-118.
-
- Goncalves Motta SH, Ferreira Camacho MP, Quintela DC, Santana RB. Relationship between clinical and histologic periodontal biotypes in humans. Int J Periodontics Restorative Dent 2017;37:737-741.
-
- Alves PHM, Alves T, Pegoraro TA, Costa YM, Bonfante EA, de Almeida A. Measurement properties of gingival biotype evaluation methods. Clin Implant Dent Relat Res 2018;20:280-284.
-
- Aguilar-Duran L, Mir-Mari J, Figueiredo R, Valmaseda-Castellon E. Is measurement of the gingival biotype reliable? Agreement among different assessment methods. Med Oral Patol Oral Cir Bucal 2020;25:e144-e149.
-
- Kan JY, Morimoto T, Rungcharassaeng K, Roe P, Smith DH. Gingival biotype assessment in the esthetic zone: visual versus direct measurement. Int J Periodontics Restorative Dent 2010;30:237-243.
-
- Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res 2008;19:73-80.
-
- Avila-Ortiz G, Gonzalez-Martin O, Couso-Queiruga E, Wang HL. The peri-implant phenotype. J Periodontol 2020;91:283-288.
-
- Thoma DS, Naenni N, Figuero E, et al. Effects of soft tissue augmentation procedures on peri-implant health or disease: a systematic review and meta-analysis. Clin Oral Implants Res 2018;29(Suppl 15):32-49.
-
- Linkevicius T, Apse P, Grybauskas S, Puisys A. The influence of soft tissue thickness on crestal bone changes around implants: a 1-year prospective controlled clinical trial. Int J Oral Maxillofac Implants 2009;24:712-719.
-
- Baldi C, Pini-Prato G, Pagliaro U, et al. Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series. J Periodontol 1999;70:1077-1084.
-
- Huang LH, Neiva RE, Wang HL. Factors affecting the outcomes of coronally advanced flap root coverage procedure. J Periodontol 2005;76:1729-1734.
-
- Tzoumpas M, Mohr B, Kurtulus-Waschulewski I, Wahl G. The use of high-frequency ultrasound in the measurement of thickness of the maxillary attached gingiva. Int J Prosthodont 2015;28:374-382.
-
- Kloukos D, Koukos G, Doulis I, Sculean A, Stavropoulos A, Katsaros C. Gingival thickness assessment at the mandibular incisors with four methods: a Cross-Sectional Study. J Periodontol 2018;89:1300-1309.
-
- Amid R, Mirakhori M, Safi Y, Kadkhodazadeh M, Namdari M. Assessment of gingival biotype and facial hard/soft tissue dimensions in the maxillary anterior teeth region using cone beam computed tomography. Arch Oral Biol 2017;79:1-6.
-
- Slak B, Daabous A, Bednarz W, Strumban E, Maev RG. Assessment of gingival thickness using an ultrasonic dental system prototype: a comparison to traditional methods. Ann Anat 2015;199:98-103.
-
- Borges GJ, Ruiz LF, de Alencar AH, Porto OC, Estrela C. Cone-beam computed tomography as a diagnostic method for determination of gingival thickness and distance between gingival margin and bone crest. Sci World J 2015;2015:142108.
-
- Pietruska M, Skurska A, Podlewski L, Milewski R, Pietruski J. Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: a Randomized Clinical Study. J Clin Periodontol 2019;46:86-95.
-
- Fons-Badal C, Alonso Perez-Barquero J, Martinez-Martinez N, Faus-Lopez J, Fons-Font A, Agustin-Panadero R. A novel, fully digital approach to quantifying volume gain after soft tissue graft surgery. A Pilot Study. J Clin Periodontol 2020;47:614-620.
-
- Lentine FN. A study of torsional and angular deflection of endodontic files and reamers. J Endod 1979;5:181-191.
-
- Couso-Queiruga E, Tattan M, Ahmad U, Barwacz C, Gonzalez-Martin O, Avila-Ortiz G. Assessment of gingival thickness using digital file superimposition versus direct clinical measurements. Clin Oral Investig 2021;25:2353-2361.
-
- Tattan M, Sinjab K, Lee E, et al. Ultrasonography for chairside evaluation of periodontal structures: a Pilot Study. J Periodontol 2020;91:890-899.
-
- Gurlek O, Sonmez S, Guneri P, Nizam N. A novel soft tissue thickness measuring method using cone beam computed tomography. J Esthet Restor Dent 2018;30:516-522.
-
- Sanz-Martin I, Permuy M, Vignoletti F, Nunez J, Munoz F, Sanz M. A novel methodological approach using superimposed Micro-CT and STL images to analyze hard and soft tissue volume in immediate and delayed implants with different cervical designs. Clin Oral Implants Res 2018;29:986-995.