TY - JOUR

T1 - Are colored periodontal probes reliable to classify the gingival phenotype in terms of gingival thickness?

AU - Bertl, Kristina

AU - Al-Hotheiry, Mehdi

AU - Sun, David

AU - Olofsson, John

AU - Lettner, Stefan

AU - Gotfredsen, Klaus

AU - Stavropoulos, Andreas

PY - 2022

Y1 - 2022

N2 - This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT). Methods Buccal GT in 3 anterior teeth in each of 50 patients was measured by transgingival sounding and classified by 3 different methods by 8 examiners. Specifically, the diagnostic potential of visual judgement and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed. Results GT ranged from 0.57-2.37mm. Using CPP resulted in a medium judgement in 87 on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥0.82) to identify thick cases, but also a high false omission rate (≥0.73) indicating that many cases classified as thin were actually thick. Further, 881mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 641mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), while visual judgement and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively. Conclusion Using CPP resulted in most of the cases in a medium judgement. It seems that CPP cannot distinctly discriminate between “thick” and “very thick” cases and fails to capture the thin high-risk cases.

AB - This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT). Methods Buccal GT in 3 anterior teeth in each of 50 patients was measured by transgingival sounding and classified by 3 different methods by 8 examiners. Specifically, the diagnostic potential of visual judgement and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed. Results GT ranged from 0.57-2.37mm. Using CPP resulted in a medium judgement in 87 on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥0.82) to identify thick cases, but also a high false omission rate (≥0.73) indicating that many cases classified as thin were actually thick. Further, 881mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 641mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), while visual judgement and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively. Conclusion Using CPP resulted in most of the cases in a medium judgement. It seems that CPP cannot distinctly discriminate between “thick” and “very thick” cases and fails to capture the thin high-risk cases.

KW - Diagnosis

KW - gingiva

KW - phenotype

KW - reproducibility of results

KW - sensitivity and specificity

U2 - 10.1002/JPER.21-0311

DO - 10.1002/JPER.21-0311

M3 - Journal article

C2 - 34309865

VL - 93

SP - 412

EP - 422

JO - Journal of Periodontology

JF - Journal of Periodontology

SN - 0022-3492

IS - 3

ER -