Comparison of Different Methods Used in the Classification of Maxillary Gingival Phenotype: A Diagnostic Accuracy Study

Abstract

Aims: This study aimed to evaluate the reliability and applicability of novel methods for determining gingival phenotypes and compare them with currently recommended methods. Methods: Six maxillary anterior teeth from 50 systemically and periodontally healthy patients were evaluated using two conventional methods (periodontal probe translucency method [PP] and transgingival measurement with an endodontic file [EF]), and two novel methods (colored biotype probe translucency method [CBP] and transgingival measurement with a Florida probe [FP]). All data were statistically analyzed. Intra-examiner reproducibility and inter-examiner reproducibility for all methods were analyzed using 10 randomly selected patients who were re-evaluated for each analysis. Results: Moderate agreement was found between EF and PP, with statistically significant differences between median gingival thickness (GT) values for thick 0.8 mm (0.5-1.1 mm) and thin 1 mm (0.6-1.7 mm) phenotypes, and a threshold GT value of <= 0.92 mm (p < .001). FP and PP also showed moderate agreement, with statistically significant differences between median GT values for thick and thin phenotypes (0.80 mm [0.40-1.60 mm] and 0.89 mm [0.40-1.60 mm], respectively), and a threshold GT value of <= 0.8 mm (p < .001). PP and CBP values showed a substantial agreement (p < .001). A statistically significant difference was found between median EF values and CBP categories (p < .001); however, paired comparisons showed that the distinction was applicable only between thin and other phenotypes. Conclusion: Although CBP was found to be successful in detecting the thin phenotype, it was not successful in distinguishing between medium, thick, and very thick phenotypes; moreover, it did not appear to offer any advantages over PP. Although FP may be preferable to EF in measuring gingival thickness, the cost of FP is a disadvantage.