Traditionally gingival biotype can be assessed, as dichotomous score, clinically, by periodontal probe transparency, and visually. A new device, consisting of 3 colored tip probes (white/green/blue) allows the clinician to distinguish gingival biotype on a 4-point scale on the base of color transparency (thin/medium/thick/very thick). This study aims to evaluate the clinical reliability of the new device and to compare its accuracy and reproducibility with those of visual assessment and probing, and the intra- and inter-operators’ agreement for all the techniques.
Method:
153 systemically healthy non-dental-related students (≥18 years) were included. At baseline and after 42days three clinical parameters were recorded on the 6 upper front teeth: Visual Gingival BioType (VGBT) and Gingival Transparency Score (GTS) as thin/thick. The new device, 3 colored tip probes, was used for assessing Gingival BioType Probe score (GBTP) on a 0-3 scale. VGBT and GBTP were scored by two independent examiners while another one scored GTS. The following analysis were performed: Cohen's Kappa coefficient of agreement for intra- and inter- operator comparison for VGBT, and between VGBT and GTS; Bland-Altman’s plots for comparing GBTP (intra- and inter-); estimating of AUROC for comparing GBTP and GTS.
Result:
VGBT showed limited agreement between and within operators (Kmax=0.49; 0.39) and with GTS (Kmax=0.41). GTS had a good intra-operator agreement (Kmax=0.60). GBTP showed a good agreement between operators and a fair intra-operator agreement. GBTP showed a generally fair/good agreement with GTS (min/max AUROC 0.63/0.86 and 0.52/0.76 for the two operators respectively).
Conclusion:
Confirming previous studies, VGBT proved to be not sufficiently reliable and reproducible. GBTP and GTS were sufficiently reliable and reproducible. The GBTP probe and the 4-point classification could provide to the clinician more detailed information on the gingival biotype. The clinical relevance needs further investigation.