Optical coherence tomography and biometric ultrasound for gingival phenotype and epithelial thickness assessment: A cross-sectional pilot study

BACKGROUND: Digital medical imaging is the basis for effective medical diagnostics and is currently part of a dynamically developing field of science. Optical coherence tomography (OCT) allows for in situ imaging of tissues in real time, without the need to perform biopsies, histological procedures, or X-rays. Pirop® Echo-son device measures the tissue ultrasonographically. OBJECTIVES: The aim of this cross-sectional pilot study was to propose a new method of gingival tissue analysis by evaluating the possibility of using OCT and echo-son jointly in periodontal diagnostics and clinical practice for assessing the horizontal mucosal thickness of healthy gingiva in adult patients. MATERIAL AND METHODS: Thirteen patients were examined using a biometric ultrasound scanner and 3D-OCT camera. The obtained results were compared and analyzed. Comparisons between age groups or sex were made with Kruskal-Wallis analysis of variance (ANOVA) and Mann-Whitney U tests, respectively. A correlation analysis was performed between Pirop® and OCT parameters, also divided into age groups and sex. RESULTS: The mean gingival thickness (GT) was 1.31 mm and the mean epithelial thickness was 0.33 mm. There was no statistically significant correlation between epithelial thickness and total GT. The thickness of the gingiva and epithelium did not depend on age or sex. Due to the limited sample size, this pilot study provides exploratory, descriptive findings that warrant confirmation in a larger, adequately powered study. No comparison reached statistical significance (all p > 0.05); effect sizes varied in magnitude and were imprecise. CONCLUSIONS: Optical coherence tomography imaging may complement ultrasonographic measurement of total GT by providing information on epithelial thickness. The combined approach warrants validation as a potential aid for donor-site assessment and periodontal surgery planning.