A Cross-Sectional Observational Study of Gingival Color Patterns in the South Indian Population

TL;DR

This study examines differences in gingival color in the South Indian population to improve dental aesthetics using digital color analysis.

Contribution

The study introduces a digital method to assess gingival color variation and suggests a need for a dual shade guide system.

Findings

Significant color differences were found between two gingival regions using CIELAB color coordinates.

The a* coordinate showed a notable shift towards a lighter shade of redness in the selected regions.

Color differences exceeded the clinical acceptance threshold, suggesting a need for improved shade guides.

Abstract

Background: Gingival aesthetics or pink aesthetics requires a prosthodontic approach to ensure an appealing smile with an optimal muco-gingival appearance by the use of colored materials with gingival shades to match adjacent soft tissues. However, the selection of this adhesive gingival-colored material becomes complex owing to the wide range of gingival color guides and shade tabs currently available on the market.

Aim: The study aims to assess the variation in gingival color between two specific regions on the anterior gingival surface through the use of a digital color assessment method. Furthermore, the study seeks to investigate the potential requirements for an innovative soft tissue dual shade guide system.

Methodology: Fifteen participants were examined with an external light source set up in a 45-degree optical configuration. The Frontal view intraoral photographs were taken with a digital Canon 70D camera using a cheek retractor. The photo was white balanced using the color sorter tool in the software (Adobe Photoshop CS6®), and the second quadrant was cropped, two regions were selected (free gingival margin and marginal gingiva) and used for all samples for standardization. The color data were represented in terms of L*, a*, and b* coordinate axes values following the CIELAB color system. The recorded color coordinates were then examined using SPSS software, version 24 (IBM Corp., Armonk, NY).

Results: The mean and standard deviation of the coordinate axes were as follows: for L1, 52.33 ± 12.92; for a1, 30.06 ± 4.81; for b1, 18.00 ± 3.89; for L2, 44.53 ± 11.01; for a2, 36.13 ± 7.92; and for b2, 18.26 ± 6.70. Statistically significant differences were found between the L*, a*, and b* color coordinates with a color difference (ΔE) beyond the clinical acceptance (ΔE > 3.7) threshold of ΔE = 4.88, mainly for a* values.

Conclusions: Within the limitations of this study, significant color differences were observed between the selected regions. The a* coordinate was found to be statistically significant (+6.07), indicating a shift towards a lighter shade of redness (+a) in the color-opponent dimensions of redness-greenness within the CIELAB color space system.

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