Background: 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 three anterior teeth in each of 50 patients was measured by transgingival sounding and classified by three different methods by eight examiners. Specifically, the diagnostic potential of visual judgment 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 to 2.37 mm. Using CPP resulted in a medium judgment in 87% of the cases, on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1 mm 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, 88% of the cases being ≤ 1 mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 64% of the cases being ≤ 1 mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), whereas visual judgment 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 judgment. It seems that CPP cannot distinctly discriminate between "thick" and "very thick" cases and fails to capture the thin high-risk cases.

Background : The majority of patients receiving a prosthetic restoration, especially in the upper anterior, require not only a functional but also a highly aesthetic outcome. Gingival thickness (GT) is one of the important parameters affecting the outcome of various procedures around natural teeth and dental implants; e.g., a thin compared to a thick gingiva is associated with an increased risk for an inferior aesthetic outcome after immediate implant placement. Aim/Hypothesis : To evaluate the potential of a new probe system (Colorvue biotype probe; CBP) to assess GT. Materials and Methods : Eight examiners judged gingival thickness in 3 teeth (central and lateral incisor, canine) in each of 50 patients, using standardized photographs. The diagnostic potential of visual judgement, standard periodontal probe (SPP) transparency, and CBP transparency was calculated, based on GT measurement with transgingival sounding. Results : Considering GT = 1 mm as cutoff value, NOe of the assessment methods showed high sensitivity to correctly identify all cases with GT ≤ 1 mm; in contrast, cases with a GT > 1 mm were classified correctly with high specificity. Considering GT = 1.5 mm as cutoff value, all assessment methods showed high sensitivity in correctly identifying all cases with GT ≤ 1.5 mm; in contrast, cases with GT > 1.5 mm were classified often incorrectly (low specificity). When using the CBP transparency to judge GT most of the cases were considered as "medium" (i.e., 65.3 to 96%) and only 1-10 cases per examiner were judged as either "thick" or "very thick". The highest-still only moderate-agreement (kappa = 0.427) among all 8 examiners was achieved when using SPP, while visual judgement showed fair agreement (kappa = 0.211) and CBP showed slight agreement (kappa = 0.112). Conclusions and Clinical Implications : Assessing GT using CBP transparency appears less precise/accurate and achieves a lower inter-rater agreement compared with the use of SPP and a subclassification into thin/medium/thick/very thick cases was not reliable. Specifically, there was insufficient sensitivity and specificity to identify the thin high-risk cases, and at the same time a discrimination between "thick" and "very thick" gingiva was not possible.