A noninvasive imaging and measurement using optical coherence tomography angiography for the assessment of gingiva: An in vivo study

Abstract

Gingiva is the soft tissue that surrounds and protects the teeth. Healthy gingiva provides an effective barrier to periodontal insults to deeper tissue, thus is an important indicator to a patient's periodontal health. Current methods in assessing gingival tissue health, including visual observation and physical examination with probing on the gingiva, are qualitative and subjective. They may become cumbersome when more complex cases are involved, such as variations in gingival biotypes where feature and thickness of the gingiva are considered. A noninvasive imaging technique providing depth-resolved structural and vascular information is necessary for an improved assessment of gingival tissue and more accurate diagnosis of periodontal status. We propose a three-dimensional (3D) imaging technique, optical coherence tomography (OCT), to perform in situ imaging on human gingiva. Ten volunteers (five male, five female, age 25-35) were recruited; and the labial gingival tissues of upper incisors were scanned using the combined use of state-of-the-art swept-source OCT and OCT angiography (OCTA). Information was collected describing the 3D tissue microstructure and capillary vasculature of the gingiva within a penetration depth of up to 2 mm. Results indicate significant structural and vascular differences between the two extreme gingival biotypes (ie, thick and thin gingiva), and demonstrate special features of vascular arrangement and characteristics in gingival inflammation. Within the limit of this study, the OCT/OCTA technique is feasible in quantifying different attributes of gingival biotypes and the severity of gingival inflammation.

Handheld optical coherence tomography for clinical assessment of dental plaque and gingiva

“…There have been several studies that have investigated OCT for the assessment of gingiva and periodontal structures in vivo. 23,24,36,39 For example, Fernandes et al 23 used a commercial OCT system to measure the gingival sulcus in vivo and compared image data with the traditional methods for healthy individuals. More recently, Le et al 24,40 utilized swept-source OCT and OCT angiography to assess human gingiva and showed different vascular arrangements and features in gingival inflammation.…”

“…23,24,36,39 For example, Fernandes et al 23 used a commercial OCT system to measure the gingival sulcus in vivo and compared image data with the traditional methods for healthy individuals. More recently, Le et al 24,40 utilized swept-source OCT and OCT angiography to assess human gingiva and showed different vascular arrangements and features in gingival inflammation. Although these studies show the potential of OCT for detecting microstructures in gingiva, most studies were performed in laboratory settings with bulky imaging systems and mounted optics or probes, limiting the accessibility to posterior teeth and the lingual sides of teeth.…”

“…[11][12][13][14] Both hard tissues and soft tissues have been investigated to study tooth decay, 15,16 enamel cracks, 17 restoration evaluation, 18 calculus, 19 pulp chamber, 20 oral cancers, 21,22 and periodontal diseases. 23,24 Although OCT can assess various features in the oral cavity, challenges exist for the further clinical translation of OCT technologies. Most commercial OCT systems are bulky and not designed for oral cavity imaging, making accessibility limited to largely frontal views of anterior teeth (incisors and canine).…”

Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

“…The LSCI detects blood movement in the superficial 0.3–0.7 mm of the tissue [ 64 ]. The superficial layers of the gingiva include the subepithelial capillary network and the small connective vessels just below that [ 62 , 65 ]. The superficial, extremely dense capillary mesh is rich in red blood cells.…”

Feasibility of a Video‐Mosaicking Approach to Extend the Field‐of‐View For Reflectance Confocal Microscopy in the Oral Cavity In Vivo

“…OCT and RCM are staining‐free and rely on endogenous backscatter for contrast. OCT images show structural detail in the oral cavity, epithelial and lamina propria layers, and microvasculature to a depth of 1–2 mm . RCM imaging shows cellular and morphologic detail down to relatively shallower depths of approximately 200–300 μm .…”