Clinical study on natural gingival color

Abstract

The aims of the study were: to describe the gingival color surrounding the upper incisors in three sites in the keratinized gingiva, analyzing the effect of possible factors which modulate (socio-demographic and behavioral) intersubject variability; to study whether the gingiva color is the same in all three locations and to describe intrasubject color differences in the keratinized gingiva band. Using the CIELAB color system, three reference areas (free gingival margin, keratinized gingival body, and birth or upper part of the keratinized gingiva) were studied in 259 individuals, as well as the related socio-demographic factors, oral habits and the chronic intake of medication. Shadepilot™ spectrophotometer was used. Descriptive and inferential statistical analysis was performed. There are statistically significant differences between males and females for coordinates L* and a* in the middle and free gingival margin. For the b* coordinate, there are differences between males and females in the three locations studied (p < 0.05). The minimum and maximum coordinates in which the CIELAB natural gingival space is delimited are L* minima 28.3, L* maximum 65.4, a* minimum 11.1, a* maximum 37.2, b* minimum 6.9, and b* maximum 25.2*. Age, smoking, and the chronic intake of medication had no significant effect on gum color. There are perceptible color differences within the keratinized gingiva band. These chromatic differences must be taken into account if the prosthetic characterization of gingival tissue is to be considered acceptable. There are significant differences between the color coordinates of the three sites studied in the keratinized gingiva of men and women.

Proposal for a gingival shade guide based on in vivo spectrophotometric measurements

“…Thus, the CIELAB color coordinates published by Ho et al50 are as follows: L * min 37.2 L * max 64.0, a * min 13.4, a * max 31.7, b * min 9.2, b * max 22.2. The amplitude in all of the coordinates of Gómez Polo et al4 is greater at the midpoint of the keratinized gingiva than those of Ho et al,50 except for the b * min coordinate: 13.450 vs. 15.04 (Table 1).…”

“…Spectrophotometry was reliable for measuring gingival color5, and the oral spectrophotometer used in this study was one of the most advanced 45. However, we must point out the possible alterations of the color coordinates of the spectrophotometers due to the physical phenomenon “edge loss”42 and metamerism.…”

“…However, given the coverage errors of the guides evaluated in other populations, we might expect these guides to be of little use in clinical practice in Spain. Gingival shade guides do not provide broad coverage of natural gingival colors 413. In addition, it remains unclear which gingival shade guide is the most effective in producing the best visual shade match.…”

“…The demand for aesthetics is becoming greater, especially with respect to the premaxilla and in patients with broad smiles. Prosthetically mimicking the gingival color of a gingival area according to the adjacent natural color is difficult45 since the selection of gingival colors is limited. This limitation includes both the number of gingival color guides currently on the market and the number of gingival color tabs available, especially with respect to natural gingival color.…”

Quantitative Assessment of Gingival Inflammation in Patients Undergoing Nonsurgical Periodontal Therapy Using Photometric CIELab Analysis

“…This system has three components L * , a * , and b * which measure lightness from black to white, green to red, and blue to yellow, respectively. Its working principles and working have been extensively elaborated by various authors [13,14]. The CIEL * a * b * system is widely used in dentistry in shade selection criteria for dental restorative material as well as shade guide for tooth colour [15].…”