Gingival pigmentation: Concurrent assessment of distribution, intensity, and extent in a black population

Abstract

Objective To evaluate prevalence, distribution, intensity and extent of physiologic gingival melanin pigmentation (GMP) in black individuals. Materials and methods For this cross‐sectional study, GMP was evaluated on digital images by three calibrated examiners, according to de Krom (distribution), DOPI (intensity) and Melanin Index (extent) classifications. Descriptive statistics, Wilcoxon, Mann–Whitney, Kruskal–Wallis, Two‐way ANOVA, chi square, and K‐means cluster analysis were used. Results Seventy participants were recruited. The most prevalent GMP categories were: de Krom category 2 (34.3%), DOPI heavy intensity (57.2%), and Melanin index Degree IV (50%). Significant inter‐group differences were found for age (p < 0.05) but not gender (p > 0.05). Significant correspondence/overlap was observed between classifications (p > 0.05). Three GMP clusters were identified: Cluster 1 (27%; n = 19) had mild asymmetric and interspersed pigmentation; Cluster 2 (46%; n = 32) had heavy pigmentation in one long continuous ribbon, with pink marginal gingiva; and Cluster 3 (27%; n = 19) had heavy pigmentation in one long continuous ribbon, symmetric, and uniform. Conclusions There may be overlap among GMP classification systems. In black individuals, the predominant GMP presentation is one of a broad zone of heavily pigmented attached gingiva, in a continuous strip from central incisors to canines, symmetrical across the midline, and with pink free marginal gingiva. Clinical relevance This is the first study to analyze distribution, intensity, and extent of gingival melanin pigmentation in the same population and to integrate the various classification systems through cluster analysis. The novel findings provide a foundation for patient assessment and counseling and for future studies.

Evaluation of Gingival Pigmentation and Related Factors on Former Smokers

“…Previous studies on GP, in which smoking is at the forefront of its aetiology, have mostly focused on the effect of consumption. In contrast, studies on the impact of cessation on regression have been limited [ 9 , 18 ]. This cross-sectional prospective observational clinical study evaluated the GP and related factors in FS and compared it with CS.…”

Assessment of gingival thickness in multi‐ethnic subjects with different gingival pigmentation levels

“…Studies on the distribution of physiologic gingival pigmentation report various patterns of pigmentation distributions including individuals with some distinct areas of more pronounced pigmentation with other areas having lighter pigmentation (Ho et al, 2015; Packyanathan & Lavanya, 2019; Longo et al, 2022). Assessment of the gingival pigmentation in the present study used frontal photographs of the gingival tissues, which included the attached gingiva as well as the free gingiva based on the DOPI (Dummett & Gupta, 1964).…”

Comparison between clinical and computerized methods for assessing gingival pigmentation

“…Additionally, there is low comparability among these clinical indexes, leading to overlaps among the classifications. 5 To address these limitations, more objective methods have been explored including visual assessment using colour tabs such as the Munsell Colour Charts, electronic colour measuring devices, and the quantification of the pigmentation using digital software. However, the use of colour tabs is susceptible to observer factors such as colour blindness, fatigue, light conditions and health impairments, and coverage errors of the available shade guides.…”