Soft Tissue Cone‐Beam Computed Tomography: A Novel Method for the Measurement of Gingival Tissue and the Dimensions of the Dentogingival Unit

Abstract

The dimensions and relationships of the structures of the dentogingival unit have been greatly overlooked because of the inability to easily and precisely determine them. The purpose of the present study was to develop a soft tissue cone-beam computed tomography (ST-CBCT) to improve soft tissue image quality and allow the determination of the dimensions and relationships of the structures of the dentogingival unit. Two separate CBCT scans were obtained from three patients with different periodontal biotypes. The first was a scan following standard methods; however, for the ST-CBCT the patients wore a plastic lip retractor and retracted their tongues toward the floor of their mouths. With the first scan, only measurements of the distance of the cementoenamel junctional (CEJ) to the facial bone crest, and the width of the facial alveolar bone were possible. In contrast, ST-CBCT allowed measurements of the distance of the gingival margin to the facial bone crest, the gingival margin to the CEJ, and width of the facial gingiva. ST-CBCT scans allowed a clear visualization, measurement of the dimensions, and analysis of the relationship of the structures of the periodontium and dentogingival attachment apparatus. CLINICAL SIGNIFICANCEThe dimensions and relationships of the structures of the dentogingival attachment apparatus are essential aspects in many fields of dentistry and this report describes a simple, novel, and noninvasive technique to determine them. This technique may aid clinicians in the planning and execution of procedures in several dental specialties. (J Esthet Restor Dent 20: 366-374, 2008)

Accuracy of linear intraoral measurements using cone beam CT and multidetector CT: a tale of two CTs

“…3,28,31,42 Literature on the accuracy of CBCT-based soft-tissue measurements is scarce. Januá rio et al 43 measured gingival tissue by means of CBCT, and Barriviera et al 44 proposed that the palatal masticatory mucosa may be measured on CBCT data. However, both failed to validate their obtained measurements against anatomical reference measurements.…”

Use of cone beam computed tomography in periodontology

“…The thickness of palatal mucosa has a major importance for the treatment planning of soft tissue grafts. However, this technique provides only quantitative assessment, thus the differences between the epithelial, fat and connective tissues can not be distinguished on ST-CBCT images [29,30] .…”

“…CBCT is well complied for imaging the highly mineralized structures such as bone or teeth but it cannot provide clear images of soft tissues. However, a novel, CBCT-based method to display and measure the dimensions of the palatal mucosa was reported in a recent study [29,30] . There are contradictory results on whether CBCT or conventional radiographs are more efficient in evaluation of periodontal ligament space [6,16] .…”

“…However, a practical method named soft tissue CBCT (ST-CBCT), was reported [29] , and it was utilized to determine the dimensions and relationships of the structures of the dentogingival unit. The tongues were retracted toward the floor of patients' mouths and a plastic lip retractor was used to retract the soft tissues away from the teeth and gingiva during CBCT scans and the images that were obtained provided clear information for the analysis of various dentogingival unit measurements [29] . Mentioned method was used in another study in which the average thickness of the palatal mucosa according to ages and specific localizations were determined on thirty one patients [30] .…”

Tomographic mapping of the hard palate and overlying mucosa

“…Cone-beam computed tomography (CBCT) is also a good tool to evaluate soft tissue thickness. [20][21][22] The aim of this study was to evaluate the thickness of cortical bone, total bone and mucosa in the palatine suture and paramedian areas using CBCT to verify the most suitable areas for miniscrew placement.…”