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

• Published in: Journal of biophotonics 2018-12, Vol.11 (12), p.e201800242-n/a
• Main Authors: Le, Nhan M., Song, Shaozhen, Zhou, Hao, Xu, Jingjiang, Li, Yuandong, Sung, Cheng‐En, Sadr, Alireza, Chung, Kwok‐Hung, Subhash, Hrebesh M., Kilpatrick, Latonya, Wang, Ruikang K.
• Format: Article
• Language: English
• Subjects: Angiography; Biotypes; Feasibility studies; Gingiva; gingival microvasculature; in vivo imaging; In vivo methods and tests; Incisors; inflammation; Medical imaging; Optical Coherence Tomography; Penetration depth; Periodontics; Teeth; Tissues; Tomography; Visual observation
• ISSN: 1864-063X; 1864-0648
• DOI: 10.1002/jbio.201800242

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. This paper describes a depth‐resolved microscopy technique, namely optical coherence tomography (OCT), for in vivo imaging of human gingiva. The paper focuses on the three‐dimensional tomography of the gingiva at microresolution and how the gingival tissues (both structure and vasculature) emerge under OCT. The findings present differences in gingival tissues between different biotypes, and strong link between gingival vascularization and inflammation. Therefore, this imaging technique can serve as an important diagnostic tool for clinical assessment of the gingiva.