Digital Color Analysis of the Graft and Recipient Site After Free Gingival Graft Surgery

NCT07199686 | Completed

• 2 other identifiers: SKOLE2025\46
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluates gingival color following Free Gingival Graft (FGG) surgery using polarized digital photography to objectively analyze grafted and adjacent tissues. Conventional verbal descriptors (e.g., pale pink, salmon pink) lack precision; therefore, digital colorimetry provides objective, non-contact, and reproducible measurements. The protocol utilizes the CIELab system with standardized color disks and polarization to document postoperative color changes accurately. The study objectives are: (1) to determine CIELab color values of FGG-treated gingiva in patients who underwent conventional surgery at least six months earlier; (2) to assess the influence of age, sex, time since surgery, and gingival thickness on these values; and (3) to compare graft color with adjacent gingiva. Hypothesis: In FGG-treated patients, graft CIELab color values are unaffected by age, sex, postoperative duration, or gingival thickness.

Conditions

Digital Photography; Cross Polarized Filter; Free Gingival Graft

Keywords

CIELab; Digital color analysis; cross-polarized filter; free gingival graft; gingiva color

Outcome Measures

Primary Outcomes (2)

• Characterization of the color values of the Free Gingival Graft (FGG) according to the CIELab color system

  Standardized intraoral photographs were obtained from fifty participants. Digital images were obtained using a camera with standardized settings to ensure reproducibility. All images, taken with and without the filter. Photographs were analyzed in Adobe Photoshop programme using the CIELAB system. The FGG region was divided into three equal zones (coronal, middle, apical). For each region, mean L\*, a\*, and b\* values were calculated.

  Through study completion, an average of 6 months

• Characterization of the color values of the adjacent keratinized gingiva according to the CIELab color system

  Standardized intraoral photographs were obtained from fifty participants. Digital images were obtained using a camera with standardized settings to ensure reproducibility. All images, taken with and without the filter. Photographs were analyzed in Adobe Photoshop programme using the CIELAB system. The adjacent keratized gingiva region was divided into two equal zones (coronal and middle) as the apical region corresponded to non-keratinized mucosa. For each region, mean L\*, a\*, and b\* values were calculated.

  Through study completion, an average of 6 months

Secondary Outcomes (8)

• Keratinized Gingiva Width

  Baseline

• Periodontal pocket depth

  Baseline

• Clinical attachment level

  Baseline

• Measurement of gingival thickness

  Baseline

• Influence of age on color values

  Through study completion, an average of 6 months

Study Arms (1)

Clinical Periodontal Measurements and Digital Imaging

For each tooth within the FGG treated sites, probing pocket depth (PD), clinical attachment level (CAL), and keratinized gingiva width (KGW) were recorded. The thickness of the FGG and adjacent keratinized gingiva (KG) was assessed using a transgingival method. Standardized intraoral photographs were obtained from the study population.

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This retrospective cohort study included patients from the Department of Periodontology, Faculty of Dentistry, Bezmialem Vakıf University, who had undergone conventional free gingival graft (FGG) in the mandibular anterior region involving one or two teeth.

You may qualify if:

• Postoperative period of at least 6 months after FGG
• Age between 18 and 65 years
• No known systemic diseases
• No use of medications adversely affecting gingival health (e.g., calcium channel blockers, immunosuppressants, antiepileptics)
• Full-mouth plaque index (PI)(1) and gingival index (GI)(2) \< 1
• Probing pocket depth (PPD) ≤ 3 mm with no bleeding on probing (BOP)(3) in the mandibular anterior teeth
• Absence of habitual mouth breathing

You may not qualify if:

• Current smoking
• Pregnancy or lactation
• Previous endodontic or restorative treatment in the mandibular anterior teeth
• Parafunctional habits (e.g., bruxism) or history of orthodontic treatment
• Conditions impairing salivary flow (e.g., Sjögren's syndrome or similar disorders)

Sponsors & Collaborators

• Bezmialem Vakif University: lead

Study Sites (1)

Bezmialem Vakif University

Istanbul, Fatih, 34093, Turkey (Türkiye)

Location

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 10, 2025
• First Posted: September 30, 2025
• Study Start: March 20, 2023
• Primary Completion: August 5, 2023
• Study Completion: April 20, 2025
• Last Updated: September 30, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Data will be made available upon publication of the manuscript

Locations

TU (1)