Title:
Correlation between subjective and objective evaluation of peri-implant soft tissue color.

Abstract:
While extensive references are present in the literature dealing with the correlation between subjective and objective evaluation of tooth shade, there is a lack of information on this correlation regarding the soft tissue color. The purpose of this experimental study was to verify whether a correlation between the objective and subjective evaluation exists in analyzing soft tissue color.
A total of 39 patients with at least one implant-supported restoration in the anterior maxilla were included in the study. The shade of the peri-implant mucosa was compared with the shade of the gingiva at the adjacent tooth in a subjective and in an objective manner. The subjective evaluation was performed by five dental professionals (prosthodontist, periodontist, general dentist, dental hygienist, and dental assistant) in a subjective scale (ranging from 1 to 4). The objective evaluation was obtained by means of a spectrophotometer in a CIELAB* Color Scale, and the differences were evaluated through formula ΔE=[(ΔL)²+(Δa)²+(Δb)²]¹/². To correlate the subjective and the objective evaluation, for each arithmetical median value of the subjective evaluation, a mean value of objective evaluation has been calculated, and the Spearman's rank correlation coefficient has been used. The differences have been also analyzed for thin and thick tissue biotypes.
The mean ∆E value for the subjective evaluation between peri-implant soft tissue and adjacent tooth gingival tissue was ∆E = 9.74. Also, mean ∆E values of 10.35 and 7.54 have been reported for thin and thick biotypes, respectively. Mean values of ∆E = 6.63, 8.54, and 15.54 were presented by median values of 1 (perfect matching), 2 (good matching), and 3 (clinically distinguishable), respectively. The threshold for the distinction of differences of mucosal color by the human eyes between perfect or good matching and distinguishable values has been calculated in ∆E = 8.74.
Within the limitation of this study, a correlation between the subjective and the objective evaluation of the peri-implant soft tissue exists and the threshold for the distinction of mucosal color differences between perfect or good matching and distinguishable subjective values has been calculated in ∆E = 8.74 in the objective evaluation.