HIỆU QUẢ CHẨN ĐOÁN VIÊM LỢI NHÓM RĂNG PHÍA TRƯỚC TRÊN ẢNH CHỤP GẦN CHUẨN HÓA

Abstract

Objective: To evaluate the diagnostic effectiveness of anterior teeth group gingivitis based on intraoral close photographs.

Study subjects: 58 first-year students of Hanoi Medical University who came for an oral health examination, with images taken of the anterior teeth group (including incisors and canines of both jaws) at the Dental Clinic, Hanoi Medical University Hospital, in August 2024.

Research method: Cross-sectional descriptive study, assessing the correlation between clinical diagnosis and photographic results. Gingival inflammation was evaluated simultaneously on photographs and clinically using the Modified Gingival Index (MGI) (classified 0-4 according to international standards). Calculus/plaque levels were classified clinically (grade 0-3). Data were processed quantitatively; percentages, charts, and tables were presented. Chi-square test was used to compare independence between categorical variables and Spearman’s correlation coefficient to assess the ordinal relationship between MGI and calculus levels. Significance level α = 0.05.

Results: Close intraoral images identified gingival inflammation lesions in the anterior teeth group with a sensitivity of 96.2%, specificity of 100%, and negative predictive value of 71.4%. The main signs included gingival tissue swelling, color changes, and gum bleeding. Most patients had an image-based MGI = 1 (32/58, 55.2%), followed by MGI = 2 (19/58, 32.8%), and only 7 cases had image-based MGI = 0 (7/58, 12.1%). Clinically, MGI was mainly 1 (26/58, 44.8%), followed by 2 (17/58, 29.3%) and 3 (11/58, 19.0%), with only 5 cases having MGI = 0 (5/58, 8.6%). The level of dental calculus was mainly at level 1 (29/58, 50.0%), followed by 2 (16/58, 27.6%) and 3 (10/58, 17.2%); 4/58 (6.9%) had no calculus. Two cases with image-based MGI = 0 were at calculus levels 0 (4/58) or 1 (3/58). Chi-square analysis showed a significant difference in the distribution between image-based MGI and clinical MGI (χ² = 76.81, p < 0.001), and the Spearman coefficient = 0.847 (p < 0.001) indicated a strong positive correlation. The correlation between image-based MGI and calculus level was also statistically significant (χ² = 65.19, p < 0.001; Spearman = 0.805, p < 0.001). Notably, clinical MGI was closely associated with the level of dental calculus. (χ²=142,12, p<0,001; Spearman=0,955, p<0,001)

Conclusion: Close intraoral photos are a useful tool for the early detection of gingivitis in the anterior teeth, supporting accurate diagnosis. Clinical close intraoral images can be used as an initial screening tool (presence/absence of gingivitis), but they cannot replace a full clinical examination to determine the stage of gingivitis and the level of oral hygiene. Combining images with clinical examination helps provide additional information. In the future, studies could expand the sample size and apply automated image analysis tools (AI) to enhance the objectivity of image-based diagnosis.