Relationship of skin complexion with gingival tissue color and hyperpigmentation. A multi-ethnic comparative study

BACKGROUND AND OBJECTIVE

The most frequently seen intra-oral soft tissue is the gingiva. Most often, it is seen as coral-pink tissue that surrounds the neck of the teeth. Gingiva that encircles the tooth necks and covers the alveolar processes of the jaws is an intra-oral tissue that exhibits biomimetic features. The wide range of colors of the gingiva depends on the configuration of gingival vascularity, the degree of epithelial cornification, level of melanogenesis, and the depth of epithelialization. However, the color of the gingiva varies depending on the degree of melanin pigmentation. The current study aimed to identify the different distribution patterns of gingival color and determine the correlation between skin color, gender, and geographical area of origin.

MATERIALS AND METHODS

A total of 839 subjects were involved in the study where the gingival color and skin tone were measured using the Dummett-Gupta Oral pigmentation Index (DOPI) combined with VITA VMK MASTER and skin shade method developed by Revlon (USA) and L'Oreal (France) for makeup foundation shades. One investigator was calibrated for the examination of the colors after being tested for normal color vision and color aptitude using the line test.

RESULTS

A significant association was found between skin color and gingival pigmentation (χ2 value (6) = 114.48; P = 0.001). It was also found that females (67.1%) significantly had darker gingiva than males (58.3%). The study statistics display that location of the individual was also statistically associated with melanin pigmentation of the gingiva (χ2 value (57) = 559.33; P = 0.001).

CONCLUSION

The study concluded that gender, skin color, and individual location are significantly associated with gingival melanin pigmentation.

Percutaneous transluminal balloon pulmonary valvuloplasty for the relief of pulmonary valve stenosis with special reference to double-balloon technique

PTBPV was performed 33 times in 32 patients in the Riyadh Armed Forces Hospital. Patients ranged in age from 6 months to 12 years (mean 4.5 years); average weight was 14.86 kg. Before dilatation, all patients had grade 4/6 late peaking systolic ejection murmurs, with right-axis deviation and right ventricular hypertrophy on ECG. Moderate to severe pulmonary valve stenosis (right ventricle-pulmonary artery gradient 50 mm Hg systolic) was confirmed both hemodynamically and angiographically. Balloon size was selected to be approximately 2 mm larger than the pulmonary valve anulus was over 25 were inflated to approximately 5 atmospheres of pressure. Two patients required two simultaneous balloons as the pulmonary valve anulus was over 25 mm. Predilatation peak systolic pressure gradients ranged from 50 to 245 mm Hg (mean 99.2 mm Hg); postdilatation gradients ranged from 8 to 93 mm Hg (mean 23.4 mm Hg). There were no deaths or complications. The systolic murmur with early systolic peak decreased in all but three patients. Systolic thrill disappeared in all but three patients. Follow-up at an average of 10 months revealed increasing exercise tolerance in two thirds of patients. Fourteen patients have been recatheterized at least 6 months after dilatation and showed persistent minimal gradient. We conclude that balloon valvuloplasty of pulmonary valve stenosis is an effective, safe procedure. At this writing, a total of 90 successful PTBPVs have been performed, with equally impressive results.