Vandeweghe Charles, Agossa Kevimy, Sabri Hamoun, Wang Hom-Lay, Colard Thomas
Private Practice, Estaires, France.
Department of Periodontology School of Dentistry, U1008-Advanced Drug Delivery Systems, INSERM, University of Lille, CHU Lille, Lille, France.
J Esthet Restor Dent. 2025 Aug;37(8):2002-2010. doi: 10.1111/jerd.13480. Epub 2025 Apr 28.
This pilot study aimed to (i) compare the diagnostic accuracy of the radiographic gingival embrasure surface area (SRE) with the vertical distance between the contact point and alveolar crest (CBC) and the inter-radicular horizontal distance (IHD), both used to predict black triangle (BT) presence and (ii) explore the association between patient-related factors, gingival phenotype and BT occurrence.
A retrospective analysis of 118 interdental papillae from 35 patients was performed using cone beam computed tomography and clinical photographs. Receiver operating characteristic (ROC) curves and Youden index were used to determine optimal thresholds for each parameter. Mixed-effects logistic regression identified factors associated with BT.
SRE demonstrated the highest diagnostic accuracy (area under the curve [AUC] = 0.98), with a sensitivity of 0.895 and a specificity of 0.984 at an optimal threshold of 5.04 mm. CBC showed an AUC of 0.89, with a sensitivity of 0.825 and a specificity of 0.770 at an optimal threshold of 4.94 mm. IHD exhibited lower performance (AUC = 0.63, sensitivity = 0.509, specificity = 0.721). Age (OR = 1.18; 95% CI: 1.03-1.36) was significantly associated with BT.
SRE outperforms linear distances (CBC and IHD) for detecting the presence of BTs. Age was also significantly associated with BT occurrence.
The surface area of the gingival embrasure provides a potentially more accurate and reliable radiographic indicator for predicting BTs, offering a valuable alternative to conventional linear measurements in clinical practice.
本初步研究旨在（i）比较用于预测黑三角（BT）存在的影像学牙龈龈乳头间隙表面积（SRE）与接触点至牙槽嵴的垂直距离（CBC）及根间水平距离（IHD）的诊断准确性，以及（ii）探讨患者相关因素、牙龈表型与BT发生之间的关联。
使用锥形束计算机断层扫描和临床照片对35例患者的118个牙间乳头进行回顾性分析。采用受试者工作特征（ROC）曲线和尤登指数确定每个参数的最佳阈值。混合效应逻辑回归确定与BT相关的因素。
SRE显示出最高的诊断准确性（曲线下面积[AUC]=0.98），在最佳阈值为5.04mm时，敏感性为0.895，特异性为0.984。CBC的AUC为0.89，在最佳阈值为4.94mm时，敏感性为0.825，特异性为0.770。IHD表现较差（AUC=0.63，敏感性=0.509，特异性=0.721）。年龄（OR=1.18；95%CI：1.03-1.36）与BT显著相关。
在检测BT存在方面，SRE优于线性距离（CBC和IHD）。年龄也与BT发生显著相关。
牙龈龈乳头间隙表面积为预测BT提供了一种可能更准确、可靠的影像学指标，在临床实践中为传统线性测量提供了有价值的替代方法。
