Three-Dimensional Geometric Estimation of Preoperative Soft-Tissue Volume in Mucogingival Surgery: A Proof-of-Concept Case Series
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Edgar Daniel Vargas-Quiroga1, Heloísa Correa Melo2, Ana Carolina Duarte Firmino1
1Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil.
Background:
This proof-of-concept study evaluated a digital workflow incorporating intraoperative scanning to provide additional geometric information on the treated area.
Methods:
Five patients with gingival recessions underwent mucogingival surgery at 14 sites; eight received a subepithelial connective tissue graft and six were treated without grafting. Intraoral scans were obtained at baseline (BL), after periosteal exposure (PE), after graft placement (GP), when applicable, and at 1 month (1M) and 3 months (3M). Serial models were superimposed to calculate root mean square (RMS), surface-deviation metrics, and regional deviation scores. The PE model served as a geometric reference for Boolean reconstruction of external and internal volumetric components, while PE and GP scans were used to reconstruct initial graft volume.
Results:
Digital measurements showed high intra-examiner reproducibility. Among three patients with complete longitudinal volumetric data, median external volume was 151.54 mm³ at BL, 270.67 mm³ at 1M, and 240.19 mm³ at 3M. External volume was numerically higher at 1M and lower at 3M, although pairwise comparisons were not significant after adjustment. Internal volume showed no significant overall difference across time points. RMS and related surface-deviation metrics did not differ significantly between BL-1M and BL-3M. Initial graft volume was reconstructed in three cases, ranging from 78.28 to 134.74 mm³.
Conclusions:
The workflow integrated surface-deviation analysis with reconstruction of external and internal volumetric components and initial graft volume. These findings support the feasibility of incorporating intraoperative scans into three-dimensional assessment of mucogingival surgery, although validation in larger, standardized samples is required.
Clinical Significance:
Intraoperative scanning combined with three-dimensional reconstruction may provide a feasible approach for estimating preoperative soft-tissue volume and assessing spatial changes after mucogingival surgery. This workflow may complement conventional clinical measurements in longitudinal soft-tissue assessment.
