Identification of soft tissue brushing lesions. A clinical and scanning electron microscopic study

The study was carried out in order to categorize visual signs of trauma caused to gingival tissues by standardized toothbrushing. The teeth of 12 dental hygienist students were professionally brushed after 2 days of no oral hygiene measures. A modified Bass technique was used in brushing. After visual classification the brushing lesions were replicated in order to assess the corresponding changes as seen in SEM examination. The visual evaluation comprised three types of soft tissue appearance: a positive lesion, an uncertain lesion and a non-traumatized gingival unit Ninety out of the 101 lesions which were clinically classified as positively traumatic were found traumatized also in the SEM analysis. Of the 26 gingival lesions which were classified as clinically uncertain, 13 were determined traumatic in the SEM analysis. Clinical evaluation was thus found to correlate significantly to the SEM findings although discrepancies between the two classification systems were also observed.