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How to Investigate the Microcirculation of the Gum (gingiva) Using the TiVi700 2.0 Tissue Viability Imager by Wheelsbridge

Gingivitis (inflammation of the gum) is a condition that may lead to loss of teeth if not discovered and treated at an early stage. Tissue inflammation manifests itself as an increased microvascular activity (often referred to as erythema). The Tissue Viability Imager TiVi 2.0 is designed to map and quantify such erythema. The recording and analysis procedures are as follow:
1. Capture one or more high resolution photos of the object and zoom in on the region of interest (See Fig 1 below). The photo is always displayed in Photo panel while the corresponding TiVi image is displayed in the Image panel. In the TiVi image red colour indicates a high local concentration of red blood cells while a low local concentration of red blood cells is indicated by blue colour. Each pixel in the image corresponds to a numerical value making it possible to quantify the erythema.


Fig 1. Analysis Page displaying the photo and TiVi image

2. Areas of suspected gingivitis are framed by a green or blue circle (Fig 2). Observe that the corresponding areas in the TiVi image are displayed in red colour indicating higher red blood cell concentration.

Fig 2. Marked areas with suspected gingivitis


3. Zoom in on the blue region of interest by clicking the ROI1 text (Fig 3). Observe the reddening of the tissue in the photo and the corresponding red marking of the areas in the TiVi image.

Fig 3. Erythema displayed in the photo and the corresponding increase in red blood cells in the TiVi image indicated by red colour. 

4. After setting the lower threshold to 52, only the TiVi values above this threshold are indicated by red colours superimposed on the TiVi image (Fig 4). The average TiVi value is automatically calculated to 169 TiVi units (left column in the Image panel).

Fig 4. TiVi image after setting the lower threshold to 52. 


5. Corresponding photo and TiVi image for the green ROI (ROI2) (Fig 5). After thresholding theaverage TiVi value is calculated to 137 TiVi units.

Fig 5. Zoomed-in Photo and TiVi image without and with thresholding for ROI2.




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