Comparison of Manual and Automated Capillary Morphometry Measurements in Oral Mucosa: A Pilot Study

This pilot study sought to evaluate and compare the performance of an automated method, developed using a neural network trained at the University of Palermo, with a traditional manual method for assessing capillary morphology in the oral mucosa. The analysis was conducted using videocapillaroscopy, a non-invasive imaging technique that allows for detailed visualization and quantification of microvascular structures. Three key parameters were examined: capillary caliber, length, and density. Measurements were taken across ten patients in four distinct anatomical sites within the oral cavity: the right buccal mucosa, left buccal mucosa, lower labial mucosa, and upper labial mucosa. The primary objective was to determine whether the automated method could serve as a reliable and efficient alternative to the manual approach, particularly in clinical and research settings where precision and reproducibility are paramount. The findings revealed that the automated method consistently produced higher values for capillary caliber and length compared to the manual method, suggesting a systematic overestimation of these parameters. This discrepancy may be attributed to the way the neural network identifies and processes capillary structures, potentially including more complex or tortuous segments that the manual method might overlook or exclude. In contrast, the two methods showed good agreement in the assessment of capillary density, with no significant differences observed. This indicates that the automated method performs well in quantifying capillary density, a critical parameter in microvascular studies. In conclusion, while the automated method shows promise as a faster and more efficient alternative to manual measurements, its systematic overestimation of certain parameters underscores the importance of continued development and validation. The availability of a non-operator-dependent, rapid, repeatable, and thus objective method represents a significant step forward in the assessment of microcirculation. However, careful consideration must be given to the limitations and potential biases of these tools to ensure their reliability and applicability in both research and clinical practice.