Digital photometric analysis of gingival response to periodontal treatment

• Published in: Journal of dentistry Vol. 127; p. 104331
• Main Authors: Ginesin, Ofir, Zigdon-Giladi, Hadar, Gabay, Eran, Machtei, Eli Eliahu, Mijiritsky, Eitan, Mayer, Yaniv
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2022; Elsevier Limited
• Subjects: Biofilms; Bleeding on probing gingival; Color; Debridement; Dental Scaling - methods; Dentistry; Diagnosis; Digital cameras; Digital dentistry; Female; Gingiva; Gingival index; Gum disease; Humans; Inflammation; Intervention; Male; Parameters; Patients; Periodontal Attachment Loss; Periodontal Pocket - surgery; Periodontal surgery; Periodontitis; Photometry; Statistical analysis; Surgery; Israel; Periodontal surgery; Inflammation; Bleeding on probing gingival; Diagnosis; Digital dentistry; Periodontitis
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2022.104331

The color is a major factor in determining inflammation status in most gingival indices. Current indices have limitations mainly due to subjective nature. Digital color analysis can provide objective and accurate measurements. Thus, the present study aimed to assess by digital tool the gingival color in the different stages of an active periodontal treatment.
Forty patients (19 males and 21 females) diagnosed with periodontitis (stage III/ IV, grade C) and treated surgically were included in the study. Clinical data (probing depth, bleeding on probing, clinical attachment level, gingival index, and gingival recession) and photographs by digital single-lens-reflex (DSLR) camera were recorded before initial periodontal treatment, which included scaling and root surface debridement (T0); the same parameters were then re-evaluated 6-8 weeks (T1) and 3 months after periodontal surgery (regenerative/resective) (T2). Differences between clinical parameters were calculated. The color space defined by the International Commission on Illumination (CIELab) was used to analyze gingival color.
In 56 periodontal surgical sites, 168 photographs were taken. The a*-value of the CIELab color system (higher a*- value translate to a stronger red color) was significantly reduced between T0 to T1 and further decreased at T2 (32.01, 29.28, and 27.45 respectively). Significant improvement in clinical parameters were found between T0 to T1 and T1 to T2. Sub-analysis of two distinct surgical interventions revealed that only regenerative procedure improved the a*-value, which was significantly correlated with pocket depth reduction.
Photometric analysis can be used to assess gingival color change during periodontal treatment of patients with periodontitis.
Gingival inflammation is a major factor in periodontal assessment; nevertheless, all current gingival inflammation indices are partially subjective and only semi-quantitative. The digital photometric analysis may allow for accurate and objective gingival color assessment during periodontal treatment.