Digital photometric analysis of gingival response to periodontal treatment

Ofir Ginesin; Hadar Zigdon-Giladi; Eran Gabay; Eli Eliahu Machtei; Eitan Mijiritsky; Yaniv Mayer

doi:10.1016/j.jdent.2022.104331

Digital photometric analysis of gingival response to periodontal treatment

J Dent. 2022 Dec:127:104331. doi: 10.1016/j.jdent.2022.104331. Epub 2022 Oct 14.

Authors

Ofir Ginesin¹, Hadar Zigdon-Giladi², Eran Gabay³, Eli Eliahu Machtei⁴, Eitan Mijiritsky⁵, Yaniv Mayer³

Affiliations

¹ Senior Faculty Staff, Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel P.O.B 9602, Haifa 31096, Israel. Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel. Electronic address: o_ginesin@rambam.health.gov.il.
² Deputy Chairman, Department of Periodontology, School of Graduate Dentistry; Director, Laboratory for Hard Tissue Regeneration, CRIR institute, Rambam Health Care Campus. Professor, Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel.
³ Senior Faculty Staff, Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel P.O.B 9602, Haifa 31096, Israel. Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel.
⁴ Chairman, Department of Periodontology, School of Graduate Dentistry; Professor, Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel.
⁵ Department of Head and Neck Surgery and Maxillofacial Surgery, ENT Array, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv 6997801, Israel.

PMID: 36252859
DOI: 10.1016/j.jdent.2022.104331

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: Photometric analysis can be used to assess gingival color change during periodontal treatment of patients with periodontitis.

Clinical significance: 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.

Keywords: Bleeding on probing gingival; Diagnosis; Digital dentistry; Inflammation; Periodontal surgery; Periodontitis.

MeSH terms

Dental Scaling* / methods
Female
Humans
Inflammation
Male
Periodontal Attachment Loss
Periodontal Pocket / surgery
Periodontitis*