Quantitative Assessment of Gingival Inflammation in Patients Undergoing Nonsurgical Periodontal Therapy Using Photometric CIELab Analysis

Abstract

Visual inspection and gingival indices have been traditionally used for diagnosis of gingival inflammation. These methods are prone for subjective variability. Thus, the study is aimed at evaluating gingival inflammation quantitatively by using CIELab colour space value obtained from digital photographs. An experimental study was conducted with 27 patients each in group A (gingivitis) and group B (chronic periodontitis, CP). Preoperative and postoperative (1 month) photographs of maxillary anterior sextant were recorded to evaluate CIELab coordinate values. Simultaneously, clinical parameters such as bleeding on probing (BOP) and periodontal probing depth (PPD) along with indices such as plaque index (PI), gingival index (GI), and sulcus bleeding index (SBI) were evaluated before and after the nonsurgical periodontal therapy. Data was presented as the $\text{mean}\pm \text{SD}$ , and a paired $t$ -test was used for the testing hypothesis with $p<0.05$ considered as significant. Data analysis was carried out with Statistical Package for the Social Sciences (SPSS) version 21. A significant reduction ( $p<0.001$ ) is seen in all the clinical parameters and indices before and after the intervention in chronic periodontitis patients. Similar results were seen in gingivitis patients ( $p<0.001$ ) except for PPD. A significant ( $p<0.001$ ) reduction in postoperative values of the $a\ast$ and $b\ast$ coordinates was seen in CP patients; whereas, only the $a\ast$ coordinate value reported a significant ( $p<0.001$ ) reduction in the gingivitis group of patients. The $\Delta E$ of the gingivitis and chronic periodontitis groups was 2.25 and 2.96, respectively. Within the confinements of the study, estimating the gingival colour with the help of CIELab values taken via digital photographs can be an excellent valuable tool to assess the gingival colour as a sign of gingival inflammation.