The validity of periodontal probing as a method of measuring loss of attachment

Abstract

Linear probe measurements are used to assess the severity and extent of attachment loss in chronic periodontitis and to identify, retrospectively, sites of disease activity. The use of the probe for these purposes is based on the implicit assumption that there is a direct and predictable relationship between linear probe measurements of attachment loss and the area of cemental surface which has been denuded of periodontal ligament. The aim of this study was to test this assumption by determining the correlation between loss of attachment as expressed by probe readings, and that expressed as the area of denuded root surface. The areas of denuded root surface of 236 teeth of different morphotype in 41 human dried skulls were determined by a rubber base impression technique and compared with their corresponding probe measurements, made at 10 sites per tooth. Although the majority of correlations between linear and area measurements were statistically significant for some individual morphotypes and categories of bone loss, there was overall, no consistent pattern of correlation between the two parameters. Furthermore, many correlations which were statistically significant had low values of the correlation coefficient: Kendall's T. It was concluded that probe readings are not a very precise measure of attachment loss, particularly with increasing severity destruction. These results cast doubt on the ability of individual linear measurements to represent the true severity of attachment loss, and thus on the precision of loss of attachment charts for retrospectively identifying sites of periodontal disease activity.

Periodontal Probing: A Review

“…These may include factors related to the characteristics of each probe type, tine and shape, which may involve the accuracy of the marking intervals, thickness of the probe, probe angulation, force of probing, accuracy of the reference point, subgingival obstruction, root anatomy, the condition of the tissue at the deepest part of the pocket and any pain provoked by probing. [26][27][28][29][30] There are also limitations in relation to the third-generation probes; for instance, the reduction of the tactile sense of the operator. In addition, any elevation in patient discomfort and the inflammatory status of the gingival tissue may affect the accuracy of measurement.…”

Factors associated with adult periodontitis in a dental teaching clinic population

“…Currently, CAJ-, and PD are believed to be the best clinical estimates of prevalence/incidence of history of periodontitis Brown et al 1990;Burt 1991. Although the validity and reliability of the latter measurement is somewhat suspect (Badersten et al 1984; Jeffcoat and Reddy 1991;Caton 1993), both measurements are currently used in cross-sectional studies attempting to identify an individual's history of periodontitis (Listgarten 1980;Theil and Heany 1991;Caton 1993) and longitudinally, through repeated measures, to access disease progression (Bergstrom and Eliason 1989;Jeffcoat and Reddy 1991).…”

“…Results are reported in (Abramson 1990 Abramson (1990) (Goodson 1990 (Goodson 1gg0 (Schei et al 1959;Stoner 1972 (content validity) to the disease, it is not considered an objective measure of destructive periodontitis (Goodson 1990 (Theil and Heany 1991). However, lack of precision may have been due partially to use of a linear measurement tool i.e., the probe, to assess surface area attachment level.…”

Periodontal tissue damage in smokers

“…the clinical adhesion loss measurement describes the pocket base, while the transgingival probing measurement describes the base of alveolar bone damage. 7,11,20 The examination is rarely performed due to its unpleasantness.…”

“…Smokers in general have no knowledge of the damaging process, they come to the dentist long overdue making it more difficult to handle. The aim of, this research at smokers to discover the scale of periodontal tissue damage by measuring clinical periodontal loss using probe 7 and radiography, 8 so that diagnosis and treatment plan can be determined. As far as the knowledge of the author, no using probe from gingival margin until the base of the pocket.…”