Intra- and inter-examiner reproducibility of manual probing depth.

The periodontal probe remains the best clinical diagnostic tool for the collection of information regarding the health status and the attachment level of periodontal tissues. The aim of this study was to evaluate intra- and inter-examiner reproducibility of probing depth (PD) measurements made with a manual probe. With the approval of an Ethics Committee, 20 individuals without periodontal disease were selected if they presented at least 6 teeth per quadrant. Using a Williams periodontal probe, three calibrated thesis-level students (k > 0.6) assessed PD at 6 sites per tooth, from the gingival margin to the bottom of the periodontal sulcus (rounded to the next 0.5 mm). Initial and repeated measurements were performed by the same three examiners. The intra-examiner agreement (± 1 mm > 90%) was 99.85%, 100%, and 100% for the three examiners, respectively. When the variables vestibular/lingual surfaces, mesial/distal surfaces, or superior/inferior jaws were evaluated, no significant differences in reproducibility were detected at the inter-examiner level (p < 0.05). At this level, the only significant differences observed were in the three examiners' measurements of the anterior and posterior sites. While high intra-examiner reproducibility was detected, inter-examiner level proved to be low. We can conclude that measurement of PD with a manual periodontal probe produced high reproducibility in healthy individuals. The operators position can affect the reproducibility of repeated measures of PD. Calibration and operator training, rather than operator experience, were fundamental for reproducibility. Other factors, such as individual technique and probing depth force, can affect inter-examiner reproducibility.

[1]  P. Fletcher,et al.  A biometric approach to aesthetic crown lengthening: part II--interdental considerations. , 2008, Practical procedures & aesthetic dentistry : PPAD.

[2]  A. Mombelli Clinical parameters: biological validity and clinical utility. , 2005, Periodontology 2000.

[3]  S. Al-Kahtani,et al.  The accuracy of the Vivacare true pressure-sensitive periodontal probe system in terms of probing force. , 2000, Journal of clinical periodontology.

[4]  T. Köse,et al.  Accuracy and reproducibility of two manual periodontal probes. An in vitro study. , 2004, Journal of clinical periodontology.

[5]  G. Linden,et al.  Comparative reproducibility of proximal probing depth using electronic pressure-controlled and hand probing. , 1994, Journal of clinical periodontology.

[6]  Dhoom Singh Mehta,et al.  Periodontal probing systems: a review of available equipment. , 2011, Compendium of continuing education in dentistry.

[7]  Gary C Armitage,et al.  The complete periodontal examination. , 2004, Periodontology 2000.

[8]  M. Trevisan,et al.  Reproducibility of Probing Depth Measurements Using a Constant-Force Electronic Probe: Analysis of Inter- and Intraexaminer Variability. , 2003, Journal of periodontology.

[9]  M. Timmerman,et al.  Comparison of two automated periodontal probes and two probes with a conventional readout in periodontal maintenance patients. , 2006, Journal of clinical periodontology.

[10]  M. Timmerman,et al.  Probe penetration in relation to the connective tissue attachment level: influence of tine shape and probing force. , 1998, Journal of clinical periodontology.

[11]  R Attström,et al.  Periodontal probe precision using 4 different periodontal probes. , 1996, Journal of Clinical Periodontology.

[12]  K. Williams,et al.  Comparison of probes for microbial contamination following use in periodontal pockets of various depths. , 2004, Journal of periodontology.

[13]  Ronir R Luiz,et al.  Manual and electronic probing of the periodontal attachment level in untreated periodontitis: a systematic review. , 2008, Journal of dentistry.

[14]  M. Timmerman,et al.  A thin or thick probe handle: does it make a difference? , 2006, International journal of dental hygiene.

[15]  J. Mühling,et al.  Reproducibility of peri-implant probing using a force-controlled probe. , 2001, Clinical Oral Implants Research.

[16]  D. Richards New readers start here , 2009, Evidence-Based Dentistry.

[17]  M. Riggs,et al.  Pain experienced by patients during periodontal recall examination using thinner versus thicker probes. , 2005, Journal of periodontology.

[18]  M. Listgarten,et al.  Periodontal probing: what does it mean? , 1980, Journal of clinical periodontology.

[19]  Saba Khan,et al.  Periodontal probing depth measurement: a review. , 2009, Compendium of continuing education in dentistry.

[20]  J J Garnick,et al.  Periodontal probing: probe tip diameter. , 2000, Journal of periodontology.

[21]  G. Koch,et al.  Comparison of manual and automated probing in an untreated periodontitis population. , 1997, Journal of periodontology.

[22]  José Eustáquio Costa,et al.  Impact of clinical experience on the accuracy of probing depth measurements. , 2008, Quintessence international.

[23]  R G Dunford,et al.  Sources of error for periodontal probing measurements. , 1996, Journal of periodontal research.

[24]  O. Sorel,et al.  [Periodontal diagnosis in orthodontics]. , 2010, L' Orthodontie francaise.