COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS

(CPITN )
BY: DR. ZOHAIB AHMED

Introduction
- The index was developed by joint working committee of the World Health Organization (WHO) and Federation Dentaire Internationale (FDI) by Jukka Ainamo, David barmes, George Beagrie, Terry Cutress, Jean Martin and Jennifer Sardo in 1978. The index was described in 1982. - It is used primarily for Epidemiologic Studies. - The CPITN is evolution for the 621 method, named for the WHO Technical Report Series (TRS) publication in which this method was first featured.

- The major difference between the CPITN and other indices is that it determines not only the severity of gingivitis (bleeding) and periodontitis (pocketing), but also provides information concerning the type of disease process and therefore also the extent of therapy that is needed. - The CPITN does not consider attachment loss on individual teeth, rather only the clinical situation requiring treatment, most severe areas in each sextant is recorded for: * Gingival Inflammation * Bleeding * Calculus * Pocket probing depth

The CPITN requires its own periodontal probe. The probe has 0.5 mm diameter probe at its tip. A black band for visibility b/w 3.5 & 5.5 mm. And circular markings at 8.5 mm and 11.5 mm. The purpose of the ball is to assist in feeling sub gingival calculus and to help prevent the probe from being pushed through inflammatory tissue at the base of a pocket. - Probing pressure is recommended to be no more than 20 grams (described as the pressure at which the probe can be inserted under a fingernail without discomfort)

Sextants for periodontal examination

- For basic periodontal examination and treatment need survey, full dentition is divided into Six (6) Sextants. - For adults aged 20 or more: The First and Second molars of all four quadrants in the four posterior sextants respectively + The upper right central incisor in the upper anterior sextant & + The lower left central incisor in the lower anterior sextant.

- For persons aged 19 or under: (All remains same except that Second molars are excluded or not examined) The First molars of all four quadrants in the four posterior sextants respectively + The upper right central incisor in the upper anterior sextant & + The lower left central incisor in the lower anterior sextant.

Modifications of CPITN
- In the United States, the Indian Health Service used CPITN in its treatment planning until the American Dental Association began to promote a slightly modified version as Periodontal Screening Record (PSR). - Another modification of CPITN appeared in Britain, where it was called British Periodontal Examination (BPE).

Important for MCQs

Belongings of Indices and their year of birth: 1) Gingival Index (GI) = Silness & Loe in early 1960s. 2) Periodontal Index (PI) = Russell in 1956. 3) Periodontal Disease Index (PDI) = Ramfjord in 1960s. 4) Plaque Index = Silness and Loe. 5) CPITN = WHO in 1982

Reference:
- Burt (Community Dentistry) - Color Atlas of Dental hygiene (Periodontology)