Continuing Education 1

Periodontal Probing Depth

Measurement: A Review
Saba Khan, DDS, MSD;^ and Leyvee Lynn Cabanilla, DDS, MSD^

Abstract: There has been significant increase in the knowledge and understanding of the etiology, pathogenesis, and
treatment of inflammatory periodontal diseases over the past few decades. However, arriving at a diagnosis and determining the course of treatment still are based largely on basic clinical techniques, such as periodontal probing. With all the
advances in dental technologies, the periodontal probe remains the best diagnostic tool to collect information regarding
the health status and attachment level of periodontal tissues, despite some inherent drawbacks, especially when it is used
to monitor periodontal status longitudinally. Dental clinicians must be aware of the strengths as well as the limitations of
using a periodontal probe to gather data. This systematic review describes several factors that affect the accuracy and reliability of periodontal probing, including periodontal health, probing force, type of periodontal probe, and probing site.

Today periodontal probing is the best diagnostic tool to gather information regarding the health status and attachment
level of periodontal tissues. Periodontal probing requires special skills as well as an understanding of the tissues being
examined, the probing procedure, and the use of an appropriately designed instrument. Periodontal probing seeks to
complement the initial visual assessment of the status of the

Learning Objectives
After reading this article, the reader should be able to:

identify factors that can affect the accuracy oi periodontal probing.

recognize the inherent limitations of using a periodontal probe as a di^nostic tool during data gathering.
describe the proper technique of using a periodontal
probe.

periodoEital tissue. It has multiple roles: to assess tbe hemorrhagic response to pbysical pressure; to determine the presence of etiologic factors such as calculus, defective dental
restorations, and root erosion; to locate tbe cementoenamel
junction (CEJ); and to determine tbe pocket dimensions.
While it remains tbe best way to meastire probing depths and
clinical attachment level during clinical examinations, periodontal probing bas several drawbacks when used to monitor
periodontal status longitudinally. Despite its lack of accuracy
in determining sulcus or pocket depth, probing provides the
clinician with a useRil estimate of the location of the coronal
insertion of intact connective-tissue fibers into the root. Altbougb the true anatomic measurement of the pocket can be
accomplisbed solely tbrough histologie examination,' periodontal probing depth (PPEi) is still an important clinical
measurement because the depth of the pocket and degree of
attachment loss may influence tbe course of the disease.^
To determine tbe degree of periodontal breakdown accurately, the tip of the probe must be located at the most

^Clinical Assistant Professor, Department of Periodontology, University of Illinois, College of Dentistry, Chicago, Illinois
^Assistant Professor, Department of Periodontology and Dental Hygiene, University of Detroit Mercy School of Dentistry,
Detroit, Michigan

12

Compendium

January | February 2009Volume 30, Number 1

coronal intact connective-tissue fibers. In other words, the

"true" pocket tleptb must be measured. In many cases, bowever, tbe recorded measurements do not correspond with
true pocket depth tneasurements. This discrepancy may be
caused by anatomic or pathologic characteristics ofthe pocket tissues or those surrounding the pocket, individual characteristics ofthe probe used, or operator factors such as
probing force, probe placement, angulation, manual dexterity, and accuracy of observation.^''* Factors that may influence the precision of periodontal probing are related to
design and handling facility ofthe instrument and health of
the gingival tissues, as well as experience ofthe clinician.^'*'
This review summarizes various aspects of PPD measurement. The importance of periodontal health relative to
probe-tip penetration also is reviewed. Different factors
that influence the PPD measurement are discussed in detail in conjunction with their effect on accuraq' and reproducibility of the PPD measurements. Three generations of
periodontal probes also are discussed.

PERIODONTAL HEALTH
A primary aim of periodontal probing is to locate the most
coronal level ofthe connective-tissue attachment. However, this generally is not attainable, as penetration ofthe

Figure 1 Probing deptb of < 3 mm. witb the tip of tbe probe
coronal to the junctional epithelium in healtby gingiva.

www.compendiumlive.com

Saba Khan. DDS, MSD

Leyvee Lynn Cabanilla,

DDS, MSD

probe tip in the pocket or the lining soft tissues correlates

with periodontal health.'''^ It has been established that the
extent of probe penetration is influenced by the inflammatory status ofthe dssues.'''^"'-^ In most instances when healthy
tissues are examined, the probe tip stops coronal to the apical termination of the junctional epithelium (Figure 1),
whereas at inflamed sites the probe tip frequently passes
apical to this point (Figure 2). The depth of probe penetration partially depends on the extent to which the gingival connective tissue has been lysed or infiltrated by inflammatory cells. In other words, intact connective tissue
underlying the crevicular epithelium is an important factor
resisting probe penetration. Spray et al'^ suggested that the
state of health of the underlying connective-tissue fibers

Figure 2 Probing depth of 6 mm, with tbe tip of the probe

apical to the corona! attachment of tbe junctional epithelium
in inflamed gingival tissue.

Compendium

13

Continuing Education 1
influences probing measurements. There is a "hammock
effect" in health, where healthy fibers act as a barrier and
prevent apical movement of the instrument, while inflamed
connective tissue offers less resistance to penetration. With
reduction in inflammation, an accurate estimate o the sulcus depth is more likely to be obtained. The probe penetration is significantly greater in the presence of visible inflammation, but not where there was bleeding after probing.^
These results suggest that the location of the inflamed connective tissue may be a critical factor. Anderson et al' determined the correlation between clinical and histologie
inflammation and probe-tip penetration of the pocket tissues in dogs. A strong correlation was found between probe
penetration and degree of inflammation, and the difference in mean inflammation scores between sites where
probes were located coronal or apical to the epithelium was
statistically significant.
Anatomically, the gingival sulcus Is defined as the distance from the gingival margin to the coronal extension of
the junctional epithelium. ' ^ However, the ability of the
periodontal probe to measure this distance accurately is
questionable. Results of human studies performed by Sivertson and Burgett'" indicate that the periodontal probe
routinely penetrates to the coronal level of the connective

tissue attachment of untreated periodontal pockets. Armitage et aF found that, in healthy specimens, the probe
failed to reach the apical termination of the junctional
epithelium. In cases with experimental gingivitis, however,
most probes came closer to the apical termination of the
junctiona! epithelium, but on the average still fell short. In
periodontitis specimens, the probes consistently went past
the most apical cells of the junctional epithelium. A significant relationship between the degree of inflammation and
level of probe penetration was found. Saglieet al noted
that probing depths measured in the laboratory were always shallower than those recorded clinically. The authors
attributed this discrepancy to the presence of a zone of
completely and partially destroyed periodontalfibers,which
allowed the probe to extend apically to the coronal level of
connective-tissue attachment. The results of these studies
illustrate that periodontal probes do not precisely measure,
and often overestimate, the true histologie sulcus depth,
and that inflammation has a significant influence on probe
penetration. This has important implications regarding
how measurements taken with periodontal probes are
interpreted. Because probes rarely stop at the exact location of the most apical cells of the junctional epithelium,
probing measurements are clearly not precise assessments

Figure 3 Manual probes (left to right): Marquis color coded probe (calibrations are in 3-mm sections); University of Michigan
"O" probe, witb Williams markings (at 1 mm, 2 mm, 3 mm, 5 mm, 7 mm, 8 mm, 9 mm, and 10 mm); UNC probe witb millimeter
markings at each millimeter and color coding at 5 mm and 10 mm; Nabers probe (calibrations are in 3 mm sections); plastic
periodontal probe with markings at 3 mm, 6 mm, 9 mm, 11 mm, and 12 mm; plastic periodontal probe with millimeter markings
at eacb millimeter and color coding at 5 mm and 10 mm.

14

Compendium

January | February 2009Volume 30, Number 1

Continuing Education 1

Figure 4 Tapered probe (left) and parallel-sided probe (rigbt).

of the actual level of connective-tissue attachment. PPD

measurements overestimate connective-tissue attachment
loss at inflamed sites and underestimate it at noninflamed
sites. An increased probing depth is a sign of reduced tissue resistance to probing, which in turn can be interpreted as an indication of the presence of an inflammatory
cell infiltrate in the gingival tissue.^' Most research has
shown that the tendency for penetration of the probe into
the tissues at the base of pocket resulting in an overestimate of probing depth is greater at inflamed sites ' ' ' '
and in nonsmokers.'^

PERIODONTAL PROBES
The periodontal probe continues to be one of the more useful diagnostic tools to determine the presence and severity
of periodontal lesions. An ideal periodontal probe should
possess specific characteristics:
1. It should be tissue-friendly and not traumatize periodontal tissues during probing.
2. It should be suitable as a measuring instrument.
3. It should be standardized to ensure reproducibility,
particularly with respect to recommended pressure.
4. It should be suitable both for use in the clinical setting
where precise data documentation is required on an
individual patient basis, and for screening purposes, as
in epidemiology.
5. It should be easy and simple to use and read.
Over the years, the shape, design, and ftinction of probes
have changed to enhance accuracy and reproducibility. Three
generations of probes have been suggested by Philstrm'^:
first generationconventional handheld instruments;

16

Compendium

second generationforce application during measurement;

third generationforce application using automated measurement and computerized data capture. The conventional
handheld probes most commonly are preferred for their
ease and simplicity in application. However, the use of
second- and third-generation probes also is common, especially in the field of research where variables such as pressure or force on probing, reproducibility, and accuracy are
investigated. Various studies considering these different
probes and their characteristics also are found in the literature. Samuel et al^** have published an in vitro study testing
the accuracy and reproducibility of automated and conventional probes. In that study automated probes were reported to ofer increased accuracy over conventional probes,
and the reproducibility of both Florida pocket-depth and
disk probes was found to be comparable with that of the
conventional probes. Buduneli et al in an in vitro model
investigated the accuracy and reproducibility of two manual
probes and concluded that overall accuracy was higher with
the WHO probe compared with the Williams probe. This
study also revealed better reproducibility percentages for the
WHO probe in comparison with the Williams probe.

PROBE CHARACTERISTICS
Characteristics of the probe, such as its diameter at the
tip and the calibration, can influence PPD measurement.
Different probes, such as Michigan, Williams, Marquis,
Goldman-Fox, and Nabers probes, have different dimensions and a different diameter at the tip. The tip diameters
range from 0.28 mm for the Michigan "O" probe to 0.7 mm
for the Williams probe. Moreover, the widths of probe markings in the painted bands differ by as much as 0.7 mm between probes because of manufacturing errors. Figure 3
illustrates different manual probes. Van der Zee et al^ evaluated the accuracy of probe markings in a variety of probes
and noted that probes from the same batch from the same
production line could differ by more than 0.5 mm in calibration and the mean tip diameter ranged from 0.28 mm to
0.7 mm. They concluded that probe-tip diameter and calibration should be considered in addition to other variables
of periodontal prohing. Standardization of tine characteristics and avoidance of the use of different types or batches in
a single study should enhance the accuracy and reproducibility of periodontal probe-dependent measurements.
Atassi et al'^^ compared a parallel-sided probe to a tapered
probe (Figure 4). Results indicated that the parallel-sided

January | February 2009Volume 30, Number 1

Continuing Education 1
tine tended to yield a deeper reading when a difference
occurred. Garnick and Silverstein^^ reviewed the effect of
the probe-tip diameter on accurate probe placement and
recommended a probe-tip diameter of 0.6 mm and a 20-g
force to measure a reduction in the clinical probing depth
after therapy. Quirynen et al^ found interexaminer variability was dependent upon probe type. The study compared a conventional periodontal probe with an autotnatic,
computerized, constant-force, electronic probe in vivo and
found tbat PPD measurements recorded with the manual
probe were consistently deeper than tbose recorded with
tbe electronic probe. Wang et al evaluated intra- and Interexaminer reproducibility for conventional and electronic
probes and found that reproducibility may not necessarily
he higher with an electronic, force-controlled periodontal
probe than with a conventional manual probe. In an attempt to overcome some of the technical challenges associated with conventional manual periodontal probes, numerous electronic periodontal probes bave been developed
that permit probe insertion with a controlled force.^

Figure 5A Florida Probe hardware.

Figure 5B Florida Probe handpiece.

18

Compendium

The con trolled-force probe that has achieved the most

widespread use is the Florida Probe*" (Florida Probe Corp,
Gainesville, FL) (Figure 5A and Figure 5B). Tbis computerlinked device has in vitro resolution of 0.1 mm and is capable of recording probing deptbs and relative attachment
levels.^^'^' Clinical measurements obtained with conventional manual probes are consistently greater than those
obtained with con trolled-force p robes. "^-^^'^^ One of the
possible reasons for tbis is reduced tactile sensitivity associated with the use of controUed-force probes. This is especially true in patients with untreated periodontitis for whom
the presence of subgingival calculus can interfere with
probe insertion. With conventional probes, it generally is
easier for the operator to manipulate the probe tip past subgingival calculus deposits. A definite advantage of computerlinked probes is that they can record probe readings automatically. Some systems allow voice-activated data entry.-^**
The usefulness of controlled-force probes in day-to-day
clinical practice bas not yet been demonstrated.^
One possible reason for tbe lack of widespread acceptance of controlled-force electronic probes by practitioners
might be increased patient discomfort when these devices
are used, particularly around the anterior teeth. During
probing with conventional manual probes, tbe operator
can decrease the insertion force rapidly if the patient shows
any early signs of discomfort. With controlled-force probes.

January | February 2009Volume 30, Number 1

Khan and Cabanilla

this patient-dentist feedback is not possible because the
probe is inserted into the pocket in one motion and with
fixed or predetermined force.

rather tban the absolute PPD that was important. Furthermore, they stated tbat application of heavy force is contraindicated and does not lead to greater precision.

PROBING FORCE

SITES OF MEASUREMENT

Probing force can influence probing measurement and has

been studied widely. Force-controlled periodontal probes
have been introdticed to increase tbe reliability of probing
measurements. Van der Velden et at-^ used probing forces
of 0.15 N, 0.25 N, 0.5 N, and 0.75 N and found a significant difference between PPD recordings with a low and a
bigh probing force. As a result, tbey recommended a probing force of 0.75 N as optimal, with probes of 0.63 mm in
diameter. Chamberlain et aK' indicated tbat bigber probing
forces are more reproducible. In their study, tbe probe tip
extended to tbe most coronal connective-tissue attacbment
in health and disease, using a force of 0.75 N. Reproducibility is important, however, because increasing PPDs
or attacbmcnt-level changes may be indicative of disease
activity. Reproducibility of repeated measurements has
been considered a good indicator of reliability.^^'^^
Osborn et al-''* compared [be intra- and interexaminer
measurement error of the Florida pocket-depth probe, the
Florida disk probe, and tbe conventional manual probe in
subjects witb moderate to severe periodontitis. At the site
level, tbe mean intraexaminer standard deviations of differences in repeated relative attacbment-level measurements
using the Florida disk probe and the conventional probe
ranged from 0.55 mm to 0.82 mm and 0.62 mm to 1.14 mm
respectively. Intraexaminer standard deviations of differences
in probing depth measurements using tbe Florida pocketdepth probe ranged from 0.6 mm to 0.93 mm {differences in relative attacbment levels for the Florida pockct-deptb
probe was not reported). Hassel et al'^'^ noted a substantial
variation in probing force exerted by six clinicians who
probed four surfaces of 30 teeth in five patients. Moreover,
they lund a poor correlation between PPD measured by
the probe and the probe force applied. Tbey concluded tbat
probing forces had only a moderate influence on tbe depcb
of measurements and tbat tbe probing technique was the
more critical factor in PPD measurement tban tbe pressure
applied to tbe probe. Hassel et a'*^ reported that probing
technique was important if clinical evaluations were to be
correlated to the condition in reality, atid favored a slow, deliberate searcbing style of probing for each area of tbe pocket. They also reported that it was the pocket topography

vwww.compendiumlive.com

Persson compared line-angle measurements witb midproximal measurements in untreated sites and found tbat the
mean PPD was 1 mm greater witb midproximal measurements than witb line-angle measurements. This finding
implies tbat clinical and epidemiologic studies using lineangle measurements may underestimate PPD and, thus,
the true level of disease. From one visit to another, it is difficult to duplicate precisely the insertion force and to reproduce exactly the site and angulation of probe insertion.
PPD appears to influence tbe reproducibility of PPD
measurements, and tbe general consensus is that measurements of shallow pockets are more reproducible than those
of deep pockets."*- Kalkwarf and Kaldabl'*^ determined
that the pressure-controlled technique produced significantly deeper clinical probing measurements on tbe direct
facial and lingual aspects of tectb regardless of the stage of
periodontal therapy that had been completed, and manual
probing obtained deeper measurements on the distolingual
aspects of teeth in the posterior regions, wbicb bad not

Figure 6 Proper and improper probe insertion techniques.

Underanguiation of probe may lead to inaccurate probing
depth (top); proper angulation of probe is parallel to the
tooth surface, which allows the tip of the probe to reach
the depth of the pocket (center); overangulation of probe
may lead to inaccurate probing depth (bottom).

Compendium

19

Continuing Education 1
received surgical therapy. Control of vertical force during
probing may provide a more objective method of monitoring periodontal status during longitudinal trials. In shallow
pockets (1 mm to 3 mm) the difference was smallest, and
the discrepancy increased with increasing PPD regardless
of sites, stage of therapy, or location in the mouth. As well
as varying by PPD, examiner reproducibility for any given
method also may vary among tooth types, tooth surfaces,
and PPD.^'^The higher degree of reproducibility for buccal surfaces probably is explained by better visibility and by
facilitated reproducibility of probe placement within tbe
sballower pockets on these surfaces. Furthermore, in this
study, access, visibility, as well as cooperation during measurements, varied between patients. Figure 6 illustrates proper probe insertion technique, highlighting possible outcomes
based on variations in the angle of insertion.

REFERENCES
1. Listgarten MA. Periodontal probing: what does it mean?/ Clin
Periodontol. 1980;7(3):]65-176.
2. Carlos JP, Brunelle JA, Wolfe MD. Artaclimenr loss vs. pocket
depth as indicators of pedodonral disease: a mthodologie note.
f Periodontal Res. 1987;22(6):524-525.
3. van der Velden U, de Vries JH. Introduction of new periodontal probe: the pressure probe./ Clin Periodontol. 1978;5(3):
188-197.
4. Wang SF, Leknes KN, Zimmerman GJ, et al. Intra- and incerexaminer reproducibility in constant force probing./ Clin
Periodontol. 1995;22(12):918-922.
5. van der Zee E, Davies EH, Newman HN. Marking width,
calibration from tip and tine diameter of periodontal probes.
/ Clin Periodontol. 1991 ;!8(7):516-520.
6. Chamberlain AD, Rerivert S, Garrett S, et a!. Significance of
probing force for evaluation of healing following periodontal

CONCLUSION
For more than a century, the periodontal probe bas played
an integral part in the periodontal examination and the
detection of periodontal diseases. Its use not only enables
treatment to be planned appropriately, but also facilitates
longitudinal monitoring so that the response to treatment
may be assessed and sites of possible disease progression
identified. Yet, periodontal probing is an imprecise technique with several potential sources of error.'*'*"*" This
review has described the effect of a number of these variables on PPD measurement. Because ofthe different factors and technical challenges affecting the PPD measurements, it is generally expected that the consecutive readings
of PPD at a given site may vary by up to 1 mm as a function ofthe limited sensitivity of this system of measurement.^*' Despite these problems and challenges, properly
used periodontal probes provide critically important information regarding the periodontal status oi patients.
Measurements obtained with periodontal probes are the
best way to assess damage caused by periodontal infections
and are essential for longitudinally monitoring the response to treatment.

therapy./C// Periodontol. 1985;12(4):306-311.

7. Armitage GC, Svanberg GK, Loe H. Microscopic evaluation
of clinical measurements of connective tissue attachment levels./ CZ/n Periodontoi. 1977;4(3):173-190.
8. Caton J, Greenstein G, Poison AM. Depth of periodontal
probe penetration related to clinical and histologie signs of
gingival inflammation./ArWonw/. 1981;52(10):626-629.
9. Armitage GC. Periodontal diseases: diagnosis. Ann Periodontoi 1996;1(1):37-215.
lO.Robinson PJ, Vitek RM. "Fhe relationship between gingival
inflammarion and resistance to probe penetration.//VnoontalRes. 1979;14(3):239'243.
11. Fowler C, Garrett S, Cri^er M, et al. Histologie probe position
in treated and untreated buman periodontal tissues./ CUn
Periodontol 1982;9(5):373-385.
12.Tessier JF, Ellen RP, Birek P, et al. Relationship between periodonra! probing velocity and gingival inflammation in human
subjects./ Clin Periodontol. ]993;20(l):41-48.
13.Spray JR, Garnick JJ, Doles LR, ct al. Microscopic demonstration ofthe position of periodontal prohes. f Periodontol.
1978;49(3): 148-152.
14.Anderson GB, Cafesse RG, Nasjleti CE, et al. Correlation of

ACKNOWLEDGEMENTS
The authors thank Dr. E. B. Hancock and Dr. S. B. Blanchard, Indiana University School of Dentistry, for their
support and feedback. The authors also thank Dr. Sarah
Fitzpatrick, University of Florida, for her assistance with
the Florida Probe images.

20

Compendium

periodonral probe penetration and degree of inflammation.

AmfDent. 199I;4(4):177'183.
1 5. Listgarten M. Ultrastructure ofthe dento-gingival junction after gingivectomy.//VttOii!oM/. 1972;7(2): 151-160.
16.Sivertson JF, Brgert FG. Probing of pockets related to the attacbment kvcif Periodontol. 1976;47(5):281-286.

lanuary | February 2009Volume 30, Number 1

Khan and Cabanilla

17.Saglie R. Johansen JR, Flotra L The zone of completely and
partially destructed periodonta!fibersin pathological pockets.
JClin Periodontol. I975;2(4):198-202.
] S.Biddcl AJ, Palmer RM, Wilson RF, er al. Comparison of the
validity O periodontal probing measurements in smokers and
non-smokers, y C//M Periodontol. 2001;28(8):806-8]2.

pressure probe and measurements made at surgery, irtt Dentj.

1990;40(6):333-338.
33.Badersten A, Nilvus R, Egelberg J. Reproducibility of probing attachment level measurements. J Clin Periodontol. 1984;
U(7):475-485.
34.Osborn JB, Stoltenberg JL, Huso BA, et al. Comparison of

19.Philstrm LB. Measurement of attachment level in clinical

measurement variability in subjects with moderate periodonti-

trials: probing methods.//Vr/Woww/. 1992;63(12 SuppI):

tis using a conventional and constant force periodontal probe.

1072-1077.

J Periodontol. 1993;63(4):283-289.

2O.Samuel ED, Griffiths GS, Petrle A. In vitro accuracy and

35. Rams TE, Slots J, Comparison of two pressure-sensitive peri-

, reproducibility of automated and conventiotial periodontal

odontal probes and a manual probe in shallow and deep pock-

probes.y C/i Periodontol. 1997;24(5):340-345.

ets. IntJ Periodontics Restorative Dent. 1993; 13(6):521-529.

21. Buduncli E, Aksoy O, Kose T, et al. Accuracy and reproducibil-

36.Perry DA, Taggart EJ, Leung A. et al. Comparison of a con-

ity of rwo manual periodontal probes. An in vitro study. 7 C//

ventional probe with electronic and manual pressure regulat-

Periodontol 2004;31(10):8I5-8!9.

ed piches. J Periodontol 1994;65(I0):908-913.

22. Atas.si F, Newman HN. Bulman JS. Probe tine diameter and
probing depth./ Clin Periodontol. 1992; 19(5):3OI-3O4.
23. Garnick JJ, Silvetstein L. Periodontal probing: probe tip diameter. J Periodontol. 200;71 ( 1 ):96-103.
24.QQrynen M, Callens A, van Steenberghe D, et al. Clinical
evaluation of a constant force electronic pmhe. J Periodontol.
l993;64(]):35-39.
25.Gibbs CH, HirshfeldJW, LeeJG, et al. Description and clinical evaluation of a new computerized periodontal probe
The Florida Probe, y C//"n/lrno)nw/. ]988;15(2):137-144.
26.Magnusson 1, Fuller WW, Heins PJ, et al. Correlation between electronic and visual readings of pocket depths with a
newly developed constant force probe.y Gin Periodontol. 1988;
15(3):180-I84.
27.Magnusson I, Clark WB, Marks RG, et al. Attachment level
measurements with a constant force electronic probe.y Clin
Periodontol. 1988;15(3):185-188.
28. Marks RG, Low SB, Taylor M, et al. Reproducibility of attachment level measurements with two models of Florida
Probe.y C/i Periodontol 1991;18(I0):780-784.
29. Yang MGK, Marks RG, Magniisson I, et al. Reproducibility of

37. Hull PS, Glerehugh V, Ghassemi-Aval A. An assessment of the

validity of a constant force electronic probe in measuring probing depths, y Periodontol 1995;66(l):848-851.
38.Mintzer RE, Derdivanis JP. Automated periodontal protiing
and recording. In: Ytikna RA, Newman MG, Williams RG, eds.
Current Opinion in Periodontology. Philadelphia, PA: C^urrcnt

Science; 1993.
39.Osborn j , Stoltenberg], Huso B, et al. Comparison of measurement variability using a standard and constant force periodontal pmbe. J Periodontol. 1990;61(8):497-503.
4O.Hassell TM, Germann MA, Saxcr UP Periodontal probing:
interinvestigator discrepancies and correlations between probing
force and recorded depdi. Helv OdontolActa. 1973;17(I):38-42.
4l.Persson GR. Effects of"line-angle versus midproximal periodontal probing measurements on prevalence estimates of
periodontal disease. J Periodontal Res. 1991 ;26(6):527-329.
42.Glavind L, Loe H. Errors in the clinical assessment of periodontal destruction. J Periodontal Res. 1967;2(3):180-184.
43. Kalkwarf KL, Kaldahl WB, Patil KD. Comparison of manual
and pressure-controlled periodontal probing. J Periodontol
1986;57(8):467-471.
44. Watts T. Constant force probing with and without a stcnt in

an electronic probe in relative attachment level measurements.

untreated periodontal disease: the clinical reproducibility prob-

JClin Periodontol. 1992;19(8):541-548.

lem and possible sources of error, y Clin Periodontol 1987;

30.Clark WB, Yang MGK, Magnusson 1. Measuring clinical

attachment: reptodticibility of relative measurements with an
electronic proht. / Periodontol 1992;63(10):831-838.
31.Clark WB, Magnusson I, Namgung YY, et al. The strategy
and advantage in use of an electronic probe for attachtnent
measurement. Adv Dent Res. 1993:7(2): 152-157.
32.Galgut PN, Waite IM, A comparison between measurements
with a conventional periodontal pocket probe, an electronic

www.compendiumlive.com

]4(7):407-41l.
45.Watts TL. Visual and tactile observational error: comparative
probing reliability with recession and cementoenamel junction measurements. Community Dent Oral Epidemiol 1989;
17(6):310-3I2.
46. Watts TL. Probing site configuration in patients with untreated periodontitis. A study of horizontal positional error. JClin
PeriodontoL 1989;16(8):529-533.

Compendium

21

Quiz 1

Continuing Education 1

1. The primary aim of periodontal probing is to locate the:

a. coronal level of the unctional epithelium.
b. most coronal level of the connective-tissue
attachment.
c. coronal extent of the alveolar crest.
d. apical extent of the inflamed connective-tissue
fibers.

7. In a study of force-controlled periodontal probes, van

der Velden et al recommended what as the optimal
probing force?

2. Based on study results, how do periodontal probes

measure the true histologie sulcus depth?
a. they underestimate
b. they overestimate
c. they accurately estimate
d. they pinpoint

8. Hassel et al concluded that probing technique was

the more critical factor in periodontal probing depth
measurements, favoring which technique?
a. slow, deliberate searching style of probing for
each area of the pocket
b quick, distinct probing in six specific sites of
the pocket
c. slow, walking-style motions from line angle to
line angle
d. It was dependent on the type of probe used.

3. An ideal periodontal probe should possess which

specific characteristics?
a. tissue-friendly
b. standardized
C. simple to use and read
d. all of the above
4. The tip of the diameter of the Michigan "O"
probe is:
a. 0.28 mm.
b. 0.7 mm.
c. 1 mm.
d. 1.2 mm.
5. Results from a comparison between a parallel-sided
tine probe and a tapered probed indicated that the
parallel-sided tine tended to yield:
a. more accurate readings.
b. shallower readings.
C. deeper readings.
d. very similar readings.
6. In a study comparing conventional with automatic,
computerized, constant-force, electronic periodontal
probes, measurements recorded with the manual
probe were found to be consistently:
a. more accurate than the electronic probe.
b. similar to the electronic probe.
C. shallower than the electronic probe,
d. deeper than the electronic probe.

a. 0.25 N
b. 0.5 N
c. 0.75 N

d. 1 N

9. The general consensus is that measurements of

shallow pockets are:
a. more reproducible than those of deep pockets.
b. less reproducible than those of deep pockets.
c. more accurately recorded with the use of
pressure-controlled probes.
d. There is no difference from deep pockets, in
terms of accuracy as long as equal forces are
used during probing.
10. In a comparison of manual and pressure-controlled
periodontal probes, the pressure-controlled technique
produced significantly deeper clinical probing measurements on which aspects of teeth regardless of the
stage of periodontal therapy that had been completed?
a. distolingual and mesiolingual
b. mesiofacial and distofacial
C. direct facial and lingual
d. all of the above

Please see tester form on page 36.

This article provides 2 hours of CE credit from AEGIS Communications. Record your answers on the enclosed answer sheet or
submit tbem on a separate sheet of paper. You may also pboneyour ansvwers i n t o (888) 596-4605 or fax them to (703) 404-1801
or log on to wwv^/.compendiumlive.com and click on "Continuing Education." Be sure to include your name, address, telephone
number, and last 4 digits of your Social Security number

22

Compendium

January | February 2009Volume 30, Number 1

CE ANSWER FORM

Compendium, January/February 2009

CE1
1.

2.
3.
4.
5.
6.
7.
8.
9.
10.

CE 2
a
a

b
b
b
b
b
b
b
b
b
b

a
a
a
a
a

a
a
a

c
c
c

d
d

d
d
d
d
d
d
d

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

c
c
c
c
c
c

Presently Enrolled in CE Program

a
a
a
a

a
a
a

a
a
a

b
b
b
b
b
b
b
b
b
b

c
c
c
c

d
d
d
d
d
d
d
d
d
d

c
c
c
c
c

Not Enrolled
n 1 exam completed = $16.00
n 2 exams completed = $28.00

Please enroll me in the Compendium Continuing Education Program marked below:

n Please enroll me in the 12-month CE Program for $243.00.
Program includes all 18 exams (up to 36 credit hours) in the Compendium for 1 year.
n CHECK (payable to AEGIS Communications)
D CREDIT CARD - Please complete information and sign below:

Expiration Date: Mo/Y

Card Number

n Visa n MasterCard ^ American Express

SIGNATURE

DATE
VDA Number

(PLEASE PRINT CLEARLY)

Last 4 digits of the SSN F

) Number

The Month and Day (not year) of Birth. Example, Jan 23 is 01/23.

Month/Date of Birth

Name
Address
City
State

Zip

Daytime Phone
Please mail completed forms with your payment to: AEGIS Communications
CE Department, 405 Glenn Drive, Suite 4, Sterling, VA 20164-4432

SCORING SERVICES: By Mail Fax: 703-404-1801 Phone-in: 888-596-4605 (9 am-5 pm ET, Mon.-Fri.)
Customer Service Questions? Please Call 888-596-4605

PROGRAM EVALUATION
Please mark your level of agreement with the following statements.
(4 = Strongly Agree; 0 = Strongly Disagree)

1) Clarity of objectives
2) Usefulness of the content
3) Benefit to your clinical practice
4) Usefulness of the references
5) Quality of the written presentation
6) Quality of the illustrations
7) Clarity of review questions
8) Relevance of review questions
9) Did this lesson achieve its educational objectives?
10) Did this article present new information?
11) How much time did it take you to complete this lesson?
36

CE 1

CE 2

S [E (U El 0 [I][I][I][Il[]
H [H [E El [] H [E ] El 0
[4][^[]|T|[o] [4][3][2][TI[o]
[4][3][2][T|[] H U ] ! ! ] E I S

S H ] [ E E l 0 E][E[EEI[E
[4] [a] [2] [T| [] [f] [E ] E [E
Yes No
Yes No
Yes

No

Yes

No

min

DEADLINE FOR SUBMISSION OF ANSWERS IS 24 MONTHS AFTER THE DATE OF PUBLICATION.

min