INTRA- INTER-EXAMINER REPRODUCIBILITY STUDY OF GINGIVAL BLEEDING/

Sulcular bleeding after stimulation with a periodontal probe has been associated with the presence of an inflammatory lesion in the gingiva. The objective of this study was to evaluate the effect of the placeme nt of the probe in relation to the tooth surface, and the effect of st andardising the probing pressure on the intra- and inter-examiner repr oducibility of the gingival bleeding when using a well-defined bleedin g index. Four different variations were defined: parallel bleeding ind ex (ParBI): when the probe is run along the marginal gingiva it is hel d parallel to the tooth surface. Angulated bleeding index (AngBI): the probe is held at an angle of approximately 60 degrees to the longitud inal axis of the tooth and in contact with the sulcular epithelium. Co ntrolled force parallel bleeding index (CF-ParBI)/controlled force ang ulated bleeding index (CF-AngBI): the same procedure as described for the ParBI and AngBI is followed, but instead of a conventional (WHO-AS H/Dentsply(R)) probe an adjustable force probe (Brodontico(R)-ASH/dent sply), adjusted to 0.25 N is used. The results show that the agreement both within and between clinicians could hardly be rated as 'fair' on a site basis. Approximately one in every three sites was given a diff erent assessment on the second examination. This might have been the c onsequence of the repeat examination. Agreement on a quadrant basis wa s slightly better. Furthermore, the direction of the probing influence s the number of provoked bleeding sites. Angulation of the probe produ ces consistently less bleeding compared with parallel placement of the probe.