COMPARISON OF MANUAL AND AUTOMATED PROBING IN AN UNTREATED PERIODONTITIS POPULATION

DIAGNOSIS OF PERIODONTAL DISEASE PROGRESSION involves recording two pr obing attachment level measurements over an adequate time interval. A diagnostic instrument which exhibits less measurement variability allo ws for increased sensitivity and earlier disease detection. Traditiona lly, a manual probe with an occlusal stent or the cemento-enamel junct ion (CEJ) as a reference landmark has been the method of choice. Autom ated probes that use an occlusal disk as the reference landmark have b een developed as an alternative means of measure. The aim of this stud y was to compare the variability of these two probing methods. Four hu ndred eleven (411) interproximal sites in 46 untreated periodontitis p atients were monitored by a single examiner over a 6-month period. Eac h site was measured on a monthly basis, first with an automated probe (AP) followed by a manual probe (MP) in combination with a custom-fabr icated acrylic stent. Measurement variability of the two probing metho ds was also compared over a 7-day interval. The AP measurements were s ignificantly more variable than the MP measurements (P<0.001) when con sidering the variability between two passes at the same visit. Over th e 6-month period, the MP measurements demonstrated significantly more variability than the AP measurements (P<0.001). It was also noted that MP measurements exhibited more variability at sites with frequent ble eding during the 6 months of the study (P=0.006). The results of this study demonstrate that AP may have less variability of attachment leve l measurements over a 6-month period and may be less influenced by loc al inflammatory changes. However, future comparison studies should inc lude multiple examiners to reduce examiner bias and should alternate t he probing method to reduce bias created by local tissue changes from multiple probings.