Influence of periodontal health on probing depth and bleeding tendency

This study investigates the effect of initial treatment on 1) probing force related to probing depth, 2) the attachment level, 3) the position of the gingival margin and 4) the clinical signs of color and change of contour of the gingiva in relation to the bleeding tendency of a pocket. It also addresses the question of whether, in deep inflamed periodontal pockets, the tip of the probe is located at the attachment level when a probing force of 0.75N is used, as has already been shown in pockets related to noninflamed gingival margins. Four different probing forces are used: 0.15N, 0.25N, 0.50N and 0.75N and results show an increasing probing depth with an increasing probing force, both before and after treatment. Initial treatment results in a decrease of mean probing depth but the change is dependent on the applied probing force. The mean probing depth reduction decreased from 1.71 mm (assessed with 0.15N) to 1.24 mm (assessed with 0.75N). Since results from this and a previous study indicate that both before and after treatment the tip of the probe is located at the attachment level when a probing force of 0.75N is used, it may be postulated that the reduction of mean probe-tip level measurements (= probing depth measurement from a fixed point) reflects a degree of connective tissue reattachment. Patients in the initial treatment study were selected on the basis of obvious redness and swelling of the gingiva. After treatment, both of these symptoms almost disappear, whereas the Periodontal Pocket Bleeding Index (P.P.B.I.) decreases only from 0.87 before treatment, to 0.45 after treatment.