Subgingival temperature as a gingival inflammatory indicator

Elevated temperature is one of 4 cardinal inflammatory signs. Previous work indicates that subgingival temperature assessments are accurate and re- liable, and provide objective, quantitative information over a broad 10 degrees C range, in small 0.1 degrees C increments with a direct, immediate report on the inflammatory status at the pocket base. However, complicating the use and interpretation of subgingival temperature assessments are its 3 forms: actual subgingival temperature, sublingual temperature minus subgingival temperature (temperature differential), and a temperature indicator light. We reasoned that if one could determine which of the temperature assessments reflected the periodontal condition, and which were independent variables, they would provide new and unique information about the inflammatory status of the periodontium. We also reasoned that by providing objective, quantitative data over a broad range, subgingival temperature should reduce the sample size required to obtain significance in clinical trials. Therefore, the purpose of this study was 2-fold: (1) to determine whether the 3 subgingival temperature assessments could differentiate between clinically defined periodontal health and disease; (2) to determine whether the 3 assessments were dependent or independent clinical variables. The data indicated that all 3 subgingival temperature assessment methods differentiated between clinically-defined periodontal health and disease (all p<0.02). All 3 assessments also correlated significantly (all p<0.03), but modestly (all r>0.49), with bleeding on probing. Based on scatter-plot matrices and common factor analysis, the data indicated that only actual subgingival temperature and temperature differential were independent variables. Taken together, this data indicates that subgingival temperature and temperature differential provide unique information about the periodontal inflammatory state. Power calculations indicated that the temperature differential may significantly reduce the subject number required to achieve significance in clinical trials examining gingival inflammation. Because of the body's rapid temperature response, these assessments may also significantly reduce the time required for gingival inflammation trials.