CAN PERIODONTAL PROBING ALTER CLINICAL VARIABLES IN UNTREATED PERIODONTAL PATIENTS? A BLIND-EXAMINER SPLITMOUTH RANDOMIZED CONTROLLED TRIAL
PURPOSE. To assess any variations in periodontal indices (dental plaque, bleeding on probing, gingival recession, pocket depth) after periodontal probing, without carrying out any therapy, in subjects suffering from periodontal disease.
MATERIALS AND METHODS. A blind-examiner split-mouth randomized trial with one-week follow-up was conducted. Adult periodontal patients were recruited from a private dental practice. At baseline (T0), an examiner measured the presence of plaque, bleeding on probing (BoP), probe depth (PD) and gingival recession in one upper and one lower quadrant of participant’s dentition. After 10 minutes (T1), another blind examiner recorded the same variables in both quadrants, one probed and one unprobed, in the same arch. The opposite quadrants were examined after one week (T2) by another blind examiner. Then, sites previously probed and not were compared at T1 and T2 using multilevel models.
RESULTS. Data from thirty patients were analysed, and no drop-outs or adverse effects were recorded during the study. At T1, plaque scores (present/absent) were lower at previously probed sites (OR = 0.61; 95% CI from 0.50 to 0.73; P <0.0001) while at T2 there was no difference in plaque score between probed and unprobed sites (P = 0.5050). Conversely, PD was higher at previously probed sites at T1 (estimated difference of 0.19 mm; 95% CI from 0.06 to 0.31; P = 0.0027) but there was no difference at T2 (P = 0.6495). BoP did not differ between probed and unprobed sites at either T1 (P = 0.6741) or T2 (P = 0.5190), but, while there was no difference in recession between probed and unprobed sites at T1 (P = 0.6682), recession at probed sites was slightly greater at T2 (estimated difference of 0.08 mm; 95% CI from 0.002 to 0.16; P = 0.0455).
CONCLUSIONS. Routine probing manoeuvres were found to be slightly invasive, removing some bacterial plaque and immediately causing a temporary increase in PD, which appeared to lead to a slight increase in recession after one week.