title: Reproducibility and validity of the assessment of clinical furcation parameters as related to different probes.
abstract: The aim of this study was to investigate the reliability of the assessment of clinical furcation parameters (horizontal attachment levels [CAL-H], class of furcation invasion). Replicate measurements of CAL-H and furcation class were performed within 14 days in 420 molars of 105 patients with advanced periodontitis using a Nabers- (n=50), a TPS- (n=30) and a PCPUNC15-probe (n=25). Validity of clinical assessments was assessed by intrasurgical measurements. The standard deviation of single measurements (s) was calculated as a measure of the reproducibility of CAL-H measurements and weighted kappa-coefficients (Kw) to estimate the agreement of furcation class assessments. The s ranged from 0.55 to 1.13 mm (Nabers), 0.55 to 1.02 mm (TPS), and 0.58 to 1.11 mm (PCPUNC15). For all probes, a statistically significantly smaller measurement error was observed in buccal and lingual sites than in mesiolingual and distolingual furcations (P < 0.005). The Kw ranged from 0.59 to 0.89 (Nabers), 0.50 to 0.80 (TPS), and 0.53 to 0.72 (PCPUNC 15). Multiple linear regression analysis identified distolingual location, probing depth (PD) and CAL-H as factors influencing the variability of CAL-H measurements. Whereas there was no statistically significant difference between pre- and intrasurgical CAL-H measurements using the Nabers probe, the TPS and PCPUNC15 probe underestimated CAL-H for distolingual furcations (P < 0.025). Using the Nabers probe, no asymmetries between pre- and intrasurgically obtained class of furcation involvement were revealed, while the TPS and PCPUNC15 probe underestimated furcation degrees (P < 0.1). Multiple linear regression analysis identified distolingual location and height of furcation, as well as PD, vertical attachment level (CAL-V) and type of probe, as factors influencing the validity of CAL-H measurements. Clinical diagnosis of furcation lesions using the 3 mm incrementally marked Nabers probe provides reproducible and valid information about furcation invasion.
authors.affiliation: Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-University, Heidelberg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Eickholz
authors.forename: T S
authors.initials: TS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003949:Diagnostic Techniques, Surgical; D004867:Equipment Design; D005260:Female; D017823:Furcation Defects / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D015999:Multivariate Analysis; D017622:Periodontal Attachment Loss / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010517:Periodontics / Q000295:instrumentation*; D010518:Periodontitis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D015203:Reproducibility of Results