Probing pressure, a highly undervalued unit of measure in periodontal probing: a systematic review on its effect on probing pocket depth.
OBJECTIVE
To investigate the influence of probing pressure on the probing pocket depth (PPD) in diseased and healthy periodontal tissue conditions through a systematic review. In addition, to facilitate comparison of the study outcomes, an attempt was made to provide a correction factor that compensates for the different probing pressures used.


METHODS
The MEDLINE-PubMed and Cochrane Central Register of controlled trails (Central) were searched up to June 2008 to indentify appropriate studies.


RESULTS
The search yielded 3032 titles and abstracts. In total, five papers fulfilled the eligibility criteria. These studies provided data with probing pressures ranging from 51 to 995 N/cm(2). For the evaluation of the results a distribution was made between diseased and healthy/treated sites. The incremental change in PPD in healthy/treated sites decreased as the pressure increased above 398 N/cm(2). In diseased sites, this phenomenon was already present at pressures above 100 N/cm(2). At healthy/treated sites, a mean increase of PPD of 0.002 mm per increase of 1 N/cm(2) in probing pressure could be calculated whereas at diseased sites this value amounted to 0.004 mm.


CONCLUSIONS
The results show that with increasing probing pressure, the PPD increases. The dimensions of the increase are dependent on the periodontal tissue conditions.
Clinic for Periodontology, Rotterdam, The Netherlands.
Christian
C
Larsen
Dick S
DS
Barendregt
Dagmar E
DE
Slot
Ubele
U
Van der Velden
Fridus
F
Van der Weijden
D018849:Controlled Clinical Trials as Topic; D003945:Diagnosis, Oral / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000473:pathology*; D011312:Pressure