Periodontal probing: Probe tip diameter

Background: Periodontal probing is one of the most common methods used in diagnosing periodontal disease. The purpose of this study was to determine the importance of the diameter of periodontal probing tips in diagnosing and evaluating periodontal disease. Methods: The literature discussing periodontal probe diameters in human, dog, and monkey studies was reviewed and compared. Tip diameters varied from 0.4 to over 1.0 mm in these studies. Probe advancement between the gingiva and the tooth is determined by the pressure everted on the gingival tissues and resistance from the healthy or inflamed tissue. The pressure is directly proportionate to the force on the probe and inversely proportionate to the probe tip diameter. The larger probing diameters reduced probe advancement into inflamed connective tissue. This effect of change in probe diameter reduced the pressure in a greater manner than an increase of similar change in probe force. Results: In the studies reviewed, the pressure used to place the probe tip at the base of the periodontal sulcus/pocket was approximately 50 N/cm(2) and at the base of the junctional epithelium, 200 N/cm(2). A tip diameter of 0.6 mm was needed to reach the base of the pocket. Clinical inflammation did not necessarily reflect the severity of histological inflammation, and the recordings may not illustrate probing depth. Furthermore, probing depth did not identify anatomical locations at the base of the pocket. Conclusions: Probe tips need to have a diameter of 0.6 mm and a 0.20 gram force (50 N/cm(2)) to obtain a pressure which demonstrates approximate probing depth. This pressure was needed to measure the reduction of clinical probing depth, which included formation of a long junctional epithelium as a result of therapy. In addition, different forces or diameter tips are needed to measure healthy or inflamed histological periodontal probing depths.