North carolina periodontal probe

At baseline, one previously calibrated periodontist (95.3% intra-examiner concordance) performed a complete periodontal examination on all participants. Periodontal biometric parameters were recorded at six sites per tooth (excluding third molars) using a North Carolina periodontal probe (Hu-Friedy, IL, USA). At the same sites, the presence of plaque [34 (link)] and BoP were recorded dichotomously. The number and percentage of PDs ≥ 4 mm and PDs ≥ 6 mm, the number of teeth, full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) were also recorded.
After clinical and radiographic examination, GP patients underwent a session of supragingival scaling and received oral hygiene instructions. Subgingival scaling and root planing (SRP) were performed by a single trained clinician on a quadrant-wise protocol using hand instruments (Gracey curettes, Hu-Friedy) together with a magnetostrictive device (Cavitron Select, Dentsply, York, PA, USA). NST was completed within 28 days and afterwards patients were recalled every month for supragingival prophylaxis and oral hygiene reinforcement. The periodontal parameters described above were recorded again 3 months after the completion of NST. HI did not receive any treatment but oral hygiene instructions were reinforced.

Two calibrated examiners, one from each center (UNG and UFPR), are performing the clinical evaluations and collection of biofilm, GCF, and blood samples. The following periodontal parameters are being evaluated: visible plaque [52 (link)], gingival bleeding (0/1), BOP (0/1), SUP (0/1), PD (mm), and CAL (mm) at six sites per tooth (mesiobuccal, buccal, distobuccal, distolingual/palatal, lingual/palatal and mesiolingual/palatal) in all teeth, excluding third molars. PD and CAL measurements are rounded to the nearest millimeter using a North Carolina periodontal probe (Hu-Friedy, Chicago, IL, USA).

Measurement of clinical parameters was performed by a calibrated clinician. Plaque index (PI) [42 (link)], gingival index (GI) [42 (link)], bleeding on probing (BOP), probing pocket depth (PPD) (mm), and clinical attachment level (CAL) (mm) were measured at six sites per tooth (mesiobuccal, buccal, distobuccal, distolingual/distopalatinal, lingual/palatinal, and mesiolingual/mesiopalatinal) in all teeth, excluding third molars. BOP was recorded as present or absent if there were signs of bleeding within 30 s after PPD and CAL measurements. Subsequently, the PPD and CAL measurements were recorded to the nearest millimeter using a North Carolina periodontal probe (Hu-Friedy, Chicago, IL, USA). The cementoenamel junction was detected by probing the cervical area of each tooth and was used to calculate the CAL.

During screening, clinical parameters including PPD, BOP (present = 1, absent = 0) and REC (relative to the implant abutment junction) were measured at six sites per implant with a calibrated probe (North Carolina periodontal probe, Hu-Friedy, Chicago, IL, USA). An IR (i.e. less than 3 months old) was used to determine the bone loss at the peri-implantitis sites. All initial and post-operative clinical measurements were carried out by a single examiner (M.C.H.) who was blinded to the study groups. A prior measurement of PPD in 20 implants with peri-implantitis (not included in the study) was repeated three times for intra-examiner calibration resulting in an intra‐agreement coefficient of κ = 0.86. Evaluation of clinical parameters was repeated at baseline and at 6 and 12 months after randomization by the same clinician that performed the measurements during screening. Additionally a Patient’s Oral Health related Quality of Life questionnaire (OHIP-14) was completed by each patient, blood samples were taken and a CBCT was performed at these visits.

One examiner performed the clinical monitoring and carried out all clinical measurements in a given subject. Visible plaque (0/1), gingival bleeding (0/1), BOP (0/1), suppuration (0/1), PD and CAL were measured at six sites per tooth (mesiobuccal, buccal, distobuccal, distolingual, lingual and mesiolingual) in all teeth, excluding third molars. PD and CAL measurements were recorded to the nearest millimeter using a North Carolina periodontal probe (Hu-Friedy, Chicago, IL, USA).

Two calibrated examiners (B.R.V. and L.S.), one from each center (UNG and USP-SP), perform the clinical evaluations and sample collection. The following parameters are evaluated during clinical examination: visible plaque [20 (link)], gingival bleeding (0/1), BOP (0/1), suppuration (0/1), PD (mm) and CAL (mm) at six sites per tooth (mesiobuccal, buccal, distobuccal, distolingual/palatal, lingual/palatal and mesiolingual/palatal) in all teeth, excluding third molars. PD and CAL measurements are rounded to the nearest millimeter using a North Carolina periodontal probe (Hu-Friedy, Chicago, IL, USA).
The two examiners were trained and calibrated prior to and during the trial, in order to achieve maximum reproducibility in the measurements. The methodology used for the inter-examiner and intra-examiner calibration was recommended by Araujo et al. [21 (link)], where the standard error of measurement for continuous periodontal clinical parameters (PD and CAL) is evaluated. For the other clinical variables, the average level of agreement between the examiners is determined and considered satisfactory when greater than 90% (Kappa test).
Clinical measurements and microbiological assessment are performed at baseline, 3, 6 and 12 months post-therapy. Immunological assessment is conducted at baseline and 12 months post-therapy.