Williams periodontal probe

Review of the participants’ family and medical histories and examinations within and outside the mouth was completed prior to commencement of the procedure. An orthodontist conducted a facial and skeletal investigation to rule out the presence of bony maxillary excess or skeletal deformity. Additionally, the clinical attachment level, bleeding index, plaque index, and keratinized tissue width was measured as part of the periodontal examination. According to Marcuschamer et al., the presence of altered passive eruption was ruled out by measuring the dimensions and ratio of the maxillary anterior teeth as well as the Zenith from the first molar to the first molar in the adjacent quadrant to make sure all teeth fell within normal dimensions [21 ]. Based on a fresh series of intra-oral peri-apical radiographs taken from the first molar to the last tooth on the opposing side, the entire bone level was evaluated. To rule out a short lip as the cause, the length of the maxillary lip length at rest (MLLR) was measured. A whole dynamic smile was used to quantify the GD on each tooth from the first molar to the first molar at three different sites for each anterior tooth. Using William’s periodontal probe, all measurements were taken and recorded to the nearest millimeter (Hu-Friedy Co., Chicago, IL, USA). The three-time readings’ mean served as the foundation for the final measurement.

Subsequent to saliva sampling, clinical periodontal recordings, including dichotomous (+/−) plaque index (PI), PD, CAL, and dichomotous (+/−) presence of BOP (occurring within 15 s after periodontal probing) were performed at 6 sites on each tooth present (except third molars) using a Williams periodontal probe (Hu Friedy, Chicago, IL, USA). CAL was assessed from the cement-enamel junction to the base of the probable pocket. All clinical measurements were performed by a single calibrated examiner (PG).

The probing depth (PD), clinical attachment level (CAL), plaque index (PI) [34 (link)], and bleeding on probing (BOP) [35 (link)] were determined at six sites per tooth in the whole mouth, excluding third molars. The papilla bleeding index (PBI) was also assessed [36 (link)]. A manual William's periodontal probe (Hu-Friedy, Chicago, IL) was used for PD (millimeters) and CAL (millimeters) measurements. All measurements were performed by a calibrated examiner (OT). The intraexaminer reliability was high as revealed by an intraclass correlation coefficient of 0.87 and 0.85 for PD and CAL measurements, respectively.

The oral hygiene was assessed according to the Silness-Löe plaque index (PI) and the gingival health with the use of the Gingival Index (GI) on the six index teeth: 16, 12, 24, 36, 32, 44. The subject's oral hygiene was described as follows: poor (PI = 1.9–3.0), average (PI = 0.7–1.8), good (PI = 0–0.6). The gingival health was assigned as follows: healthy (GI = 0), mild gingivitis (GI = 0.1–1), moderate gingivitis (GI = 1.1–2), severe gingivitis (GI = 2.1–3) [23 (link), 24 ]. The probing depth (PD) measurements were performed using a Williams periodontal probe (Hu-Friedy Mfg. Co. LLC, Chicago, USA). Bleeding upon probing score (BOP%) was assessed as the percentage of sites bleeding after stimulation with a probe. The measurements of PD and BOP% were recorded on all teeth at six sites (buccal, distobuccal, mesiobuccal, lingual, distolingual, and mesiolingual) [25 (link)].
All subjects were examined by a calibrated pediatric dentist (N.W.). Calibration exercises were performed on healthy teenage patients, not included in the main study. The examiner was considered calibrated when she reached substantial correlation of repeated measurements and a considerable correlation with evaluations of her trainer (J.O.-S) (Cohen’s Kappa > 80).

Dichotomous plaque index (PI) and bleeding on probing (BOP) were recorded as present or absent and percentage values for whole mouth were calculated for each individual. The probing depth (PD) and clinical attachment level (CAL) values were recorded with a Williams periodontal probe (Hu-Friedy, Chicago, IL) and mean values were calculated for all participants in each study group. All parameters were obtained at six sites per tooth (mesial-buccal, mid-buccal, distal-buccal, distal-palatal, mid-palatal, and mesial-palatal) in all teeth present except the third molars in each patient.