Effect of nonsurgical periodontal therapy

Incisors, cuspids and premolars in 49 patients with advanced chronic periodontitis were treated with initial, nonsurgical periodontal therapy. The results were monitored by probing attachment level measurements for 6 sites of each tooth every 3rd month during a period of 24 months. Amongst sites with initial probing depth greater than or equal to 4.0 mm, sites with probing attachment loss were identified using regression analysis. Scores for plaque, bleeding, suppuration on probing and probing depth, obtained for these sites during the 24-month study, were analyzed to determine whether any of the scores could be used diagnostically as an indicator of probing attachment loss. Diagnostic sensitivity and predictability were calculated for different levels of each of the scores. The results showed that sites with probing attachment loss were more frequent for sites with high scores for plaque, bleeding, residual probing depth and suppuration than in sites with low scores. However, the diagnostic sensitivity and predictability of these clinical indicators was generally low. Thus, records of plaque, bleeding, suppuration and probing depth do not obviate the need for probing attachment level measurements for identification of sites with probing attachment loss following initial, nonsurgical periodontal therapy.