probes

1. PERIODONTAL PROBES
DR RAMYA GANESH
SENIOR LECTURER
MALABAR DENTAL COLLEGE RESEARCH CENTRE

2. CONTENTSINTRODUCTION
DEFINITION
PARTS OF A PROBE
HISTORY
CHARACTERISTICS
USES
PRINCIPLES
CLASSIFICATION
TRANSGINGIVAL PROBING
PERI IMPLANT PROBING
NICDR CRITERIA
RECENT ADVANCES
CONCLUSION
REFERENCESCONTENTS

3. INTRODUCTION
Periodontalinstruments
Periodontal probes
Explorers
Scaling , root planning
and curettage
Periodontal endoscope
Cleansing and polishing

4. PROBE
• Is a slender instrument with a blunt end suitable for use in exploring a channel ,
wound , sinus or pocket - American academy of periodontology
DEFINITION
PROBO in latin means ‘to test’

5. HISTORY
John.W.Riggs [1885] was the first
person to describe probe as “the
use of very thin flat explorers to
determine the depth of pockets”.
Periodontal probe and its use was
first described by F.V. Simoton of
the University Of California, San
Francisco in 1925. (3)
Miller suggested probing of all
pockets and recording their depth
and putting this information on
diagnostic chart.(4)
Simonton proposed flat probes 1
mm wide, 10 mm long, and
notched every 2 mm.
Orban [1958] described probe as
“an eye of operator beyond
gingival margin.”

6. Goldman et al . stated that “Clinical probing
with suitable periodontal instruments such
as the Williams calibrated probe is a prime
necessity in delineating the depth,
topography and character of the
periodontal Pocket”
Glickman stated that "The probe is an
instrument with a tapered rod-like blade
which has a blunt and rounded tip”
The probes most commonly used today
were developed by Ramfjord in 1959.
In 1967, Clavind and Loe reported the
results of a research protocol in which they
used a periodontal probe tip that was 0.8
mm in diameter with a 10 gram force.
In 1992, B. L. Pihlstrom created a
classification of periodontal probes with first
second and third generation which was
further modified by Watts including fourth
and fifth generation.

7. PARTS OF PROBE
working end
shank
handle

8. CHARACTERISTICS
Tapered
Straight
Calibrations[mm]
Blunt
Rounded tip
Angled shank

9. USES

12. PROBNG POSITIONS

13. GRASP

14. TECHNIQUE

15. ©M. S. Ramaiah University of Applied Sciences
15

17. CLASSIFICATION B.L.PHILSTROM[1992] WATTS[2000]
FIRST
• Conventional manual probes
SECOND
• Pressure sensitive but lacked tactile sensitivity
THIRD
• Computerized probes
FOURTH
• Three dimensional probes
FIFTH
• Ultrasonographic probes which provides painless probing

18. FIRST GENERATION PROBES
Conventional/manual
No pressure or force measuring device
Tapered,flat or rectangular with smooth rounded ends
Calibrations are in mm
Curved or straight working end to facilitate probing
William’s probe,WHO probe,UNC 15 probe,Marques color coded
probe,Merritt B probe,Goldman fox probe,Naber’s probe

19. WILLIAM’S PROBE
Introduced by Charles.H.M.Williams in 1936.
Stainless steel probe with length 10mm with a blunt tip end
Angle between probe tip and handle is 130 degree

20. CPITN PROBE
• Designed by George.S.Beagrie and Jukka Ainamo in 1978.
• WHO…….CPITN-E / CPITN-C

21. GOLDMAN- FOX PROBE
• Have similar markings as William’s probe but has a flat tip.

22. MICHIGAN ‘O’ PROBE
UNIVERSITY OF MICHIGAN ‘O’ PROBE

23. MERRITT B PROBE• Round tip with single bend in shank.

24. UNIVERSITY OF NORTH CAROLINA PROBE
• 15 mm probe with markings in each mm.
• Color coding in 5th , 10th,15th mm.

25. NABER’S PROBE
• Used for detecting and measuring horizontal periodontal furcation
involvement in a multirooted teeth.

26. MARQUIS COLOR CODED PROBE• Has markings in 3-3-3-3/3-3-2-3/2-2-2-2 mm intervals.
• Very thin tip

27. Advantages Disadvantages
This are easily available and inexpensive Probing force cannot be measured
Easily navigated by operator Heavy in weight
Tactile sensation is preserved Assistant is required for recording the
readings
Color coding -reading Inter-examiner variation is high

28. SECOND GENERATION PROBES
Pressure sensitive
probe
Probing pressure
should not exceed
0.2N/mms
True pressure sensitive probe
Gabathuller and hassell
Armitage
Tromp et al
Vivek et al
Polson et al

29. In 1971 first probe was designed with constant force application.
In 1977 Armitage - pressure sensitive holder which determined a constant
probing pressure of 25 pounds affects the connective tissue attachment.
In 1978 van der valden – pressure sensitive probe using a cylinder and
piston connected to a air water system.
GABATHULLER AND HASSELL
ARMITAGE AND VANdER VALDEN

30. TROMP ET AL
 In 1979 introduced a pressure sensitive probe in which a torque spring was attached to a loose probe head that
could rotate in a point bearing.
 By doing this they achieved a constant force application of 15 gms which is independent of operator.
VIVEK ET AL
 Designed a leaf spring force controlled periodontal probe.
 Force of 0.5 gms with a tip diameter of 0.35 +_ 0.05mm.

31. VINE VALLEY PROBE
Introduced by Poulson et al in 1980.
Electronic pressure sensitive probe.
DESIGN-had a handpiece and a control base which allowed examiner to
control probing pressure.
WORKING-an electromagnetic device designed to accurately measure
force applied .The force was ‘preset’ and probing was performed . ’BEEP’
sound will be heard if operator exceeds the pressure.

32. TRUE SENSITIVE PROBE
• Introduced in 1994 by Frank Hunter.
• DESIGN-has a disposable probing head and a hemispheric probe tip with
a diameter of 0.5mm.
• WORKING-rim surrounding side of ball tip helps in detection of
CEJ,calculus and root surface irregularities.Controlled probing force is
provided using a parallelogram.

33. Advantages Disadvantages
Less inter-examiner variation Assistant is required to record the
readings
Comfortable to the patient
Limitations
 Errors in constant pressure application
 Errors in reading
 Errors in calculation of attachment loss

34. THIRD GENERATION PROBES
Automated probing
system
Computerised storage of
data
-Florida probe
-foster miller probe
-Toronto automated probe
-interprobe

35. FLORIDA PROBE
• Developed by Gibbs et al in 1986.
Easy to use
Non-invasive
Standardized
force
Proper guidance
Easy access to any
location
Light weight No biohazard
Direct electronic
reading
Quick digital
output

36. • DESIGN

38. FOSTER-MILLER PROBE [ALABAMA]
• Measuring the pocket depth along with detection of CEJ.
Components of probe
-pneumatic cylinder
-linear variable differential transducer
-force transducer
-accelerator
-probe tip

39. • Detection of CEJ is done by running probe on root surface at a controlled
speed and preset pressure.
• When probe reaches CEJ there is abrupt change acceleration which is
indicated by graph

40. TORONTO AUTOMATED PROBE
-By Mc Culloch and Birek in 1991
Used to measure gingival attachment loss
Tilt sensor device with handle –angulation changes
Advantages-Incorporated electronic guidance ,
Precision in probe angulation
Disadvantages- Difficulty in probing around 2nd
and 3rd molars

41. INTERPROBE
• Was introduced by Goodson and Kondon in year 1988.
• Also known as PERIO PROBE
• Fibre optic technology
• Parameters
Bleeding
Loss of ttachment
Furcation involvement
Suppuration
Mobility

42. -probe tip
-optical transducer
element
-control unit
-memory cards
-foot switch
Working
Fiber bundle transmits light to the transducer and
reflected light to signal processor……probing depth is
computed by comparison of reflected light with
reference ……0.4N

44. FOURTH GENERATION PROBE
Watts TLP in 2000
3D Technology
Under development
Sequential probe positions along gingival sulcus are measured
Is an attempt to extend linear probing in a serial manner

45. Advantages LIMITATIONS
-Allow 3 dimensional
measurement of pocket
-Under development

46. FIFTH GENERATION PROBES
Hinders in 2001
Non invasive
Detects,images and maps upper boundary of periodontal
ligament and its variation over the time
Ultrasonographic probes

47. ULTRASONOGRAPHIC PERIODONTAL PROBES
Introduction
Non invasive
Echoes/ultrasonic waves
3 dimentional information-hard and soft
tissues

48. PRINCIPLE

49. WORKING
Parallel to
long axis of
teeth
Place in
gingiva till
slight
blanching
occurs
Probe is
activated
with foot
paddle….intro
duces a small
stream of
water to
sulcus
Beam is
scattered
reflected
absorbed
Reflected
portion is
absorbed by
machine
Reconstruction
of image
Transducer in
probe will
record
echoes…..com
puter analyses
the data

50. COMPONENTS
-Transducer
-contra angled handpiece
-computer
-hollow conical tip
-water pressure control
-foot pedal

51. Advantages Disadvantages
-Non invasive -Technique sensitive
-Accurate measurement of pocket
depth
-Expensive
-Provides information on condition
of gingival tissues
-Special training required for
interpreting the image
-Computerized storage of data
-Printouts can be obtained

52. TRANS-GINGIVAL PROBING
• Transgingival probing , a procedure carried out under local
anesthesia is used to confirm the extent and configuration of the
intrabony component of the pocket or of the furcation defects and
thickness of gingiva.

54. RECENT ADVANCES
• Color vue probe
Have yellow tip with black markings to provide superior contrast to intraoral
structures for enhanced visibility.

55. PERI-IMPLANT PROBING
Natural teeth…..supracrestal
fibers……resist probe
No fibre attachment
……implants
Measures depth of tissue
around implants
Measure level of attachment
of mucosa

56. Sulphide concentrations[S,HS ] as an
indicator of gram-negative bacterial activity.
Combines the use of conventional Michigan
‘o’ probe with a sulphide sensor and has a
disposable probe tip
Diamond probe

57. DetecTar Probe
• Detects subgingival calculus by means of audio readings [beep].

58. PERIO TEMP PROBE• Detects early inflammatory changes in gingival tissues by measuring
temperature variation.
• Detects pocket temperature of 0.1 degree Celsius from a referenced
subgingival temperature.

59. RECENT STUDIES
Study was conducted by K.N. Al shayeb,W.Turner and D.G.Gilliam in year 2014
were they measured the accuracy and reproducibility of Williams 14 W,
Chapple UBCF-15, and Vivacare TPS probes and results showed TPS probe
produced the most accurate and most reproducible forces, whereas the
Williams probe produced the least accurate and least reproducible forces.

60. CONCLUSION
Newer developments in the field of periodontal probes
provide the potential for error free determination of pocket
depth and clinical attachment level at a very early stage .
Screening periodontal diseases at a early stage is gaining
importance as it is associated with systemic conditions.
With more research the advent of newer error free probes
may resolve the remaining problems and those yet to be
realised.

61. REFERENCES
• Periodontal probes –a review article by k.venkata Srikanth et al 2012.
• Periodontal instruments [periobasics.com]
• Fundamentals of Periodontal Instrumentation by Nield Gehrig Jill.
• Carranza’a clinical periodontology ,vol 2 edition 11 ,chapter scaling and
root planning, page numbers-492-493
• Probing in to probes measuring the choices-a review article by Heidi
emmerling and elen standley in 2010.
• Periodontal probing systems a review of available equipment-a review
article by Srinivas et al in 2011.
• A textbook of periodontology by Enrico G Bartlucci ,second volume
• A color atlas of Periodontology by J.M Waite,JD Strahan
• Contemporary periodontics by D Walter Cohen.