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.
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.
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
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
43.
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
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
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
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.
53.
54. RECENT ADVANCES
• Color vue probe
Have yellow tip with black markings to provide superior contrast to intraoral
structures for enhanced visibility.
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
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.
Editor's Notes
Explorers are used to locate calcus deposits and caries……
no 3 is further divided in to sickle scalers[supragingival plaque],currets[subgingival scaling,root planning,and removal of soft tissue pocket wall],hoe scalers[tenacious sub gingival calculus and altered cementum],ultrasonic and sonic[cleaning and currettig soft tissue wall of pocket wall]
Perio endoscope [to c subgingival pockets and furcations] cleaning and polishing[rubber cups,brushes,dental tape are used to clean and polish surfaces]
Relative attachment level-distance from fixed reference point on a tooth or stent to tip of perio probe
Clinical attachment level the distance from cej to tip f periodontal probe during diagnostic probing
Pseudo pocket,,periodontal pocket ,height of keratinized gingiva,,presence or absence of bop,width and height of gingival recession,size of a lesion[width length and height]
Readings are difficult to read
Measure pocket depth,subgingival calculus,assess treatment needs
Cpitn e and cpitn c
probing depth recordeding is not precise
Flat shanks donot allow easy access to fibrotic pockets
Michigan o probe-3,6,8…cannot measure deep pockets as markings and here
Readings are difficlut to read
Thin tip will most of time penetrate junctional epithelium and cause false readings
3,6,9 and 12 mm
They penetrate junctional epithelium
PROBING FORErrors in probe positioning,difficulty in recording pocket depths around 2nd and 3rd molars,reproducibility is not there
CE RANGES FROM 0.1 N TO 0.9 N
Friction clutch mechanism
National institute of dental and craniofacial research