Journal of Clinical Periodontology 1983: 10: 11-21

Key words: Clinical probins rcptoducibiliiy - pi-rioilonwl FIa'!l-o-Priihi- - prohi- lip h'cali.iiiiion.
Accepwd for puWication February 7, 1982

Periodontal pocket measurements with

a modified Plast-o-Probe and a metai probe
R. B. A. SANDERINK, W . H . MORMANN AND F . BARBAKOW

Department of Cariology, Periodontology and Preventive Dentistry, University of Zurich, Zurich, Switzerland

Abstract. Two types of periodontal probes used to measure pocket depths, i.e. a modified Plast-o-Piobe
(PoP) and a metal probe (MP), were compared, Periodontal pocket depths in 5 volunteers were
determined by 5 clinically trained investigators using each of the probes. The average periodontal pocket
depth was found to be the same for both probes and was independent of the degree of gingival
inflammation and the localisation of probing. The results obtained by I of the 5 investigators were
influenced by the type of probe. 4 investigators found that PoP permitted a 2.8-lL0% greater degree of
reproducibility while MP exhibited a 0.9-12.2% higher inter-investigator agreement. In vivo-dud in vitro
radiological and histometrica! analysis on another group of patients showed a similar degree of
penetration into the connective tissue zones with both probes. The investigators considered PoP a
precise instrument but suggested that its readability should be improved for routine clinical use.

Clinical probing to determine the attachment (Hassell et al. 1973). Standardised probing
level of periodontal tissues is an imprecise forces did not, however, improve the repro-
technique. This has been described in histolog- ducibility of periodontal pocketdepth measure-
ical studies by Schroeder & Listgarten (1971), ments (van der Velden & de Vries 1980). Other
Armitage et al. (1977) and Poison et al. (1980). factors which influence the mea.surement of
In both dental practice and clinical studies, pocket depth are the presence of subgingival
however, periodontal attachment is estimated calculus, overcontoured restorations and incor-
using periodontal probes of various design rect probing techniques (Tibbetts 1969, List-
(Ramfjord 1959, 1977, Glavind & Loe 1967, garten 1980). In addition, the quality and
Schmid 1967, Ramfjord et ai. 1968, 1973, precision of the probe tips influence the data.
Ramfjord & Nissle 1974, Rosling et al. 1976, The calibration of metal probes can differ by as
Valderhaug & Birkeland 1976, Axelsson & tnuch as 14% (Winter 1979), and the accuracy
Lindhe 1978, Loe et al. 1978, Lang & Fngel- of periodontal probes with removable plastic
mayer 1979, Morrison et al. 1979). tips (Plast-o-Probe, Schmid 1967) was ques-
The probing measurement is influenced by tioned by virtue of their possible elastic defor-
several factors, including local anatomical fac- mation (Lange 1979).
tors, degree of inflammation of the periodontal The purpose of the present study was to
tissues (Saglie et al. 1975, Armitage et al. 1977, compare the accuracy and the reproducibility of
Garnick et al. 1980, Listgarten 1980, Magnus- a modified PIast-o-Probe and a metal type
son & Listgarten 1980) and probing force (van periodontal probe during measurements of pe-
der Velden & de Vries 1978). The latter varies riodontal pockets in a clinical and histometrical
considerably among experienced clinicians study. By accuracy is meant the ability to

0303-6979/83/010011-1] $02.50/0 © 1983 Munksgaard, Copenhagen

 SANDERINK, MORMANN AND BARBAKOW

Material and Methods

This study was conducted in two sections, a
clinical and a radiological-histometrical study.

i. Clinical study
5 newly admitted patients, varying in age from
26-55 years, and diagnosed as having severe
periodontitis, participated in this study. Oral
hygiene instructions, motivation and therapy
were not undertaken until the end of the study.
Fig. 1. Modified Plast-o-Probe (PoP), original Plast- In each patient, 6 teeth with periodontai pock-
o-Probe (middle) and metal probe (MP), (2:1). ets up to 10 mm were selected forthe study. The
Modifiziene Ptast-O'Probe Sonde(PoP). original Plasl- periodontal pockets of each of the selected teeth
O'Probe (Mitte) und Metalhonde (MP). (2:1). were measured on their mesio-facial, facial,
Sonde Pla.st-o-Probe modifiee (Pop), sotide Plast-o- disto-faciai, mesio-orai, oral and disto-oral
Probe nriginale (au ceniie) ei sonde metalHque (MP). aspects. Probing was performed with the metal
(2:1).
probe ZI 8 (MP: A. Deppeierand Fils, CH-l 180
RolJe) and with the modified Plast-o-Probe
(PoP: MaiIleferSA,CH-1338BaIlaigues) (Figs.
minimize al! possible factors leading to in- 1,2).
accurate measurements. Such factors include The periodontal pockets were measured by 5
anatomical variations, probing force, available investigators, who regularly, in the course of
space in the pocket and the consistency of their daily duties, carry out periodontal pocket
tissues at the base of the periodontal pocket. By measurements. To ensure maximum reprodu-
reproducibility is meant the ability of different cibility, the 5 examiners attempted to standard-
examiners to obtain the same pocket depth in
each measured locality at different times.
SBI SBI SBI SBI
MP/PoP MP PoP MP Pop

- 1 0 2 7 9 Day

Fig. 3. Schematic reprcsenlalion of the Study design.

MP, PoP and SBI indicate days when pocket depths
were measured using metal probes (MP) or modified
Plast-o-Probes (PoP), and SBI days when sulcus
\flo.i bleeding indices were recorded.
Uniey.mchungsabtauf: MP/PoP. Probemessungen altcr
Vniersucher mit beiden Sonden. MP bzw. PoP. Mess-
duichgange mit der Metailsonde (MP) oder der modi-
fiiierlen Plasi-o-Probe (PoP)- SBI, Suikusblulmgs-
index durch den Untersucher E unmittelbar vor den
Taschenmessungen.
Deroulemem de I'experience: MP/PoP=mesures~iesls
Fig. 2. Modified Plast-o-Probe (PoP) and metal probe
de lous ies examinaieurs: avec les deux sondes. MP.
(MP), dimensions in mm.
respeclivemeni PoP^^ mensurations avec la sonde me-
Modifiziene Plasi-o-Probe Sonde (PoP) und Metall- taUique (MP) ou la sonde Piast-o-Probe modifiee (PoP).
sondc (MP). Masse in mm. SBJ= enregisirement de I'indice de soignement du siUon
Sonde Plast-o-Probe modifiee (PoP) el sonde metai- gingival, par un meme examinateur E immediatement
lique (MP). dimensions en mm. avant ie xondage. Day=)our.
 COMPARISON OF PLAST-O-PROBE AND METAL PROBE 13

ize their techniques by measuring periodontaJ dontal pockets of the i 1 teeth was probed using
pockets present in another patient, unrelated to MP, and in each case, the tip was cut from the
the study, 1 day prior to beginning the investi- probe and subsequently replaced into the
gation. deepest part of the periodontai pocket. Black
The probing technique required the probe to ciass II inlay-type cavities were prepared on
be placed parallel to the long axis of the tooth. that part of the crown related to the positioned
Measurement of the periodontaJ pockets was MP tip. Each "inlay" preparation was filled with
carried out with the two probes alternatively, composite material (Adaptic®, Johnson &
using MP on days 0 and 7 and PoP on days 2 and Johnson, U.S.A.), which enclosed and formed a
9 (Fig. 3). Before probing, the sulcus bleeding unit with the positioned periodontal probe tip
index (SBI) (Muhlemann & Son 1971) was (PT). When this material had set, a radiograph
recorded in the gingival sulci of the teeth was taken at a standardised angle and the PT
chosen, always by the same investigator. Sub- removed. This procedure was repeated using
sequently, each of the 5 investigators, Pop tips prepared for radiological evaluation as
repeatedly in the same order, carried out pocket follows: two holes, cut into the upper and lower
depth measurements on each of the patients. thirds of the measuring sections of the PoPtips,
The time interval between the pocket depth were filled with amalgam to act as radio-opaque
measurements by each of the 5 different inves- localizing points. The PoP tips were inserted
tigators was 30 min. into the deepest part of the periodontal pocket
Finally, the investigators completed a ques- and the previously prepared inlay cavities filled
tionnaire on their impressions of the use of the with composite material enclosing the posi-
two periodontal probes. Statistical analysis of tioned PoP tips (PT). When the composite had
the recorded data was carried out using Stu- set, radiographs of the PoP tips were taken al
dent's t-test and F-test for (a) the pocket depths the standardised angle, and the PT units re-
alone, or related to (b) SBI (c) the different moved.
investigators and (d) the different probing posi-
tions (Clemmer &. Barbano 1974, Vendrik 1975, B. In vitro macro-photographic examination
Wijvekate 1976). The analysis of variance test The teeth in which the "inlay cavities" had been
was used to evaluate the effect of probe type on prepared were then extracted under local anaes-
pocket deplh (Clemmer &, Barbano 1974, Wij- thesia, washed for 1 min in flowing water,
vekate 1976). stained for 1-2 min with 0.5% loluidin blue
(Waerhaug I97§) and fixed for 24 h in 10%
2. Radiological-histometrical smdy neutral buffered formalin. The purpose thereof
This section of the study was divided into 3 was to differentiate between plaque and cal-
parts: culus, epithelium and connective tissue. The
A. In vivo radiological examination. probe tips of MP and PoP in their PT units were
B. In vitro macro-photographic examination. repositioned into the cavity of each extracted
C. In vitro micro-photographic examination. tooth, photographed at a 1:1 magnification
after which the PT units were removed.
A. In vivo radiological examination
8 other unrelated patients were used in this part C. In vitro micro-photographic examination
of the study. I! teeth, scheduled for extraction Undercuts were subsequently made into each of
due to advanced periodontitis, were selected the il cavities. The PT units, 5 with MP tips, 6
from these patients. These teeth comprised 3 with PoP tips, were inserted using freshly mixed
incisors, 2 cuspids, 3 premolars and 3 molars composite in their respective cavities. It was
from both jaws. The deepest area of the perio- important that the fit of the PT units in the in
14 SANDERINK, MORMANN AND BARBAKOW

vitro investigation was identical to that ob- A. In vivo radiological measurements

tained in vivo. Longitudinal sections, parallel to MP tip: tbe distance between tbe radiographic
tbe long axis of tbe retained probe tip, were root apex and tbe radiographic lip of the metal
made of eacb tootb-inlay probe tip complex and probe was measured using a grid composed of
stained as follows: sequential immersion in 50 % 0.65 mm squares.
and 70% alcohol for 24 h; in alcobol (80% and
96%) witb 0.5% fuchsin for 24 b; in absolute PoP tip: tbe radiograpbic position of tbe most
alcohoj with 0.5 % fuchsin (48 h); and in acetone apical part of tbe plastic probe was determined
(60 b). by comparing tbe rea! and the radiograpbic
During tbis pbase, 3 PT units (1 witb PoP tip, distances between tbe two radio opaque amal-
2 witb MP tip) dislodged from the preparations gam points. A horizontal line was drawn on the
and were discarded. Tbe remaining 8 PT tootb- radiograph indicating the most apical part of
inlay complexes (4 witb MP tip, 4 witb PoP tip) the plastic probe tip. The distance between this
were embedded in 40 ml metacrylic acid-meta- line and the radiographic apex of the root was
cryl-ester (Fluka .AG, CH-9470 Bucbs) witb 9.5 measured using tbe same grid as above. The
ml Plastoid N (Roiim GmbH, FRG) as weak- type of probe witb tbe sbortest distance between
ener and 0.68 g benzylperoxide powder (Merck the radiograpbic apex of tbe root and the probe
& Hobein, Zuricb). After setting, tbe blocks tip (Rap) was recorded.
were sectioned (Isomet 11-1180 Low Speed
Saw, Buehler Ltd., U.S.A.) and photographed B. In vitro macro-photographic nieasurements
at a 1:3 magnification. MP and PoP tips: tbe distance between tbe root
Tbe following measurements were deter- apex and probe tip in each specimen was
mined from tbe radiological and pbotograpbic measured using the same grid as above. Tbe
examinations: type of probe witb tbe sbortest distance on tbe

Tahie I. Average pocket depths (x±s.d,} with iden-

tical A (n = 72) and changed B (n=!OS) degrees of
POCKET MEASUREMENTS
marginal gingival inflammation. Measurements with
the metal probe (MP) and the modified Plasi-o-Probe
(PoP) on 4 experimenttii days
Durchschniitliche Taschentiefeii fx±.s.d.) bei glelchcm
A (ti=72) und veranderiem B (n= lOH) Entzundungs-
grad der marginalen Gingiva. Messungen mi! der
Metalisonde (MP) und der modifiziertcn Ploit-o-Prohe
(PoP) an 4 Untersuekuiigstagen
Profondeur moyenne des poches ei ecarl-!ype(x±i.d.),
A: dan.^ les ca.'i oil le degre d'inflammation de la gena've
marginale est inchange (n = 72). B; torsque ce degre
change (n = !08). Mesures avec la sonde metallique
(MP) et la Plast-o-Probe modifiee (PoP) aux 4jours ou
fig. 4. Frequency distribution, average pocket depths ont ete faits les examens
and standard deviations for pocket depths using MP Periodontal pocket depths (mm)
and Pop. /'F, F-test for comparison of two variances.
Haufigkeitsverteilung der Taschenmesswerte, Durch- Day 0 2 7 9
•schninswerte und Standardabweickungeii fiir MP und Probe MP PoP MP PoP
Pop. P].; P-Tesf fur den Vergleich zweier Varianzen. A 4.2 + 1.7 4.1±1.6 4J±1,5 4.2±1.7
B 4.2 + 1.5 4.2±].5 4.5±].5 4.4±1.6
Distribution de la frequence des mesures de la profon-
deur des poches. moyenne (x) et ecart-type fs.d.) pour Day {Tag. jour)., probe (Sonde. sonde), periodontal
MP el Pop. Pp." te.il-P pour la comparaison de deux pocket depths (mm) {parodontale Tasehentiefen in
variances. mm. profondeuvs des poches (mm)).
 COMPARISON OF PLAST-O-PROBE AND METAL PROBE 15

Table 2 Significance (P) of the effect of the probing C. In vitro micro-photograpiiic measurements
instrument on the pocket depth values for the 5 MP or PoP tips: in these measurements, the
investigators (A, B, C, D and E)
distance (D) between the lateral root surfaces
Signifikanz (P) der Sondeneffektc auf die Taschen-
and the ends of the probe tips was measured
messwerle fiir die 5 Vntersucher (A. B. C, D und E)
Degre de signification (P) de!'influence de la sonde sur using the same grid.
les vaieurs de la profondeur des poches pour les 5
examinateurs (A. B, C, D et E)
Results
Investigator P
1. Clinical study
A 0.12
0.03*
The probing depths of the periodontal pockets
»
C 0.84 determined with PoP (x = 4.3± 1.7 mm) did not
nE 0.92 differ significantly from those determined with
O.li MP (x = 4.3 ± 1.4 mm), but their standard devia-
* P<0.05. tions differed significantly (/'F<O.OI) (Fig. 4).
Investigator (Untersucher. examinaieur). The periodontal pocket depths obtained with
both probes were not influenced by the SBI
photograph between the root apex and the obtained during the course of the study (Table
probe tip (Pap) was recorded. It was also possible 1). The SBI remained unaltered in 72 ( = 40%)
to determine whether the MP and PoP tip ends of the 180 measuring localisations during this
were localised adjacent to either the connective study. At the remaining measuring points,
tissue (CT) or epithelial (E) zones. however, the SBI changed by 1,2, 3, or 4 grades
in 5, 19, 57 and 27 measuring points respec-
Table 3. Proportional intra- and inter-investigator
agreement with the metal probe (MP) and the modi-
fied Plast-o-Probe (PoP) between the 5 investigators Table 4. Average pocket depths (n = 360, x±s.d.)
(A, B, C, D, E) recorded by 5 investigators (A. B, C, D, E) each at 36
Prozentuate (Jbereinstiminung innerhalb und zwischen locations on 5 volunteers in 2 measuring procedures
den Untersuchern (A. 13. C. D. E) fiir die Metallsonde with the metal probe (MP) and the modified Plast-o-
(MP) und fur die modifizierte Plasi-o-Probe (PoP) Probe (PoP)
Concordance proportionne/le cntrc les resuliais d'une Durchschniitliche Tasc/ientiefen (n—360. x±s.d.) von
meme examinateur et entrc ceux des different^ exami- 5 verschiedenen Untersuchern (A. B. C. D, E) anje J6
nateurs tors des mesuresfaites avec la sonde meiallique Messlokalisationen bei 5 Probanden in 2 Messdurch-
(MP) et la sonde Plast-o-Probe modifiec (PoP) par les gangen pro Sonde mit der Metalhonde (MP) und der
examinateurs (A, B. C.D. E) ntodifizierten Plast-o-Probe (PoP)
Profondeur moyenne des poches (n = 360) ei ecari-type
% Proportion of agreement (x±s.d.) pour les 5 examinatew.s (A, B. C, D, E)
B C D examinant 5 patients volonlaires au niveau de 36
localisations au cows de 2 series dc mesiires avec la
MP 45.6 48.9 46.4* 42,8 48.1 sonde metalUque (MP) et la Plast-o-Probe modifies
PoP 56.6 47.8 34.4* 39.2* 41.7 (PoP) _ _ ^
MP 56.7 51.9* 48.9 49.2 Periodontal pocket depths (mm)
PoP 53.9 39.7* 45.0 46.4
Investigator MP PoP
MP 50.6 50.0 47.2*
Pop 58.9 46.7* 44.4* A 4.1 + 1.5 4.0+1.6
B 4.2±!.6 4.I±].5
MP 48.9 48.3
C 4.5±1.6 4.6±1.7
PoP 51.7 49.4
D 4.3±1.5 4.3±1.6
MP 47.8 E 4.2±1.5 4.2+1.5
PoP 54.4
Periodontal pocket depths (mm) (parodontale
Taschentiefen in mm. profondeurs des poches (mm)).
16 SANDERINK, MORMANN AND BARBAKOW

tively. An analysis of variance (Table 2) showed icant differences between the use of MP and
that the measurements obtained by one inves- PoP at the 6 different probing positions about
tigator (B) were influenced by the type of probe each tooth {Table 5).
(P<0.05). Cross-matching of identically mea- From the completed questionnaire it ap-
sured periodontal pocket depths per measuring peared that 3 of the 5 investigators (A, B and D)
point (proportion of agreement) is listed in suggested that MP enabled deeper penetration
Table 3. This indicated that the intra-and inter- into the periodontal pockets than PoP. All
investigator proportions of agreement were investigators agreed that MP was better than
always better than chance. Because the pocket PoP, as far as reliability and ease of reading the
depths in this study varied between 1 and 10 markings were concerned.
mm, the chance of agreement of two measure-
ments was 10%. The jntra-investigator findings
using PoP were 2.8-11.0% better than when
Table 6. Histometrical and radiological evaluation of
using MP, except in the case of investigator B.
the prepared extracted teeth (E). The distance (D) of
Except for two investigators (D and E), the the probe tip to the lateral root surface (mm) for the
inter-investigator agreement was 0.9-12.2 % metal probe (MP) or the modified Plast-o-Probe
better with MP. Significant differences (PoP). Location (L) of the probe tips in either
the epithelial (E) or connective tissue (CT) zones.
(7'<0.05) between investigators were observed Radiologically the most apical position of MP or PoP
for A-C, B-C and C-E for both probes, and (Rap). Mosl apjcaJ position of MP or P D P (P^p)
between investigators A-D and C-D when the measured from the photographs
modified Plast-o-Probe was used. Histometrische und ronrgenologische Auswertung der
Extraktion.'ipreparate (E). Distanz (D) Sondenspiize -
Table 4 indicates the degree of inter- and Wurzeloberflache (mm) i)er MP oder PoP. Lokalisaiion
intra-examiner agreement estimated from 360 (L) der Sondenspitzen im Epithet- (E) oder Binden-
periodontal pocket depth measurements per gewebsbereich (CT). Ronfgenologi.'ich apikalste Posi-
tion der MP oder PoP fflspj. fotografisch apikahie
examiner per probe type. There were no signif- Position der MP oder PoP (P,y,)
Evaluation histometriquc el radiologique des dents
Tabie 5. Average pocket depths (n —360,x±s.d.)at 6 extraites (E). Distance (D) extremite de la sonde-
different probing positions, metisured with the metal surface de ia racine(mm) pour MP ou PoP. Localisation
probe (MP) arid the modified PJasl-o-Probc (PoP) (L) de rextremite de ia sonde. dam I'epithelium (E) ou ie
related to 6 teeth each in 5 patients tissu conjonctif (CT). Sonde. MP ou PoP atteignani Ie
niveau ie plus apical, a I'examen radiographique (R^p) el
Diirchschriirtiiche Taschentiefen (n=360. x + s.d.) an 6 a I'examen pholographique (P^^J
versehiedenen Messlokalisationen. gemessen mit der
Metaltsonde (MP) und der inodifizierlen Plast~o-Ptobe L
(PoP) an Je 6 Zcihnen bei je 5 Paiienten E D MP PoP R.-, P»p
Profondeur inoyenne des poches (ii = 360) ei 6cart-type CT CT MP-PoP PoP
(x±s.d.) pour 6 endroits differents mesures avec la E CT PoP
sonde metaiiique (MP) et la Piast-o-Probe modifiee 0.65 (MP) CT CT MP MP
C
(PoP) sur 6 dents chez chacun des 5 patients CT CT MP MP
D 0.65 (MP)
Periodontal pocket depths (mm) E 0.33 (Pop) E CT PoP PoP
H * CT CT PoP PoP
Position MP PoP E 1.31 (PoP) CT CT MP MP
K 0.65 (PoP) CT CT PoP PoP
Mesio-facial 4.3+i.l 4.2±1.2 0.13 (MP) PoP
L CT CT PoP
Facial 2.7±0.9 2.8+0.8 0.65 (MP) MP
M CT CT MP
Disto-facial 5.2±1.3 5.3±1.5 0.46 (PoP) PoP
N E CT PoP
Mesio-oral 4.5+1.3 4.4+1.2
Oral 3.6+1.4 3.6±1.4 * no measurement, ** not possible to estimate.
Disto-ora! 5.3±].5 5.2±1.7 No measurement (keine Messung. pas mesuree), not
possible to estimate (nicht messbar. estimation impos-
Position (Messlokaiisation. endroit). sible}.
 COMPARISON OF PLAST-0-PROBE AND METAL PROBE 17

2. Radiohgical-histometrical study were not performed to minimize additional

The results determined from the radio- and irritation at tbe bases of the periodontal pock-
photographs taken during tbis study arc shown ets. Probing measurements are influenced by
in Table 6. In 1 case tbe radiographs were tbe design of tbe probes (Listgarten et al. 1976,
discarded because of poor quality. From the Sivertson & Burgett 1976, Robinson & Vitek
radiographs it appeared that in 5 cases (F, H, K, 1979, van der Velden 1979, 1980). In this study,
L, N) the tip of PoP was more apically posi- the two probes used were found to record
tioned than MP. In 1 case (A), the probe tips ciinicaily similar mean pocket depths. The
were equal but in 4 cases (C, D, I, M) MP was standard deviations, however, showed a statis-
more apically positioned tban PoP. The posi- tically significant (/'<0.01) difference between
tions of the probe tips on the photographs the 1800 measurements each for both probes,
corresponded with those on the radiographs, tbe variance being smaller with MP.
except in case A. In all cases (11 teeth), the tip of The intra-investigator reproducibility of
PoP was found adjacent to the connective tissue measurements was better with PoP tban witb
zone while this occurred in 8 cases where MP MP, probabiy indicating a higher probing sen-
was used. In the remaining 3 cases (B, F, N) the sitivity with PoP. The inter-investigator repro-
tips were located in the epithelial zone. ducibihty was greater with MP, probably indi-
The probe tip localisations in case L are cating that MP was less dependent upon dis-
demonstrated in Fig. 5. The mean distances crete individual technique variations during
between the probe tip ends and the lateral root periodontai pocket measurements. These mar-
surfaces, as determined from tbe micro-photo- ginal differences in reproducibility of measure-
graphs, were smaller with MP (x = 0.52 mm) as ments between MPand PoP could be influenced
compared to PoP (x = 0.69 mm). by the different probe tip morphology. The
degree of reproducibility of periodonta! pocket
measurements in this study does not allow a
Discussion direct comparison to the results publisbed pre-
The clinical conditions set for this study were viously (Glavind & Loe 1967, Smitb et al. 1970,
judged to be similar to tbose encountered in Coppes 1972, Lennon & Davies 1974, Waite
patients presenting with advanced untreated 1976, Loe et al. 1978). Differences between
periodontitis. These conditions were main- results could be explained by variations in the
tained during the observation period of 9 days. probes and in the clinical techniques used.
The degrees of the marginal gingival inflamma- All 5 patients found probing with PoP less
tion, determined using the SBI of Miihlemann comfortable than that with MP. This informa-
& Son (1971) did not influence the measure- tion was obtained by unsolicited and spon-
ments of the periodontal pocket depths. This taneous statements made by the 5 patients
was in agreement with findings reported by following tbe use of PoP at the second examina-
Garnick et al. (1980) and Magnusson & List- tion (Fig. 3). Tbe tbird examination using MP
garten (1980). Probe penetration into tbe tissues again confirmed tbe better acceptance of tbis
of tbe pocket base is, however, dependent upon type of probe. It was not anticipated at the start
the inflammation of these tissues (Armitage et of tbe investigation to examine the acceptability
al. 1977. Spray et al. 1978, Robinson & Vitek of one probe type over the other. It was an
1979, Jansen et al. 1981). Inflammation at tbe interesting finding, although the penetration of
bases of periodontal pockets can be estimated MP and PoP into the connective tissue zones
clinically by deep probing using tbe Periodontal was judged to be similar. If the probing pres-
Pocket Bleeding Index (PPBI) (van der Velden sures exerted on both types of probes were
1979). In tbe present study. PFBl measurements equal, it is possible that PoP by virtue of its
 SANDERINK, MORMANN AND BARBAKOW

AP

D
Fig. 5. A. Radiograph with positioned MP. B. Extracted tooth after staining with 0.5% toiuidin blue indicating
the connective tissue gone (CT), epithelial attachment zone (H) and the pocket zone (PZ) with plaque and
calculus. PT-unit, MP in the connective tissue zone embedded in the composite material. C. Radiograph with
 COMPARISON OF PLAST-0-PROBE AND METAL PROBE 19

shape traumatized the tissues of the pocket probing positions. In addition, the completed
bases and/or lateral walls more than MP. The questionnaire indicated that the 5 examiners
relationship between probing force and pain favoured the use of MP,
threshold values reported bySchmid (1967) was
65 ponds for MP and 46 ponds for the originally Conclusions
designed Plast-o-Probe. The relationship of The modified Plast-o-Probe was found to have
probing force to subjective pain threshold with no marked clinical advantage over the metal
the modified Piast-o-Probe was, however, not probe used in this study. The depths of the
determined. periodontal pockets recorded with the two
An advantage of flexible periodontal probe types of probes used were similar. The legibility
tips might be their ability to adapt to the of PoP should be improved for routine clinical
periodontal pocket morphology (Schmid 1967). use.
The distances, however, of the probe dp ends to
the lateral root surfaces were less with MP in the
in vitro examination. This is due to the ability of Acknowledgements
PoP, because of its flexibility, to return to its The authors wish to thank Prof. H. R. Muhle-
original straight orientation when removed mann for his advice, and Dr. Helfenstein for his
frdm the pocket. Following extraction, lateral assistance with the statistical analysis.
pressures from the pocket walls were no longer
exerted. Therefore, the in vitro results of the
distance PoP tip to lateral root surfaee do not Zusammenfassung
reflect the in vivo situation. No probe tip
Parodonlale Taschenmessungen mit einer modifizierten
exhibits the feature of shape-retention reflecting Plast-o-Probe Sonde und einer Metallsonde
the pocket morphology following removal from Zwei ftir die klinisclie Taschenmessung verwendete
the periodontal pocket. Parodontalsonden, eine modifizierte Plast-o-Probe
(PoP) und eine Metallsonde (MP), wurden ver-
The gradations of PoP tips are marked on one gleichend uniersucht. An 5 Probanden wurden von 5
side only. When changing from buccal to Unlersuchern mit jeder Sonde zweimal die gleichen
lingual measuring localisations, "the PoP tip Taschen gemcsKen. Unabhangig vom Entzundungs-
grad der marginalen Gingiva und von der Messlokali-
required re-adjustment on the handle to ensure sation erzielten die beiden Sonden im Durchschnitt
good visibility of the markings. In contrast, the die gleiche Messwerte. Lediglich bei einem Unter-
circular grooves of MP were legible in all sucber wurde ein sondenbedingtcr Einflu.ss auf die

positioned PoP. Note tbe two amalgam points (AP), D. Extracted tooth staining with 0.5% toluidin blue and
witb positioned PT-unit witb PoP, probe tip in the connective tissue zone, AP= amalgam poini.
A. Rontgenbild mil MP in Sondierungsstetlung. B. Exirahierter Zahn nach Fdrbung mit 0.5% Toluidinblau.
CT~apikaldunkle Zone. Bindegewebshereich: E—^irku!dr schmaleZone. Bcrcicb desEpithelamaizes: PZ=nach
koronat unschliessende Zone. Taschenbereich mit Plaque und Zahnsiein. PT-Unit mit Metallsonde in Sondierung.'i-
stellung reponicrt. Sondenspitze im Bereich bindegewebigen Stiitzgewebes. C. Rdmgenbildmi! PoP in Sondierungs-
steltung. Beachie die zwei Amatgammarkierungen (AP). D. Exirahierter Zahn, gefarbt mit 0.5% Toluidinblau. mil
PT-Unit mit PoP in Sondierungssiellung reponieri. AP=Amalgammarkierung.
A. Radiographie avec MP en position de sondagC- B. Dent extraite. apres coloration au bleu de totuidine a 0,5%.
CT=zone sombre apicale, tissu conjonctif: E=zone claire etroite circulaire. epithelium de Jonciion; PZ—zone
voisine. vers la couronne. poche avee plaque ei tarlre. PT~enxemble maintenam par une fixation de composite
I'extremite seetionnee de la sonde MP en position au niveau du tissu conjonctif. C. Radiographie avec PoP en
position de sondage. AP=rcperes d'amalgame places dans la PoP. D. Dent extraite. apres coloration au bleu de
toiuidine a 0,5%. avec I'ensemble PTmaintenant lapointe de PoPfixee dans la zone de tissu cotyonctif AP= reperes
d'amalgame dans la PoP.
 SANDERINK, MORMANN AND BARBAKOW

Taschcnme.sswerte festgestellt. 4 von 5 Untersuchcrn Axelsson. P. & Lindhe, J. (1978) Effect of controlled
reproduzierten die Taschenmesswerte mit PoP 2,8- oral hygiene procedures on earies and periodontal
11,0% besser als mit MP. Mil MP wurde dne um disease in adults. Journal of Clinical Periodonlology
0,9-12.2% grossere Ubereinstimmung zwischen den 5, 133-151.
Untersuchern erreicht als mit PoP. MP wurde bei den Clemmer, B, A. & Barbano, J. P. (1974) Reproduei-
Untersuchern ah Messinstrument deuilich bevorzugt. bility of periodontal scores in clinical triais.,/oHn;«/
In einem rbntgenologisch-histometrischen Versuch of Periodonlal Research 9, 118-128,
wurden die Eindringtiefen der beiden Sonden er- Coppes, L. (1972) Routine - sulcus - dieptemetingen
mittelt, Nur in 3 von insgesarat i 1 Extraktionspriipa- in de parodontotogie: het belang-debetrouwbaar-
raten wurde ein Unterschied in der Gewebspeneira- heid - de toepassing. Tliesis. University of Amster-
tion bei den beiden Sonden festgesteJh. Gesamthaft dam, The Netherlands.
diirften die Unterschiede der Messeigenschaften Garnick, J. J., Spray, .T. R., Vernmo, D. M. & Kla-
zwischen MP und PoP nicht relevant sein. Die witter. J. J, (1980) Demonstration of probes in
Ablesbarkeit von PoP sollte fiir den k)inischen Rou- human periodontal poekets. Journal of Periodonl-
tinegebrauch verbessert werden. ology 51. 563-570.
Glavind, L. & Loe, H. (1967) Errors in the cimical
assessment of periodontai destruction. Journal of
Periodonial Research 2, 180-184.
Resume
Hassell, T. M., Germann, M. A. & Saxcr, U. P. (3973)
Mesure des poches parodonlales aii moyen d'line .wide Periodontal probing: Inter-investigator discrepan-
Plasl-o-Probe modifier ei d'une sonde metalUquc cies and correlations between probing force and
On a dans eette etude compare deux types de sondes recorded depth. Helvetica Odontologicu Acia 17,
parodontales utilisees pour mesurer la profondeur de 38-42.
pqches. une sonde PlasI-o-Probe modifiee (PoP) et Jansen, J., Pilot, T. &Corba, N. (1981) Histologieal
une sonde metalHque (MP). Chez 5 voiontaires, 5 evaluation of probe penetration during elinical
examinateurs specialement entraines ont mesure 2 assessment of periodontal attachment levels. An
fois les memes poehes avec chacone des sondes. Les investigation of experimentally induced peri-
vaieurs moyennes obteniies etaient ies memes avec les odonta! lesions in beagle dogs. Journal of Clinical
deux sondes et etaient iiidcpendantes du degre d'in- Periodontohgy 8, 98-106,
flammation gingivale et de ia locaiisation du sondage. Lang, N. P. & Engelmayer, H. (1979) Parodontai-
Pour 1 des 5 examinateurs, le type de la sonde influait zustand bei einer Gruppe von Sehweizer Wehr-
sur les resultats. 4 des examinatears ont trouve que mannern im Ailer von 28 bis 32 Jahren. Schweize-
PoP permettah un degre de reproduclibilite superieur rische Monatschrift fiir Zahnheilkunde 89, 11 i - i 19.
de 2,8-11,0% a eelui obtenu avee MP, tandis que la Lange, D. E. (1979) tJber die Verwendimg von Mess-
eoncordance entre les examinateurs avee MP etait de sonden und Sonden bei der Diagnostik parodon-
0,9-12,2% siiperieure. Les examinateurs preferercnt taler Erkrankungen. Die Quiniessenz 12, 67-72,
netiement MP eomme instrument de mesure. A I'aide Lennon, M. A. & Davies, R. M. (1974) Prevalence
d'examens radioJogiques et histometriques realises in and distribution of alveolar bone loss in a popula-
vivo et In vitro sur un autre groupe de patients, on tion of t5-year-old schoolchildren. Journal of Clin-
rechereha la profondeur de penetration des deux ical Periodonlology 1, 175-182.
sondes dans les zones du tissu conjonctif. On constata
Listgarten, M, A. (1980) Periodontal probing: what
seulement sur 3 des 11 dents e\traites une difference
does it mestnl Journal of Clinical Periodonlology 1,
de penetration du tissu entre les deux sondes. Dans
165-176.
['ensemble, les differences de mesure entre MP ei PoP
ne devraienl pas avoir d'importance du poini de vue Listgarten, M, A., Mao, R. & Robinson, P. J. (1976)
clinique. La lisibilite de PoP devrait etre amelioree Periodontal probing and the relation of the probe
pour Temploi clinique courant. tip to periodontal tissues. Journal of Periodonlology
47,511-513.
Loe, H., Anerud, A., Boysen, H. & Smith, M. (1978)
The riatural history of periodontal disease in man.
The rate of periodontal destruction before 40 years
of age. Journal of Periodonlology 49, 607-62L
Magnusson, \. & Listgarten, M. A. (i9S0) Histo-
logieal evaluation of probing depth following peri-
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 COMPARISON OF PLAST-O-PROBE AND METAL PROBE 21

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