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Transcript of CPITN Probing
Used primarily for epidemiologic studies CPITN PROBING The major difference between CPITN and other indices is that it determines not only the severity of gingivitis (bleeding) and periodontitis (pocket probing depth), but also provides information concerning the type of disease process and therefore also the extent of therapy that is necessary.
Thus, the CPITN provides not only conclusions about the incidence of gingivitis and periodontitis in a population, but also about the necessary expense, in both time and money that will be necessary for treatment for a population group.
The CPITN does not consider the attachment loss on individual teeth, rather only the clinical situations requiring treatment (gingival inflammation, bleeding, calculus, pocket probing depth.)
The CPITN is measured and ascertained using a special probe on all teeth, and the most severe areas in each sextant is noted in the chart. Three indicators of periodontal status are used for this assessment:
1.presence or absence of gingival bleeding
2.supra- or subgingival calculus
3.periodontal pockets-subdivided into shallow (4-5mrn) and deep (6mm or more).
The probe is used to determine probing depth, bleeding response, and presence of calculus. A specially designed lightweight probe with a 0.5-mm ball tip is used, bearing a black band between 3.5 and 5.5 mm from the ball tip.
CPITN PROBE PROCEDURES 1) The teeth are first divided into sextants, defined by teeth numbers 18-14, 13-23 24-28, 38-34, 33-43, and 44-48. A sextant should be examined only if there are two or more teeth present and not indicated for extration. When only one tooth remains in a sextant, it should be included in the adjacent sextant. TEETH SELECTION Children and adolescent 7-19 years old:
Six teeth are examined: the first molar in each quadrant, and the maxillary right and mandibular left incisors. If designated tooth missing, mark sextant with an X.
2.When inserting the probe, the ballpoint should follow the anatomical configuration of the surface of the tooth root. If the patient feels pain during probing, this is an indicative of the use of too much force.
For adults 20 years old and older:
Ten teeth are examined: the first and second molars in each posterior sextant and if one molar is not present then the remaining molar is recorded and no substitute for the tooth is made, and the maxillary right central incisor and mandibular left central incisor. . A sextant with no teeth or one tooth, an X is marked
Then the highest code score would be used to put them into a classification. 3. The probe tip should be inserted gently into the gingival pocket and the depth of insertion read against the colour coding. The total extent of the pocket should be explored: At least 6 points on each tooth should be examined: mesio-buccal, mid-buccal, disto-buccal, and the corresponding lingual sites RECORDING Use the 2x3 box chart. An X is marked for all missing sextants. Record only the highest code (most severe) for the designated sextant. Once a Code 4 has been assessed, there is no need to continue assessing the reaming teeth of the sextant. SCORING The patient(s) are classified into treatment needs based on the highest code recorded
Individual: Each sextant is interpreted
Groups: Treatment needs can be reported as the number or percentage in each treatment need category OR the mean number of sextants with calculus, bleeding and deep pockets can be calculated for both age groups. CPITN PROBE Ref: Extracts of the Third edition of "Oral Health Surveys - Basic methods", Geneva 1987.http://www.emro.who.int