Methods for Clinical Assessment in Periodontal Diagnostics: A Systematic Review

Abstract

Aim: This systematic review aimed to answer the following PECOS questions: In human subjects with untreated periodontitis (Q1) or enrolled in supportive periodontal care (SPC) (Q2) (P), are there clinical assessment methods (E) other than the contemporary manual probe (C) that increase diagnostic accuracy or reliability when examining/screening for periodontitis (Q1) or when monitoring disease stability or progression (Q2) (O) as demonstrated in clinical studies (S)?. Material and Methods: A single search strategy was devised to identify relevant studies addressing Q1 and Q2 from four electronic databases. The main clinical parameters considered were probing depth (PD) and clinical attachment level (CAL). Risk of bias (RoB) was assessed using a modified Newcastle-Ottawa scale. Results: Of the 5417 identified titles, 26 studies were finally included. The evidence revealed that manual probes generally yielded higher PD values, while pressure-sensitive/electronic probes demonstrated a trend for higher inter- and intra-examiner reproducibility. No clear trend for the superiority of one probe over the other could be identified for Q1 or Q2. Conclusions: The outcomes of the present systematic review indicated no clear benefit from the use of pressure-sensitive/electronic probes over contemporary manual probes. Manual probes remain the clinical standard for the diagnosis and monitoring of periodontitis patients.