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Bleeding on Probing

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Jorgen Slots – 1st expert on this subject based on the ideXlab platform

  • gingival Bleeding on Probing relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse
    Journal of Periodontal Research, 2015
    Co-Authors: S Gonzalez, Calvin J Cohen, M Galvan, Faisal Abdullah Alonaizan, S K Rich, Jorgen Slots

    Abstract:

    Background and Objective
    This study evaluated the potential of gingival Bleeding on Probing to serve as a predictor of future periodontal breakdown. It also assessed the ability of 0.25% sodium hypochlorite twice-a-week oral rinse to convert periodontal pockets showing Bleeding on Probing to nonBleeding sites.

    Material and Methods
    The study was performed as a randomized, single-blinded, clinical trial in parallel groups. Seven periodontitis patients rinsed twice-weekly for 3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and five periodontitis patients rinsed with water. The 12 study patients received no subgingival or supragingival scaling. Clorox® Regular-Bleach was the source of sodium hypochlorite. At baseline and 3-mo visits, gingival Bleeding was assessed within 30 s after Probing to full pocket depth using an approximate force of 0.75 N.

    Results
    A total of 470 (38%) of 1230 periodontal pockets in the bleach-rinse group revealed Bleeding on Probing at the initial visit but not at the 3-mo visit; only 71 (9%) of 828 pockets in the control group became Bleeding-negative during the study (p < 0.001). Bleeding on Probing in 4- to 7-mm-deep pockets decreased by 53% in the bleach-rinse group but increased by 6% in the water-rinse group (p < 0.001). Ninety-seven pockets showed depth increases of ≥ 2 mm after 3 mo: 60 (62%) of those pockets exhibited Bleeding on Probing at both the initial and the 3-mo visits; 24 (25%) bled at only one of the two visits; and 13 (13%) never demonstrated gingival Bleeding (p < 0.001). Conclusions
    Persistent gingival Bleeding on Probing was associated with an increased risk for periodontal breakdown, and the absence of gingival Bleeding seemed to be a useful, although not perfect, indicator of disease stability. Twice-weekly oral rinsing with dilute bleach (0.25% sodium hypochlorite) produced a significant reduction in Bleeding on Probing, even in deep unscaled pockets. Sodium hypochlorite constitutes a valuable antiseptic in periodontal self-care.

  • Gingival Bleeding on Probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse
    Journal of Periodontal Research, 2014
    Co-Authors: S Gonzalez, Calvin J Cohen, M Galvan, Faisal Abdullah Alonaizan, S K Rich, Jorgen Slots

    Abstract:

    Background and Objective
    This study evaluated the potential of gingival Bleeding on Probing to serve as a predictor of future periodontal breakdown. It also assessed the ability of 0.25% sodium hypochlorite twice-a-week oral rinse to convert periodontal pockets showing Bleeding on Probing to nonBleeding sites.

    Material and Methods
    The study was performed as a randomized, single-blinded, clinical trial in parallel groups. Seven periodontitis patients rinsed twice-weekly for 3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and five periodontitis patients rinsed with water. The 12 study patients received no subgingival or supragingival scaling. Clorox® Regular-Bleach was the source of sodium hypochlorite. At baseline and 3-mo visits, gingival Bleeding was assessed within 30 s after Probing to full pocket depth using an approximate force of 0.75 N.

    Results
    A total of 470 (38%) of 1230 periodontal pockets in the bleach-rinse group revealed Bleeding on Probing at the initial visit but not at the 3-mo visit; only 71 (9%) of 828 pockets in the control group became Bleeding-negative during the study (p 

Niklaus P Lang – 2nd expert on this subject based on the ideXlab platform

  • Bleeding on Probing as it relates to smoking status in patients enrolled in supportive periodontal therapy for at least 5 years
    Journal of Clinical Periodontology, 2015
    Co-Authors: Christoph A Ramseier, Niklaus P Lang, Damiano Mirra, Christian Schutz, Anton Sculean, Clemens Walter, Giovanni E Salvi

    Abstract:

    AIM

    To relate the mean percentage of Bleeding on Probing (BOP) to smoking status in patients enrolled in supportive periodontal therapy (SPT).

    MATERIALS AND METHODS

    Retrospective data on BOP from 8’741 SPT visits were related to smoking status among categories of both periodontal disease severity and progression (instability) in patients undergoing dental hygiene treatment at the Medi School of Dental Hygiene (MSDH), Bern, Switzerland 1985-2011.

    RESULTS

    A total of 445 patients were identified with 27.2% (n = 121) being smokers, 27.6% (n = 123) former smokers and 45.2% (n = 201) non-smokers. Mean BOP statistically significantly increased with disease severity (p = 0.0001) and periodontal instability (p = 0.0115) irrespective of the smoking status. Periodontally stable smokers (n = 30) categorized with advanced periodontal disease demonstrated a mean BOP of 16.2% compared to unstable smokers (n = 15) with a mean BOP of 22.4% (p = 0.0291). Assessments of BOP in relation to the percentage of sites with periodontal Probing depths (PPD) ≥ 4 mm at patient-level yielded a statistically significantly decreased proportion of BOP in smokers compared to non-smokers and former smokers (p = 0.0137).

    ConCLUSIonS

    Irrespective of the smoking status, increased mean BOP in SPT patients relates to disease severity and periodontal instability while smokers demonstrate lower mean BOP concomitantly with an increased prevalence of residual PPDs.

  • Bleeding on Probing and pocket Probing depth in relation to Probing pressure and mucosal health around oral implants
    Clinical Oral Implants Research, 2009
    Co-Authors: J A Gerber, T E Balmer, G E Salvi, Niklaus P Lang

    Abstract:

    OBJECTIVES: To assess the Bleeding on Probing (BOP) tendency and periodontal probe penetration when applying various Probing forces at implant sites in patients with a high standard of oral hygiene with well-maintained peri-implant tissues. MATERIAL AND METHODS: Seventeen healthy patients with excellent oral hygiene in a maintenance program after having been treated for periodontitis or gingivitis were recruited. Missing teeth had been replaced using oral implants. The BOP and Probing depth (PPD) were assessed at the mid-buccal, mid-oral, mesial and distal aspects of the buccal surfaces of each implant. Moreover, contralateral teeth were designated and assessed for BOP and PPD in the same locations and at the same observation visits. At each visit, implants and contralateral teeth were randomly assigned to one of the standardized Probing forces (0.15 or 0.25 N). The second Probing force was applied at the repetition of the examination 7 days later. RESULTS: Increasing the Probing pressure by 0.1 N from 0.15 N resulted in an increase of BOP percentage by 13.7% and 6.6% for implants and contralateral teeth, respectively. There appeared to be a significant difference of the mean BOP percentage at implant and tooth sites when a Probing pressure of 0.25 N was applied. A significantly deeper mean PPD at implant sites compared with tooth sites was found irrespective of the Probing pressure applied. ConCLUSIonS: The results of the present study demonstrated that 0.15 N might represent the threshold pressure to be applied to avoid false positive BOP readings around oral implants. Hence, Probing around implants demonstrated a higher sensitivity compared with Probing around teeth.

  • effect of interleukin 1 gene polymorphisms on gingival inflammation assessed by Bleeding on Probing in a periodontal maintenance population
    Journal of Periodontal Research, 2000
    Co-Authors: Niklaus P Lang, Maurizio S Tonetti, Judith Suter, Julian Sorrell, Gordon W Duff, Kenneth S Kornman

    Abstract:

    Bleeding on Probing (BOP) is the most significant clinical parameter for the assessment of periodontal inflammation. The aim of this prospective longitudinal trial was to study the association between allelic variants of the IL-1 gene complex and gingival inflammation. Three hundred and twenty-three randomly selected periodontal maintenance patients (64.4% females) received a periodontal examination that included Probing depth measurements and BOP at each of 4 supportive periodontal therapy (SPT) appointments. A blood sample taken from each subject was analysed for the presence of specific allotypes of the IL-1 gene complex. Two polymorphisms located at +4845 bp in the IL-1α region and at +3954 bp in the IL-1β region were evaluated by a polymerase chain reaction method; 35.3% of the examined subjects were positive for specific combinations of allotypes of the IL-1 gene complex previously associated with an increased risk for severe periodontitis. The population consisted of 90 current smokers and 94 former smokers. An analysis of the association between the IL-1 genotype and BOP in the whole population (including smokers) did not reach statistical significance because of the overriding effect of smoking. A subset analysis of the 139 never smokers indicated that genotype positive patients had a significantly elevated chance of presenting an increase in the BOP% over a 4-appointment recall period (p=0.03) after correcting for oral hygiene. In fact, patients who were genotype-negative had a 50% smaller chance of showing increases in BOP% during SPT. A further analysis explored the relationship between the genotype and the level of BOP% at the most recent recall visit. A generalized linear model showed a statistically significant effect of the genotype status after correcting for plaque accumulation and prevalence of residual pockets (≥5 mm). Genotype-negative subjects had significantly lower BOP%(p=0.0097). It is concluded that the increased BOP prevalence and incidence observed in IL-1 genotype-positive subjects indicates that some individuals have a genetically determined hyper-inflammatory response that is expressed in the clinical response of the periodontal tissues.

S Gonzalez – 3rd expert on this subject based on the ideXlab platform

  • gingival Bleeding on Probing relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse
    Journal of Periodontal Research, 2015
    Co-Authors: S Gonzalez, Calvin J Cohen, M Galvan, Faisal Abdullah Alonaizan, S K Rich, Jorgen Slots

    Abstract:

    Background and Objective
    This study evaluated the potential of gingival Bleeding on Probing to serve as a predictor of future periodontal breakdown. It also assessed the ability of 0.25% sodium hypochlorite twice-a-week oral rinse to convert periodontal pockets showing Bleeding on Probing to nonBleeding sites.

    Material and Methods
    The study was performed as a randomized, single-blinded, clinical trial in parallel groups. Seven periodontitis patients rinsed twice-weekly for 3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and five periodontitis patients rinsed with water. The 12 study patients received no subgingival or supragingival scaling. Clorox® Regular-Bleach was the source of sodium hypochlorite. At baseline and 3-mo visits, gingival Bleeding was assessed within 30 s after Probing to full pocket depth using an approximate force of 0.75 N.

    Results
    A total of 470 (38%) of 1230 periodontal pockets in the bleach-rinse group revealed Bleeding on Probing at the initial visit but not at the 3-mo visit; only 71 (9%) of 828 pockets in the control group became Bleeding-negative during the study (p < 0.001). Bleeding on Probing in 4- to 7-mm-deep pockets decreased by 53% in the bleach-rinse group but increased by 6% in the water-rinse group (p < 0.001). Ninety-seven pockets showed depth increases of ≥ 2 mm after 3 mo: 60 (62%) of those pockets exhibited Bleeding on Probing at both the initial and the 3-mo visits; 24 (25%) bled at only one of the two visits; and 13 (13%) never demonstrated gingival Bleeding (p < 0.001). Conclusions
    Persistent gingival Bleeding on Probing was associated with an increased risk for periodontal breakdown, and the absence of gingival Bleeding seemed to be a useful, although not perfect, indicator of disease stability. Twice-weekly oral rinsing with dilute bleach (0.25% sodium hypochlorite) produced a significant reduction in Bleeding on Probing, even in deep unscaled pockets. Sodium hypochlorite constitutes a valuable antiseptic in periodontal self-care.

  • Gingival Bleeding on Probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse
    Journal of Periodontal Research, 2014
    Co-Authors: S Gonzalez, Calvin J Cohen, M Galvan, Faisal Abdullah Alonaizan, S K Rich, Jorgen Slots

    Abstract:

    Background and Objective
    This study evaluated the potential of gingival Bleeding on Probing to serve as a predictor of future periodontal breakdown. It also assessed the ability of 0.25% sodium hypochlorite twice-a-week oral rinse to convert periodontal pockets showing Bleeding on Probing to nonBleeding sites.

    Material and Methods
    The study was performed as a randomized, single-blinded, clinical trial in parallel groups. Seven periodontitis patients rinsed twice-weekly for 3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and five periodontitis patients rinsed with water. The 12 study patients received no subgingival or supragingival scaling. Clorox® Regular-Bleach was the source of sodium hypochlorite. At baseline and 3-mo visits, gingival Bleeding was assessed within 30 s after Probing to full pocket depth using an approximate force of 0.75 N.

    Results
    A total of 470 (38%) of 1230 periodontal pockets in the bleach-rinse group revealed Bleeding on Probing at the initial visit but not at the 3-mo visit; only 71 (9%) of 828 pockets in the control group became Bleeding-negative during the study (p