A systematic review on the use of residual probing depth, bleeding on probing and furcation status following initial periodontal therapy to predict further attachment and tooth loss.

BACKGROUND: Chronic periodontitis affects many adults. Initial cause related therapy (ICRT) is aimed at elimination of factors causing disease progression.
OBJECTIVES: To use a systematic review process of peer reviewed publications to assess the predictive value of residual probing depths (PD), bleeding on probing (BOP) and furcation involvement (FI) in determining further loss of attachment and tooth loss following ICRT.
MATERIAL AND METHODS: An electronic search of the Cochrane Oral Health Group specialized register, MEDLINE and EMBASE, was performed using specific search terms to identify studies assessing the predictive value of residual probing depths (PD), bleeding on probing (BOP) and furcation involvement (FI) in determining further loss of attachment and tooth loss following ICRT.
RESULTS: The searches resulted in 941 uniquely identified studies. Titles and abstracts were then independently screened by two reviewers (S.R. and G.R.P.) to identify publications that met specific inclusion criteria. The agreement between the reviewers was assessed and statistical analysis failed to demonstrate a difference between the two reviewers (kappa-value: 0.94, P = 0.003). Detailed review of 47 included publications resulted in acceptance of one publication which utilized data based on patient as unit of observation. This study included 16 subjects over 42 months demonstrating that residual probing depths are predictive of further disease progression whereas persisting bleeding on probing are not.
CONCLUSIONS: Data based on one study suggest that residual probing depths are predictive of further disease progression. The implications for carefully designed multicentre randomized clinical control trials are many.