PSI the gold standard for initial periodontal exams

Jan 13, 2011

While the periodontal screening index (PSI) is an essential screening tool for periodontal disease, panoramic images are less so, according to a new study in BMC Oral Health (January 14, 2011).

Researchers from University Medical Centre Göttingen compared the role of PSI to that of panoramic imaging for determining a patient's "periodontal situation."

They examined 112 male subjects, ages 18-58. The exam covered DMF-T, QHI, and PSI scores at four proximal sites per tooth; the examining dentist was unaware of the radiographic finding.

Based on the PSI scores, the findings were scored as follows:

0-2 = no periodontitis
3 and 4 = periodontitis

Independent of the clinical evaluation, two dentists examined the panoramic images of the subjects. The results were classified as:

no bone loss = no periodontitis
bone loss = periodontitis

Using the PSI findings, 17 subjects were diagnosed as having no periodontitis, while 95 were diagnosed with periodontitis. However, according to the evaluation of the panoramic images, 70 subjects were diagnosed as having no periodontitis and 42 as having periodontitis. The difference between both methods was statistically significant (p < 0.001).

While the PSI is essential for initial periodontal exams, panoramic images are of no value in cases of initial screening for periodontal problems, the researchers concluded. However, if signs of pathological changes in the periodontium are established, a radiographic examination and detailed findings are essential for further diagnostics, they added.