Increased sensitivity of a papillary inflammation bleeding gingivitis index

Objective: A dental prophylaxis has been shown to reduce gingivitis within 3-5 days after the procedure. The objective of this research study was to evaluate the sensitivity of three gingivitis indices using a prophylaxis model. Methods: This was a 4-day, parallel-group, examiner-blind, randomized and controlled clinical trial. Adult subjects with mild to moderate gingivitis were enrolled into the study. All subjects received clinical examinations with three gingivitis indices: a color-based index (modified gingivitis index - MGI), an inflammation and bleeding combined index (Mazza gingivitis index), and a similar combined index that focuses on papilla (Papillary inflammation bleeding index - PIBI). Following the baseline examinations, subjects were randomly assigned (2:1) to one of the two treatments, prophylaxis (9) and non-prophylaxis (5) groups. All subjects brushed with regular anti-cavity toothpaste and toothbrush. Four days after the baseline visit, subjects returned to the clinical site for the final gingivitis examinations. Results: All fourteen subjects completed the study. Average age was 41 years old and there were more females (10) in the study. Age, gender, and ethnicity were well balanced between the treatment groups. Prophylaxis treatment difference at day 4 versus baseline was detected by all three indices with PIBI resulting in the biggest change versus baseline (41.2%). Despite the small sample size, PIBI and Mazza gingivitis index detected significant treatment differences between the prophylaxis and non-prophylaxis groups (p=0.055 for PIBI, p=0.072 for Mazza). Conclusion: The research suggested that the inflammation and bleeding combined indices, particularly the PIBI index may offer increased sensitivity in detecting treatment differences when compared to the color based index (MGI).