Supportive Periodontal Therapy (SPT)

How to use the online form

Enter the following clinical findings in the online form to determine the indicated SPT interval:probing depth in mm, furcations, oral hygiene and bleeding index. Recessions, implants or notes can also be entered.

The degree of furcation involvement is indicated by using a circle. An open circle (degree 1), a semicircle (degree 2), and a filled circle (degree 3).

Personalized interval for supportive periodontal therapy (SPT)

Clicking the number of any tooth will visually darken the tooth as well as fade out all its values. Hold down SHIFT and click the number to reset all values of the tooth.

Clicking the implant button will replace the tooth symbol with an implant symbol.

Bleeding on Probing (BOP) and Plaque will be recorded on six sites per tooth (three buccal and three oral sites, respectively).

Click on the "Plaque" or "BOP" button to display the recorded areas in blue or red.

After entering the vaues hit the TAB key to move the cursor to the next field automatically.

By clicking on the buttons "5mm" and "≥6mm" these probing depths will be displayed in yellow and orange.

Repeatedly clicking the furcation button will allow for setting the degree of any furcation:
1 click: degree 1
2 clicks: degree 2
3 clicks: degree 3
4 clicks: reset

Clicking the note field enables entering a short note for each tooth.

Note:

Recording both Plaque and Bleeding on Probing can be simplified:

By clicking on the label for "PLAQUE" or "BLEEDING ON PROBING" the entire line will be marked. By SHIFT-clicking the same labels, the respective lines will be reset.

By holding down the SHIFT-key, the tabs can be activated by simply hovering with the mouse arrow (not by clicking).

After clicking the "Direct" button, the data relevant for determining the SPT interval can alternatively be entered into the corresponding form. This way, the larger form above can be bypassed.

Anleitung zur digitalen Erfassung des online Formulars

The values to be entered into the form are: number of teeth and number of sites with probing depths of 4mm, 5mm or ≥6mm. The following data will also be recorded: the number of sites with degree 2 or 3 furcation involvement and the perscentage of sites with plaque and bleeding on probing (BOP).

The interval suggested in the analysis or a self-selected interval can be entered into the form.

Note:

The data from the upper form will be used again for the analysis by once more clicking the "Direct" button.

The summary of the findings for oral hygiene (plaque index) as well as probing depths (ST) and bleeding on probing (BOP) can be downloaded as an PNG-image file.

Note:

The download button should only be clicked once. It may take a few seconds for the download to start.

Click the"pockets", "bone" an/or "furc." button in order to discuss the findings with the patient.

Note:

The individual figures are displayed in the personalised report after activating the corresponding button.

The personalised report can be produced and made available to patient at any time. The "Report" button must be clicked to do so.

How to save the online form

The online form cannot be saved on the hard drive like other text documents. Moreover, this website does not save any data entered into the form.

An alterative option is that the website can be saved on both Apple Macinosh and Windows PCs in a PDF file. Using the "PRINT" command will open the print dialogue to select one of the following options: Adobe PDF or FreePDF. Clicking OK will allow the user to choose a file name and location where the PDF file should be saved.

In the printing menu chose "Save as PDF".

Note:

Paper size will need to be set to A4. If necessary (e.g. in Apple Safari), the content can be scaled down below 100%.

Background

Recommended SPT intervals are based on the residual periodontal pocket profiles recorded on this website. The profiles are based on the percentage of residual pockets from 4mm, 5mm and ≥6mm.

Residual PPD-based algorithm according to Ramseier et al. (2019)

In the first step of the evaluation, a maximum interval is determined for each category of residual pockets from 4mm, from 5mm and from 6mm: in the evaluation table, the corresponding cell is shaded in green.

In a second step, the resulting SPT interval is determined from the category with the shortest interval: in the evaluation table, the corresponding cell with the recommended interval is shaded in yellow.

The algorithm used here to determine the SPT interval goes back to a retrospective study from 2019, in which the threshold values for periodontal stability were determined from existing residual pocket profiles in 883 patients and a total of 11,842 SPT visits (Ramseier et al. 2019).

Considering risk factors

The recommended SPT interval should not be exceeded. If necessary, the proposed interval should be shortened if there is an increased inflammatory (BOP) index or risk factors are present.

Periodontal stability is assessed with the existing inflammation index (bleeding on probing, BOP). For non-smokers or former smokers, a value of 23% is considered the threshold, while for smokers this value is 16%. These thresholds are based on a retrospective study of 445 patients who had been enrolled in SPT for at least five years (Ramseier et al. 2015). A shorter interval should therefore be chosen for patients with an increased inflammation index. In the evaluation this is shown with an arrow labelled with BOP.

Furthermore, teeth with a degree 2 or 3 furcation involvement are classified in a higher risk category. This finding is based on a retrospective study with 117 patients who had been enrolled in SPT over an average period of 11.5 years (Salvi et al. 2014). Accordingly, a shorter interval should be chosen for affected patients. In the evaluation, this is indicated by an arrow labelled with the letter F.

Finally, a shorter interval is also recommended for smokers and patients with type II diabetes. In the evaluation this is shown with an arrow and the letters S and D respectively.

Note:

An arrow labelled with the letters SFD suggests that the interval should be shortened due to the findings "smoking", "furcation involvement" and "type 2 diabetes".

Literature

Ramseier, C. A., Nydegger, M., Walter, C., Fischer, G., Sculean, A., Lang, N. P., Salvi, G. E. (2019). Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy. Journal of Clinical Periodontology, 46(2), 218-230. doi:10.1111/jcpe.13041.

Ramseier, C. A., Mirra, D., Schutz, C., Sculean, A., Lang, N. P., Walter, C., Salvi, G. E. (2015). 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, 42(2), 150-159. doi:10.1111/jcpe.12344.

Salvi, G. E., Mischler, D. C., Schmidlin, K., Matuliene, G., Pjetursson, B. E., Bragger, U., & Lang, N. P. (2014). Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. Journal of Clinical Periodontology, 41(7), 701-707. doi:10.1111/jcpe.12266.