O uso do fio dental como diagnóstico de gengivite proximal

Abstract

The marginal probing for diagnosis of gingivitis appears to be limited in the proximal sites with present point of contact for difficulty of contact to the fullest extent of the papilla. Therefore, this study verify the accuracy of the dental floss as a diagnostic method for proximal gingivitis and established associations with the presence of gingival bleeding after the use of the periodontal probe and the dental floss with visual color changes and swelling of proximal gingiva in adult subjects with no history of periodontitis. For this, the clinical diagnosis with the floss was compared with the periodontal probe (Gingival Bleeding Index - GBI) and visual changes of color and edema were compared with GBI and floss in inspections performed in the proximal sites in 100 eligible individuals. The subjects were randomly divided into 5 scanning protocols: group GBI floss; group floss GBI; group GBI GBI; group tooth floss floss; group gingival floss floss. Two evaluations were made in each protocol with interval of 10 minutes. The percentage of bleeding and visual changes, the sensitivity, the specificity, the accuracy and the positive and negative predictive values were compared with the gold standard. The results showed that the dental floss detects a higher percentage of bleeding sites compared to GBI, especially in posterior teeth with established point of contact. There were more visual changes in sites which not bled with GBI and dental floss, this suggests that the visual changes precede the bleeding. Few sites that bled with GBI and floss had no visual changes. We conclude that the dental floss seems to have better diagnostic ability of proximal gingivitis in adults compared to GBI. Moreover, visual changes seem to precede the gingival bleeding, and the color change occurs before the edema. From these results, it is suggested that the diagnosis of proximal gingivitis in teeth with point of contact should be complemented with dental floss rubbed against the gum.