CPITN+Index

= The Community Periodontal Index of Treatment Needs =

The CPITN Index was developed by the Federation Dentaire Internationale and World Health Organization. This index was designed to assess the treatment needs of specific groups. It can be used as a screening or monitoring tool to determine the periodontal treatment needs of either a community or an individual. Only six measurements per a person are recorded, so it is time efficient when assessing a large group. Example: A study was done in Ninevah, Iraq to estimate the presence of periodontal disease and asses the community's periodontal treatment needs (Khamrco, 1999).
 * Purpose & When to use**:


 * Category**: Oral Hygiene & Periodontal

This index is reversible (oral hygiene) and irreversible (periodontal).

The teeth are first divided into sextants, with each box representing a sextant.
 * Procedure**:
 * UR || max. ant || UL ||
 * LR || mand ant. || LL ||

Teeth selection: Determined by the age of the patient. If the patient is 20 years or older then begin distal to canines. A sextant with no teeth or one tooth, an X is marked. If only one functional tooth present, assess with adjacent sextant. Third molars are only assessed if they function in place of second molars. For children and adolescents, one tooth per sextant is evaluated: all first molars, maxillary right central incisor, and mandibular left central incisor. If designated tooth missing, mark sextant with an X.

Probe: Special probe used (same one as PSR) The ball at the end of the probe functions to aid in detection and reduce the risk of over-measurement. The probe is used to determine probing depth, bleeding response, and presence of calculus. Pressure: no greater than 15-25g. Use color coded band for prompt identification.

Codes:
 * CODE ||  ||
 * 0 || Healthy periodontal tissues ||
 * 1 || Bleeding after gentle probing ||
 * 2 || Supragingival or subgingival calculus or defective margin of filling or crown ||
 * 3 || 4mm or 5mm pocket ||
 * 4 || 6mm or deeper pathologic pocket ||

Recording: Use the 2x3 box chart. An X is marked for all missing sextants. Record only the highest code (most severe) for the designated sextant. Once a Code 4 has been assessed, there is no need to continue assessing the reaming teeth of the sextant.

Scoring: The patient(s) are classified into treatment needs based on the highest code recorded
 * SCORE ||  ||
 * 0 || No need for treatment (Code 0) ||
 * I || Oral hygiene instruction (Code 1) ||
 * II || OHI + scaling and rootplaning, including elimination of plaque-retentive margins (Codes 2 & 3) ||
 * III || I + II + complex periodontal therapy that may include surgical intervention and/or deep scaling and root planing with local anesthetic (Code 4) ||

Individual: Each sextant is interpreted Groups: Treatment needs can be reported as the number or percentage in each treatment need category OR the mean number of sextants with calculus, bleeding and deep pockets can be calculated for both age groups.

There are limitations to using this index! http://www.ncbi.nlm.nih.gov/pubmed/7836008

References: Khamrco, T.Y. (1999). Assesment of periodontal disease using the CPITN index in a rural population in Ninevah, Iraq. //Eastern Mediterranean Health Journal//, //5//(3), Retrieved from http://www.emro.who.int/publications/emhj/0503/13.htm

Wilkins, E.M. (2005). //Clinical practice of the dental hygienist, 9th edition//. Baltimore, MD: Lippincott Williams & Wilkins.


 * // Theresa - Very good; this was a difficult one to understand. Ms. Lesser //**