community periodontal index of treatment needs (cpitn
TRANSCRIPT
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COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS (CPITN)By Cutress
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•Advocated by Cutress, Barmes, Sardo-Infirri and J Ainamo in 1980.•Finalized and described in 1983.•Originally intended as a screening procedure for epidemiological purposes.•Adopted in developing periodontal health awareness programmes.
Historical Background
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To determine periodontal status and treatment needs by CPITN index
What is the CPITN for?
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Sextants Examined only if there are two or more
teeth present
Divided into six sextants
17-14, 13-23, 24-27, 37-34, 33-43, 44-47
Adjacent Sextant
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Index Teeth 20 years or more
17 16 11 26 27 47 46 31 36 37
!6 to 19 years old 16 11 26 46 31 36
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Box Chart Use for recording CPITN Data
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Probing Must be in the same plane as the long
axis of the tooth
Ball-end should be kept in contact with the root surface
A light not a firm grip of the instrument is recommended
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Codes And Criteria Code X - When only one tooth or no
functional teeth are present in a sextant. Code 0 - Healthy Tissues Code 1 - Bleeding observed during or after
probing Code 2 - Supra- or subgingival calculus seen
or felt during probing Code 3 - Pathological Pocket of 4 or 5mm Code 4 - Pathological Pocket of 6mm or more
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Type of Measure Periodontal pockets Calculus Gingival Bleeding
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Classification of Treatment Needs Treatment needs are assigned based on
the highest code received by each sextant. TN 0 – no further therapy needed.(0/X)
TN 1 – need to improve personal oral hygiene.(1>)
TN 2 – patient requires oral hygiene improvement and professional scaling(2>)
TN 3 – patient requires complex treatment (4)
Treatment needs are assigned based on the highest code received by each sextant. TN 0 – no further therapy needed.(0/X)
TN 1 – need to improve personal oral hygiene.(1>)
TN 2 – patient requires oral hygiene improvement and professional scaling(2>)
TN 3 – patient requires complex treatment (4)
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HOW TO CALCULATE AND SUMMARIZE THE RECOMMENDED STANDARD TABULATIONS OF A CPTIN SURVEY
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Subjects: 21 Adults
0 0 0
0 0 00 0 4
0 0 40 1 0
0 1 01 1 0
1 1 1
4 3 1
2 3 13 3 3
3 4 3X 4 4
4 4 X1 2 2
2 2 2
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
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0 0 0
1 1 01 1 3
1 1 13 2 3
2 3 20 0 0
1 0 0
0 0 X
3 3 32 1 3
3 2 12 0 2
0 2 02 2 3
2 2 X
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
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3 3 3
3 3 34 0 1
1 0 04 4 3
4 4 12 2 4
1 1 1
X X X
X X X
(17) (18)
(19)
(20)
(21)
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Note: TOTAL H + B + c +P1 + P2 = (100%)
Table IPrevalence of Persons Affected
Age No. Examin
ed
No. of Dentate Persons
% Persons Coded
H B C P1 P2
35 - 44 21 20 5 20 10 30 35
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Step 1: Count the number of charts with Code 0
only. Count the number of charts with a Code
1 recorded as the highest score. Count the number of charts with the
Code 2 recorded as the highest score. Count the number of charts with Code 3
recorded as the highest score. Count the number of charts with Code 4
recorded as the highest score.
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So.. Subject has Code 0(number 1) Subjects has Code 1 (numbers 2, 4, 9,
12) Subjects has Code 2 (numbers 8 and 4) Subjects has Code 3 (numbers 10, 11,
13, 15, 16, 17) Subjects has Code 4 (numbers 3, 5, 6, 7,
18, 19, 20)
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Step 2: Calculate the percentage (prevalence) To obtain the prevalence of subjects with
Codes 0, 1, 2, 3, 4, as their highest score, divide the counts of codes respectively, by the total number of dentate subjects and multiply 100.
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Code 0 = 1/20 * 100
Code 1= 4/20 * 100
Code 2 = 2/20 * 100
Code 3 = 6/20 * 100
Code 0 = 7/20 * 100
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Step 3: Tabulate data
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Note (A.): Scores H + B + C +P1 + P2 + X do not = 6 (except
when all sextants score 0, 1 or X)
Table IIMean Number of Sextants Affected per Person
Age No. of Dentate Persons
% Persons Coded
H B C P1 P2 X
A.) 35 – 44*
20 1.60 4.20 2.90 1.90 0.70 0.20
B.) 35 – 44+
20 1.60 1.30 1.00 1.20 0.70 0.20
Note (B.): MNS H + B + C +P1 + P2 + X = 6
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Table II (A): Step 1:
Form the charts of dentate persons, count the number of sextants which have Healthy tissues (H) – that is sextants coded 0 Bleeding (B) – that is sextants coded 1 of
higher Calculus (C) – that is sextants coded 2 or higher Pockets 4 -5mm (P1) - that is sextants coded 3
or higher Pockets 6mm or deeper (P2) - that is sextants
coded 4 or higher Edentate or excluded - that is sextants coded X
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There are: 32 scored 0 84 scored 1 or higher scores 58 scored 2 or higher scores 38scored 3 or higher scores 14 scored 4 or higher scores 4 scored X
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Step 2: For each condition, obtain the mean number
of sextants (MNS) per person by dividing the total number of sextants that score (or higher) by the number of dentate subjects
Example:MNS Bleeding = # of Coded 1 (84) / # of dentate
subjects (20) = 4.2
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Table II (B.): Step 1:
Count the number of sextants of dentate persons which have: Healthy tissues (H) – that is sextants coded 0 Bleeding (B) – that is sextants coded 1 Calculus (C) – that is sextants coded 2 Pockets 4 -5mm (P1) - that is sextants coded 3 Pockets 6mm or deeper (P2) - that is sextants
coded 4 Edentate or excluded - that is sextants coded X
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These are: 32 scored 0 26 scored 1 20 scored 2 24 scored 3 14 scored 4 4 scored X
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Step 2: For each condition obtain MNS per person by
dividing the total number of sextants with scores 0, 1, 2, 3, 4, or X by number of dentate subjects
Example:MNS bleeding = # of coded 1 (26) / # of dentate subjects (20) = 1.3
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Table IIITreatment Needs
Age No. of Dentate Persons
% TN 0 % TN 1 % TN 2 (mean # of sextants)
% TN 3 (mean # of sextants )
A.) 35 – 44 20 5 95 75 (2.9) 35 (0.7)
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The three types of treatment needs (TN) are defined: TN 0 = no treatment required –
Periodontally Healthy TN 1 = oral hygiene instruction (OHI) TN 2 = Scaling and prophylaxis (SC) + OHI TN 3 = Complex Treatment + SC + OHI
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Table IVFrequency Distribution
Age No. of Sextants
Sextant scores ( # of Subjects)
H B C P1 P2 M
35 – 44 0 11 9 13 11 13 171 1 3 1 3 4 22 1 5 2 2 1 13 2 1 2 2 0 04 3 0 1 0 2 05 1 2 1 1 0 06 1 0 0 1 0 NA