The Relationship Between Bleeding on Probing and Subgingival Deposits. An Endoscopical Evaluation

Luigi Checchi1, *, Marco Montevecchi1, Vittorio Checchi2, Franco Zappulla1
1 Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum - University of Bologna. Bologna, Italy
2 Department of Odontostomatological, Orthodontic and Surgical Sciences. Second University of Naples, Naples, Italy
3 Department of Pediatrics, School of Medicine, Alma Mater Studiorum - University of Bologna, Bologna, Italy

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© Checchi et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Periodontology and Implantology, School of Dentistry, Alma Mater Studiorum, University of Bologna, Via S. Vitale 59, 40125 Bologna, Italy; Tel: +39/0512080115; Fax: +39/0514391718; E-mail:



Bleeding on probing (BOP) is an indicator of tissue inflammatory response to bacterial pathogens. Due to anatomical limitations, the entity and physical state of microbial aggregations located under the gingival margin and their relations to BOP have been hardly investigated till now. The recent introduction of the endoscopy has allowed clinicians to observe the subgingival environment in a non-traumatic way. The aim of this study is to evaluate the correlation between BOP and subgingival deposits by using this new technology.


107 teeth (642 individual sites) from 16 periodontal patients, treated with scaling and root planing, were evaluated for plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), endoscopic biofilm index (EBI), and endoscopic calculus index (ECI) at one-month revaluation.


A linear association between BOP and PD, EBI, and ECI was detected. The BOP provided a high level of specificity but quite low sensitivity values both for ECI (sensitivity 40%, specificity 86%) and EBI (sensitivity 37%, specificity 89%). The BOP sensitivity was directly linked to the amount of subgingival deposits.


This study demonstrates a direct relationship between BOP and presence/amount of subgingival deposits. More investigations on larger samples are, however, needed.

Keywords:: Endoscopy, bleeding on probing, pocket depth, root planing, biofilm, calculus.