Temperature as a periodontal diagnostic.

Elevated temperature, normally a characteristic of inflammation, is a potential indicator of periodontal disease. Conversely, local periodontal site temperatures within normal variation could suggest relative periodontal health. To evaluate this potential, a temperature probe was designed with rapid response (less than 1 s), high accuracy and reproducibility (+/- 0.1 degree C), good transducer thermal isolation and physical dimensions approximating those of a conventional periodontal probe. To compensate for subject-to-subject variations in core temperature, site temperatures were measured and expressed as differences relative to the sublingual temperature. A cross sectional study was conducted using this instrument in which pocket temperatures of 14 subjects with advanced adult periodontitis were measured and compared with the sulcus temperatures of 11 healthy subjects. Overall, the mean site temperature of the diseased subjects was 0.65 degree C higher than that of the healthy subjects. A natural posterior-to-anterior temperature gradient was observed with the posterior sites being hotter than the anterior sites. Tooth-by-tooth analysis showed that diseased teeth have higher temperatures than anatomically equivalent healthy teeth (p less than 0.01). Threshold temperatures for differentiating diseased and healthy teeth were determined to optimize sensitivity and specificity. The results suggest that site temperature is a diagnostic of inflammatory activity associated with periodontal disease. The specifically designed instrument detected significant disease-related departures from normality.