COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS (CPITN)

By Cutress

Historical Background
Advocated by Cutress, Barmes, SardoInfirri 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.

What is the CPITN for?

To determine periodontal status and treatment needs by CPITN index

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

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

Box Chart

Use for recording CPITN Data

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

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

Type of Measure

Periodontal pockets Calculus Gingival Bleeding

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>) 2 patient requires oral hygiene improvement and professional scaling(2>)
3 patient requires complex treatment (4)

TN

TN

HOW TO CALCULATE AND SUMMARIZE THE RECOMMENDED STANDARD TABULATIONS OF A CPTIN SURVEY

Subjects: 21 Adults

0 0

0 0 (1 )

0 0

0 0

1 1 (2 )

0 0

0 0

0 0 (3 )

4 4

1 1

1 1 (4 )

0 1

4 2

3 3 (5 )

1 1

X 4

4 4 (6 )

4 X

3 3

3 4 (7 )

3 3

1 2

2 2 (8 )

2 2

0 1

0 1 (9 )

0 0

3 2

2 3 (10)

3 2

1 1

1 1 (11)

3 1

0 1

0 0 (12)

0 0

0 3

0 3 (13)

X 3

2 0

0 2 (14)

2 0

2 3

1 2 (15)

3 1

2 2

2 2 (16)

3 X

3 3

3 3 (17)

3 3

4 4

4 4 (18)

3 1

4 1

0 0 (19)

1 0

2 1

2 1 (20)

4 1

X X

X X (21)

X X

Table I Prevalence of Persons Affected

Age No. Examine d No. of Dentate Persons % Persons Coded H B C P1 P2

35 - 44

21

20

20

10

30

35

Note:
TOTAL H + B + c +P1 + P2 = (100%)

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.

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)

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.

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

Step 3:

Tabulate data

Table II Mean Number of Sextants Affected per Person

Age No. of Dentate Persons % Persons Coded H B C P1 P2 X

A.) 35 44*
B.) 35 44+

20
20

1.60
1.60

4.20
1.30

2.90
1.00

1.90
1.20

0.70
0.70

0.20
0.20

Note (A.):
Scores H + B + C +P1 + P2 + X do not = 6 (except when all sextants score 0, 1 or X)

Note (B.):
MNS H + B + C +P1 + P2 + X = 6

Table II (A):

Step 1:
Form

the charts of dentate persons, count the number of sextants which have
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
Healthy

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

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

Table II (B.):

Step 1:
Count

the number of sextants of dentate persons which have:

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
Healthy

These are:
32

scored 0 26 scored 1 20 scored 2 24 scored 3 14 scored 4 4 scored X

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

Table III Treatment Needs

Age No. of Dentate Persons % TN 0 % TN 1 % TN 2 (mean # of sextants) % TN 3 (mean # of sextants )

A.) 35 44

20

95

75 (2.9)

35 (0.7)

The three types of treatment needs (TN) are defined:

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
TN

Table IV Frequency Distribution

Age No. of Sextants H B Sextant scores ( # of Subjects) C P1 P2 M

35 44

0 1
2 3 4 5

11 1
1 2 3 1

9 3
5 1 0 2

13 1
2 2 1 1

11 3
2 2 0 1

13 4
1 0 2 0

17 2
1 0 0 0

NA