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A clinical study was conducted among 200 adult males and females to compare the intrusive gingival index (GI) for estimating gingivitis with the nonintrusive and only visually applied papillary-marginal-gingivitis index (PMGI). The GI examinations were performed by a senior examiner with long experience and a junior examiner, while the PMGI was graded by only a senior examiner with long experience. A 4th examiner was included for grading bleeding sites by gentle intrusion at the orifice of the gingival crevice. Following the baseline examination by all examiners, the subjects were randomly assigned to either a group that received an oral prophylaxis immediately or to a group that received an oral prophylaxis 6 weeks after the baseline. All subjects were regraded by all examiners 4 days after the 2nd group received a prophylaxis. This delayed prophylaxis design created a difference in the responses between treatment groups. Both the GI examiners and the PMGI examiner concluded there was significantly less gingivitis in the group receiving a prophylaxis second. There were also significantly fewer bleeding sites in the group receiving a prophylaxis second as determined by both GI examiners and the bleeding-sites examiner.

The purpose of the present study was to evaluate a clinical procedure for determining the proficiency of gingivitis examiners. After 4 examiner trainees were instructed by and participated in practice examination sessions with a senior examiner, the 5 examiners participated in a 2-group clinical study which employed appropriately timed-staggered dental prophylaxes to create a gingivitis treatment effect between the 2 groups. The 1st group received dental prophylaxes 30 days before the 2nd group. 10 days after the 2nd group had received dental prophylaxes, both groups were examined independently by all 5 examiners. Baseline examinations had been made on all subjects by all 5 examiners independently to serve as a covariable in the statistical analyses. During this clinical exercise, the examiners did not know at what time prophylaxes had been given nor did they have access to the previous examination records. The expected presence of a treatment effect, as confirmed by the senior examiner, was found by all of the examiner trainees in this exercise. The treatment effect for all examiners was statistically significant.

An index (PMGI) that combines the Massler-Schour (PMA) and Löe-Silness (GI) indices for non-invasive scoring of gingivitis was applied in 2 independent comparative clinical studies. 4 statistical transformations of the scores of individual papillary and marginal units were analyzed: the whole-mouth mean, its square root, the proportion of units judged to be inflamed, and its arc sin transformation. According to the criteria of how closely the transformations produced approximately normal distributions, and of how successful they were in detecting treatment differences, the square root transformation performed the best.