The PSR system does not replace the need for a comprehensive periodontal examination. It acts as a time saving screening of periodontal health to indicate when a partial or full-mouth examination is required. When the clinician becomes familiar with the PSR system examination process, it should only take a few minutes to conduct a screening.
Similar to a traditional comprehensive periodontal examination, the PSR system measures each tooth individually, with implants examined the same way as natural teeth. However, the mouth is divided into sextants instead of quadrants (Figure 1).
Six measurements for each tooth are obtained, utilizing a special ball-tipped probe. This probe has a 0.5 mm ball at the tip and a color-coded area 3.5 to 5.5 mm from the tip. The probe may be plastic or metal. The ball at the end of the probe is intended to enhance patient comfort and assist in detecting overhanging margins and subgingival calculus (Figure 2).
The probe is inserted into the sulcus or pocket and walked around the circumference of each tooth. This method is the same technique used as with a comprehensive periodontal examination. However, the PSR system is unique in the way the probe is read. The clinician need only observe the position of the color-coded band in relation to the gingival margin. The color-coded band is commonly known as a reference mark, which spans between 3.5 mm to 5.5 mm. For each area probed, the clinician will decide if the colored band is either totally visible, partly visible, or not at all visible.14 The presence of furcation involvement, mobility, mucogingival problems, or recession should also be noted with an asterisk. After each tooth in the sextant has been examined, only the highest code obtained is recorded and only one score is recorded for each sextant. If a sextant is edentulous, an "X" is placed. Measurements are recorded by sextants as shown below (Figure 3).
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