Quantitative Assessment of Periodontal Inflamed Surface Area in Patients with Periodontitis

Objective: The Periodontal Inflamed Surface Area (PISA) enables quantification of periodontal inflammatory burden by translating clinical periodontal findings into a surface area metric. The present retrospective study aimed to calculate PISA values in individuals diagnosed with Stage III Grade B and Stage III Grade C periodontitis and to evaluate the associations between PISA and conventional periodontal clinical parameters. Material and Methods: Healthy individuals as well as patients with Stage III Grade B and Stage III Grade C periodontitis were evaluated for periodontal parameters. PISA scores were calculated based on bleeding on probing positive sites and probing depth. Correlations between PISA values and periodontal clinical parameters were analyzed statistically. Results: Significant differences in PISA values were observed among healthy individuals and Stage III Grade B and Grade C periodontitis patients, with the highest values were found in Grade C periodontitis. PISA values were positively correlated with bleeding on probing (BOP), probing depth (PD), and plaque index (PI) indicating an increase in inflammatory burden with greater periodontal tissue breakdown. Conclusion: PISA provides a robust quantitative representation of periodontal inflammation and demonstrates strong associations with established clinical periodontal parameters. These findings highlight the value of PISA as a complementary outcome measure for assessing periodontal inflammatory burden and disease severity in periodontitis.