periodontalchart-online.com – User Manual

Version 1.0 · 23.03.2026 · Author: Prof. Dr. Christoph A. Ramseier

About this Guide

periodontalchart-online.com is the official Periodontal Chart from perio-tools.com, free of charge and available in more than 30 languages; the same application runs in German at parodontalstatus.ch. It records the periodontal and peri-implant chart at six sites per tooth or implant, displays it graphically and evaluates it – classification, comparison of two charts, recall interval and calibration exercise. The data remain in the browser; they are not transmitted to a server.

Which measures are suitable for monitoring after active therapy, and why the application records exactly these, is described in the following review. It places probing, bleeding on probing, radiographs, biomarkers and microbiological tests in context and describes the application periodontalchart-online.com as a tool for this follow-up monitoring.

Ramseier, C. A. (2024). Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry. Periodontology 2000, 95(1), 129–155. doi:10.1111/prd.12588. PubMed

The guide follows the structure of the application: Part A describes where the charts are stored, Part B recording them, Part C evaluating them, Part D the further charts and Part E assessing the history. All figures are generated from the code of the application itself, not photographed; the personal data shown are fictitious.

Part A Managing Data Where the charts are stored, how they are organized and how they leave the device.

1. Navigation Panel

The Navigation Panel is the central control unit for patient management and data organization. It provides access to all stored records and to the main system functions.

periodontalchart-online.com/?lang=en

+ Add Patient

Search …

Aaa Aaa

16.07.2026 Aaa… (A)

Bbb Bbb

09.08.2026 Bbb… (A)

Ccc Ccc

16.08.2026 Ccc…

Notice on data saving

Local Data Storage

All your data are stored exclusively locally in your browser and are not transmitted to an online server.

Your data remain on your device and are accessible only to you.

Header

+ Add Patient

Add Patient – creates a new entry.

: Hide navigation – hides the whole panel; the working area then uses the full screen width. The same button brings it back.
: Sorting – switches in turn: favorites first, A–Z, Z–A, custom order.
: Data Management – opens Export and Import.

On the Name

: Expand and collapse – a click on the name shows that patient's charts.
1: Counter – number of charts. It turns red if details are missing in a chart.
: Favorite – appears on hover. Favorites are shown in yellow and at the top.
: Edit – change the master data. Appears on hover.
: Remove – deletes the person with all charts. Appears on hover.

Action Row

: Show charts – opens the History with all examinations.
: Sort by date in ascending order.
: Sort by date in descending order.
: New Periodontal Chart – creates a further examination.

Note: With the button at the top right of the panel you hide the navigation completely. The Periodontal Chart thereby gains about 310 pixels in width – on smaller screens the difference between scrolling and an overview.

Figure 1: The Navigation Panel at the left edge of the window, on the right the meaning of all buttons. A click on a name expands that patient's charts and shows the action row; "Ccc Ccc" would be only one line when collapsed. Charts have an orange border, a yellow entry is a favorite. The names have been replaced by placeholders.

Opening and Use

The Navigation Panel is opened with the menu button in the top left corner. Here you find a list of all patients. Clicking on a name shows or hides that patient's clinical charts (periodontal charts), which are listed chronologically.

Patient Management

Adding patients: Use the corresponding button to add new entries.
Editing: Click on the pencil icon to change the patient details.
Deleting: Use the trash icon to remove a patient. Note: Deleting a patient permanently removes all associated clinical charts.
Favorites: Mark important patients with a star icon for quick access.

Privacy note: All patient data remain stored locally in the browser on your device and are not transmitted to a server.

Important: Deleting your browser data (LocalStorage, cookies or website data) leads to the irreversible loss of all patient records.

Register patient

Last name:

Last name

First name:

First Name

Date of birth:

dd.mm.yyyy

P-number (optional):

e.g. P0123456789 (max. 20 characters)

Save Cancel

Figure 2: The window for creating a patient. Last name and first name are free text, the date of birth is selected from the calendar. The Patient ID is marked as optional; if it is set, it must begin with a capital P followed by up to eight digits. Otherwise the application shades the field in the chart header pink. A missing date of birth later leads to a red exclamation mark on every chart of this person – so enter it right here.

Search, Sorting and Organization

Search: Type letters into the search field to filter patients in real time. The search applies to the names, not to the contents of individual charts.
Sorting: Patients can be sorted alphabetically (A–Z or Z–A) or by favorites.
Manual order: You can reorder the list manually by drag-and-drop .
Chronological view: The History button in the Navigation Panel (or in the tabs) provides an overview of all charts in historical order, with the most recent entry at the top.

Data Management (Export / Import)

The Data Management button opens a window for transferring data between devices or software:

Export: Choose between the formats CSV (.csv) or Excel (.xlsx). You can choose whether only the active patient is exported and whether empty charts are ignored.
Import: Loading a file adds its patients to your current list. Existing patients with matching IDs are overwritten, other existing records remain untouched.
Storage indicator : Below the export options the same symbol as on the Data Management button appears, next to it a bar and a percentage. They show how much of the browser's storage is already in use: blue up to 70 %, amber from 70 %, red from 90 %. Hover over it to see the exact figure. Once the storage is full, no further chart can be saved – export your data and delete older charts to free space.

Tip: The export function should be used regularly to create external backups of your clinical data.

Critical: Since the data is stored only in the browser, regular backups are essential to prevent data loss.

Apple Safari: Safari deletes a website's locally stored data after seven days of Safari use without visiting that site. Only days on which Safari is actually used are counted, and any click on this page resets the period. This also applies to every browser on iPhone and iPad – there, even the browser called "Chrome" is in fact Safari. If you work with Safari, export your data after every session. A corresponding note appears in the Data Management window only if you are actually using such a browser.

Data management (Export / Import)

Export

CSV Export Excel Export

Export Options

Anonymize data

Export current patient only

Tooth Numbering System (FDI / Universal)

3 %

Import

Select file

Supported Formats

CSV files (.csv)
Excel files (.xlsx)

Figure 3: The Data Management window. On the left the export as CSV or Excel with three switches: anonymize the data, output only the currently selected person, and switch the tooth numbering system between FDI and Universal. On the right the import, which accepts the same two formats. On import, existing patients with a matching identifier are overwritten, all others remain untouched. Below the export options, the symbol, percentage and bar show how much of the browser's storage is already in use.

Settings

The Settings menu allows the Periodontal Chart to be customized:

General

Invert Gingival Margin sign

Tooth Numbering System (FDI / Universal)

Mirror Views

Set probing sequence

→ 1 → → 2 → ← 4 ← ← 3 ← → 7 → → 8 → ← 6 ← ← 5 ←

Standard of the Clinic for Periodontology, University of Bern Variant 1

Upper and lower jaw from right to left Variant 2

Ideal for data entry from a paper table Variant 3

Further Settings

Record Gingival Margin (Recession) and Probing Depth in pairs

Figure 4: The Settings window. At the top the three general switches, in the middle the probing sequence. The eight fields above the tooth diagram indicate the direction in which data entry proceeds from quadrant to quadrant; they can be moved with the mouse. The three variants apply established sequences in one step. At the bottom the switch for pairwise data entry of Gingival Margin and Probing Depth, shown switched on.

Invert the sign of the gingival margin: Choose whether negative or positive values represent recession.
Tooth numbering system: A toggle slider button switches between the FDI and the Universal tooth numbering system.
Mirror tooth orientation: Display the roots of the maxilla pointing upwards and those of the mandible pointing downwards.
Probing sequence: The arrows for the probing direction can be adjusted by drag-and-drop (globally or per chart).
Pairwise data entry: Makes it easier to enter GM and PD one after the other for each site.

Data format of the charts

Each chart is held as a JSON object – in the browser, on export and when handed over to other programs. The format was created specifically for periodontalchart-online.com and has deliberately remained simple: the clinical values lie flat side by side, without nesting, and every key itself states where its value belongs.

The name of a key follows the pattern parameter_tooth_site. Per tooth there are tooth_ for presence, mobility_, implant_ and furcation_; per site bop_ for bleeding on probing, pi_ for plaque, gm_ for the gingival margin and pd_ for the probing depth. The teeth carry their FDI number, the sites their abbreviation: db, b and mb buccal, dp, p and mp palatal, in the mandible dl, l and ml lingual.

pd_16_mb is therefore the probing depth mesiobuccal at tooth 16 – everywhere, and without a legend having to stand next to it.

A single tooth as an excerpt

{
  "date": "18.11.2025",
  "patient_number": "P4",
  "initial_exam": "0",
  "reevaluation": "1",
  "clinician": "Dr. A",

  "tooth_16": "1",
  "mobility_16": "0",
  "furcation_16_b": "1", "furcation_16_dp": "1", "furcation_16_mp": "1",
  "implant_16": "0",

  "bop_16_db": "0", "bop_16_b": "0", "bop_16_mb": "0",
  "pi_16_db":  "1", "pi_16_b":  "0", "pi_16_mb":  "1",

  "bop_16_dp": "0", "bop_16_p": "0", "bop_16_mp": "1",
  "pi_16_dp":  "1", "pi_16_p":  "0", "pi_16_mp":  "1",

  "gm_16_db":  "0", "gm_16_b":  "0", "gm_16_mb":  "0",
  "pd_16_db":  "0", "pd_16_b":  "4", "pd_16_mb":  "0",

  "gm_16_dp":  "0", "gm_16_p":  "0", "gm_16_mp":  "0",
  "pd_16_dp":  "4", "pd_16_p":  "0", "pd_16_mp":  "0",

  "note_16": ""
}

All values are stored as strings: millimeters and degrees as digits in text form, states as 0 or 1. Besides the teeth, the object contains the header data of the chart and a few additional entries – classification, recall interval, activated indices – which are held within it as objects of their own.

Export as CSV or Excel writes the same keys as column headings, one row per chart. A collection of charts can thus be loaded into R, Python, SPSS or a spreadsheet without an intermediate step. And because every column carries parameter, tooth and site in its own name, the same table is suitable both for statistical analyses and as training material for machine learning.

The complete list of all keys and their binding order is given in the API Documentation.

Part B Periodontal Chart Recording the periodontal chart, from the header data to dictation.

2. Periodontal Chart Tab

The Periodontal Chart tab is used for recording and visualizing the clinical periodontal examination. It allows the entry of patient information and clinical measurements and the visualization of the chart.

Patient and Examination Details

At the top there are input fields for the patient details, the name of the examiner and the type of examination (initial examination or re-evaluation).

PERIODONTAL CHART

Patient ID P0123456789

Date 09.08.2026

Patient Last Name

First Name

Date of Birth 12.12.2000

Initial Examination

Re-evaluation

Clinician

Figure 6: The form header of the chart. Patient ID, last name, first name and date of birth come from the patient's master data and cannot be changed here; "Edit Patient" in the Navigation Panel is responsible for that. The date of the examination, the type of chart and the clinician can be entered freely. A cross next to Initial Examination or next to Re-evaluation determines how the chart appears in the chart list and in the History; the text field beside it takes a custom label. If a required value is missing or invalid, the application highlights the field concerned in pink.

Privacy note: All data remains stored locally in the browser and is not transmitted to a server.

Warning: Deleting browser data leads to the permanent loss of all recorded charts.

Recording Teeth and Implants

Missing teeth: Click on the tooth number to mark the tooth as missing (crossed out).
Implant status: Use the implant button to cycle through the states:
- First click: implant present
- Second click: implant marked red (e.g. peri-implantitis)
- Third click: implant marked green (e.g. successfully treated peri-implantitis)
- Fourth click: the implant is removed and the position returns to the natural tooth

Tooth

Mobility

Implant

Furcation

Bleeding on Probing

Plaque

Gingival Margin

Probing Depth

Attachment Level

1817161514131211

-2-10

0-1-3

-10-2

-201

101

-1-1-1

1-21

687

657

765

566

556

455

434

897

6610

867

765

455

566

353

Gingival Margin

Probing Depth

Attachment Level

Plaque

Bleeding on Probing

Furcation

Note

-101

101

100

101

554

566

554

445

677

766

667

653

465

454

344

576

665

566

Per Tooth/Implant

Tooth Number – one click marks the tooth as missing; it is then shown in gray, like tooth 18 here. Another click removes the marking.

Mobility – degree of mobility according to Miller, 0 to 3. In the example, tooth 17 has grade 2.

Implant – the button steps through the states: first present, then marked red for peri-implantitis, then green after successful treatment, then a natural tooth again. The symbol in the table always stays black; the color appears on the implant. In the example, 15 (marked red) and 11 carry an implant. As long as an implant is set, the application hides the tooth mobility.

Furcation Grade 1 – the probe detects a concavity but does not enter it.

Furcation Grade 2 – the probe enters but does not pass through. In the example buccally at tooth 16.

Furcation Grade 3 – through and through. In the example palatally at tooth 16.

Per Site

Bleeding on Probing – six sites per tooth/implant. A click on the row label fills the entire row, shift and click clears it again.

Plaque Index – six sites per tooth/implant. A click on the row label fills the entire row, shift and click clears it again.

Measurements (mm)

Gingival Margin – position of the gingival margin relative to the cemento-enamel junction in millimeters. Negative values mean that the margin lies above it.

Probing Depth – red from 4 mm upward, so that increased probing depths stand out.

Attachment Level – the application calculates it as the sum of probing depth and gingival margin and therefore shows it on a gray background: it is not entered.

Figure 7: The first quadrant as it appears in the form: at the top the buccal values, in the middle the two tooth views, at the bottom the oral values. Beside them the meaning of each row. The red line traces the gingival margin, the blue line the attachment level; the blue area between them is the probing depth. Each tooth has three sites side by side – from distal via buccal or palatal to mesial. Tooth 18 is marked as missing and therefore gray throughout, 15 and 11 carry an implant, 17 and 16 a furcation involvement. Implants and furcations appear not only in the table but also at their site on the tooth graphic. All values come from an example chart.

For supportive periodontal therapy, the same chart can be kept in a compact form. The button PD/BOP in the controls (Figure 5) switches between the full periodontal chart and this shortened view; its label always names the view that the next click leads to – in the full chart it reads PD/BOP, in the shortened view Status. The name of the tab changes with it.

In the PD/BOP view, gingival margin and attachment level are omitted, and the two tooth views with the curves are replaced by a single occlusal view of the dental arch, on which each surface is colored separately. Only probing depths of 4 mm and above are recorded; all other sites remain at 0. This keeps data entry at recall short without losing the sites that stand out.

Tooth

Mobility

Implant

Furcation

Bleeding on Probing

Plaque

Probing Depth

1817161514131211

040

004

000

004

000

Probing Depth

Plaque

Bleeding on Probing

Furcation

Note

400

000

004

Figure 8: The first quadrant in the PD/BOP view. The buccal rows are at the top, the oral rows at the bottom, with the dental arch seen from occlusal in between. The missing teeth 18, 17 and 12 are gray, the one surface with bleeding on probing is red – mesial at tooth 16. The open circles on the diagram are grade 1 furcation involvements: buccal, distopalatal and mesiopalatal at tooth 16 as well as mesiopalatal at tooth 14. Of the probing depths, only the values of 4 mm and above are shown. Gingival margin and attachment level are absent from this view entirely.

Clinical Parameters and Indices

Measurements are typically recorded at six sites per tooth. The application supports various clinical indices, which are categorized as follows:

Probing Depth, Gingival Margin and Attachment Level

Probing depths in mm (measured)

Gingival Margin in mm (measured)

Attachment Level in mm (calculated)

Oral Hygiene

Plaque

Plaque Index according to O'Leary et al. (1972)

Plaque Index according to Silness and Löe (1964)

mPI

Plaque Index according to Mombelli et al. (1987)

Gingivitis and Peri-implant Mucositis

BOP

Bleeding on Probing according to Lang et al. (1986)

Gingival Index according to Löe and Silness (1963)

mGI

Gingival Index according to Mombelli at al. (1987)

Recessions

REC Mi

Recession value according to Miller (1985)

REC Ca

Recession value according to Cairo et al. (2011)

REC X

Custom recession value (2 values per tooth)

KG (MGJ)

Keratinised Gingiva (Mucogingival Junction) in mm (measured)

Gingival Thickness (Phenotype)

Width in mm (measured) according to Pandey & Mehta (2013)

CEJ

Visibility of Cemento-Enamel Junction

Step

Concavity of the root surface

REC Y

Custom recession value (6 values per tooth)

Figure 9: The selection window behind the button Indices. It determines which rows appear in the chart table. Entries outlined in blue are switched on; in the default configuration these are probing depth, gingival margin, attachment level, the plaque index according to O’Leary and the bleeding on probing according to Lang. You display the remaining indices as needed – for daily practice the five presets are as a rule sufficient, the group Recessions is aimed at clinical studies. What is switched off here disappears only from the view; recorded values are retained.

1. Probing Depth, Gingival Margin and Attachment Level

PD (Probing Depth): Measured in millimeters at 6 sites per tooth.
GM (Gingival Margin): Measured in millimeters relative to the cementoenamel junction (CEJ).
AL (Attachment Level): Calculated automatically as the sum of PD and GM (AL = PD + GM).

2. Oral Hygiene Indices

Plaque (O'Leary et al. 1972): Binary recording (0/1) for calculating the oral hygiene status (plaque index). [Default]
PI (Silness and Löe 1964): Plaque index for assessing the plaque thickness at the gingival margin.
mPI (Mombelli et al. 1987): Modified plaque index, developed specifically for dental implants.

3. Gingivitis and Peri-Implant Mucositis

BOP (Bleeding on Probing): Bleeding on probing according to Lang et al. (1986), recorded as 0 (no bleeding) or 1 (bleeding). [Default]
GI (Gingival Index): Assessment of gingival inflammation according to Löe and Silness (1963).
mGI (Modified Gingival Index): Assessment of inflammation at implants according to Mombelli et al. (1987).

4. Recessions and Advanced Parameters

Additional indices are available for clinical practice and clinical studies in order to record parameters at either 2 or 6 sites per tooth:

REC Mi: Recession classification according to Miller (1985).
REC Ca: Recession classification according to Cairo et al. (2011).
REC X / REC Y: Custom recession values (2 or 6 values per tooth).
KG (MGJ): Width of the keratinized gingiva (mucogingival junction) in mm.
GT (Gingival Thickness): Assessment of the gingival phenotype (thin/thick).
W (Width): Measured width in mm according to Pandey & Mehta (2013).
CEJ: Documentation of the visibility of the cementoenamel junction.
Step: Assessment of concavities of the root surface.
Furcation involvement: Horizontal probing of the furcation entrance with the furcation probe, classified into grades 0 to 3 according to Hamp et al. (1975). Grade 1 up to 3 mm, grade 2 more than 3 mm, grade 3 through and through.
Tooth mobility: Measured bidigitally and classified into grades 0 to 3 according to Miller (1950).

Hamp S. E., Nyman S., Lindhe J., Periodontal treatment of multirooted teeth. Results after 5 years. J. Clin. Periodontol. 1975;2:126–135. doi:10.1111/j.1600-051X.1975.tb01734.x. PubMed

Miller S. C., Textbook of Periodontia, 3rd edition, The Blakiston Co., Philadelphia and Toronto, 1950.

Tip for efficient recording of BOP and PI:

Clicking on the labels "Bleeding on Probing" or "Plaque Index" fills the corresponding row completely with positive values (BOP+ or PI+).
With Shift-click on these labels, all entries in the row are deleted again.
In addition, the Shift key can be held down while moving the mouse over the BOP or plaque surfaces in order to activate or deactivate these sites selectively.

In this way, significant time can be saved when recording BOP and plaque.

Copying Values from the Previous Chart

When creating a new chart for a patient who already has existing examinations, the system offers a dropdown menu "Copy Values" . This function is particularly useful for transferring baseline data that may not have changed since the last visit:

Parameters: You can selectively copy the tooth status (including implants), furcation grades, Probing Depths (PD), Gingival Margin (GM), Bleeding on Probing (BOP) and Plaque Index (PI).
Availability: This copy function is available for a time window of 5 minutes after the new chart has been created.
Reversibility: The transfer is interactive: clicking the same entry in the dropdown again immediately undoes the data transfer.

Copy values from the last examination

Tooth Status

Copies tooth status and implant information.

Furcations

Copies furcation grades.

Probing Depths (PD)

Copies probing depth values.

Recessions (GM)

Copies Gingival Margin values.

BOP

Copies Bleeding on Probing values.

O’Leary (PI)

Copies Plaque Index values.

Figure 10: The window behind the button Copy. Each entry transfers a group of values from the previous examination into the open chart. Clicking the same entry again undoes the transfer. The button is available only as long as an earlier examination exists, and only within five minutes of creating the new chart; after that it is grayed out.

Dictation with the audio widget

The Periodontal Chart can be dictated in full. The audio widget is located in the header next to the logo. Clicking the microphone button starts the recording, clicking it again ends it; the spoken word "Stop" does the same. This is useful chairside, where your hands are on the patient and a second person would otherwise have to write the values down.

Requirement: Speech recognition uses the browser's native engine. It is available in Google Chrome and Microsoft Edge ; other browsers report that audio input is not supported. The recognition language follows the language set for the application.

1 · Idle

2 · Recording

3 · Commands and voice training expanded

Live…

Available Voice Commands:

Situation	Voice Command (Examples)
Tooth Status	"Tooth 18 is missing", "All wisdom teeth missing", "All upper teeth missing" "Tooth 21 is present", "All wisdom teeth are present"
Tooth Mobility	"Tooth 18 mobility grade 2", "Mobility 46 zero"
Implants	"Implant 14", "33 implant", "36 implant"
Furcations	"46 furcation grade 2 buccal", "46 buccal furcation grade 3"
Bleeding (BOP) / Plaque (PI)	"Bleeding", "BOP", "Plaque", "PI", "Plus", "Minus"
Start recording at specific site	"Start 17 distobuccal"(Focuses Gingival Margin in Periodontal Chart or Probing Depth in PD/BOP) Likewise "BOP 17 distobuccal" and "Plaque 17 distobuccal" to start in BOP or the plaque index.
Stop dictation	"Stop"

Tip: If you repeat the same word multiple times (e.g., "plus, plus, plus"), speech recognition might filter it out as "stuttering". Just say "next" in between to prevent this.

Personalized Speech Training

Correct stubborn misinterpretations. The system automatically replaces the incorrect text before evaluating it.

Select expected command... Misheard as (e.g., 'Disco') Learn

No words learned yet.

EXPORT IMPORT

Figure 11: The audio widget in its three states. In the idle state, only the round button appears in the header. A click starts the recording: the area turns green, the label names the mode, the level meter shows that the microphone is listening, and the field next to it holds the text most recently understood. The arrow on the right opens the list of voice commands and, below it, the personal voice training.

Live mode and batch mode

The green label next to the microphone button names the current mode and switches it when clicked; so do the spoken commands "Live mode" and "Batch mode".

Live: Every recognized word is entered at once. You see immediately whether it was understood correctly.
Batch: The words are collected and entered together only after a pause of about one and a half seconds. This is calmer when you dictate a whole row of teeth in one go.

The voice commands

The arrow on the right of the widget opens the full list. It covers the tooth roll call, mobility, implants and furcations, the values for bleeding and plaque, and the targeted start at a specific site. With "Start 17 distobuccal" you set the focus exactly where you begin probing; data entry then moves along the configured probing sequence.

If the same word follows repeatedly: If you say "plus, plus, plus" several times in a row, speech recognition filters the repetition out as stuttering. In between, say "continue", and every mention is kept.

Personalized Speech Training

If the engine persistently misrecognizes a word, enter the pair of expected command and misrecognized text in the lower part of the widget. From then on, the system replaces the incorrect text automatically before evaluating it. The learned terms remain stored in the browser and can be transferred via Export and Import as a file to another device.

Periodontal Classification

Provides an automatic diagnostic suggestion (stage and grade) according to Tonetti et al. (2018). The system analyzes clinical parameters such as the molar-incisor pattern, the distribution of probing depths, smoking status and the stability of diabetes.

Bone loss estimation: Since no radiographs are stored, the application estimates bone loss from the clinical attachment loss (CAL) in relation to anatomically average root lengths.

Periodontitis Classification: Bbb Bbb, born 12.12.2000 (25 years)

Diagnosis: Advanced Periodontitis, Stage IV

Periodontitis Stage

Stage I

Initial Periodontitis

Stage II

Moderate Periodontitis

Stage III

Severe Periodontitis with potential for additional tooth loss

Stage IV

Advanced Periodontitis with extensive tooth loss and potential for loss of the dentition

Severity

Interdental attachment loss at the site of greatest loss

1–2 mm

3–4 mm

≥ 5 mm

Radiographic bone loss

Coronal third
(<15%)

Coronal third
(15–33%)

Middle to apical third

Tooth Loss

No tooth loss due to periodontitis

Tooth loss due to periodontitis of ≤ 4 teeth

Tooth loss due to periodontitis of ≥ 5 teeth

Complexity

Local

Max. Probing Depth
4–5 mm

Mostly horizontal bone loss

In addition to the complexity of Stage II:

Probing depth ≥ 6 mm

Vertical bone loss ≥ 3 mm

Furcation involvement Class II or III

Moderate ridge defect

In addition to the complexity of Stage III:

Need for complex rehabilitation due to:

Masticatory dysfunction

Secondary occlusal trauma (tooth mobility ≥ degree 2)

Severe ridge defect

Bite collapse, drifting, flaring

Fewer than 20 remaining teeth (10 opposing pairs)

Extent and Distribution

For each stage, describe the extent as:

Additional description of the stage

localized
(< 30% of the teeth)

generalized
(≥ 30% of the teeth)

Molar/Incisor Pattern

Periodontitis Grade

Grade A

Slow rate of progression

Grade B

Moderate rate of progression

Grade C

Rapid rate of progression

Primary criteria

Direct evidence of progression

Longitudinal data
(radiographic bone loss or attachment loss)

Evidence of no loss over 5 years

Evidence of < 2 mm loss over 5 years

Evidence of ≥ 2 mm loss over 5 years

Indirect evidence of progression

Bone loss (%)
divided by age

< 0.25

0.25 – 1.00

> 1.00

Phenotype

Heavy biofilm deposits with a low level of destruction

Destruction commensurate with the biofilm deposits

Destruction exceeds expectations given the biofilm deposits

Clinical pattern suggests periods of rapid progression and/or early-onset disease (e.g. molar/incisor pattern; lack of the expected response to standard control therapies)

Modifiers

Risk Factors

Smoking

Non-smoker

< 10 cigarettes/day

≥ 10 cigarettes/day

Diabetes

No diabetes

HbA1c < 7.0% in patients with diabetes

HbA1c ≥ 7.0% in patients with diabetes

• Maximum probing depth: 11 mm (36 dl) → Complexity: Stage 3

• Approximal attachment loss: 12 mm (36 dl) → Severity: ≥ 5 mm

• Distribution: 100.0 % of the teeth (27/27) affected → generalized

• Bone loss/age: 85.7 % / 25 = 3.43 → Grade C

Tonetti, M. S., Greenwell H., Kornman K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology. 89(1), 159-172. doi: 10.1002/JPER.18-0006.

Figure 12: The "Periodontal Classification" window following Tonetti et al. (2018). Three states are to be distinguished: A blue border marks a suggestion that the application has calculated from the chart – here for the severity, for the complexity, for the distribution and for the grade. A cell filled in blue is a choice you have clicked; it is saved immediately. Rows with a light red background are still awaiting a decision. Below the table, the application states what it derives its suggestions from.

Overview

A visualization focusing on Plaque Index (PI%) and Bleeding on Probing (BOP%) for the current data set. The Overview can be downloaded as an image.

plaque at this site missing tooth

Bleeding on Probing missing tooth

Figure 13: The Overview. At the top the Plaque Index, at the bottom Bleeding on Probing, each transferred onto the tooth diagram. Every tooth is divided into four surfaces: buccal, oral, mesial and distal. Blue stands for plaque, red for bleeding, in each case at exactly that site; teeth with a gray background are missing. The display uses the same tooth graphic and the same colors as the application and can be downloaded as an image.

Part C Evaluation What the application calculates from the recorded values and how it presents it.

3. Evaluation

Automatic Calculations

In the middle of the Periodontal Chart, summaries are calculated automatically:

Mean Probing Depth (one decimal place)
Mean Attachment Level (one decimal place)
BOP percentage (BOP%)
Plaque Index percentage (PI%)

Comparative Overlay

Procedure: To compare two charts, click the first data set in the Navigation Panel, then hold down the SHIFT key and click the second data set. Green area = 1st examination, Blue area = 2nd examination.

Tooth

Mobility

Implant

Furcation

Bleeding on Probing

Plaque

Gingival Margin

Probing Depth

Attachment Level

1817161514131211

-4-2-1

-1-1-3

-2-3-2

-3-1-1

-1-1-1

-1-20

0-21

465

545

444

333

323

886

658

777

755

555

453

342

Gingival Margin

Probing Depth

Attachment Level

Plaque

Bleeding on Probing

Furcation

Note

-2-10

0-10

00-1

-1-1-1

-10-1

-1-1-2

444

454

344

334

544

455

445

654

464

345

445

645

556

557

1st examination 2nd examination Attachment Level Gingival Margin

Figure 14: The Comparative Overlay on the same first quadrant as in Figure 7, here with a chart from 16.07.2026 and one from 16.08.2026. The table always shows the second, more recent chart. On the tooth graphic the first chart lies below it in green, the second above it: blue traces the attachment level, red the gingival margin. Where the blue area is narrower than the green one, the probing depth has decreased. At 16 and 14 the red line lies deeper than the green one: the pockets have become shallower, the recession has increased.

rare frequent plaque missing tooth

rare frequent bleeding missing tooth

Figure 15: The same Overview for two charts on top of each other, at the top the Plaque Index, at the bottom Bleeding on Probing. For each surface the application counts at how many sites a chart was positive, and gives the more recent chart double weight. The higher the sum, the more intense the color: pale means that only the older chart was positive, intense that it is the more recent one or both. In the lower part the application adds the probing depths from 4 mm upwards in red and the furcation involvements as circles.

Controls

Various controls highlight specific clinical parameters or control the image export:

Plaque

BOP

5mm

≥6mm

PRA

Image export

Complete chart – downloads the maxilla and the mandible together as an image.

Upper Jaw – downloads the upper arch only.

Lower Jaw – downloads the lower arch only.

Highlights in the chart

Plaque – highlights all sites with a positive plaque index.

BOP – highlights all bleeding sites. In the figure this button is switched on; the active one has a blue background. Only one highlight can be shown at a time.

5mm – marks probing depths of 5 mm and more.

≥6mm – marks probing depths of 6 mm and more. Together the two show at a glance where the residual pockets are.

Further calculation

PRA – passes the values of the current examination to the risk diagram on perio-tools.com. How this works is described in the next section.

Figure 16: The controls to the left of the chart, here with the BOP highlight switched on. At the top the three buttons for the image export, below them the highlights and at the bottom the jump to the risk diagram.

Periodontal Risk Assessment (PRA)

This button opens www.perio-tools.com with the parameter i and the values from the current examination.

https://www.perio-tools.com/pra/?lang=en&i=0000000032000

Analysis

Procedure: Select the first chart, hold SHIFT and select the second one. Green represents the first examination; Blue represents the follow-up examination.

Analysis of the Periodontal Status Data

Number of teeth:

Plaque Index (%):

Probing Depths 4mm (%):

Probing Depths 5mm (%):

Probing depths ≥6mm (%):

Probing Depths (mean):

Recessions (mean):

Attachment Level (mean):

Bleeding on Probing (%):

09.08.2026

85 %

18.5 %

17.3 %

25.9 %

4.6 mm

-0.5 mm

-5.0 mm

96 %

16.08.2026

26 %

12.5 %

3.5 %

4.2 %

2.9 mm

-1.2 mm

-4.2 mm

40 %

Date: 09.08.2026

Oral Hygiene

Pockets from 4mm

Bleeding on Probing (BOP)

20%

100%

Date: 16.08.2026

Oral Hygiene

Residual Pockets from 4mm

Bleeding on Probing (BOP)

20%

100%

Change in probing depths (PD) and BOP

Initial Exam (mm)	Re-evaluation (mm)	Change (mm)	Pockets (number)
≤2	2.00	0.00	6
3	2.45	-0.55	53
4	2.54	-1.46	26
5	3.32	-1.68	25
6	3.33	-2.67	15
7	4.20	-2.80	10
8	3.50	-4.50	4
9	4.67	-4.33	3
≥10	5.00	-5.00	2

≤2

≥10 mm

100%

Correlation and distribution

Pearson r = 0.94, df = 4, p = 0.9975, 95% CI: [0.5502, 2.8818]

PD / BOP	BOP reduced	BOP unch.	BOP incr.
PD reduced	67	41	0
PD unch.	13	17	1
PD incr.	2	3	0

χ² = 7.6152, df = 4, p = 0.1067

≤2

≥10 mm

Figure 17: The "Analysis" window for the two charts of 09.08.2026 and 16.08.2026. At the top the summary metrics of both examinations stand side by side, to their right the same values as bars: oral hygiene, pockets from 4 mm graded by depth and bleeding on probing. In the middle, for each initial depth, the value the re-evaluation reached and how many sites lie behind it; the diagram shows the same: blue the residual depth, green the gain. At the bottom the application checks whether the decrease in depth and the decline in bleeding are related; the contingency table counts the sites, the diagram shows the proportion of sites still bleeding for each initial depth.

The system provides a comprehensive comparison between the two examinations:

Color coding: Green indicates a clinical improvement, blue represents residual pockets and red marks a clinical deterioration.
Change in bleeding: A dashed diagonal represents the expected correlation between probing depth and bleeding. The analysis follows the shift in bleeding intensity, statistically confirmed by a chi-square test.

Recall Interval

Determines the recommended recall schedule based on Ramseier et al. (2019). The risk calculation takes into account the probing profile, systemic factors (smoking, diabetes) and furcation involvement (grade ≥2). Results can be downloaded as an image.

Three studies stand behind this calculation. The length of the interval is derived from the residual pockets and the time between visits (Ramseier et al. 2019). The bleeding on probing is included as a measure of the inflammation – note that smokers bleed less at the same disease severity and that the value there is lower than the chart warrants (Ramseier et al. 2015). The furcation involvement is counted from grade 2 upwards, because multi-rooted teeth carry a markedly increased risk of loss only from this grade – grade 1 does not differ from grade 0 in this respect (Salvi et al. 2014).

Ramseier, C. A., Nydegger, M., Walter, C., Fischer, G., Sculean, A., Lang, N. P., Salvi, G. E. (2019). Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy. Journal of Clinical Periodontology, 46(2), 218–230. doi:10.1111/jcpe.13041. PubMed

Ramseier, C. A., Mirra, D., Schütz, C., Sculean, A., Lang, N. P., Walter, C., Salvi, G. E. (2015). Bleeding on probing as it relates to smoking status in patients enrolled in supportive periodontal therapy for at least 5 years. Journal of Clinical Periodontology, 42(2), 150–159. doi:10.1111/jcpe.12344. PubMed

Salvi, G. E., Mischler, D. C., Schmidlin, K., Matuliene, G., Pjetursson, B. E., Brägger, U., & Lang, N. P. (2014). Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. Journal of Clinical Periodontology, 41(7), 701–707. doi:10.1111/jcpe.12266. PubMed

Evaluation

	4mm	5mm	≥6mm
Number of Pockets	18	5	6
Pockets (%)	12.5	3.5	4.2
Cumulative (%)	20.2	7.7	4.2

	≥4mm	≥5mm	≥6mm
3 months	≤ 30%	≤ 20%	≤ 4%
4 months	≤ 20%	≤ 10%	≤ 3%
6 months	≤ 20%	≤ 6%	≤ 2%
9 months	≤ 10%	≤ 4%	≤ 1%
12 months	≤ 10%	≤ 2%	≤ 1%

Personalized Recall Interval

Smoking (S) Diabetes (D)

3 4 6 9 12

Selected interval:Months

Figure 18: The "Recall Interval" window for the chart of 16.08.2026. On the left, how many sites measure 4, 5 and 6 mm and more, in absolute numbers, as a percentage and cumulated. The table below contains the limits for each interval; green marks which limits the chart keeps to, yellow the interval the application proposes from them. The column for 6 mm and more is always shown on a red background, because it is the decisive one. On the right the same values as bars; the black lines are the thresholds at 20 percent plaque and 23 percent bleeding. Smoking and diabetes shift the proposal; with smoking the bleeding threshold drops to 16 percent. You enter the selected interval yourself at the bottom.

3D Visualization

Renders a 3D model of the periodontal surface, documents the total periodontal surface area (TPSA) in cm² and analyzes BOP-positive vs. BOP-negative surfaces. The model can be zoomed, rotated and exported as a GLTF file for virtual reality (VR) or augmented reality (AR) applications.

Reset Camera Download GLTF

Surface Analysis

Total: 13.2 cm² (100%)

Inflamed: 8.1 cm² (61.1%)

61%

77%

48%

Buccal and Oral: 5.9 cm² (100%)

Inflamed: 4.6 cm² (77.2%)

Interdental Spaces: 7.3 cm² (100%)

Inflamed: 3.5 cm² (48.0%)

Figure 19: The "3D Visualization" window in its initial position. Every measurement site becomes a surface in space: its height is the probing depth, its width the distance to the neighboring site. The sites with bleeding on probing are red, those without blue; the lighter tones are the interdental spaces. The maxilla is at the top, the mandible at the bottom; the black curves are the two dental arches. The model can be rotated and zoomed with the mouse, "Reset Camera" restores exactly this view, and "Download GLTF" outputs the scene as a file for virtual and augmented reality applications.

Below it the application sums up the same surfaces. The large square is the total periodontal surface area, here 13.2 cm²; the red portion from below is the 8.1 cm² at which bleeding occurs, that is 61 percent. The two small squares divide the same area: at the top the buccal and oral surfaces, at the bottom the interdental spaces, in the lighter tones. The comparison is worthwhile because the plain BOP percentage conceals it: buccally and orally 77 percent of the surface bleeds, in the interdental spaces 48 percent – but the interdental spaces are, with 7.3 cm², the larger surface.

Reset Camera Download GLTF

Surface Analysis

Baseline: 23.6 cm² (100%)

Follow-up: 13.2 cm² (56.0%)

56%

54%

58%

Buccal and Oral: 11.0 cm² (100%)

Follow-up: 5.9 cm² (53.8%)

Interdental Spaces: 12.6 cm² (100%)

Follow-up: 7.3 cm² (57.9%)

Figure 20: The same view for two charts. In green, the first chart of 09.08.2026 lies underneath, in blue the second chart of 16.08.2026 on top; the lighter tones are again the interdental spaces. Wherever green shows through, the surface has become smaller – and here that is the case almost everywhere.

In this mode the three squares read differently than in Figure 19: green is now the first chart as a whole, blue the portion of it that is still left at the second chart. Of 23.6 cm², 13.2 cm² have remained, that is 56 percent; the periodontal surface has almost halved. Buccally and orally it is 54 percent, in the interdental spaces 58 percent – the interdental spaces have thus gained somewhat less, although with 12.6 cm² they were the larger initial surface.

QR Code Sharing

Generates a QR code for the current chart, which can be displayed on mobile devices in a responsive web viewer.

The QR code contains the complete chart in the same compressed form as the API parameter i. Anyone who scans it with a mobile phone opens the chart in the viewer without any data going to a server. The code does not transmit personal data.

Figure 21: QR Code Sharing. The code carries the anonymized chart itself within it, not an address under which it would be looked up. That is the reason why the sharing works without server access and without an account. The code shown is a sample without content.

API Access

The aim of this API is to make the online periodontal chart accessible to external applications (e.g. practice management software). A generated link transmits anonymized chart data and visualizes it directly in the viewer.

Base URL

https://www.periodontalchart-online.com/api/

Query String Parameter

The query string is transmitted via the parameter i and contains the anonymized and compressed data of the periodontal chart.

Example URL

https://www.periodontalchart-online.com/api/?i=5051505050...

You will find detailed technical documentation of the API here: API Documentation.

Examiner Calibration

Two charts of the same person, recorded shortly one after the other, can be compared with each other: what differs does not go back to the patient but to the measuring. That is exactly what the calibration examines. It is suitable for two examiners (Inter-Examiner) as well as for two rounds by the same person (Intra-Examiner) and is used in the training of dentists and dental hygienists.

The application places each site of the two charts side by side and calculates from them the intraclass correlation coefficient (ICC) for each parameter as well as a Bland-Altman plot for the probing depths. The two answer different questions: the ICC says how closely the two measurements agree overall; the plot shows where they diverge – whether evenly across all depths or only at the deep pockets.

How to read the plot: Each bubble stands for one or more sites. Horizontally lies the mean of the two measurements, that is roughly how deep the pocket is; vertically the difference, that is how far apart the two lie. A bubble on the zero line means agreement. The turquoise line is the mean difference – if it lies clearly away from zero, one person measures consistently deeper than the other. The two red lines are the limits of agreement (mean ± 1.96 standard deviations); around 95 % of the sites should lie between them, the remaining ones appear in red.

Two charts must be selected in the Navigation Panel for this – the second with the Shift key held down. The result can be downloaded as an image and thus serves as documentation for a calibration exercise or for the methods section of a study.

Comparison of Periodontal Measurements

The 10 largest deviations

The following sites show the largest deviations:

Gingival Margin	Δmm	Probing Depths	Δmm	Furcations	ΔGrade
33 db	4	23 mp	5	16 dp	2
33 b	3	24 mp	5	14 mp	1
21 mb	2	36 mb	5	24 dp	1
27 db	2	25 mp	4	27 b	1
34 db	2	45 ml	4	36 b	1
36 ml	2	47 ml	4	36 l	1
11 mb	1	12 mp	3	37 l	1
11 dp	1	15 dp	3	47 b	1
12 db	1	22 mb	3	47 l	1
12 mb	1	24 dp	3

Bland-Altman plot (probing depths)

The plot sets the difference between two measurements of the probing depth against their mean. Blue circles lie within the thresholds, red ones outside; the circle size stands for the number of sites.

Analysis of the agreement

The intraclass correlation coefficient (ICC) assesses the degree of agreement. A value close to 1 indicates high agreement, a value close to 0 low agreement.

Gingival Margin	Probing Depths	Furcations
ICC: 0.8680 F-value: 14.1568 p-value: <0.0001	ICC: 0.6882 F-value: 5.4152 p-value: <0.0001	ICC: 0.7857 F-value: 8.3333 p-value: <0.0001

Agreement: ICC ≥0.90 excellent, ≥0.75 good, ≥0.50 moderate, <0.50 poor.

Mean Deviations

Entire Dentition

Gingival Margin Δmm	Probing Depth Δmm	Furcation ΔGrade
Maxilla: M: 0.38 * D: 0.63 * B: 0.50 * P: 0.33 * total: 0.45 Mandible: M: 0.50 * D: 0.50 * B: 0.50 * L: 0.50 * total: 0.50	Maxilla: M: 0.88 * D: 0.88 * B: 0.83 * P: 0.67 * total: 0.80 Mandible: M: 1.88 * D: 1.00 * B: 0.92 * L: 1.33 * total: 1.25 *	Maxilla: B: 0.25 * MP: 0.00 DP: 0.50 * total: 0.25 Mandible: B: 0.50 * L: 0.75 * total: 0.63

The same breakdown follows once more in the window for anterior teeth, premolars and molars.

Summary

Gingival Margin: The agreement between the measurements is good.
Probing Depths: The agreement between the measurements is moderate.
Furcations: The agreement between the measurements is good.

Figure 22: The "Examiner Calibration" window for a calibration exercise: the same patient, examined on 16 and on 17.08.2026 by Clinician A and Clinician B . 27 teeth with 162 probing sites are compared. At the top are the ten sites with the largest deviations. The Bland-Altman plot below plots the difference between the two measurements against their mean; the circle size stands for the number of sites. The turquoise line is the mean difference (−0.15 mm, so hardly any systematic bias), the two red lines are the limits of agreement at +2.43 and −2.73 mm. Twelve of the 162 sites lie outside them and are red. The ICC summarizes this for each parameter: good for the gingival margin and the furcations, only moderate for the probing depths – which is exactly what the exercise is for. The breakdown below shows where the deviations lie; an asterisk marks conspicuous values, and the application additionally highlights strongly deviating sites in red. For reasons of space, only the first of four blocks is shown.

Part D Further Charts General Health and Microbiology complement the periodontal chart.

4. General Health Tab

Edit Save

Expand

Collapse

GENERAL HEALTH

General Information

Systemic Diseases

Cardiovascular

group_1_0_description

Taking blood thinners

History

09.08.2026: Yes

Heart valve defects, artificial heart valves or heart transplant

High blood pressure (hypertension)

Coronary heart disease (CHD), heart attack or stent

Figure 23: The "General Health" tab. At the top five buttons: Print, Edit, Save as well as Expand and Collapse for all sections at once. Below it would come the form header with Patient ID, name and clinician – it is the same as in the Periodontal Chart and is therefore omitted here; it is shown in Figure 6. Then follows the questionnaire: blue bars are sections, they contain groups such as "Cardiovascular", and these contain the individual questions. To the right of a question the History appears – but only where the finding was already positive in an earlier examination. In this way you see, while filling in the form, what was last recorded, without having to open the old chart.

Structure of the questionnaire

The list covers a wide range of medical questions, which can be expanded or collapsed as needed. Individual health areas are divided into sections that can be managed independently for a better overview.

Data storage and export

For each chart, all selections in the health questionnaire are stored and time-stamped individually. These data are fully integrated into the data export function so that medical information can be analyzed statistically together with clinical periodontal parameters.

Customization (Questionnaire Editor)

The entire questionnaire can be fully customized with the Editor button as follows:

Editing: Add new questions, create custom dropdown menus or define new categories.
Flexibility: Completely new health forms can be created, which makes the application ideal for data collection in clinical studies.
Reset: If required, the questionnaire can be returned to its default state at any time.

Edit questionnaire

Restore Defaults ×

Adjust the structure of the health questionnaire here. Changes are stored locally.

General Information

Add section Save

Systemic Diseases

Cardiovascular

group_1_0_description

anticoagulants Taking blood thinn Checkbox

endocarditis_risk Heart valve defects, art Checkbox

blood_pressure High blood pressure (hyp Checkbox

coronary_disease Coronary heart disease ( Checkbox

Figure 24: The Questionnaire Editor behind the "Edit" button. It shows the same structure as the form, only editable: sections, containing groups, containing the fields. For each field the internal name, the label and the field type are shown; checkbox, text field and selection list are available. The handles on the left move sections, groups and fields by dragging, the trash can icons delete them. Dashed frames show where something can be dragged to. "Insert section" adds a new block, "Save" applies the structure, and "Restore default" at the top right resets the whole questionnaire to the delivered version.

Taking it with you and passing it on: Both the recorded answers and the questionnaire you have assembled yourself can be exported and imported again. The answers go into the backup file together with the chart (see Data Management), the form structure is stored locally in the browser. A questionnaire that has been built once can thus be passed on to other workstations – and reset to the delivered version at any time with "Restore default".

5. Microbiology Tab

Periodontopathogenic Bacteria

A.a. Aggregatibacter actinomycetemcomitans 105

P.g. Porphyromonas gingivalis 106

T.f. Tannerella forsythia 105

T.d. Treponema denticola 105

P.i. Prevotella intermedia 104

F.a. Filifactor alocis 104

Potentially Periodontopathogenic Bacteria

P.m. Parvimonas micra 104

F.n. Fusobacterium nucleatum 105

C.r. Campylobacter rectus 100

E.n. Eubacterium nodatum 104

E.c. Eikenella corrodens 104

C.sp. Capnocytophaga species 100

Periodontopathogenic Bacteria: A.a., P.g., T.f., T.d., P.i., F.a.
Potentially periodontopathogenic bacteria: P.m., F.n., C.r., E.n., E.c., C.sp.

Figure 25: The Microbiology tab. On the left the twelve pathogens are recorded as exponents to base 10; 0 means not detected. The background of the cards becomes stronger as the exponent rises and makes the load visible during entry. On the right the twelve-sided polygon chart summarizes the findings: the further out a vertex lies, the higher the bacterial count. Here P.g. and the other pathogens of the red complex dominate, while C.r. and C.sp. are not detectable.

Recording the Pathogens

The system allows the load to be recorded for 12 different pathogens. Data entry is based on exponents (e.g. entering 4, 5 or 6 for 10⁴, 10⁵ or 10⁶). A value of 0 means that the pathogen was not detected.

Visualization (Polygon Chart)

The findings are visualized in a 12-sided polygon chart (spider chart), which provides an immediate overview of the patient's microbiological profile.

Microbiological Shift (Comparison View)

When two charts are selected for comparison (SHIFT+click in the Navigation Panel), the Microbiology tab visualizes the shift between the two time points:

Green shading: Represents the microbiological profile of the first examination.
Blue shading: Represents the profile of the second examination (follow-up chart).

This overlay makes it easy to visualize the reduction or the clinical shift of pathogens after treatment.

Part E Assessing the History Several examinations compared: what has changed, and was the appointment scheduled correctly.

6. History Tab

The History tab provides a comprehensive longitudinal view of all periodontal charts of a patient, in reverse chronological order (most recent chart first).

Inflammation (%)

Probing Depths from 4mm (%)

Oral Hygiene (%)

Figure 26: The History tab, first view, here with six charts from three years of supportive therapy. The gray bar at the top switches between the views; the one switched on has an orange background. Below it the three metrics stand side by side, one column per chart: on the left the inflammation as the proportion of bleeding sites, in the middle the probing depths from 4 mm graded by depth – light gray 4 mm, dark gray 5 mm, red from 6 mm –, on the right the oral hygiene. All three axes go up to 100 percent so that the images can be compared. The history reads from left to right: active disease in 2022 with 76 percent plaque and red proportions from 6 mm, then the therapy, from 2024 a very good condition with 6.3 percent bleeding and no pocket from 6 mm – and in the last chart a relapse: plaque back up to 46.5, bleeding to 16.7 percent. Setbacks like these in the history are the reason why this view comes first.

Comparative Visualization

Each data set shows the probing and bleeding findings on the left and the oral hygiene findings (plaque) on the right, side by side, to allow a straightforward comparison.

Between two charts the application also assesses the interval: it compares the interval derived from the residual pockets with the actual one and reports, according to Ramseier et al. (2019), whether the follow-up appointment took place early, on time or late.

PD/BOP PD ≥ 6mm Furcations Implants PI +

LATE

(expected approx. 180 days, actual 213 days)

Figure 27: The second view shows each chart on the tooth diagram: on the left Bleeding on Probing in red, on the right the Plaque Index in blue, with the date and the percentage at the edge. The more recent chart is at the top. For reasons of space only the two most recent of the six charts are shown here; the others follow below in the same form. The switches above show and hide what is drawn in addition – the probing depths from 4 mm as red numbers, the furcations as "I", the implants as open circles; the circle with a yellow background marks a pocket from 6 mm. "PD from 6mm" and "PI +" are switched off by default and are deliberately switched on here so that the figure shows everything the view can do; without them the right side is limited to the blue plaque surfaces. Between the charts stands the assessment of the interval: LATE, because about 180 days are derived from the residual pockets, but the visit did not take place until after 213 days. The comparison shows the deterioration clearly: bleeding from 8 to 17 percent, plaque from 21 to 47 percent, and at the bottom right on tooth 47 new red values have appeared.

Change Analysis (Arrow Buttons)

Clicking on the arrow buttons between two charts inserts a visual analysis of the clinical changes:

Color coding:
- Green/light green: Significant clinical improvement.
- Yellow: Stable (no change).
- Pink/dark pink: Clinical deterioration of the probing depths.
Closed pockets: The analysis identifies "closed pockets", defined as sites with a probing depth of ≤4 mm and without bleeding on probing (BOP).
Ranking tables: The toggle switches between distribution data (Table 1) and a ranking of the sites with the greatest need for treatment (Table 2).

-10 mm5 mm

Table 1/2	Before	After	Difference
Date	Mar 2025	Oct 2025	7 month(s) (213 days)
Teeth	24	24	0
4 mm	9	16	+7
closed	9	10	+1
5 mm	0	1	+1
from 6 mm	1	1	0
Furcation Grade 1	4	2	-2
Furcation Grade 2	0	1	+1
Furcation Grade 3	2	2	0
Implants	1	2	+1

Improvement no change Worsening

Figure 28: The change analysis between the two most recent charts, 25.03. and 24.10.2025. On the left the application plots the difference in probing depths onto the tooth diagram: green means a lower depth, yellow no change, magenta a greater one. Of 144 sites, 122 are unchanged, but this time the changes mostly go in the wrong direction: 10.4 percent deteriorated against 4.9 percent improved. The histogram shows this in the two magenta bars to the right of zero. On the right the table sets the two charts against each other: seven additional pockets at 4 mm, one new one at 5 mm, one furcation worsened from grade 1 to grade 2 and a second implant. This is exactly what a relapse in supportive therapy looks like.

Interactive Tools

Animation loop: Use the Play/Pause/Loop buttons to visualize the course of disease and healing in a time-lapse overlay.
Heatmap: Highlights sites with frequent bleeding or plaque across several examinations.
Risk indicators: The exclamation mark button marks sites with repeated bleeding (BOP), which indicates an increased risk of further attachment loss (Lang 1986).

Figure 29: The fourth view combines all six charts into one image – on the left the bleeding, on the right the plaque. The surface color shows the proportion of examinations at which a site was affected – for the interproximal areas both sites count. A surface is therefore fully opaque only if it was affected at every examination. The dots on the bleeding side mean something different: they sit where the probing figure otherwise stands, and count the consecutive bleeding events. According to Lang et al. (1986) the risk of further attachment loss rises when a site bleeds at several appointments in a row – a single examination without bleeding resets the count. The color follows the five categories of the study, which counts the bleeding at the last four appointments: dark yellow from two consecutive bleeding events, orange from three, dark red from four; the dot grows with it. That is why there are only three dark yellow dots here: 25 distopalatal, 47 buccal and 43 lingual bled twice in a row most recently. The comparison with tooth 47 distal is instructive: bleeding was recorded there at four of six appointments, but twice in 2024 none – the series is interrupted, the risk starts again from the beginning, and no dot appears. The timeline below shows every chart; the orange one is the one currently displayed. With the play buttons the series runs as a time lapse, and the timeline can also be dragged by hand.

Reports and AI Integration

Stability assessment: Generates a patient-friendly report in plain language on the current periodontal stability and the recommended recall profile.
AI chart report: The AI button generates an anonymized clinical prompt based on the patient's charts. Users can copy this prompt or open Google Gemini directly to create a clinical report in natural language by copy and paste.

How stable are your gums?

Assessment of your periodontal stability

Periodontal stability is possibly not fully achieved. The following points deviate from the stability target:

Oral hygiene, at 25.7%, is above the target value of 20%.
There are still 4.2% residual pockets of 6mm and more.
Furcations Grade 2 or higher are present.
Inflammation (BOP: 41%) is above the target value (20%).

Oral Hygiene (%)

With a plaque index of 25.7%, oral hygiene still leaves room for improvement (target: below 20%). Pay closer attention to your daily tooth cleaning and follow the instructions you have received.

Probing Depths (%)

There are still 4.2% residual pockets of 6mm and more, which could make further treatment necessary. Discuss possible options for stabilization with your dental professional.

Furcations (number)

Furcations of grade 2 or 3 were found, which represent an increased risk of tooth loss. Discuss suitable measures with your dental professional.

Inflammation (%)

With a BOP value of 41%, inflammation is increased (target: below 20%). Discuss with your dental professional how the inflammation can be specifically reduced.

Summary Notes

The following steps could be necessary for periodontal stabilization:

improvement of oral hygiene (below 20%)
reduction of residual pockets ≥ 6mm through further treatment (provided oral hygiene is improved)
an assessment of the grade 2 or 3 furcations with regard to surgical correction options (with improved oral hygiene)
a reduction of the inflammation below 20% (after prior reduction of the residual pockets)

Figure 30: The "Profile" window is addressed to the patient. At the top stand the three summary metrics as bars, below them in plain language what they mean and what still needs work. For this the application compares against fixed target values: below 20 percent plaque, below 20 percent bleeding, no residual pockets of 6 mm and more, no furcations of grade 2 and more. The text names deviations without making a diagnosis.

Prompt for Gemini (Google), ChatGPT (OpenAI), etc.:

Language: English ▾

Create an understandable and respectful summary of the periodontal condition of a patient
with the following data:

Plaque index: 25.7% (target value: <20%)
Probing depths of 6mm and more: 4.2%
Bleeding (BOP): 41% (target value: <20%)
Number of affected furcations of grade 2 or 3: 3

Please:\n- explain to the patient in understandable terms what these values mean\n- point out
the connections between oral hygiene, residual pockets and inflammation\n- point out the need to
reduce any risk factors that may be present, such as smoking tobacco products, snus or poorly
controlled diabetes\n- refrain from medical recommendations or diagnoses\n- use a
neutral, factual, motivating language

Create the summary in this language: English

Copy Prompt Copy Prompt & Open Gemini

Figure 31: The "AI Prompt" window assembles a ready-made text from the same numbers, which you can paste into a language model. Only the four summary metrics are passed on – no name, no date of birth, no chart data. The instructions in the prompt explicitly require the model not to make a diagnosis and not to recommend treatment. The language can be changed at the top.

7. References

The following scientific references were used to establish the clinical indices and algorithms in the online Periodontal Chart. The PubMed links open the entry in the database of the U.S. National Library of Medicine in a new tab. The two textbooks are not listed there.

Textbook of Periodontia. 3rd ed. Miller SC (1950). Philadelphia: Blakiston.
Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21:533-551 PubMed
Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121-135 PubMed
O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43:38 PubMed
Hamp SE, Nyman S, Lindhe J. Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol. 1975;2:126-135 PubMed
Miller PD, Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985;5:8-13 PubMed
Lang NP, Joss A, Orsanic T, Gusberti FA, Siegrist BE. Bleeding on probing. A predictor for the progression of periodontal disease? J Clin Periodontol. 1986;13:590-596 PubMed
Mombelli A, van Oosten MA, Schurch E, Jr., Lang NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987;2:145-151 PubMed
Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol. 2011;38:661-666 PubMed
Pandey S, Mehta DS. Treatment of localized gingival recession using the free rotated papilla autograft combined with coronally advanced flap by conventional (macrosurgery) and surgery under magnification (microsurgical) technique: A comparative clinical study. J Indian Soc Periodontol. 2013;17:765-770 PubMed
Salvi GE, Mischler DC, Schmidlin K, Matuliene G, Pjetursson BE, Brägger U, Lang NP. Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. J Clin Periodontol. 2014;41:701-707 PubMed
Ramseier CA, Mirra D, Schütz C, Sculean A, Lang NP, Walter C, Salvi GE. Bleeding on probing as it relates to smoking status in patients enrolled in supportive periodontal therapy for at least 5 years. J Clin Periodontol. 2015;42:150-159 PubMed
Woelfel's Dental Anatomy. Schneid RC, Weiss G (2017). Philadelphia: Wolters Kluwer.
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89 Suppl 1:S159-S172 PubMed
Ramseier CA, Nydegger M, Walter C, Fischer G, Sculean A, Lang NP, Salvi GE. Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy. J Clin Periodontol. 2019;46:218-230 PubMed
Ramseier CA. Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry. Periodontol 2000. 2024;95:129-155 PubMed