Clinical Assessment of Periodontal Diseases - Radiography and periodontal tissue exam Flashcards
What is the most appropriate radiographic image?
intra-oral periapical radiographs
Why are intra-oral periapical radiographs used?
allows for full root length review
What is an OPT radiograph?
orthopantomograph
When would an OPT radiograph be used?
where there is evidence of multiple pockets +/or ID
recession, an OPT can provide better efficiency of imaging.
panoramic image
what are the stages of interproximal bone loss?
stage II (early/mild )
stage II (moderate)
stage III (severe)
stage IV (very severe)
Describe stage I of interproximal bone loss
<15% (or <2mm attachment loss)
Describe stage II of periodontal bone loss
coronal third of root
Describe stage III of periodontal bone loss
mid third of root
Describe stage IV of periodontal bone loss
apical third of tooth
What is the difference between the apical and coronal part of a tooth?
Coronal refers to the direction towards the crown of a tooth, as opposed to apical, which refers to the direction towards the tip(s) of the root(s). It may also refer to something relating to the crown, such as coronal forces
Name the top, middle and bottom third of the tooth
top - coronal surface
middle - middle third
bottom - apical third of root
What instrument would you use for measuring a periodontal pocket in a periodontal tissue exam?
UNC15 probe
How many sites do you measure for pocket depth of a tooth in a periodontal tissue exam?
6
What sites do you measure for a periodontal pocket?
What does a periodontal tissue exam measure?
- Pocket depth in mm, on 6 sites
for each tooth - Measures gingival recession in
mm, on 6 sites for each tooth - Records BOP
- Records suppuration
- Records mobility
- Records furcation
What 2 aspects do you measure in a periodontal tissue exam?
- mobility
- furcation
What classification is used to chart the mobility in periodontal pocket exam?
miller classification
How do you measure mobility in a periodontal pocket exam?
2 hard instruments
How many classes are there in Miller classification? (mobility)
4
0-3
Describe the classes in the Miller classification (mobility)
- Class 0- Physiological movement
- Class 1- Greater lateral movement but <1mm
- No vertical movement.
- Class 2 - Lateral movement >1mm
- No vertical movement.
- Class 3 - >1mm vertical movement
What instrument is used to measure the furcation in periodontal pocket exam?
Measured using Nabers probe
How many classifications of furcation are there?
4
0-3
Describe each degree of furcation
- Degree 0 - No furcation!
- Degree 1 - <3mm
- Degree 2 - >3mm but not fully through the periodontal tissue
- Degree 3 - Through and through - entire periodontal bone width loss
How do you grade the rate of bone loss over time?
%BL/age
* Slow (G:A), Moderate (G:B), Rapid (G:C)
What are the stages in diagnosis of periodontal disease?
Pattern (localised, generalised, molar-incisal patterns)
staging (amount of bone loss)
- early, moderate, severe or very severe
grading (rate of bone loss over time)
status (current disease activity)
- in remission of unstable
risks (things that will make disease worse)
What is a grade A, B and C?
A = <0.5 slow
B = 0.5-1.0 moderate
C = >1.0 rapid
