Clinical Assessment of Periodontal Diseases - Radiography and periodontal tissue exam

Question 1

What is the most appropriate radiographic image?

Answer 1

intra-oral periapical radiographs

Question 2

Why are intra-oral periapical radiographs used?

Answer 2

allows for full root length review

Question 3

What is an OPT radiograph?

Answer 3

orthopantomograph

Question 4

When would an OPT radiograph be used?

Answer 4

where there is evidence of multiple pockets +/or ID
recession, an OPT can provide better efficiency of imaging.

panoramic image

Question 5

what are the stages of interproximal bone loss?

Answer 5

stage II (early/mild )
stage II (moderate)
stage III (severe)
stage IV (very severe)

Question 6

Describe stage I of interproximal bone loss

Answer 6

<15% (or <2mm attachment loss)

Question 7

Describe stage II of periodontal bone loss

Answer 7

coronal third of root

Question 8

Describe stage III of periodontal bone loss

Answer 8

mid third of root

Question 9

Describe stage IV of periodontal bone loss

Answer 9

apical third of tooth

Question 10

What is the difference between the apical and coronal part of a tooth?

Answer 10

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

Question 11

Name the top, middle and bottom third of the tooth

Answer 11

top - coronal surface
middle - middle third
bottom - apical third of root

Question 12

What instrument would you use for measuring a periodontal pocket in a periodontal tissue exam?

Answer 12

UNC15 probe

Question 13

How many sites do you measure for pocket depth of a tooth in a periodontal tissue exam?

Answer 13

6

Question 14

What sites do you measure for a periodontal pocket?

Answer 14

Question 15

What does a periodontal tissue exam measure?

Answer 15

• 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

Question 16

What 2 aspects do you measure in a periodontal tissue exam?

Answer 16

1. mobility
2. furcation

Question 17

What classification is used to chart the mobility in periodontal pocket exam?

Answer 17

miller classification

Question 18

How do you measure mobility in a periodontal pocket exam?

Answer 18

2 hard instruments

Question 19

How many classes are there in Miller classification? (mobility)

Answer 19

4

0-3

Question 20

Describe the classes in the Miller classification (mobility)

Answer 20

• 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

Question 21

What instrument is used to measure the furcation in periodontal pocket exam?

Answer 21

Measured using Nabers probe

Question 22

How many classifications of furcation are there?

Answer 22

4

0-3

Question 23

Describe each degree of furcation

Answer 23

• 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

Question 24

How do you grade the rate of bone loss over time?

Answer 24

%BL/age
* Slow (G:A), Moderate (G:B), Rapid (G:C)

Question 25

What are the stages in diagnosis of periodontal disease?

Answer 25

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)

Question 26

What is a grade A, B and C?

Answer 26

A = <0.5 slow
B = 0.5-1.0 moderate
C = >1.0 rapid