Clinical Diagnosis

Question 1

What are the major factors in determining diagnosis?

Answer 1

Probing depth
CAL
BOP
furcation involvement
mobility
fremitus: mobility of tooth in occlusion
bone defects: horizontal vs. vertical; 1-wall, 2-wall, 3-wall

Question 2

What are the primary local factors that a dentist would need to consider in a periodontal diagnosis?

Answer 2

bacteria: involved species, retentive areas
compliance: to OHI, to maintenance program

Question 3

What are the primary systemic risk factors to periodontal disease?

Answer 3

smoking
diabetes
genetics

Question 4

What are the radiographs you would need to evaluate before a periodontal diagnosis?

Answer 4

full set of periapical radiographs

patient’s old radiographs and periodontal charts

Question 5

What are you looking at in clinical charting?

Answer 5

probing depths
gingival recession of hyperplasia
bleeding on probing
bacterial plaque
suppuration
tooth mobility and fremitus
furcation involvement
the amount of attached and keratinized gingiva

Question 6

How do you calculate clinical attachment loss?

Answer 6

probing depth + gingival recession

Question 7

Describe the different furcation involvements

Answer 7

Class I: can engage probe up to 3 mm; can’t engage the root furcation
Class II: probe passes more than 3 mm into the furcation, but does not go through and through
Class III: probe passes through the entire furcation
Class IV: probe passes through the furcation and is supragingival (furcation is visible clinically)

Question 8

How is BOP calculated?

Answer 8

expressed as a % of total sites available

Question 9

What would be the diagnosis for a patient with the following conditions:
probing depths of 1-3 mm
no history of attachment loss
no clinical signs of inflammation

Answer 9

Health

Question 10

What would be the diagnosis for a patient with the following conditions:
probing depths of 1-3 mm
no history of attachment loss
clinical signs of inflammation

Answer 10

gingivitis: plaque-induced or from some other form

Question 11

What is gingivitis characterized by?

Answer 11

probing depths less than/equal to 3 mm
no gingival recession
red and edematous soft tissue

Question 12

What would be the diagnosis for a patient with the following conditions:
probing depths greater than 4
attachment loss
clinical signs of inflammation

Answer 12

Periodontitis: now you have to indicate whether it is chronic or aggressive

Question 13

How is chronic periodontitis further defined?

Answer 13

localized/generalized: based off of # of sites

slight/moderate/severe: based of CAL

Question 14

What is the general approach to periodontal care?

Answer 14

perform an examination
make an initial clinical diagnosis
identify the risk factors for future progression of the disease
establish a prognosis
present treatment alternatives
obtain informed consent
treat the patient
initial non-surgical therapy
re-evaluation
periodontal maintenance