Examination and Diagnosis Flashcards
Describe healthy periodontium
No clinical signs of inflammation and no history of attachment loss
Describe periodontium which is diagnosed with gingivitis
- Clinical signs of inflammation
- No clinical evidence of attachment loss
- Soft tissue margins at or coronal to the CEJ
Describe the periodontium in periodontitis
Clinical evidence of attachment loss (pocket depth), often associated with clinical signs of inflammation
List the three most important clinical and radiographic signs of period disease progression
- Bleeding on probing
- Pocket depth and gingival margin changes
- Bone level changes
List List 5 parameters of periodontal health you can observe just by looking at the gingiva
- Colour
- Contour
- Consistency
- Texture
- Position in relation to CEJ
- What does BPE stand for
- What does PSR stand for?
- Basic Periodontal Exam
- Periodontal Screening and Recording
What is the difference between PSR and CPITN
Nothing other than CPITN has asterix system
A person comes in with PSR of all 1’s. What is the appropriate care?
OHI and removal of subgingival plaque.
What does a PSR code 2 reflect
Supra or Subgingival calc OR defective restorative margin
What is the appropriate management of a code III PSR
- Comprehensive charting and exam of the affected sextant inbluding probing depths, mobility, gingival recession, mucogingival problems, furcation invasions, radiographs.
- If 2+ sextants have a 3, full periodontal charting.
When should you add an asterix to a PSR score
When findings of clinical abnormalities such as:
- Furcation invasion
- Mobility
- Mucocgingival problems
- Recession extending to the coloured area of probe 3.5mm or greater
- What is the main sign of perio disease activity?
- What is the main sign of period disease progression?
- Presence of inflammation
- Attachment loss
What do you need to tell perio patient?
- Nature of disease
- Treatment
- Monitoring and maintenance
- Prognosis
Are implants included in BPE?
No. The tissue connection and anatomical position often leads to deeper probing depths in healthy sites. Do 6 point probing and observe for bleeding or suppurtaion around each implant.
How is adult BPE different to children/adolescents?
Child/Adolescent BPE involves assessing six index teeth: UR6, UR1, UL6, LL6, LL1, LR6
What BPE scores should radiographs be obtained for?
Anything over a 3.
Why are radiographs useful for perio assessment?
- Aid diagnosis and prognosis
- Permit assessment of morphology
- Assess petern of alveolar bone loss and monitor stability
- Provide info on other pathologies to guide overall prognosis
Why is it important to use a beam aiming device for PAs to assess perio?
To avoid distortion of bone levels in relation to CEJ and the root length.
PAs are the gold standard for perio assessment.
List 5 periodontal features which should be assessed and reported on a radiograph
- Degree of bone loss
- Pattern or type of bone loss
- Presenve of furcation defects
- Presence of subgingival calculus
- Other features eg perio-endo lesions, widered PDL spaces, abnormal root length or root morphology, overhanging restorations
What might you see on a radiograph that would suggest a complex tx need and consideration for referral
- Multiple angular defects
- Furcation involvement
What is clinical attachment loss?
CAL is recession + probing depth
When would a diagnosis of aggressive periodontitis be considered/
Where the plaque is inconsistent with the amount of attachment loss
Does mobility increase or decrease after cleaning?
Should increase with CT reconnection unles there is some sort of issue with occlusion etc
What is supportive periodontal therapy
Surveillance and monitoring of stable periodontitis patients
What is observed clinically to diagnose gingivitis?
BoP in more than 10% of sites
What usually takes a diagnosis from gingivitis to periodontitis?
PD (CAL) over 4mm (in at least two non-adjacent teeth)
What is the difference betwen the clinical crown and anatomic crown?
Clincail = what you see
Anatomic = incisal to CEJ
Which classifies the severity and extent of an individual based on currently measurable extent of destroyed and damaged tissue?
a) Staging
b) Grading
a) staging
Which estimates future risk of periodontitis progresion and responsiveness to standard therapeutic principles
a) staging
b) grading
b) grading
What is the ideal endpoint of non-surgical perio therapy
No pockeds with BOP greater than 4mm
