Initial Examination and Clinical Diagnosis Flashcards
A comprehensive periodontal exam for daily practice provides what?
Adequate/accurate baseline data
Initial diagnosis/therapy
Re-evaluations (via baseline data)
What are the components of a Comprehensive Exam?
Health History
Data on Risk Factors
Radiographic Exam/Treatment
Clinical Charting
What are the components of health history?
Basic Info Chief Complaint Medical History Dental History Family History
What are the components of Data on Risk Factors?
Primary Local Factors
Primary Systemic Factors
What are components of primary local factors?
Bacteria (species and plaque retentive areas)
Patient compliance to OHI and maintenance programs (an informed patient decreases the gap between wants and needs)
What are primary systemic factors
Smoking
Diabetes
Genetics
What do we want to have for Radiographic Exam/Treatment
Full set of PA radiographs
Patients old radiographs/charts (helps show progression)
What are the components of clinical charting?
Probe depths Gingival recession (+) or hyperplasia (-) BOP Plaque (tells us if it's plaque induced) Suppuration (pus) Mobility and fremitus Furcations Amount of attached and keratinized gingiva
What is the Diagnosis of Periiodontal Problems based on?
- Probe depths + Gingival recession = CAL
- Ammount of keratinized tissue, BOP, furcations, mobility
- Fremitus (mobility on occlusion)
- Bony defects (horizontal, vertical, walled)
What are the types of perio probes (that we use)
CPITN (used for PSR)
Williams
CPITN probe measurements
- 5
- 5
- 5
- 5
- 5
WIlliams probe measurements
1 2 3 5 7 8 9 10 (skips 4 and 6)
3 catergories of perio diagnosis
Health
Gingivitis
Periodontitis
Signs of healthy gingiva
Probe depths ≤ 3mm
No history of CAL
No inflammation
If a patient has no current disease, but has a history of periodontal disease (CAL), what are they labeled as?
Health on a reduced periodontium
What are the types of gingivitis? Which is more common
Plaque-induced**
Non-plaque induced
Non-plaque induced gingivitis
Difficult to diagnose/treat
Due to systemic disease and/or medication etiology
Signs of gingivitis
Probe depths ≤ 3mm
No history of CAL
Inflammation via plaque or other causes
Signs of periodontitis
Probe depths ≥ 4mm
CAL
Inflammation (unless it’s GAP)
What are the types of periodontitis?
Chronic Periodontitis
Aggressive Periodontitis
How do you measure the severity of chronic periodontitis?
Slight = 1-2mm Moderate = 3-4mm Severe = 5+ mm
How do you measure the extent of chronic periodontitis?
Localized = 30% of sites
What are some characteristics of Aggressive Periodontitis?
Specific sites
Non-plaque induced
Familial history - genetically predisposed and have the right bacteria
Must have at least 1 1st molar to be considered AP
Localized Aggressive Periodontitis
≤2 permanent teeth besides 1st molars and incisors
Generalized Aggressive Periodontitis
≥ 3 permanent teeth besides first molars and incisors
How do we know aggressive periodontitis is non-plaque induced?
The amount of CAL does not correlate to the amount of plaque present
Signs of Localized Aggressive Periodontitis
Puberty-20 years old
High/robuts serum-antibody response
Little gingival inflammation
Signs of Generalized Aggressive Periodontitis
Under 30 years old (usually)
Episodic destruction of CAL/Bone
Poor/little serum-antibody response
Lots of gingival inflammation
Glickman’s Classification
Classification of furcation involvement Class I Class II Class III Class IV
Class I furcation
Not seen on radiograph
Just a catch in the probe
Class II furcation
Seen radiographically
aka a Cul-de-sac furcation
Does not go all the way through
Class III furcation
Through and through furcation
Class IV furcation
When the furcation can be seen clinically
