perio indices Flashcards
how are periodontal diseases identified?
Assessment of inflammation +
Loss of periodontal tissue support
how can a Loss of periodontal tissue support be measured?
Probing depths
Clinical attachment levels
Radiographic evaluation
what is the purpose of the Simplified Oral Hygiene Index (OHI-S)?
To assess oral cleanlines by estimating the tooth surface covered with debris and/or calculus
what are the components of the Simplified Oral Hygiene Index (OHI-S)?
Simplified Debris Index
Simplified Calculus Index
what tooth surfaces are selected for a OHI-S index?
Facial surfaces of # 3, 8, 14, 24
Lingual surface of # 19, 30
how are DI-S AND CI-S scores calculated?
by totaling the debris score of each surface and dividing by the number of surfaces examined
what does the plaque index (Pli) assess?
assesses the amount of plaque at the gingival margin, examining the same anatomical units as the GI
plaque index scores range from ____ to ____
0 to 3
A probe is used to distinguish between plaque scores of ____ to _____. Visible plaque is scored a _____ or a _____
A probe is used to distinguish between scores 0 and 1. Visible plaque is scored a 2 or a 3
The Pl-I (plaque index) is computed for what 3 categories?
for a:
tooth (4 surfaces)
subject
or population
T/F: Plaque Index ignores coronal extent of plaque on the tooth surface area and assesses only the thickness of plaque at the gingival area of the tooth.
true
the plaque index was developed as a component to parallel what other measurement technique?
the gingival index (GI)
T/F: the Pl-I is not usually used in longitudinal studies and clinical trials
FALSE:
It is generally used in longitudinal studies and clinical trials
In 1962 Quigley and Hein reported a plaque measurement that focused on the _______ third of the tooth surface
gingival
what would a score of 2 on the Turesky Modified Pl-I? a score of 3?
score of 2: Thin, continuous band of plaque, 1 mm wide, at cervical margin
score of 3: A plaque band >1 mm but <1/3 of crown height
what is the highest score possible on the Turesky Modified Plaque index? what does this signify?
a Score of 5
Plaque covering at least 2/3 of crown height
Plaque is made visible using a disclosing agent in what plaque index system?
O’Leary Index
gives the % of teeth with plaque
T/F: the quigley-hein Pl-I is the most frequently used plaque index in clinical trials
true
what are the 3 index systems used to assess calculus?
Simplified Oral Hygiene Index (OHI-S)
Probe Method (Volpe-Manhold)
NIDR Calculus Index
how is the NIDR Calculus Index scored?
a score of 0: no calculus
score of 1: Supragingival calculus
score of 2: Supragingival and subgingival, or subgingival calculus only is present
the ____________ index determines the quantity of supragingival calculus
Volpe-Manhold Index
what tooth surfaces are used for the Volpe-Manhold Index?
Lingual surfaces of lower anteriors (#22-27)
which calculus index is the Most frequently used calculus index in longitudinal studies?
Volpe-Manhold Index
how is the Quantity of calculus determined in the Volpe-manhold index?
determined in mm of calculus along the 2 diagonal and the central lines drawn over the lingual surface of each tooth
what is the “background” theory of the Papillary-Marginal-Attachment (PMA)-Index?
The number of units affected correlates with the severity of gingival inflammation
in the PMA index, the Facial gingival surface is divided into _____ scoring units
divided in 3 scoring units: P - M - A
papillary, marginal, attachment
______ units affected with gingivitis are counted in the PMA index
gingival
T/F: Severity component can be considered when conducting a PMA index
true
how is the Gingival Index (GI) assessed?
The severity of inflammation is assessed in 4 distinct gingival areas: distofacial papilla, facial margin, mesiofacial papilla, lingual gingival margin
how is the GI (gingival index) scored?
0 to 3; bleeding is considered. Presence of bleeding automatically leads to a score ≥2
what is the GI (gingival index) useful for?
Useful for the calculation of prevalence and severity of gingivitis in population and individual
T/F: the Gingival index can be used to determine the prevalence and severity of gingivitis in epidemiologic surveys, but cannot be used as an evaluation of individual dentition
FALSE
can be used for both
while the original gingival index is scored from 0 to 3, the modified GI is scored in what increments?
from 0 to 4
what is the difference between a score of 1 and 2 on the modified Gingival index?
1 = Mild inflammation in a Portion of unit
2 = Mild inflammation in the Entire unit
what differentiates between moderate and severe inflammation in the modified GI?
Bleeding, congestion, or ulceration
if any of the 3 are present, you have severe
T/F: The bleeding tendency in a BOP exam is assessed upon probing a periodontal pocket using standardized pressure
true
where is the periodontal probe inserted during a BOP exam?
Periodontal probe is inserted to the bottom of the periodontal pocket. Bleeding is observed 15 seconds following retraction of probe.
B-o-P is a valid indicator for periodontal stability. However, it is a poor indicator of what?
poor indicator of periodontal breakdown.
why is bleeding upon probing a preferred diagnostic observation?
the use of gingival bleeding indices is desirable because bleeding is a more objective indicator than early gingival color changes and because it provides evidence of recent plaque exposure
attachment level (mm) =
probing depth (mm) + recession (mm)
in the Extent and severity index, Disease is defined as what?
attachment loss >1mm
what is meant by the “extent” in a ESI index?
the proportion of tooth sites in a patient showing signs of destructive periodontitis
what is meant by the “severity” in a ESI index?
Amount of attachment loss at the diseased sites, expressed as a mean value
the ESI is based on probe measurements at _____ sites in one maxillary quadrant, and _____ in the contralateral mandibular quadrant
14
Unlike other periodontal disease indeces, ESI describes the ________ of disease.
distribution
what are the scores of The Periodontal Index System (PI)? what do they correlate with?
Score 0: Negative.
Score 1, 2: Gingivitis
Score 6: Gingivitis with pocket formation
Score 8: Advanced destruction with loss of masticatory function
during the PI exam, All teeth are examined. The circumference of each tooth is inspected _______, and given a score
visually
Crevicular measurements, and Periodontal Disease Index are both examined in what index system?
The Periodontal Disease Index System
for a given tooth, The __________ score is tabulated and used for the calculation of the subject’s PDI
most severe (of the 4 measurements taken)
why was the Community Periodontal Index of Treatment Needs (CPITN) created?
Primarily designed to assess periodontal treatment needs in under served parts of the world
how are the teeth examined in the CPITN?
10 index teeth are examined and worst finding is recorded per sextant
how many scores are there for the CPITN? how many treatment categories?
4 categories/levels for each
what is the purpose of the Periodontal Screening & Recording® (PSR)
rapid and effective way to screen patients for periodontal diseases and summarizes necessary information with minimum documentation.
T/F: The ADA and the AAP support the use of PSR® by dentists as a part of oral examinations.
true
how many PSR “codes” are there?
5 codes (from 0 to 4)
a PSR exam is broken down into ____ areas
6
its a sextant exam
what are the benefits of a PSR screening?
Early detection
speed
simplicity
cost-effectiveness
recording ease
risk management
PSR® is a screening system designed to _______ periodontal diseases
detect
t/f: the PSR is not intended to replace a comprehensive periodontal examination when indicated.
true
Patients who have been treated for periodontal diseases and are in a maintenance phase of therapy require periodic __________ periodontal examinations.
comprehensive
what are the potential problems (examiners bias) associated with perio exams?
halo effect
Leniency/Severity Error
Central Tendency Error
what does “calibration” involve during perio indices?
Several examiners at different experience levels
Subjects with various disease extend and severity
Follow-up appointments
what is the main goal of “calibration” when conducting perio exams?
Main goal is to determine inter/intra-examiner variations
what is sensitivity?
The probability that a test result will be positive when the test is administered to people who actually have the disease in question
what is specificity?
The probability that a test will be negative when administered to people who are free of the disease in question
________ is the probability of disease in a subject with a positive test result
Predictive Value Positive (PVP)
_______ is the probability of not having the disease when the test is negative
Predictive Value Negative (PVN)
what does the O’Leary Plaque Index measure?
the percentage of tooth surfaces positive for plaque
how is the periodontal disease index system scored?
Score 1, 2, 3: Severity of gingivitis
Score 4: Initial attachment loss ( 3 mm and
6 mm)
what is the main goal of “calibration” during perio exams?
Main goal is to determine inter/intra-examiner variations
what does a score of 1 on the PSR system indicate?
- colored portion of probe is completely visible
- NO calculus or margin defects present
- Bleeding after probing
what does a score of 2 on the PSR system indicate?
- colored area of the probe remains completely visible
- Supragingival or subgingival calculus and/or defective margins are detected
what does a score of 3 on the PSR system indicate?
The colored area of the probe is PARTIALLY covered by the margin of the pocket
what does a score of 4 on the PSR system indicate?
The colored area of the probe completely disappears indicating a probing depth of greater than 5.5 mm
During a PSR exam, If two or more sextants score a Code ________, a comprehensive full mouth examination and charting are indicated
three
if a code of ______ is found in a PSR exam, It can be assumed that complex treatment will be required
4
