Perio Swep 1.3 Flashcards
Papillary-Marginal-Attachment (PMA)-Index
Background: “The number of units affected correlates with the severity of gingival inflammation”
Facial gingival surface is divided in 3 scoring units P - M - A
Gingival units affected with gingivitis are counted. Presence or absence of inflammation is counted as {1} and {0}, respectively
Severity component can be considered
Score computed for tooth subject population
First published by Schour & Massler (1947)
Gingival Index (GI)
The severity of inflammation is assessed in 4 distinct gingival areas: distofacial papilla, facial margin, mesiofacial papilla, lingual gingival margin.
Scores: 0 to 3; bleeding is considered. Presence of bleeding automatically leads to a score ≥2
Score for tooth subject population
Useful for the calculation of prevalence and severity in population and individual
Frequently used index in clinical trials
First published by Löe (1961) and Löe & Silness (1963)
The bleeding tendency is assessed upon probing a periodontal pocket using
standardized pressure
Periodontal probe is inserted to the bottom of the periodontal pocket. Bleeding is observed 15 seconds following retraction of probe.
Presence or absence of bleeding is scored as {1} and {0}, respectively.
Not to be confused with bleeding as scored in GI
B-o-P is a valid indicator for periodontal stability. However, it is a poor indicator of periodontal breakdown.
The Extent and Severity Index (ESI)
Agreement
Disease is defined as attachment loss >1mm
Extent
Proportion of tooth sites in a patient showing signs of destructive periodontitis
Severity
Amount of attachment loss at the diseased sites, expressed as a mean value
The Periodontal Index System (PI)
Score 0: Negative.
Score 1, 2: Gingivitis
Score 6: Gingivitis with pocket formation
Score 8: Advanced destruction with loss of masticatory function
All teeth are examined. The circumference of each tooth is inspected visually, and given a score.
Index computed for subject, population.
The Periodontal Disease Index System:
This system includes several components:
Gingival status Crevicular measurements Periodontal Disease Index Plaque criteria Calculus Criteria
The Periodontal Disease Index System
Score 1, 2, 3: Severity of gingivitis
Score 4: Initial attachment loss (£3 mm)
Score 5: Moderate attachment loss (>3 mm and
£6 mm)
Score 6: Advanced attachment loss (>6 mm)
4 areas per tooth are examined using a probe. The most severe score is tabulated and used for the calculation of the subject’s PDI
Index computed for subject, population
Community Periodontal Index of Treatment Needs (CPITN)
Primarily designed to assess periodontal treatment needs in under served parts of the world
Uses a specially designed probe
Epidemiology: 10 index teeth are examined and worst finding is recorded per sextant
For individual subjects: worst finding of all teeth in a sextant is recorded, resulting in 6 scores per subject. The worst score determines the treatment needs score
Published and promoted by the World Health Organization (1982).
Community Periodontal Index of Treatment Needs (CPITN)
Perio status
Periodontal Status Score 1: Bleeding on gentle probing Score 2: Calculus felt during probing,crevicular depth £3 mm Score 3: Probing depth 4 mm or 5 mm Score 4: Probing depth ³6 mm
Community Periodontal Index of Treatment Needs (CPITN): treatment status
Treatment Needs Code 0: No treatment Code I: Improved oral hygiene Code II: I + professional scaling Code III: I + II + complex treatment
Periodontal Screening & Recording® (PSR)
Purpose:
Periodontal Screening and Recording® (PSR®) is a rapid and effective way to screen patients for periodontal diseases and summarizes necessary information with minimum documentation.
Periodontal Screening & Recording® (PSR)
Endorsement:
The ADA and the AAP support the use of PSR® by dentists as a part of oral examinations.
PSR - Benefits: Early detection:
PSR® includes evaluation of all sites. For this reason, it is a highly sensitive technique for detecting deviations from periodontal health and a uniquely appropriate screening tool for periodontal diseases that are, by nature, site specific and episodic.
PSR - Benefits:
Speed:
Once learned, PSR® takes only a few minutes to conduct for each patient. It can be readily incorporated into routine oral examinations.
PSR - Benefits
Simplicity:
PSR® is easy to administer and comprehend. The simplicity of the scoring system aids in monitoring a patient’s periodontal status.
PSR - Benefits
Cost-effectiveness:
PSR® utilizes a simple periodontal probe designed specifically for use with this screening system. It does not require the use of expensive equipment.
PSR - Benefits:
Recording ease:
Documentation for PSR® requires the recording of six numerical scores, one for each sextant of the mouth. It does not require extensive charting or lengthy narrative explanation.
PSR - Benefits:
Risk management:
Proper, consistent, and documented use of PSR® shows that the dentist is evaluating a patient’s periodontal status.
PSR - Limitations
PSR® is a screening system designed to detect periodontal diseases. It is not intended to replace a comprehensive periodontal examination when indicated.
Patients who have been treated for periodontal diseases and are in a maintenance phase of therapy require periodic comprehensive periodontal examinations.
In addition, PSR® is designed primarily for use with adult patients and has limited utility in screening children and adolescents.
Peri-implant Tissues and Indices
Modified PlI
Modified GI
Reliability of gingival indices
(Reliability of an index to measure a condition in the same subject repeatedly and obtain the same score results each time)
Validity of a diagnostic test
(Sensitivity and specificity of various diagnostic tools used to create an index)
Halo Effect (Thorndike 1920):
The examiner’s general impression of target distorts his/her perception of the target on specific dimensions
Leniency/Severity Error (Saal & Landy 1977):
The examiner’s tendency to be lenient or severe
