Periodontal assessment Flashcards
Why complete a periodontal assessment?
Diagnosis and treatment planning.
Baseline measure for comparison post-treatment review
Identifies specific sites for intervention.
What are the indications for periodontal assessment?
Following BPE, patients with codes 3 or 4 need to undergo further investigation and more detailed periodontal charting is required.
Code 3 requires initial therapy (OHI, risk factor control and RSD) and then post inital therapy a pocket depth chart in that sextant only.
Code 4 - full 6ppc in mouth (all sextants).
Pts with historical periodontitis
Review following periodontal treatment
Pts with implants
What conditions may false pocketing occur?
Gingivitis (due to swelling) or gingival hyperplasia
What depth of a periodontal pocket is considered pathological?
> 4mm
What is included in a full periodontal assessment?
- Pocket depths
- Bleeding
- Mobility
- Furcation
- Recession
- Suppuration
- Radiographs
How do you measure periodontal pocket depth?
Use UNC15 and measure in mm from tip of the gingival margin to the base of the pocket.
What do we do to pockets which are larger than 3mm once we have recorded it on our chart?
Highlight them
What do we do to sites around teeth which have BOP when we have recorded pocket depth on our chart?
Red circle around depth score
How long after probing do we measure BOP?
15 seconds
What is BOP a sign of?
acute inflammation
What is millers mobility classification?
Mobility arises due to loss of periodontal support due to inflammation of the periodontium.
Grade 1 = horizontal mobility <1mm
Grade 2 = horizontal mobility >1mm
Grade 3 = horizontal mobility >1mm + vertical mobility.
How do we measure tooth mobility?
- Place finger or instrument against the tooth palatally/lingually
- Use this as a fixed point to observe movement
- Apply gentle pressure in bucco-lingual direction with end of mirror handle & observe movement
- Apply pressure occlusally/incisally to record vertical movement.
What is the Hamp index for furcation involvement?
Describes the degree of inter radicular bone loss from teeth with more than one root.
Measure using Naber, furcation or williams probe from buccal or lingual direction in a horizontal plane.
Grade 1 = <3mm
grade 2 = >3mm
grade 3 = through and through.
How do we record supppuration?
Creamy exudate of fluid and inflammatory cells
May be released during probing or on pressure of the gingiva
If present record with a tick
How do we measure gingival recession?
Use probe to measure btw CEJ and gingival margin in mm
What is gingival recession?
Apical migration of marginal gingiva
Displaced away from the cementoenamel junction, exposing the root surface.
What is clinical attachment loss?
gingival recession + pocket depth = attachment loss
Describe the recession index
RT1 = REC with no loss of interproximal CAL.
Interproximal CEJ is not visible
RT 1 = REC with loss of Interproximal CAL
Interproximal loss of CAL is less than or equal to buccal CAL.
RT3 = REC with loss of interproximal CAL however Interproximal loss is greater than buccal loss of CAL.
At what BPE scores do we take radiographs?
3 and 4
What is the gold standard radiograph in order to see bone loss?
Full mouth periapicals
What is the maximum depth a williams probe can measure?
10mm
What is the maximum depth a UNC15 probe can measure?
15mm
What other radiographs can we use to see periodontal bone loss?
PA
Vertical BW >6mm pockets
DPT
