Periodontal assessment

Question 1

Why complete a periodontal assessment?

Answer 1

Diagnosis and treatment planning.

Baseline measure for comparison post-treatment review

Identifies specific sites for intervention.

Question 2

What are the indications for periodontal assessment?

Answer 2

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

Question 3

What conditions may false pocketing occur?

Answer 3

Gingivitis (due to swelling) or gingival hyperplasia

Question 4

What depth of a periodontal pocket is considered pathological?

Answer 4

> 4mm

Question 5

What is included in a full periodontal assessment?

Answer 5

1. Pocket depths
2. Bleeding
3. Mobility
4. Furcation
5. Recession
6. Suppuration
7. Radiographs

Question 6

How do you measure periodontal pocket depth?

Answer 6

Use UNC15 and measure in mm from tip of the gingival margin to the base of the pocket.

Question 7

What do we do to pockets which are larger than 3mm once we have recorded it on our chart?

Answer 7

Highlight them

Question 8

What do we do to sites around teeth which have BOP when we have recorded pocket depth on our chart?

Answer 8

Red circle around depth score

Question 9

How long after probing do we measure BOP?

Answer 9

15 seconds

Question 10

What is BOP a sign of?

Answer 10

acute inflammation

Question 11

What is millers mobility classification?

Answer 11

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.

Question 12

How do we measure tooth mobility?

Answer 12

• 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.

Question 13

What is the Hamp index for furcation involvement?

Answer 13

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.

Question 14

How do we record supppuration?

Answer 14

Creamy exudate of fluid and inflammatory cells

May be released during probing or on pressure of the gingiva

If present record with a tick

Question 15

How do we measure gingival recession?

Answer 15

Use probe to measure btw CEJ and gingival margin in mm

Question 16

What is gingival recession?

Answer 16

Apical migration of marginal gingiva

Displaced away from the cementoenamel junction, exposing the root surface.

Question 17

What is clinical attachment loss?

Answer 17

gingival recession + pocket depth = attachment loss

Question 18

Describe the recession index

Answer 18

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.

Question 19

At what BPE scores do we take radiographs?

Answer 19

3 and 4

Question 20

What is the gold standard radiograph in order to see bone loss?

Answer 20

Full mouth periapicals

Question 21

What is the maximum depth a williams probe can measure?

Answer 21

10mm

Question 22

What is the maximum depth a UNC15 probe can measure?

Answer 22

15mm

Question 23

What other radiographs can we use to see periodontal bone loss?

Answer 23

PA
Vertical BW >6mm pockets
DPT