Periodontal Indices Flashcards
How can you assess the presence of inflammation?
Color Texture/edema Bleeding Exudate Plaque
How can you identify the presence of disease?
Assessment of inflammation and
Loss of periodontal tissue support
How do you assess the loss of periodontal tissue support?
Probing depths
Clinical attachment levels
Radiographic evaluation
What is the initial treatment if periodontal disease?
Scaling and potentially root planing
What is the purpose of simplified oral hygiene index
To assess oral cleanliness by estimating the tooth surfaces covered with debris and/or calculus
Which teeth are selected for Simplified Oral Hygiene Index?
Facials of 3, 8, 14, 24
Linguals of 19, 30
What are the components of a simplified oral hygiene index?
Simplified debris index
Simplified calculus index
What are the Simplified debris index scores?
0 = No debris present 1 = soft debris covering no more than 1/3 of tooth surface 2 = soft debris covering between 1/3 - 2/3 of the tooth surface 3 = soft debris covering more than 2/3 of the tooth surface
What are the Simplified calculus index scores?
0 = no calculus present 1 = supragingival calculus covering no more than 1/3 of exposed tooth surface 2 = supragingival calculus covering 1/3 - 2/3 of the tooth surface 3 = supragingival calculus covering >2/3 of the exposed tooth surface
How do you score Simplified oral hygiene index?
Add debris index and divide by 6 (num. of teeth scored)
Add calculus index and divide by 6
Add those two numbers and get their score
0 = excellent
0.1 - 1.2 = good
1.3 - 3.0 = fair
3.1 - 6.0 = poor
Plaque Index
Assesses the amount of plaque at the gingival margin, examining the same anatomical units as the GI
Scores range from 0-3
Probe is used to distinguish between 0 and 1
Visible plaque is scored a 2 or 3
What is the most used plaque index in clinical trials?
Turesky Modification of Quigley-Hein Plaque Index
What is the scoring of the Turesky Modification of Quigley-Hein Plaque Index?
0 = no plaque 1 = Spots of plaque at cervical margin 2 = Thin, continuous band of plaque ≤ 1mm wide at cervical margin 3 = Plaque band >1 mm but 2/3 of crown height
What plaque index is used in the OSU clinic?
O’Leary Plaque Index
NIDR Calculus Index scoring
0 = calculus is absent 1 = supragingival calculus, but non subgingival 2 = supragingical and subgingivcal calculus, OR only subgingival calculus
Volpe-Manhold Index
Determines the quantity of supragingival calculus
Lingual surfaces of lower anteriors
Determined in mm of calculus along the 2 diagonal and central lines drawn over the lingual surfaces of each tooth
Most frequently used calculus index in longitudinal studies
What are methods to assess gingival and/or periodontal inflammation?
Papillary-Marginal-Attachment Index
Gingival index
Modified gingival index
BoP
Papillary-Marginal-Attachment Index
Counts units affected with gingivitis
Presence or absence is counted as 1 or 0, respectively
Gingival Index
Severity of inflammation is assessed in 4 distinct gingival areas: distofacial papilla, facial margin, mesiofacial papilla, lingual gingival margin
Scored from 0-3
Bleeding automatically gives score of at least 2
What are the scores of the Modified Gingival Index?
0 = no inflammation; all normal 1 = Mild inflammation (portion of unit); slight change in color, little change in texture 2 = Mild inflammaiton (entire unit); slight change in color, little change in texture 3 = Moderate inflammation; glazing, redness, edema, a/o hypertrophy 4 = Severe inflammaiton; marked redness, edema, hypertrophy, bleeding, ulceration
Bleeding on Probing
Presence or absence is scored as 1 or 0 respectively
Valid indicator for periodontal stability, but a poor indicator of periodontal breakdown
How much should you tilt the perio probe to make sure you get depths for the col?
15-20’
What are the components of the Periodontal Disease Index System?
Gingival status Crevicular measurements Periodontal disease index Plaque criteria Calculus criteria
What is the Periodontal Index System scoring?
0 = negative
1, 2 = gingivitis
6 = gingivitis with pocket formaiton
8 = advanced destruction with loss of masticatory function
What is the Periodontal Disease Index System scoring?
1, 2, 3 = severity of gingivitis
4 = initial attachment loss (≤3 mm)
5 = moderate attachment loss (>3mm and ≤6mm)
6 = advanced attachment loss (>6mm)
What is the purpose of Periodontal Screening and Recording?
PSR is a rapid and effective way to screen patients for periodontal diseases and summarizes necessary information with minimum documentation
How do you do PSR?
Score each sextant
If one sextant has a score of 3, stop and probe to get depth numbers
If 3 or more sextants have a score of 3, do full mouth probing
What are the PSR codes?
0 = colored area visible, no calculus or BoP 1 = colored area visible, no calculus, BoP present 2 = colored area visible, calculus present, BoP may present 3 = colored area partially visible, calculus and BoP may or may not be present 4 = colored area not visible, calculus and BoP may or may not be present
What are the benefits of PSR?
Early detection - appropriate screening tool for periodontal diseases that are site specific and episodic
Speed - once learned, only takes a few minutes
Simplicity
Cost-effective - only need a perio probe
Recording ease - only need a number for each sextant
Risk management
What are the limitations of PSR?
Designed to detect periodontal diseases - can’t replace comprehensive perio exam
Patients who are in the maintenance phase of therapy require a comprehensive exam
Primarily designed for adults
Reliability
Can measure a condition in the same subject repeatedly and obtain the same score results each time
Validity
Sensitivity and specificity of various diagnostic tools used to create an index
What are some potential problems (examiner bias)
Halo effect
Leniency/severity error
Central tendency error
Halo effect
The examiner’s general impression of target distorts his.her perception of the target on specific dimensions
Leniency/Severity Error
The examiner’s tendency to be lenient or sever
Centeral Tendency Error
The examiner’s reluctance to rate at either the positive or negative extremes, so all scores cluster in the middle
Sensitivity
The probability that a test result will be positive when the test is administered to people who actually have the disease
No false negatives
Specificity
The probability that a test will be negative when administered to people who are free of the disease in quesiton
Predictive Value Positive (PVP)
The probability of disease in a subject with a positive result
Predictive Value Negative (PVN)
The probability of not having a disease when the test is negative
