W3 Indicies, ICDAS, CAL measurments Flashcards
What do we record in a periodontal examination?
Mobility Probing depth Furcation involvment Bleeding Suppination Clinical attachment loss Attached gingiva levels Radiographic assessment
How do we assess plaque?
Extend/amount of biofilm Location/distrubution - supragingival, subgingival - pits and fissures - tooth surfaces involved Distribution - loaclised, generalised, marginalised Pathogenicity - Mature vs immature
What is material albla?
Associated with biofilm, it loosely adherent mass of bacteria and cellular debris. It appears bulky, soft deposit appears without use of disclosing agent, can be removed via irrigation.
Likely to accumulate under fixed/removable prosthesis
How we assess calculus?
Location: supragingival, subgingival.
Distrubution
Colour: light or dark
Where do we measure probing depths?
Measurement from base of sulcus to ginigival margin. All 6 sites are measured and the highest is recorded
How do we measure recession?
It is parrt of the tooth root that may be visible in jthe mouth. Measured from cementoenamel junction to gingival margin
How do we measure clinical attachment levels?
Distance measured from CEJ to the base of the sulcus measured in millimetres. . It is dependant on jthe location of the gingival maargin.
At CEJ
Apical to CEJ
Coronal to CEJ
How do we calculate CAL at CEj, apical to CEJ, coronal to CEJ?
If the gingival margin is AT the CEJ, the CAL equals the pocket depth. If the gingival margin is APical to CEJ the CAL equals the recession recording plus the probing depth recording. If the Gingival margin is coronal to CEJ the CAL equals the probing depth - gingival margin level that is covering the CEJ
When can bleeding occur?
Bleeding can occur on stimulation of gingival tissues eg. brushhing is frequently associated with gingivitis. After probing, the bleeding index is used to measure the extent of BOP. Absence of bleeding id s good indicator of health.
What is furcation involvement?
Loss of attachment between roots on a multirooted tooth, the presence of a furcation impacts the prognosis of the tooth. Is measured with a nabers probe and via the furcation index
What is mobility?
Degree to which a tooth is able to moive in a horizontal/vertical direction
Define attached gingiva levels
Inadequate attached gingiva. Less than 1mm of keratinized attached gingiva present on a tooth. Usually more sensitive areas - can develop into a mucogingival problem requiring a skin graft.
What is the gingival biotype?
Clinical observation of the thickness and width of facial keratinized tissue. Reduced gingival thickness is one of the factors that cause perio attachment loss - orthodontics.
The gingival contour closely mimics the contour of the underlying alveolar bone.
What is flat gingiva?
Associated with a square tooth form?
What is highly scalloped gingiva
Associated with a taper tooth form.
What are 3 ques for clinical assessment of gingivall biotype?
Visual evaluation: canot assess he degree of gingival thickness.
Probe transparency: evaluate probe visibility through gingival tissue - important for aesthetics in restorative denistry.
Transgingival probing: measure tissue thichness: >1.5mm = thick. <1.5mm = thin.
Describe bilogical width?
Describes the combine heights of the junctional epithelium and CT attachment to a tooth.
Why is biological width important?
It is essential for preservation of periodontal health and removal of irritation that might cause damage the periodontium. Primarily the significance of biological width to the position of restorative margins and post surgical. If margin placed within biological width → neg effective on peridontal health + plaque retentive factor
Descrie the clinical evaluation of biological width and violation
Chronic progressive gingival inflamation around the restoration. BOP Localised gingival hypoplasia. Gingival recession Pocket formation CAL Alveolar bone loss Discomfort.
If the margin is placed too deep = biological response = inflamation. Supra gingiva biologival width is not a risk. Subgingival is at risk
How do you calculate bleeding score?
No. of sites with bleeding present / no. of sites examined x 100. By obtaining a bleeding score allows a base line for patient to improve upon.
What is the furcation index?
Used to record the severity of bone loss around a tooth of furcation. It is classified by Class I, Class II, Class III, Class IV.
What basically is Class I, CLass II, Class III, Class IV?
Class I: beginning of involvment, cannot be entered fully.
Class II: when you can enter furcation point from buccal/ lingual aspect, nut cannot penetrate through opposite side.
Class III: Through and through involvment, but the furcation is still covered by soft tissue.
Class IV: Through and through furcation involvment that is NOT covered by soft tissue and clinically exposed area.
What is the mobility index?
Used to record the severityof mobility of a tooth. Classified into 3:
Class I
Class II
Class III
What basically is the classifications in the mobility index?
Class I: Tooth can be moved upto 1mm in any direction.
Class II: Tooth can be moved >1mm in any direction but is not depressible in socket,
Class II: Tooth can be moved in buccolingual direction and is depressible in socket
