pre-clinical periodontitis
DESCRIPTION
EXPLANATION, DIAGNOSIS, AND PROGNOSISTRANSCRIPT
Dr Jamal NaimPhD in Orthodontics
Pre-clinical PeriodonticsExamination,
Diagnosis and Prognosis
Review
Gingivitis is the inflammation of a periodontium with no
attachment loss or with previous attachment loss that
is stable and not progressing.
Periodontitis is the inflammation of a periodontium
caused by specific microorganisms resulting in
progressive destruction of the PDL and alveolar bone
(attachment loss) with pocket formation, recession or
both.
Periodontal Examination can be performed using a number of
conventional methods. However, conventional methods only give
information about past episodes of disease and their outcome.
The determination of an active site is still unattainable.
Advances into producing chair side tests, that can detect active disease or increased susceptibility to disease progression continue.
Periodontal Examination
Index
Periodontal Examination Plaque indices:
Plaque Index – PI (silness & Loe 1964) Interdental Hygiene Index - HYG Hygiene Index - HI
Gingival indices Sulcus Bleeding Index – SBI (muehlemann 1971) Gingival Index - GI Gingival Bleeding Index – GBI (Ainamo 1975) Papilla Bleeding Index – PBI (Saxer & Muehlemann
1975) Papilla Bleeding Score - PBS (Loesche 1979)
Periodontal Examination Periodontal indices
Plaque Index - PI
Interdental Hygiene Index - HYG
Interdental Hygiene Index - HYG
Interdental Hygiene Index - HYG
Disadvantages: Only one surface of the tooth is checked Not for epidemiological studies
Hygiene Index - HI
Hygiene Index - HI
Gingival indices
Sulcus Bleeding Index - SBI
Sulcus Bleeding Index - SBI
Gingival index - GI
Gingival index
Gingival Bleeding Index - GBI
Papilla Bleeding Index - PBI
Papilla Bleeding Index - PBI
Papilla Bleeding Index - PBI
Papilla Bleeding Index - PBI
Indices versus clinical findings
Indices versus clinical findings
Re
Re
Probing
with manual probe to evaluate: Pocket Depth Attachment loss
Pocket & PAL relationships
Pocket & PAL relationships
Re
Re
facial
dis
talm
esial
lingual
TM
Re
Pocket & PAL relationships
-3
Pocket & PAL relationships
0
Pocket & PAL relationships
+3
Recessions Recessions may affect the whole attached gingiva
Tooth mobility
Physiologic tooth mobility:
Initial stage (intrasocket) about 0.05 to 0.1 mm with forces of about 100g
Secondary stage (bone deform.) about 0.04 to 0.2 mm with forces of about 500g
pathologic tooth mobility:
Grade 0: normal mobility
Grade I: detectably more than normal (0.2-1mm)
Grade II: moderately more than normal, visible, > 1mm
Grade III: severe horizontal + vertical mobility
Tooth mobility
Pocket & PAL relationships
Furcations – Class I, II, III (a numerical probe can be used to assess disease progression in more detail)
Furcation involvement