Periodontal Exam and Radiographic Aids Flashcards
(49 cards)
what does a periodontal exam include?
- Medical History
- Dental History
- Chief Complaint
- Photographic Documentation
- Clinical Exam
- Extraoral
- Intraoral
- Oral Hygiene Assessment
- Periodontal Exam
- Periodontal Charting
- Probing Depth
- Disease Activity
- Furcation
what should a medical history chart include?
- Vital signs assessments: Including blood pressure readings, heart rate
- Date of last physical exam and the frequency of physical exams and physician visit
- Previous hospitalizations, surgeries
- Allergies
- Detailed medical history (system by system)
- Medications
- Pregnancy/breastfeeding
- Alcohol/smoking
what should a dental history chart include?
- Frequency of past dental visits
- Previous treatments including orthodontic treatment
- Oral hygiene habits
- Periodontal history
- Surgical history
- Parafunctional habits
what should a clinical exam consist of?
- Extraoral examination
- Intraoral examination
- Oral hygiene assessment
- Periodontal examination
what should be considered during an intraoral exam?
if there is swelling of the gingiva, press on it and see if puss comes out
- this can show signs of potential periodontal disease or detachment
what is the oral hygiene assessment Silness-Loe Plaque Index?
0= absence of microbial plaque
1= thin film of microbial plaque along free gingival margin
2= moderate accumulation with plaque in sulcus
3= large amount of plaque in sulcus or pocket along free gingival margin
what does a periodontal exam start with?
visual inspection of the gingiva to look for recession
* do not start with probing
what are the two different pocket depths (probing depths)?
- biological or histological depth
- clinical or probing depth
what is the definition of probing depth?
- the distance from the gingival margin to the bottom of the probable crevice
- generally less than or equal to 3 mm is healthy
what are the factors that can lead to probing penetration (depth) variations?
- Force applied
- Shape and size of the probe tip
- Direction of probe insertion
- Tooth contours
- Resistance of the tissues, which is typically related to the degree of tissue inflammation
in healthy, gingivitis and periodontitis patients how far does the probe penetrate?
- healthy: junctional epithelium about 2/3 its length
- gingivitis: 0.1 mm short of the apical portion of the junctional epithelium
- periodontitis: past junctional epithelium into the connective tissue
how might probing depth change in patients that do not have periodontitis?
- Probing depth may change as a result of changes in the position of the gingival margin
*** reduction in gingival inflammation may show reduction in probing depth NOT gain of attachment
where is probing depth generally deeper?
mid-proximal area
is BOP a sign of disease or attachment loss progression?
no, BOP does not indicate disease or deep pocket progression but can be a good indicator of periodontal stability
what is the absence of BOP an indicator of?
periodontal stability
why may pain on probing occur?
- probing of sites presenting inflammation is more likely to produce pain
- Gingivitis and periodontitis are generally not associated with pain
what is attachment loss?
apical migration of the dentogingival junction
how is attachment loss measured?
distance from the cementoenamel junction to the bottom of the probeable crevice
When the gingival margin is located coronal to the CEJ (on the anatomic crown), CAL (clinical attachment loss) is determined by ?
subtracting the distance from the gingival margin to the CEJ from the probing depth
**Example: If gingival margin is 2 mm coronal to the CEJ and probing depth is 4 mm, CAL is 2 mm (= 4 - 2)
When the gingival margin coincides
with the CEJ, CAL is ?
equal to the probing depth
** Example: If gingival margin is at the CEJ and probing depth is 4 mm, CAL is 4 mm
When the gingival margin is located apical to the CEJ, clinical attachment loss is greater than the probing depth and CAL is ?
the sum of gingival recession depth and probing depth
**Example: If gingival margin is 2 mm apical to the CEJ and probing depth is 4 mm, CAL is 6 mm (= 4 + 2)
what is attachment level?
the most coronal location of the dentogingival junction on the tooth surface
** For example, the attachment level of a tooth can be on the coronal third of the root or the apical third of the root
The width of the attached gingiva is determined by
subtracting the sulcus or pocket depth from the total gingival width (i.e., the distance from the gingival margin to the mucogingival junction).
**Example 1: If the distance from the gingival margin to the mucogingival junction (MGJ) is 4 mm and the probing depth is 3 mm, attached gingiva is only 1 mm (4 - 3)
**Example 2: If the distance from the gingival margin to MGJ is 5 mm but the probing depth is 7 mm, there is NO attached gingiva despite 5 mm of keratinized gingiva
what is connsidered insufficient attached gingva and what does this correlate with?
- dimensions less than 1 mm
- insufficient attached gingiva sometimes correlates with movement of the free gingival magin when the lips or cheeks are stretched
