Flashcards in Periodontal Indices Deck (47):
What are the 5 characteristics that are assessed regarding inflammation?
There is always _______ in the gingival sulcus, but when it becomes _______ it indicates an underlying problem.
_________ + __________ = Identification of Disease
Assessment of Inflammation
Loss of Periodontal Tissue Support
What three characteristics are evaluated when studying periodontal tissue support?
Clinical Attachment Levels
Following initial treatment, a patient will be instructed to come back for one of three things based on the assessment of periodontium. What are these three circumstances?
2. Periodontal Maintenance
3. Referral to Periodontist
The Plaque Index assesses the amount of plaque at the _____ _____, examining the same anatomical units as the GI.
Using the plaque index, a probe can be used to decipher between ____ and _____; however, visible plaque is scored a _____ or ______.
The Plaque index can be applied to a ____, ______, or _____.
True or False: the Turesky Modified Plaque Index uses disclosing dye to examine facial and lingual surfaces.
True or False: The Turesky Modified Plaque Index is the most frequently used index in clinical trials and the Volpe-Manhold is the most used calculus index used in longitudinal studies.
*The O'Leary Plaque Index provides a ______ of tooth surfaces ______ for plaque.
*The NIDR Calculus Index ranks calculus from ____ to ____. Describe the difference between levels.
0 to 2
0 = calculus absent
1 = supragingival calculus only, no subgingival
2 = supra and subgingival calculus
*Using the Gingival Index (GI) [aka: Loe & Sillness], inflammation is assessed in ____ distinct gingival areas. What are these areas?
lingual gingival margin
(basically....the margin around the tooth)
How is the GI scored?
Inflammation is scored 0 to 3 in the four areas:
normal = 0
1 = no bleeding, inflamed, red
2= moderate inflammation, redness, BoP
3= spontaneous bleeding upon brushing, eating, or sleeping
_____ is the tendency to bleed 15 seconds following retraction of a probe from the periodontal pocket.
Bleeding on probing is score as either ___ which indicates presence of blood, or _____ which indicates absence.
1 if present
0 if absent
BoP is a valid indicator of periodontal _____ but it is a poor indicator of periodontal ______.
Which probe do we typically use for Periodontal Screening?
the "Michigan-O" with Williams Markings
Attachment level = ______ mm + ______ mm
probing depth + recession
(recession is written as a positive number, inflammation as a negative)
For periodontal probing, how many surfaces are examined per tooth? What type of force is used? Correct _____ is important.
What is the correct angulation for interproximal probing (after reaching the contact point with parallel probe, you angulate this much)?
The ESI is a _______ index that relates disease to two characteristics: ______ and ______.
extent and severity
What is the difference between extent and severity?
Extent = proportion of tooth sites showing destruction
Severity = amount of attachment loss at the sites (avg.)
Using the PDI system, how many areas of the tooth are examined and how are they examined?
4 areas using a perio probe
Describe the Community Periodontal Index of Treatment Needs and how scores are recorded.
CPITN uses a specially designed probe to index in under-served parts of the world.
The mouth is divided into 6 sections (sextants): the worst score of each sextant is recorded (gives 6 scores per subject). Then the worst overall score will determine the treatment needs
The CPITN is scored ____ to ____ and then given one of four codes to distinguish level of treatment needed.
Score 0 to 4
0 = no treatment
I = improve oral hygiene
II = I + professional scaling
III = I + II + complex treatment plan
Which Periodontal Index do we use in the clinics?
PSR (Periodontal Screening and Recording)****
(it is endorsed by the ADA)
*PSR is a ____ and ____ way to screen patients for periodontal disease and summarizes necessary information with ______ ______.
rapid and effective
What is special about the PSR probe?
there is a dark- colored band that indicates a 5.5mm depth when covered
Scoring for PSR is done per _____.
What are the PSR scores? How do they relate to the colored band, calculus, and BoP?
0 = colored band is visible,no calculus, no BoP
1 = colored band is visible, no calculus, but +BoP
2 = colored band is visible, +calculus, may have BoP (+/-)
3 = colored band partly seen, +/-calculus, +/- BoP
4 = colored area not visible, +/- calculus, +/- BoP
Using PSR, what is the rule for charting?
Divide the mouth into six sections: Quickly find the highest score per sextant.
*if one sextant has a score greater than 2...chart only that 1/6 of the mouth fully
*if two or more sextants have a score greater than 2...chart the entire mouth fully!
What are the six benefits to PSR?
risk management (documentation/proof of evaluation)
What are the limitations of PSR?
designed to DETECT only
some need more comprehensive exams
doesn't work for reduced periodontium or recession
designed for use in ADULTS
Why are screening indices different for peri-implant tissues?
Implants are circular, there are no B-L or M-D surfaces to evaluate. Use Modifed PLi and Modified Gi
What is reliability?
ability to measure a condition in the same subject repeatedly and obtain the same score each time (reproducible)
What is validity?
the sensitivity (+ when +) and specificity (- when -) of a diagnostic tool
What are three potential examiner biases?
1. Halo Effect
2. Leniency/Severity Error
3. Central Tendency Error
What is the Halo Effect?
the examiner's general impression of a target distorts his/her perception of the target on specific dimensions
What is the Central Tendency Error? How does this differ from the leniency/severity error?
the examiner's reluctance to rate at either the positive or negative extremes so all scores cluster in the middle
(L/S Error: simply just the examiner's personality = tendency to be lenient or severe)
How do we attempt to eliminate clinician error?
Calibration and Training
How do we determine the validity of a diagnostic test?
Predictive Value Positive (PVP) and Predictive Value Negative (PVN). Basically: its the
"real +" over the "assigned +" = PVP
"real -" over the "assigned -" = PVN
What is Predictive Value Positive (PVP)?
the probability of disease in a subject with a positive test result
What is the Predictive Value Negative (PVN)?
the probability of not having the disease when the test is negative
Does the O'leary index use disclosing solution?
How many surfaces are studied per tooth using the O'leary index?