clinical perio assessment
a fact gathering process designed to provide a complete picture of pt.s perio health. This process includes two parts.
gingival description
first part of perio assessment using vision
periodontal examination
second part of perio assessment using perio probes to obtain most of the findings
-color
-size
-position of gingival margin
-shape of margins and papillae
-texture and consistency
-bleeding and/or exudate
What does gingival description describe
papillary gingiva
pointed gingiva located between the teeth
Col
part of the papillary gingiva apical to the contact area, non-keratinized and susceptible to disease
free gingiva
most coronal portion of the gingiva that is unattached
gingival sulcus
V-shaped space between internal portion of the free gingiva and the tooth
sulcular epithelium
extend from the marginal gingiva inside the gingival pocket (directly opposite the tooth structure)
attached gingiva
extends from the free gingival groove to the alveolar mucosa
junctional epithelium
located at the bottom of the gingival sulcus (what tissue is stopping the probe)
eryematous tissue
What color change in disease is pictured here
cyanotic tissue
What color change in disease is shown here
pale pink fibrotic tissue
What color change in disease is shown here
edematous tissue
What size change in disease is shown here
rolled margin
What disease change in the shape of the margin is shown
slitline stillmans cleft
What disease change in shape of margin is shown
v-shaped stillman's cleft
What disease change in shape of margin is shown
bulbous
How would the papillae be defined with this disease change
blunted
How would the papillae be defined with this disease change
cratered
How would papillae be defined with this disease change
diseased because it is more than 2 mm coronal to CEJ
Is this margin healthy gum tissue or diseased? Why?
diseased because it is smooth and shiny with no stippling
Is this gum texture healthy or diseased? Why?
Diseased because it is nodular fibrotic
Is this gum texture healthy or diseased? Why?
acute
sudden onset, sharp rise, short duration
chronic
long duration, frequent recurrence
<30% involvement
What percentage involvement is considered localized in the mouth
>30% involvement
What percentage involvement is considered generalized in the mouth
-probing depth
-loss of perio attachment
-BOP
-exudate
-recession
-mobility
-furcation involvement
-open contacts
-occlusion and oral habits
What does the perio exam look for
true
(T/F) gingivitis results in reversible damage to the gingiva
No
With gingivitis, is there damage to the perio ligament or alveolar bone?
No
Does the height of bone change with gingivitis
True
(T/F) periodontitis results in permanent damage to the periodontal attachment system
-gingival connective tissue
-periodontal ligaments
-alveolar bone
What three things damaged with perio disease
-margin slightly coronal to CEJ
-margin covers CEJ
-margins apical to CEJ
What are the three possible levels of the gingival margin
deep periodontal pocket
In periodontitis, gingival margin may remain near CEJ. This creates a _____________________
distance from gingival margin to the CEJ
How is gingival recession measured
Clinical attachment level
estimated position of the structures that support the tooth as measured with a perio probe
gingival margin level plus probing depth readings
How is the clinical attachment level of a tooth calculated
furcation involvement
A lossof alveolar bone and perio ligament fibers in the space between the roots of a multirooted tooth
mandibular first molar on the buccal side
What tooth surfaces are the most susceptible for furcation involvement
root trunks
Teeth with longer _______ _______ are less likely to have furcation involvement
bleeding on probing
What is the first cardinal sign of disease
Nabers furction probe
What instrument is used to evaluate bone support in furcation of tooth
concavity can be felt with probe
Describe class I furcation involvement
Probe tip can partially enter the furcation
Describe class II furcation involvement
Probe passes completely through the furcation
Describe class III furcation involvement
Same as class III but furcation is visible
Describe class IV furcation involvement
Class I
What class of furcation involvement
Class II
What class of furcation involvement
class III
What class of furcation involvement
Class IV
What class furcation involvement
slight mobility up to 1 mm of horizontal displacement
Describe class 1 mobility
greater than 1 mm but less than 2 mm of horizontal displacement
Describe class 2 mobility
greater than 2 mm of horizontal displacement OR having vertical mobility
Describe class 3 mobility