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The Periodontal Examination
The Periodontal Examination
The Periodontal Examination
Examination
Hope you studied
Medical History
Cardiovascular/Circulatory
(Infective Endocarditis)
Bleeding Disorder
(LA, Multiple appt.)
Infective risks
(Special IC measures)
Allergic reactions
(Latex, LA, medications)
Symptoms of Periodontal
Disease
Bleeding
Mobility
Pain (Hypersensitivty/pulpal)
Halitosis and bad taste
Recession
Swelling
Bleeding on Probing
Does not indicate disease severity or
progression of the disease
Absence is a good predictive (98.5%)
indicator of gingival stability
Suppuration, or pus in pocket should
also be recorded.
Tiny drop/ Profuse bleeding and
suppuration should be noted
Attachment Loss
Calculated from PPD + Recession
Less than 4mm = Mild-Moderate
Periodontitis
More than 4mm = Severe
Periodontitis
Furcation Involvement
Mobility
Miller Index
Degree 0: Physiological mobility. 0.1-0.2mm
mobility horizontally
Degree 1: Crown mobile up to 1mm horizontally
Degree 2: Crown mobile from 1-2mm horizontally
Degree 3: Crown mobile >2mm horizontally,
moves vertically, may be rotated, depressed in
socket, etc.
Always consider CAUSE of mobility; perio,
hyperocclusion, parafunction, etc.
Special Investigations
Radiographs*
Plaque Index (and General Calculus)
Percussion Tests
Occlusal analysis
Diagnosis
Gingivitis
Mild-Moderate
Periodontitis
Advanced/Severe
Periodontitis
P 1-3mm, possibly
P Pseudopockets
D >3mm
4-6mm
6+
Furcation
involvement
Periodontitis
B Yes
O
P
Yes
Yes
Yes
B No AL or BL
L
/
Tends to have
horizontal or angular
bone loss. Infrabony
lesions can be
classed as 1,2 or 3
wall defects*
Tends to have
horizontal or angular
bone loss. Infrabony
lesions can be
classed as 1,2 or 3
wall defects*
N/A: Adjunctive
diagnosis for
multirooted teeth.
Superficial if Degree
1 FI, else considered
deep
A
L
Questions?