Periodontal probes and Explorers

Periodontal probes are used to measure the depth of pockets and to determine their configuration. The typical probe is a tapered, rod-like instrument calibrated in millimeters, with a blunt, rounded tip. There are several designs with various millimeter calibratios.

When measuring a pocket, the probe is inserted with a firm, gentle pressure to the bottom of the pocket. The shank should be aligned with the long axis of the tooth surface to be probed. Several measurements are made to determine the level of attachment along the surface of the tooth.

Furcation areas can best be evaluated with the curved, blunt Nabers probe .

Explorers are used to locate subgingival deposits and carious areas and to check the smoothness of the root surfaces after root planing. Explorers are designed with different shapes and angles for a variety of uses.

Pocket depth was measured from each of the four sides of the tooth: the medial, buccal, distal, lingual.

Types of pockets:
a) gingival - no extended beyond the gums, is not associated with the destruction of periodontal tissue and with hypertrophy of the gums;
b) periodontal - extended beyond the gums, is associated with the destruction of the ligaments;
c) periosteal (supraosseous) - pocket, whose bottom is located above the alveolar bone;
d) intraosteal (intraosseous) – pocket, whose bottom is located between the alveolar bone and the root of the tooth + below the peaks of interdental septum (apical region of destructive changes is located inside the alveolar)

According to the location osteal pocket relative to the tooth (N.M. Goldman, 1949, 1958):
a) one-sided,
b) two-sided,
c) three-sided,
d) four-sided, or circular (combined).
This means that pocket has three, two or one bone walls.

Pocket, which is located along only one surface of the tooth, called simply, covering two or more surfaces - integral (combined), and bend around it, or getting into a bifurcation - complex.

The degree of bone loss does not always correspond to depth of pocket.

Loss of periodontal attachment - the clinical term that characterizes the destruction or loss of the tooth-epithelial attachment. It corresponds to the measurements conducted on the long axis of the tooth away from the cement-enamel connection to the apical border of periodontal destruction. Expressed in millimeters (mm).

Periodontal attachment saved (not lost), if:

- Exposure of the tooth root is absent + the vertical sounding of periodontal less than 3 mm - clinical gingival sulcus;
- Exposure of the tooth root is absent + gum hides the coronal part of the tooth due to hypertrophy + vertical sounding reveals clinical pocket, which depth - is the size hypertrophic gums - "false pocket."

Index gingival recession (Stahl Morris, 1955) - evaluated in all groups of teeth and is defined as the distance from the gingival margin to the enamel-cement border. To determine the gingival recession better to use special graded probes to determine recession or periodontal probe.

Recession index is calculated as:

number of teeth with recessionх 100%

total number of teeth

Easy degree - up to 25%;
Medium -26-50%;
Severe - 51-100%

For assessing the status of bone tissue use the index of exposed roots (the index of the recession). Measure the depth of the pocket, or, more precisely, the X-ray measure the distance between the top of the alveolar process and the cement-enamel boundary. These data are summed and divided by the number of examined teeth.

B. Test tasks:

1. Normal ratios of divisions of the gums corresponds to a state, in which the size:
A. Attached gingiva equal to the size of the free gingival;
B. Attached gingiva larger than the size of the free gingival;
C. Free gum larger than the size of the attached gingival;
D. Attached gingiva less than the size of the free gingival.

2. Hyperemia of the gums can be a symptom of:
A. Inflammation;
B. Bleeding;
C. Gingival hypertrophy;
D. Clinical pocket.

3. Glossy shine gum retained after drying during symptom:
A. Pain;
B. Swelling;
C. Pocket;
D. Hyperemia.

4. Symptom hypertrophy gums reveal consistently applying:
A. Primary and secondary research methods;
B. Vertical sensing and vital staining gums;
C. Visual assessment of the size of the visible part of the tooth crown and vertical sensing;
D. Visual assessment of the size of the visible part of the tooth crown and horizontal sensing.

5. Clinical symptom corresponds to immersion of the graduated probe to the depth of pocket

A. To 1 mm;
B. Less than 2 mm;
C. Less than 3 mm;
D. 3 mm or more.

6. The size of the exposed surface of the root corresponds to the measurement carried out by:
A. From the gingival margin to the bottom of the pocket at the cement-enamel border;
B. From the cemento-enamel border to the bottom of the clinical pocket;
C. From the cemento-enamel border to the edge of the gums;
D. From the gingival margin to the bottom of the pocket.

7. Pathological mobility of the tooth I degree:

A. The mobility in bucco-lingual (palatal) or vestibular-oral direction (no more than 1 mm);
B. The mobility in bucco-lingual (palatal) or vestibular-oral direction (more than 1 mm) + the mobility in medio-distal direction;

C. The tooth is mobile in all directions, including vertical + rotational movements about the axis of the tooth;

D. The tooth is mobile in all directions, including vertical.

8. Dental calculus in the lumen of the periodontal pocket detect with:
A. Direct inspection with the naked eye;
B. Vertical sounding of the root surface;
C. X-ray methods of investigation of periodontal;
D. Vital staining calculus with a solution of fuchsine or erythrosine;

9. Periodontal attachment loss is equal to:
A. Clinical pocket depth;
B. The size of the exposed surface of the root;
C. The sum of the clinical pocket depth and size of the exposed surface of the root;
D. Arithmetic difference between the exposed surface of the root and depth of pocket.

10. Measurements, wich made from the cemento-enamel connection to the apical border of periodontal destruction, corresponds to:
A. False pockets;
B. Clinical sulcus;
C. The depth of the periodontal pocket;
D. The loss of periodontal attachment.

Control questions of the subject:

1. What are the main methods of examination of patients?
2. Tell anatomical and physiological features of the structure of periodontal tissues.
3. Tell the features of the clinical examination of patients with periodontal disease.

Homework:

1. To write a short report on "Clinical Evaluation of a patient with generalized periodontitis”.

Date: 2015-12-17; view: 977