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Content of the topic

TO REALIZE THE SHARED GOAL OF OCCUPATION MUST BE

 

Particular goals The purpose of the initial level of knowledge
Know the clinical signs of periodontal disease.   To be able to conduct a survey of patients with periodontal pathology.   Learn the methodology of the index of assessment of the hygienic condition of oral cavity and periodontal tissues.   To be able to interpret the results of the index of assessment of patients with pathology of periodontal diseases.   To solve the test tasks and situational tasks.   Know the anatomical and physiological structural features of the periodontal tissues.   Know the algorithm for the examination of periodontal patients.   Know the classification of periodontal disease by Danilevsky, by Mashchenko, International Classification of Diseases (ICD), 1998.  

 

 

Theoretical issues on the basis of which it is possible implementation of the targeted activities:

1. Special methods of investigation of gingivitis and the initial stages of periodontal disease:

- sample with formalin of C.Parma (1960);

- identification of exudate in periodontal pockets;

- sample with benzidine (S.Sorrin, 1960).

 

2. The intensity and prevalence of gingivitis:

- the trial (test) of Schiller-Pisarev;

- sample with perhydrol.

 

3. Determine the pH content of periodontal pocket.

 

4. The index of assessment of the condition of periodontal tissues.

a. Hygienic indexes:

- hygienic index by Fedorov-Volodkina;

- OHI-S (Simplified Oral Hygiene Index) by J.я.Green and J.R.Vermillion.

b. Gingival indices:

- the index плю;

- gingival index (N. Loe, P. Silness, 1963).

 

Control questions

 

1. Special methods of investigation of gingivitis and the initial stages of periodontal disease:

- sample with formalin of C.Parma (1960);

- identification of exudate in periodontal pockets;

- sample with benzidine (S.Sorrin, 1960).

 

2. The intensity and prevalence of gingivitis:

- the trial (test) of Schiller-Pisarev;

- sample with perhydrol.

 

3. Determine the pH content of periodontal pocket.

 

4. The index of assessment of the condition of periodontal tissues.

a. Hygienic indexes:

- hygienic index by Fedorov-Volodkina;

- OHI-S (Simplified Oral Hygiene Index) by J.я.Green and J.R.Vermillion.

b. Gingival indices:

- the index плю;

- gingival index (N. Loe, P. Silness, 1963).

 

HOME TASK:

Describe the methodology of the index assessment:

1. hygienic index by Fedorov-Volodkina;

2. OHI-S (Simplified Oral Hygiene Index) by J.я.Green and J.R.Vermillion;

3. the index плю;

4. gingival index by N. Loe, P. Silness.

content of the topic

The differential diagnosis of gingival and periodontal pockets (gingivitis and the initial stage of periodontitis) is advisable to use special methods of investigation - the formalin test by C.Parma (1960), reveals the ulcer bottom pocket. Turundy with a small amount of a solution consisting of 5 ml of 40% formalin solution, 20 ml of glycerol and 175 ml of distilled water is placed in the pocket. In the presence of ulceration causes pain, which indicates the beginning of the formation of periodontal pockets, the transition of gingivitis to periodontitis. Pain reaction limits the use of this method, it is recommended to be used only in difficult cases.



On examination the patient visually evaluate the presence, amount and nature of the exudate released from the pocket. To determine whether the contents of the periodontal pockets in the clinical setting with your finger (or a cotton swab) easily presses on the gum in the projection of the corresponding apex of the tooth and gradually move it to the gingival margin. In the presence of purulent exudate evaluate its intensity.

The intensity of the pyorrhea can be measured in points:

0 points - no pus;

1 point - little pus (pus in a periodontal pocket);

2 points - moderate pyorrhea (pus swept over the edge of the pocket);

3 points - pus strong (in the marginal gingival traces of pus, abscesses).

The final results are calculated by determining the average of the number of surveyed areas of the gums.

For a more precise identification of the pus of the periodontal pocket spend benzidine test (S.Sorrin, 1960).

For this purpose, 1 drop of a solution consisting of 0.5 ml of benzidine, 10 ml of polyethylene glycol and 15 ml of acetic acid (1:1000), mixed with 1 drop of 3% hydrogen peroxide solution and injected at turundae in the pocket. Turundae painted in green, blue-green, and blue. The color intensity indicates the amount of purulent discharge.

The intensity and prevalence of inflammation of the gums reflects iodine sample by Schiller-Pisarev, which is based on a lifetime (vital) painting of glycogen gums iodine-containing solution, which consists of 1g of iodine, 2g of potassium iodide and 40 ml of distilled water.

With a cotton ball soaked in this solution, brush the gums. Glycogen, which is located in the inflamed tissues of the gums, reacts with iodine, and these areas are colored in various shades of brown, depending on the degree of inflammation and the test is considered positive. In the absence of inflammation, gum colored straw-yellow color, the sample is considered negative.

In some cases the sample is applied to the simultaneous use stomatoscop (increase by 20 times). Sample by Schiller-Pisarev spend in diseases of periodontal before and after treatment; it is used to determine the prevalence of inflammation and volume of operative intervention when gingivectomy, papillotomy, curettage of periodontal pockets, to identify subgingival dental deposits. Sample Schiller-Pisarev can be an objective test of the evaluation of the effectiveness of treatment, for the differential diagnostics and others.

Sample with perhydrol allows you to identify the inflammatory reaction in the gum. The method of its implementation is simple: a swab moistened with perhydrol, lubricates the mucous membrane of the gums. Inflamed gums become white due to the congestion in her tiny bubbles of oxygen. Normal gum color does not change.

The change of pH in the periodontal pockets allows to judge the intensity of the inflammatory reaction, the hygienic state of the oral cavity, the effectiveness of the treatment.

We use pH-meters with a set of glass electrodes to determine the pH. Approximate data can be obtained with the help of the indicator paper with the coloured markings - the change of the intensity of its colour reflects the value of pH. Saliva has a pH from 5.6 to 7.6. The average normal pH of saliva in the mouth is in the range 6.5 - 7.5, that it is neutral.

In the presence of inflammation and ulceration of tissue reaction of the environment is reduced to 4.6-5.1, and when effective treatment and observance of hygiene of an oral cavity noted alkalization - increasing the reaction of the environment to 9.0-11.0.

 


Date: 2015-12-17; view: 819


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