OF THE CONDITION OF PERIODONTAL TISSUES

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

To assess the condition of the gums are:

• sample by Schiller-Pisarev;

• define the index РМА;

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

The condition of periodontal tissues is determined by periodontal indices:

• periodontal index PI (A.L.Russel, 1956);

• index CPITN (1982) (the index of need in the treatment of periodontal disease).

To assess the hygiene of the oral cavity use indexes based on staining of dental plaque. For this purpose use Lugol's solution (1 part of iodine, 2 parts of potassium iodide and 17 parts of water), the standard tincture of iodine, 2% aqueous solution of methylene blue, 2% solution of fuchsin, etc.

When processing the surface of the tooth with iodine plaque becomes dark brown in colour, in the case of the use of methylene blue or fuchsin - respectively blue or bright orange.

To assess the hygiene of the oral cavity Fedorov and Volodkina (1970) proposed a hygienic index (quantitative and qualitative). In determining the index painted vestibular surface of the front teeth of the lower jaw (33,32,31,41,42,43) solution Schiller - Pisarev (1 g crystalline iodine, 2 g of potassium iodide, 4 g - distilled water) or other iodine-containing solution. Defined plaque painted in dark-brown color.

Hygienic condition of oral cavity evaluated on a five-point system:

coloring the entire surface of the crown of the tooth - 5 points,

3/4 surface - 4 points,

1/2 of the surface - 3 points,

1/4 of the surface - 2 points,

the absence of staining the surface of the crown of the tooth - 1 point.

The calculation is carried out according to the formula:

hygienic index = sum of points / 6.

The index of hygiene of an oral cavity estimated as follows:

1.1-1.4 points - good care (optimal);

1.5-1.8 points - satisfactory;

1.9-2.5 points - unsatisfactory;

2.6-3.8 points - poor;

3.9-5.0 points - very bad.

Index of hygiene, reaching 2.6 and more points, indicates the absence of a regular oral care. Normal hygienic index does not exceed 1,5 points.

J.С.Green and J.R.Vermillion (1960, 1964) proposed simplified index hygiene of the oral cavity OHI-S (Simplified Oral Hygiene Index, which consists of the index plaque - DI-S (Simplified Debris Index) and the index of Tartar - CI-S (Simplified Calculus Index).

Method of determination: a study conducted on the vestibular surface of the teeth 16,11,26,31 and lingual surfaces of the teeth 36 and 46 with dental probe and with the use of dyes.

On all surfaces first determine plaque and then tartar.

Assessment:

DI-S:

0 - lack (absence) of dental plaque;

1 - plaque covered not more than 1/3 of the surface of the tooth;

2 - plaque covers more than 1/3, but no more than 2/3 of the surface of the tooth;

3 - plaque covers more than 2/3 of the surface of the tooth.

CI-S:

0 – absence of calculus;

1 - supragingival calculus covers less than 1/3 of the surface of the tooth;

2 - supragingival calculus covers 1/3 to 2/3 of the surface of the tooth or there are separate particles subgingival calculus;

3- supragingival calculus covers more than 2/3 of the surface of the tooth.

Formula:

DI-S = sum of points / 6,

CI-S = sum of points / 6,

OHI-S=DI-S + CI-S.

The most commonly used index was proposed by Schour and M.Massler (1947, 1948) papillary-marginal-alveolar index PMA in the modification of Parma (1960). It allows to objectively assess the degree of inflammation in the gum.

Gingiva is divided into three parts: the interdental papilla (P), marginal part of the gums (M) and attached alveolar gingiva (A). The absence or presence of inflammation in these parts of the gums evaluated accordingly index 0 or 1 for each of the surveyed tooth. The resulting indices are summed and divided by the number of examined teeth.

Method of determination: visually assess the state of gums near each tooth on the intensity of the hyperemia or on the intensity of the coloration of the gums after the application of the solution by Schiller-Pisarev.

Assessment (rating):

C.Parma (1960) proposed to evaluate the

1 point - inflammation of the gingival papilla;

2 points - inflammation of the gum edge (marginal part of the gums);

3 points - inflammation of the alveolar (attached) gums.

The overall index of RLGS then expressed as a percentage according to the formula:

PMA = (sum of points / 3 x the number of teeth of the patient) x 100%.

Any index value is more than zero indicates inflammatory changes.

The index PMA value:

up to 25% - slight degree of gingivitis

25-50% - average degree of gingivitis;

above 51% - heavy degree of gingivitis.

PMA index reflects dynamics of the disease and effectiveness of the treatment.

The degree of inflammation of the gums can be estimated using gingival index (GI) by H. Loe, P. Silness (1963). The condition of the gums from the vestibular, lingual, medial and distal surfaces must be determined.

All surfaces are scored on the following criteria:

0 - normal gums;

1 - mild inflammation, slight color change, light swelling, no bleeding in touch;

2 - moderate inflammation, gum hyperemic, swollen, bleeding in touch;

3 - severe inflammation, expressed hyperemia and edema, ulceration, the tendency to spontaneous bleeding.

The amount of the assessments is divided into 4 and finds the index near the tooth. This index is advisable to determine near the molar, premolar and incisor on each half of the jaw.

The index corresponds to:

up 0.1 to 1 - slight gingivitis,

up 1.1 to 2 - moderate gingivitis (medium gravity),

over 2.1 - heavy gingivitis.

Test tasks:

1. How can you determine the violation of the integrity of the bottom of gingival sulcus?

A. PMA index;

B. sample by Schiller-Pisarev;

C. radiographically;

D. button-sensing probe;

E. formalin test.

2. Sample by Schiller-Pisarev allows determining:

A. The reactivity of the gums.

B. The hydrophilicity of the gums.

C. The intensity of the inflammation of the gums.

D. The resistance of the capillaries of the gums.

E. The degree of gum’s bleeding.

3. What solution do you use in conducting of sample by Schiller-Pisarev?

A. The solution of potassium iodide.

B. Tincture of iodine.

C. Iodinol.

D. Iodine and potassium iodide solution.

E. The solution of methylene blue.

4. You can evaluate the presence of plaque and tartar using an index.

A. The index by Fedorov-Volodkina.

B. The index РМА.

C. Simplified Oral Hygiene Index by J.С.Green and J.R.Vermillion.

D. Gingival index by N. Loe and P. Silness.

E. Sample with perhydrol.

5. In severe gingivitis value of index PMA is:

A. 25%

B. 30%-40%

C. 25%-50%

D. 51% and above

E. 41%-50%

6. Use the index PMA to detect the prevalence (severity):

A. Gingival bleeding.

B. Pathological tooth mobility.

C. Gingival hypertrophy level.

D. Inflammation.

7. Formalin test allows determining:

A. the capillary resistance.

B. the nature of fluid in the gingival pocket.

C. the hidden swelling gums.

D. the ulcer on the bottom of the periodontal pocket.

E. the phagocytic activity of leukocytes.

8. Benzidine test allows determining:

A. the nature of fluid in the gingival pocket.

B. the presence of ulceration in the wall of the periodontal pocket.

C. the phagocytic activity of leukocytes.

D. the glycogen level in the gum.

E. the saturation of the gums by ascorbic acid.

9. When inflammation and ulceration in the mouth the pH of saliva is in the range of:

A. 4,6 - 5,1;

B. 9,0 - 11,0;

C. 5,6 - 7,6;

D. 6,5 - 7,5;

E. 8,2 - 9,0.

10. Sample by Schiller-Pisarev is used to solve all of the following tasks except: