9: Periodontal and Risk Assessment

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Figure 17-2 A, Incorrect technique for probing the interproximal area. B, Correct technique. C, Incorrect technique.

(Adapted from Perry D, Beemsterboer P, Carranza FA: Techniques and theory of periodontal instrumentation, Philadelphia, 1990, Saunders.)

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Figure 17-3 Failure to tilt the probe far enough to keep its end in contact with the tooth surface. Probe is resting on the pocket wall, resulting in an inaccurate probing depth measurement.

(Adapted from Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds: Carranza’s clinical periodontology, ed 10, St Louis, 2006, Saunders.)

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Figure 17-4 Occlusal view of the six surfaces measured in periodontal probing.

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Figure 17-5 Periodontal probing limitations. A, Wrong angulation of probe. B, Probe blocked by calculus. C, Probe blocked by overhanging restoration.

(From Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds: Carranza’s clinical periodontology, ed 10, St Louis, 2006, Saunders.)

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Figure 17-6 Radiograph showing widening of the periodontal ligament associated with occlusal trauma (arrow).

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Figure 17-7 Mucogingival defects. A, Irregular gingival contours and recession with severe gingival inflammation. B, Gingival recession, crater formation, and chronic inflammation with fibrotic tissue. Bottom of the pocket is beyond mucogingival junction. C, Recession on maxillary canine with presence of shallow pocket and absence of attached gingiva. D, Advanced gingival recession and inflammation caused by heavy plaque and calculus accumulation.

(Courtesy Dr. Kenneth Marinak, Adjunct Clinical Instructor, Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University, Norfolk, Virginia.)

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Figure 17-8 Periodontal examination record. A, Periodontal charting code. B, Periodontal chart.

(Courtesy Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University, Norfolk, Virginia.)

TABLE 17-1 Classifications of Furcations

Class Description
Class I Beginning involvement. Concavity of furcation can be detected with an explorer or probe, but it cannot be entered. Cannot be detected radiographically.
Class II The clinician can enter the furcation from one aspect with a probe or explorer but cannot penetrate through to the opposite side.
Class III Through-and-through involvement, but the furcation is still covered by soft tissue. A definite radiolucency in the furcation area on a radiograph is visible.
Class IV A through-and-through furcation involvement that is not covered by soft tissue. Clinically it is open and exposed.

TABLE 17-2 Classification of Mobility

Class Description
Class I Tooth can be moved up to 1 mm in any direction.
Class II Tooth can be moved >1 mm in any direction but is not depressible in socket.
Class III Tooth can be moved in a buccolingual direction and is depressible in socket.

TABLE 17-3 Classification of Fremitus

Class Description
Class I Mild vibration or movement detected
Class II Easily palpable vibration but no visible movement
Class III Movement is clearly visible

TABLE 17-4

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Related posts:

  1. 10: Dental Hygiene Care Plan and Evaluation
  2. 18: Acute Gingival and Periodontal Conditions, Lesions of Endodontic Origin, and Avulsed Teeth
  3. 6: Assessment of the Dentition
  4. 38: Medical Emergencies
  5. 44: Clients with Special Needs
  6. 5: Extraoral and Intraoral Clinical Assessment

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Jan 1, 2015 | Posted by in Dental Hygiene | Comments Off on 9: Periodontal and Risk Assessment

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