Periodontal Indices Flashcards

1
Q

What are the 5 characteristics that are assessed regarding inflammation?

A
color
texture
bleeding
exudate
plaque
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2
Q

There is always _______ in the gingival sulcus, but when it becomes _______ it indicates an underlying problem.

A

transudate

exudate

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3
Q

_________ + __________ = Identification of Disease

A

Assessment of Inflammation

Loss of Periodontal Tissue Support

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4
Q

What three characteristics are evaluated when studying periodontal tissue support?

A

Probing Depths
Clinical Attachment Levels
Radiographic Evaluation

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5
Q

Following initial treatment, a patient will be instructed to come back for one of three things based on the assessment of periodontium. What are these three circumstances?

A
  1. Recall
  2. Periodontal Maintenance
  3. Referral to Periodontist
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6
Q

The Plaque Index assesses the amount of plaque at the _____ _____, examining the same anatomical units as the GI.

A

Gingival Margin

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7
Q

Using the plaque index, a probe can be used to decipher between ____ and _____; however, visible plaque is scored a _____ or ______.

A

0, 1

2, 3

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8
Q

The Plaque index can be applied to a ____, ______, or _____.

A

tooth
subject
population

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9
Q

True or False: the Turesky Modified Plaque Index uses disclosing dye to examine facial and lingual surfaces.

A

True

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10
Q

True or False: The Turesky Modified Plaque Index is the most frequently used index in clinical trials and the Volpe-Manhold is the most used calculus index used in longitudinal studies.

A

True

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11
Q

*The O’Leary Plaque Index provides a ______ of tooth surfaces ______ for plaque.

A

percentage

positive

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12
Q

*The NIDR Calculus Index ranks calculus from ____ to ____. Describe the difference between levels.

A

0 to 2
0 = calculus absent
1 = supragingival calculus only, no subgingival
2 = supra and subgingival calculus

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13
Q

*Using the Gingival Index (GI) [aka: Loe & Sillness], inflammation is assessed in ____ distinct gingival areas. What are these areas?

A
4
distofacial papilla
facial margin
mesiofacial papilla
lingual gingival margin
(basically....the margin around the tooth)
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14
Q

How is the GI scored?

A

Inflammation is scored 0 to 3 in the four areas:
normal = 0
1 = no bleeding, inflamed, red
2= moderate inflammation, redness, BoP
3= spontaneous bleeding upon brushing, eating, or sleeping

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15
Q

_____ is the tendency to bleed 15 seconds following retraction of a probe from the periodontal pocket.

A

BoP

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16
Q

Bleeding on probing is score as either ___ which indicates presence of blood, or _____ which indicates absence.

A

1 if present

0 if absent

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17
Q

BoP is a valid indicator of periodontal _____ but it is a poor indicator of periodontal ______.

A

stability

breakdown

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18
Q

Which probe do we typically use for Periodontal Screening?

A

the “Michigan-O” with Williams Markings

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19
Q

Attachment level = ______ mm + ______ mm

A

probing depth + recession

recession is written as a positive number, inflammation as a negative

20
Q

For periodontal probing, how many surfaces are examined per tooth? What type of force is used? Correct _____ is important.

A

6 surfaces
light force
correct angulation

21
Q

What is the correct angulation for interproximal probing (after reaching the contact point with parallel probe, you angulate this much)?

A

15 degrees

22
Q

The ESI is a _______ index that relates disease to two characteristics: ______ and ______.

A

Periodontal index

extent and severity

23
Q

What is the difference between extent and severity?

A
Extent = proportion of tooth sites showing destruction
Severity = amount of attachment loss at the sites (avg.)
24
Q

Using the PDI system, how many areas of the tooth are examined and how are they examined?

A

4 areas using a perio probe

25
Q

Describe the Community Periodontal Index of Treatment Needs and how scores are recorded.

A

CPITN uses a specially designed probe to index in under-served parts of the world.
The mouth is divided into 6 sections (sextants): the worst score of each sextant is recorded (gives 6 scores per subject). Then the worst overall score will determine the treatment needs

26
Q

The CPITN is scored ____ to ____ and then given one of four codes to distinguish level of treatment needed.

A
Score 0 to 4
Codes:
0 = no treatment 
I = improve oral hygiene 
II = I + professional scaling
III = I + II + complex treatment plan
27
Q

Which Periodontal Index do we use in the clinics?

A

PSR (Periodontal Screening and Recording)**

(it is endorsed by the ADA)

28
Q

*PSR is a ____ and ____ way to screen patients for periodontal disease and summarizes necessary information with ______ ______.

A

rapid and effective

minimal documentation

29
Q

What is special about the PSR probe?

A

there is a dark- colored band that indicates a 5.5mm depth when covered

30
Q

Scoring for PSR is done per _____.

A

sextant

31
Q

What are the PSR scores? How do they relate to the colored band, calculus, and BoP?

A
0 = colored band is visible,no calculus, no BoP
1 = colored band is visible, no calculus, but +BoP
2 = colored band is visible, +calculus, may have BoP (+/-)
3 = colored band partly seen, +/-calculus, +/- BoP
4 = colored area not visible, +/- calculus, +/- BoP
32
Q

Using PSR, what is the rule for charting?

A

Divide the mouth into six sections: Quickly find the highest score per sextant.

  • if one sextant has a score greater than 2…chart only that 1/6 of the mouth fully
  • if two or more sextants have a score greater than 2…chart the entire mouth fully!
33
Q

What are the six benefits to PSR?

A
speed
early detection
simple
cost effective
recording ease
risk management (documentation/proof of evaluation)
34
Q

What are the limitations of PSR?

A

designed to DETECT only
some need more comprehensive exams
doesn’t work for reduced periodontium or recession
designed for use in ADULTS

35
Q

Why are screening indices different for peri-implant tissues?

A

Implants are circular, there are no B-L or M-D surfaces to evaluate. Use Modifed PLi and Modified Gi

36
Q

What is reliability?

A

ability to measure a condition in the same subject repeatedly and obtain the same score each time (reproducible)

37
Q

What is validity?

A

the sensitivity (+ when +) and specificity (- when -) of a diagnostic tool

38
Q

What are three potential examiner biases?

A
  1. Halo Effect
  2. Leniency/Severity Error
  3. Central Tendency Error
39
Q

What is the Halo Effect?

A

the examiner’s general impression of a target distorts his/her perception of the target on specific dimensions

40
Q

What is the Central Tendency Error? How does this differ from the leniency/severity error?

A

the examiner’s reluctance to rate at either the positive or negative extremes so all scores cluster in the middle
(L/S Error: simply just the examiner’s personality = tendency to be lenient or severe)

41
Q

How do we attempt to eliminate clinician error?

A

Calibration and Training

42
Q

How do we determine the validity of a diagnostic test?

A

Predictive Value Positive (PVP) and Predictive Value Negative (PVN). Basically: its the
“real +” over the “assigned +” = PVP
“real -“ over the “assigned -“ = PVN

43
Q

What is Predictive Value Positive (PVP)?

A

the probability of disease in a subject with a positive test result

44
Q

What is the Predictive Value Negative (PVN)?

A

the probability of not having the disease when the test is negative

45
Q

Does the O’leary index use disclosing solution?

A

yes

46
Q

How many surfaces are studied per tooth using the O’leary index?

A

4

47
Q

How do you calculate the amount of plaque using the O’Leary index?

A

total #sites with plaque / total #sites in the mouth