Periodontal Assessments Part 2 PDF

Periodontal Assessments Part 2 Foundations in Clinical Skills and Practice Pat Lazarou Intended Learning Outcomes By the end of this session students should be able to: Define the term furcation involvement Revise morphology of multi rooted teeth Identify the Nabers probe and describe i...

Periodontal Assessments Part 2 Foundations in Clinical Skills and Practice Pat Lazarou Intended Learning Outcomes By the end of this session students should be able to: Define the term furcation involvement Revise morphology of multi rooted teeth Identify the Nabers probe and describe it’s key features Describe the grades of furcations (Glickman 1953) Identify the challenges associated with undertaking a furcation index Describe the mobility index (Miller 1950) Furcation Index Glickman (1953) Furcation Involvement Progression of periodontitis around multi-rooted teeth may involve destruction of bone in furcation area Why is this so important to identify and measure? Normal Not Normal Measuring furcations Looking from the apices of teeth Different entry points All have to be assessed With Nabers probes Nabers Probe Similar to BPE probe First black band 3-6mm Second black band 9-12mm Why is it this pig-tail shape? So it can wrap around Grade 1 The concavity – just above the furcation entrance can be detected with tip of probe BUT furcation probe cannot enter furcation area Evident on Radiograph? Grade 1 Furcation Radiograph Grade 2 Probe can partially enter the furcation – extending approximately 1/3 the width of the tooth BUT not able to completely pass through furcation Evident on Radiograph? Grade 2 Furcation Radiograph Grade 3 In lower molars the probe passes completely through the furcation- between mesial & distal roots In upper molars the probe passes between mesiobuccal & distobuccal roots & touches the palatal root Evident on Radiograph? Grade 3 Furcation Radiograph Grade 4 Same as Class 3 except the entrance to furcation is visible clinically owing to tissue recession Grade 4 image Compare Nabers Probe access for maxillary teeth Nabers probe access for mandibular teeth What challenges do you meet in trying to access furcations? Think variances in morphology What is the problem here? Mobility Index Miller (1950) Classification Description CLASS 0 Tooth show mobility of 0.1 – 0.2mm in horizontal direction (normal) CLASS 1 Slight mobility, up to 1mm of horizontal displacement in a facial-lingual direction CLASS 2 Moderate mobility, greater than 1mm of horizontal displacement in a facial lingual direction CLASS 3 Severe mobility, greater than 1mm of displacement in a facial-lingual direction combined with vertical displacement (tooth depresses into socket) 2 directions of mobility Horizontal tooth mobility Assessing Vertical Tooth Mobility What is left?!