Changes

==Introduction==

==Introduction==

[[File:Periodontal probe in situ.jpg|right|200px|thumb|Periodontal probe used to measure gingival sulcus depth and feel for attachment loss. Here the probing depth is 2mm and considered normal on a canine tooth<small>''© Lisa Milella 2013''</small>]]

[[File:Periodontal probe in situ.jpg|right|200px|thumb|Periodontal probe used to measure gingival sulcus depth and feel for attachment loss. Here the probing depth is 2mm and considered normal on a canine tooth<small>''© Lisa Milella 2013''</small>]]

[[File:Periodontal probe and furcation.jpg|right|200px|thumb|Periodontal probe used to check for furcation exposure. The probe is passed horizontally between the roots. The probe extends from the palatal aspect through to the buccal aspect, indicating that there is complete bone loss between the roots, a grade 3 furcation exposure.<small>''© Lisa Milella 2013''</small>]]

[[File:Periodontal probe and furcation.jpg|right|200px|thumb|Periodontal probe used to check for furcation exposure. The probe is passed horizontally between the roots. The probe extends from the palatal aspect through to the buccal aspect, indicating that there is complete bone loss between the roots, a grade 3 furcation exposure.<small>''© Lisa Milella 2013''</small>]]

[[File:Worn dog teeth.jpg|right|200px|thumb|Severely worn maxillary canine and premolars. The canine and 2nd premolar have pulp exposure (black spot) and draining fistulae just above the mucogingival junction. The first and 3rd premolars are worn with tertiary (or reparative) [[Enamel Organ#Dentin|dentine]] (tan colour).<small>''© Lisa Milella 2013''</small>]]

[[File:Worn dog teeth.jpg|right|200px|thumb|Severely worn maxillary canine and premolars. The canine and 2nd premolar have pulp exposure (black spot) and draining fistulae just above the mucogingival junction. The first and 3rd premolars are worn with tertiary (or reparative) [[Tooth - Anatomy & Physiology#Dentin|dentine]] (tan colour).<small>''© Lisa Milella 2013''</small>]]

The following indices and criteria should be evaluated for each tooth:

The following indices and criteria should be evaluated for each tooth:

#Gingivitis and gingival index

#Gingivitis and gingival index

==Gingivitis and Gingival Index==

==Gingivitis and Gingival Index==

The presence and degree of '''[[gingivitis]]''' (inflammation of the [[gingiva]]) is assessed based on a combination of redness and swelling, as well as presence or absence of '''bleeding''' on gentle probing of the '''gingival sulcus'''. An index which relies on both visual inspection and bleeding, namely the '''modified Löe and Silness gingival index''' <font color="red">(Löe, 1967)</font color>, can also be used:

The presence and degree of '''[[gingivitis]]''' (inflammation of the [[gingiva]]) is assessed based on a combination of redness and swelling, as well as presence or absence of '''bleeding''' on gentle probing of the '''gingival sulcus'''. An index which relies on both visual inspection and bleeding, namely the '''modified Löe and Silness gingival index''' <ref>Loe. H (1967) '''The gingival Index, the plaque index and the retention index system.''''' Journal of Periodontology'' 38: 610-616</ref>, can also be used:

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:'''Gingival index 0''' - Clinically healthy gingiva

:'''Gingival index 0''' - Clinically healthy gingiva

:'''Gingival index 2''' - Moderate gingivitis: the gingival margin is red and swollen; gentle probing of the gingival sulcus results in bleeding

:'''Gingival index 2''' - Moderate gingivitis: the gingival margin is red and swollen; gentle probing of the gingival sulcus results in bleeding

:'''Gingival index 3''' - Severe gingivitis: the gingival margin is very swollen with a red or bluish-red color; there is spontaneous hemorrhage and/or ulceration of the gingival margin

:'''Gingival index 3''' - Severe gingivitis: the gingival margin is very swollen with a red or bluish-red color; there is spontaneous hemorrhage and/or ulceration of the gingival margin

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==Periodontal Probing Depth (PPD)==

==Periodontal Probing Depth (PPD)==

The depth of the sulcus can be assessed by gently inserting a graduated [[Periodontal Probe|periodontal probe]] '''until resistance is encountered at the base of the sulcus'''. The depth from the free [[Gingiva|gingival margin]] to the base of the sulcus is measured in mm at several locations around the whole circumference of the [[:Category:Teeth - Anatomy & Physiology|tooth]]. The probe is moved gently horizontally, walking along the floor of the sulcus. The '''gingival sulcus is normally 1–3 mm deep in the dog''' and '''0.5–1 mm in the cat'''. Measurements in excess of these values usually indicate [[Periodontal Disease|periodontal disease]], when the [[Enamel Organ#Periodontal Ligament|periodontal ligament]] has been destroyed and [[Enamel Organ#Alveolar Bone|alveolar bone]] resorbed, thus allowing the probe to be inserted to a greater depth. The term used to describe this is '''periodontal pocketing'''. All sites with periodontal pocketing should be accurately recorded. Gingival inflammation resulting in swelling or hyperplasia of the free [[gingiva]] will, of course, also result in measuring sulcus depths in excess of normal values. In these situations, the term '''pseudopocketing''' is used, as the periodontal ligament and bone are intact (i.e.there is no evidence of [[periodontitis]]) and the increase in PPD is due to swelling or [[Gingival Hyperplasia|hyperplasia of the gingiva]].

The depth of the sulcus can be assessed by gently inserting a graduated [[Periodontal Probe|periodontal probe]] '''until resistance is encountered at the base of the sulcus'''. The depth from the free [[Gingiva|gingival margin]] to the base of the sulcus is measured in mm at several locations around the whole circumference of the [[:Category:Teeth - Anatomy & Physiology|tooth]]. The probe is moved gently horizontally, walking along the floor of the sulcus. The '''gingival sulcus is normally 1–3 mm deep in the dog''' and '''0.5–1 mm in the cat'''. Measurements in excess of these values usually indicate [[Periodontal Disease|periodontal disease]], when the [[Tooth - Anatomy & Physiology#Periodontal Ligament|periodontal ligament]] has been destroyed and [[Tooth - Anatomy & Physiology#Alveolar Bone|alveolar bone]] resorbed, thus allowing the probe to be inserted to a greater depth. The term used to describe this is '''periodontal pocketing'''. All sites with periodontal pocketing should be accurately recorded. Gingival inflammation resulting in swelling or hyperplasia of the free [[gingiva]] will, of course, also result in measuring sulcus depths in excess of normal values. In these situations, the term '''pseudopocketing''' is used, as the periodontal ligament and bone are intact (i.e.there is no evidence of [[periodontitis]]) and the increase in PPD is due to swelling or [[Gingival Hyperplasia|hyperplasia of the gingiva]].

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==Gingival Recession==

==Gingival Recession==

Gingival recession is also measured using a [[Periodontal Probe|periodontal probe]]. It is the '''distance (in mm) from the [[Enamel Organ|cemento-enamel]] junction to the free [[Gingiva|gingival margin]]'''. At sites with gingival recession, [[#Periodontal Probing Depth (PPD)|PPD]] may be within normal values despite loss of [[Enamel Organ#Alveolar Bone|alveolar bone]] due to [[periodontitis]].

Gingival recession is also measured using a [[Periodontal Probe|periodontal probe]]. It is the '''distance (in mm) from the [[Tooth - Anatomy & Physiology|cemento-enamel]] junction to the free [[Gingiva|gingival margin]]'''. At sites with gingival recession, [[#Periodontal Probing Depth (PPD)|PPD]] may be within normal values despite loss of [[Tooth - Anatomy & Physiology#Alveolar Bone|alveolar bone]] due to [[periodontitis]].

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==Furcation Involvement==

==Furcation Involvement==

Furcation involvement refers to the situation where the '''bone between the roots of multirooted teeth is destroyed''' due to [[periodontitis]] <font color="red">(Fig. 6.4)</font color>. The furcation sites of multirooted teeth should be examined with either a ''[[Periodontal Probe|periodontal probe]]'' or ''[[Dental Explorer|dental explorer]]''. Furcation involvement is graded as follows:

Furcation involvement refers to the situation where the '''bone between the roots of multirooted teeth is destroyed''' due to [[periodontitis]]. The furcation sites of multirooted teeth should be examined with either a '''[[Periodontal Probe|periodontal probe]]''' . Furcation involvement is graded as follows:

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:'''Grade 0''' - No furcation involvement

:'''Grade 0''' - No furcation involvement

==Crown Abnormalities==

==Crown Abnormalities==

Any '''surface defect of the [[Enamel Organ#Crown|crown]]''' needs to be identified and recorded. Surface defects are diagnosed using the [[Dental Explorer|explorer probe]] – the sharp point is run across the crown to identify any catches. Crown defects such as [[Radiographic Interpretation of Dental Developmental Abnormalities - Small Animal#Abnormal Tooth Shape or Structure|enamel dysplasia]], fractured teeth (with or without pulp exposure), worn teeth, [[Dental Caries|caries lesions]] or [[Feline Odontoclastic Resorptive Lesions|odontoclastic resorptive lesions]] are noted on the [[Dental Recording|chart]] and treated appropriately.

Any '''surface defect of the [[Tooth - Anatomy & Physiology#Crown|crown]]''' needs to be identified and recorded. Surface defects are diagnosed using the [[Dental Explorer|explorer probe]] – the sharp point is run across the crown to identify any catches. Crown defects such as [[Radiographic Interpretation of Dental Developmental Abnormalities - Small Animal#Abnormal Tooth Shape or Structure|enamel dysplasia]], fractured teeth (with or without pulp exposure), worn teeth, [[Dental Caries|caries lesions]] or [[Feline Odontoclastic Resorptive Lesions|odontoclastic resorptive lesions]] are noted on the [[Dental Recording|chart]] and treated appropriately.

 

 

 

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[[Category:Oral Examination]]

[[Category:Oral Examination]]

[[Category:To Do - Mars Check]]

[[Category:Waltham reviewed]]

[[Category:To Do - Dentistry Images]]