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Caroline Mohamed
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D Caroline Mohamed
Outline of lecture
Description of normal gingiva
Gingival index by silness and loe
OHI index simplified
CPITN index
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Remembering gingiva
anathomy
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Characteristics of
normal gingiva
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Characteristics of gingivitis
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Individual complaine
Bleeding gums
Red gums
Blood on my pilow
Bad taste
Bad smell (halitosis)
Smokers ....less bleeding
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Clinical examinations
Plaque index
Gingival index
Pocket measurment
Furcation
Tooth mobility
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Gingival index of
loe and silness
The most frequently used index for evaluating
gingivitis.
It is possible to measure
bleeding tendencies
color, contour changes of the gingiva
alternations in the consistency of tissue
and the presence of ulcerations.
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Steps..
The gingival condition around each tooth is
examined, and a score for the mesial, distal,
buccal, and lingual areas is recorded.
If desired, the gingival index can also be used on
only selected teeth in the mouth.
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Bleeding
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B
u
c
c
a
l
Mesiofacial
B
u
c
c
a
l
Distofacial
Mesial
L
i
n
g
u
a
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Distal
Palatine
or lingual
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Gingival Index: GI
0
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Bleeding
Inflammation
Points
normal
no bleeding
none
mild
moderate
severe
redness,
hypertrophy, edema
and glazing
bleeding on
probing/pressu
re
marked redness,
hypertrophy, edema,
ulceration
spontaneous
bleeding
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Training
What is the gingival index of this
tooth?
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0 normal
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0 normal
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2 bleeding on
probing/pressure
moderate
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spontaneous bleeding
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Gingival Index
Method
Six index teeth
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GI FORMULA
GI ( tooth) =
GI ( individual ) =
GI ( group) =
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scores M+D+B+L
4
GI each teeth added
N. of teeth
GI each individual added
N. of individuals
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Training
Sum of scores of
each tooth
divided for 4:
/4=
/4=
/4 =
/4=
/4=
/4=
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GI individul=
Scores each tooth added
N. Teeth
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Training
Sum of scores of
each tooth
diveded for 4:
6/4=1.5
7/4= 1.75
2/4 = 0.5
4/4=1
7/4=1.75
8/4=2
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GI individual=
Scores each teeth
N. Teeth
Omars GI=
=1.5+1.75+0.5+1+1.75+2
6
Omars GI= 8.5
= 1.4
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Gingival Index
Le & Silness 1963
Average
Gingival Index
Interpretation
Patient
evaluation
no inflammation
Healthy
0.1 - 1.0
mild inflammation
Mild gingivitis
1.1 - 2.0
moderate
inflammation
Moderate gingivitis
2.1 - 3.0
severe
inflammation
Severe gingivitis
< 0.1
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Debris Index
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How to proceed?
Each tooth is dried and examined visually using a mirror,
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Criteria
Moderate accumulation of
soft deposits in the gingival
pocket or on the tooth. Soft
debris covering more than 1/3
but not more than 2/3 of the
exposed tooth surface
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Training
Give me the right debris score:
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Criteria
No calculus present
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Training
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Training
3
1
2
0
3
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To help to memorize....
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epidemiologic study
Greene and Vermillion have also developed a
simplified OHI in which the clinician measures
only one tooth surface in each sextant,
equaling only six surfaces. ( 6 rather than 12)
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16
11
26
46
31
36
Index
surfaces
are
examined:
The buccal surface of the upper
1st molars ( 16, 26)
The lingual surfaces of the
lower 1st molars ( 36, 46)
The labial surface of the upper
right central incisor (11 )
The labial surface of the lower
left central incisors ( 31)
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Calculating OHI-Simplified
DI-S
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Good
0.0 to 1.2
Fair
1.3 to 3.0
Poor
3.1 to6.0
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score.
It is easy to score.
It is useful in survey
work
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Disadvantages:
trials {Research}.
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CPITN index
Indicators. Three indicators of periodontal status are
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CPITN probe
A specially designed
light weight probe with a
0.5-mm ball tip is used,
bearing a black band
between a 3.5 and 5.5
mm from the ball tip.
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Sextant
The mouth is divided into
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Upper right
posterior
18-14
Upper
anterior
Upper left
posterior
24-28
13-23
lower right
posterior
44-48
Lower
anterior
lower left
posterior
38-34
33-43
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Teeth to be examined
For adults aged 20 years and over, the teeth to be examined are: The
2 molars in each posterior sextant are paired for recording, and if one is
missing, there is no replacement.
If no index teeth or tooth is present in a sextant qualifying for examination,
all the remaining teeth in that sextant are examined
For young people up to the age of 19 years, only six teeth
16,11,26,36,31 and 46 are examined
For children under 15 recording for pocket should not be attempted.
ie., only bleeding and calculus should be considered
If no index tooth is present in a sextant qualifying for examination,
single fully erupted incisor or premolar may be substituted
17
16
11
26
27
47
46
31
36
37
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CPTIN Score
Additional X ray
criteria
Treatment Needs
Radiographic appearance
normal
--------------------------------
TN 1 .Need to improve
individual OH. Require
OHI nstructions
Gingivitis. Inflammation
surrounds the tooth, but
there is no apparent break
in the epithelial
attachment
---------------------------------
TN 3. Needs of complex
treatment ( deep scaling,
efficient personal OH
measures)
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Scores for each tooth are added, and the total divided by
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Thank you
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