ESSENTIALS OF PERIODONTOLOG AND PERIODONTICS

The normal consistency of the gingiva can be checked by palpation either with a blunt instrument
or digital pressure. Pitting on palpation indicates soft and edematous gingiva. (HAL 441)

Biasanya, konsistensi gingiva kuat dan tangguh. Di kondisi sakit, dapat menunjukkan lunak dan
edematous atau konsistensi yang tegas dan kasar. (HAL 158)

Marked inflammation, as indicated by loss of surface continuity (ulceration), spontaneous

hemorrhage, loss of faciolingual continuity or any interdental papilla, marked deviation from
normal contour, recession and clefts. (HAL 53)

Contour is scalloped and knife edged, interdental papilla in the anterior region is pyramidal and
posteriorly tentshaped. In disease, it can become rounded or rolled, whereas interdental papilla can
become blunt and flat. (HAL 158)

Furcation involvement refers to commonly occurring conditions in which the bifurcation and
trifurcation of multirooted teeth are invaded by the disease process. Furcation involvement can be
diagnosed by Naber’s probe and radiographs. (HAL 389)

Curettage is the scraping of the gingival wall of a periodontal pocket to separate the diseased soft
tissue. There are gingival, subgingival and inadvertent curettage which should be differentiated.
(HAL 315)

Curettage as such does not eliminate local factors like plaque and calculus, therefore it should
always be followed by scaling and root planing procedures.
After adequate local anesthesia, the correct curette is selected and adapted in such a way that the
cutting edge is against the tissues. The instrument is inserted so as to engage the inner lining of the
pocket wall and is carried along the soft tissue wall usually in a horizontal stroke. The pocket wall
may be supported by gentle finger pressure on external surface.
In subgingival curettage, the tissue attached between the bottom of pocket and the alveolar crest is
removed with a scooping motion of the curette to the tooth surface. The area is flushed to remove
debris. If necessary sometimes sutures and a pack may be indicated.
(HAL 315)

FASE PERAWATAN (HAL 408-411)

Scaling
This is the process by which plaque and calculus are removed from both supragingival and subgingival tooth
surfaces.
Root Planing
This is the process by which residual embedded calculus and portions of cementum are removed from the roots
to produce a smooth, hard, clean surface. The prime objective of scaling and root planing is to restore gingival
health by completely removing the tooth surface elements that provoke gingival inflammation.
(HAL 486)

COLOR ATLAS OF DENTAL MEDICINE PERIODONTOLOGY

The clinical manifestations of recession are numerous. Gingival recession usually begins with a
gradual apical migration of the entire facial aspect of the gingiva, revealing the CEJ. Less
frequently, the first sign of recession is the relatively rapid formation of a small groove in the
gingiva, a socalled Stillman cleft. This can expand into pronounced recession. As a consequence
of recession, the remaining attached gingiva may become somewhat thickened and rolled, a
noninflammatory fibrotic response known as McCall’s festoon (Fig.350).
350 McCall’s Festoons
The attached gingiva consists of nothing more than a collar-like, fibrous thickening (arrow). This
may be a tissue response to further recession beyond the mucogingival line.
Stillman Cleft (left)
Cleft-like defect of traumatic etiology. Such clefts may spread laterally, creating an area of gingival
recession. The exposed root surface may be extremely sensitive. Such clefts are often covered with
plaque.
(HAL 157)
CARRANZA’S CLINICAL PERIODONTOLOGY Ed 12

Treatment plan (HAL 408-410)