640 likes | 2.06k Views
The Periodontal Probe. Presented by: Mellissa Boyd, RDH, BSDH. Calibrated Probe. Assessment instrument Determine health of periodontal tissues. Working-End. Blunt Rod-shaped Millimeter markings Color coded Cross-section Round Rectangular. Purpose. A. B. C. Measurement
E N D
The Periodontal Probe Presented by: Mellissa Boyd, RDH, BSDH
Calibrated Probe • Assessment instrument • Determine health of periodontal tissues
Working-End • Blunt • Rod-shaped • Millimeter markings • Color coded • Cross-section • Round • Rectangular
Purpose A B C • Measurement • Sulcus/pocket depths • Width of attached gingiva • Bleeding • Exudate • Oral lesions • Furcations E D
Sulcus vs. Pocket • Sulcus • Space between free gingiva and tooth • 1-3mm • Pocket • Sulcus deepened because of disease • 4mm+ • Gingival vs. periodontal
Probing Depth • Entire sulcus probed • Six sites per tooth • 3 buccal • 3 lingual • Record deepest reading per site • Depth rounded up to nearest mm
Basic Technique • Insert tip to JE, feel slight resistance • Gentle walking strokes • 10 – 20 grams pressure • Digital motion • Close together • 1-2 mm • Not out of sulcus
Probe Position ‐ Healthy Tissue Sulcus • Space between free gingiva and tooth • Healthy sulcus = 1 to 3 mm • Probe tip touches tooth near the CEJ
Probe Position – Diseased Tissue Pocket • Sulcus deepened because of disease • 4mm+ • Bleeding • Probe tip touches rootat point apical of CEJ
Comparison MeasurementMarquis Probe (3‐6‐9‐12) Healthy Sulcus Diseased Pocket Probing Depth? Probing Depth?
Measurements Recorded • 6 sites per tooth • Record deepest reading
Insertion of Probe Tip • Keep side of tip against tooth surface • Tip = 1-2mm of probe • Observe enamel contour near CEJ • Tip parallel to tooth surface, keep constant contact with tooth surface
Incorrect Insertion • Probe tip should NOT be held away from tooth •Inaccurate measurement •PAIN
Adaptation Parallel to long axis of tooth Inaccurate measurement
Probe Walking Stroke • Gently insert to base of sulcus • Walking Stroke – Series of light bobbing strokes – Made within sulcus/pocket while keeping side of probe tip against tooth surface
Maxillary Posterior Technique • Extraoral fulcrum • Begin at DB line angle of maxillary right most posterior tooth (1, 2, etc) • Insert & walk probe into distal “area” • Record deepest measurement from DB line angle to D of tooth Walk all the way to the direct Distal
Maxillary Posterior Technique • Remove and reinsert probe @ DB line angle • Walk probe across B surface • Walk probe around MB line angle and touch M contact • Slant probe under contact (col) • Take measurement under M contact in col area
Maxillary Anterior Technique • NOTE: – When you reach midline, walking sequence will reverse for max L quadrant …starting @ #9 you will walk probe from MF line angle into M – Touch contact and slant probe very slightly to access col reading (anterior teeth are thinner so don’t over tilt) – Remove & reinsert at MF line angle, probe across M around DF line angle (continue sequence for max L quad) – Probe Lingual surfaces from #15, 16, etc. back across arch
Mandibular Technique • Posterior – Begin at DB line angle of mandibular right most posterior tooth (32, 31, etc) • Anterior – At midline walking sequence will reverse for mand L quadrant starting @ #24 you will walk probe from MF line angle into M – Touch contact and slant probe very slightly to access col reading (anterior teeth are thinner so don’t over tilt) – Remove & reinsert at MF line angle, probe across M around DF line angle (continue sequence for mand L quad) – Probe Lingual surfaces from #17, 18, etc. back across arch
Furcation Involvement • Bone loss in area of furcation • Result of periodontal disease • Furcation probe or periodontal probe • Access • Mandibular molars • Maxillary molars • Maxillary 1st premolar
Oral Lesions or Deviations • Document with measurement • Use anatomical references • anterior-posterior (front to back) • superior-inferior (top to bottom)
Mucogingival Examination • Attached Gingiva • Area from base of sulcus to mucogingival junction (MGJ) • Attached to the cementum of tooth and alveolar bone by collagenous fibers
Mucogingival Examination • Alveolar mucosa • located apical to the MGJ • deeper red color than attached • Shiny and loosely attached to underlying bone • MG defect • Recession near MGJ or into alveolar mucosa
Clinical Attachment Level • Measurement from the CEJ to JE • Most accurate measure of attachment loss • Three possible relationships: • GM apical to CEJ (recession) • GM coronal to CEJ (hyperplasia) • GM level with CEJ
Accuracy of Measurement Affected by: • Size & design of probe • Technique • Tissue health • Adaptation of probe tip against side of tooth • Walking stroke control • Avoiding excessive pressure • Correct angulation into “col” area
Charting Practice • Typodont • William’s probe • Probe and record • Mandibular right first molar, facial aspect (Nield p 233 –235) • Mandibular left canine, facial aspect (Nield pp 236-237)