Tooth remineralization index. Quantitative and qualitative assessment of dental plaque. Hygiene protocol and index. Clinical methods for assessing the condition of the gums

Mineralized deposits: а pellicle а supragingival tartar b dental plaque b subgingival tartar in soft dental plaque d food debris detritus Tooth pellicle is an acquired thin organic film that replaces ...

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PAGE 3

METHODOLOGICAL DEVELOPMENT

practical lessons. № 8 - 9

by section

IV semester).

Theme: Soft dental plaque, plaque, their meaning, definition. Hygiene index according to Fedorov-Volodkina, according to Pakhomov, Green-Vermillion, OHI - S, Sinles Lowe. O determination, counting, indicators of the norm.

Target: To teach students to recognize and identify non-mineralized dental deposits using qualitative and quantitative methods.

Place of study: Hygiene and prevention room of GKSP No. 1.

Material support:Typical equipment of a hygiene room, a dentist's workplace - prophylaxis, tables, stands, an exhibition of hygiene and prophylaxis products, a laptop, solutions for detecting plaque in determining the hygiene index.

Duration of the lesson: 3 hours each (117 minutes).

Lesson plan

Stages of the lesson	Equipment	Tutorials and controls	A place	Time in min.
1. Verification of the initial data.	Lesson content plan. Notebook.	Test questions and tasks, tables, presentation.	Hygiene room (polyclinic).
2. Solution of clinical problems.	Laptop, table, dyes.	Forms with control situational tasks.	\|\|	74,3%
3. Summing up the results of the lesson. Assignment for the next lesson.		Lectures, textbooks, additional literature, methodological developments.	\|\|

The lesson begins with instructing the teacher about the content and objectives of the lesson. In the course of the survey, find out the initial level of knowledge of the students. The composition, location, recognition and significance of non-mineralized dental deposits (according to Pakhomov's classification) are analyzed in detail. Methods for the quantitative assessment of dental plaque are analyzed (index of hygiene of Fedorov-Volodkina, index of hygiene of Pakhomov, Green-Vermillion, OHI - S, Sinles Lowe).

The teacher on one of the students shows the acquired structures of the oral cavity and methods of their recognition. An assessment of the hygienic state of the oral cavity is carried out using the Fedorov-Volodkina hygiene index. Further, students independently determine and assess oral hygiene. The lesson ends with solving situational problems and test tasks.

Until now, there is no single terminology in the literature that objectively characterizes the acquired structures. Under the same name, there are different structural formations ( Jenkins, 1966, Schroeder , 1969). In our opinion, the most objective grouping of acquired structures is reflected in the classification of G.N. Pakhomov (1982), according to which they are combined into two large groups:

Non-mineralized dental deposits: 2. Mineralized deposits:

a) pellicle a) supragingival calculus

b) dental plaque b) subgingival calculus

c) soft plaque

d) food residues (detritus)

Tooth pellicle Is an acquired thin organic film that replaces

congenital nasmitic membrane covering the tooth after it erupts. Pellicle is both a mineralized and non-mineralized formation, a structural element of the surface layer of enamel and can be removed only with the help of strong abrasives (Leontiev I.K., Petrovich K.A., 1976). Pellicle is difficult to detect with the naked eye, bacteria quickly colonize on its surface and dental plaque forms.

Dental plaque Is a colorless formation that is located above the pellicle

tooth. It can only be found with special staining. The plaque is not washed off and is practically not removed when brushing your teeth. It can only be scraped off with an excavator or trowel, i.e. special dental instruments. It is in the dental plaque that the active vital activity of microorganisms occurs, accompanied by acid formation, enzymatic activity and other metabolic processes of microorganisms. Often, after removing the plaque, an area of demineralized enamel with a changed dull color can be found.

Soft plaquecan be seen without special dye solutions. Plaque

deposited on the surface of teeth, fillings, stones, and on the gums. An especially large amount of plaque is observed on teeth that are incorrectly positioned in the dentition. Soft plaque can form on previously cleaned teeth for several hours, even when no food is being consumed.

Plaque can be washed away with a water jet, but mechanical cleaning is required to ensure complete removal. Previously, it was believed that plaque consists of stagnant food detritus, but now it has been established that the white matter is a conglomerate of microorganisms, constantly exfoliating epithelial cells, leukocytes, a mixture of salivary proteins and lipids with or without food particles. Soft dental plaque, unlike plaque, does not have a permanent internal structure. Its irritating effect on the gums is associated with bacteria and their waste products. It has been established that the toxicity of plaque for experimental animals persists even after the destruction of the bacterial component by boiling.

Due to oral hygiene, food intake, especially hard and dense, part of the plaque from the surface of the teeth and gums is constantly removed, but it quickly forms again. During its stay in the oral cavity, a number of qualitative changes occur with plaque. It “grows old” over time and this process is accompanied by increased mineralization. Therefore, partially mineralized plaque should be considered longstanding and is an indicator of poor oral hygiene.

Identification of dental plaque

Coloring agent	Coloring technique	Purchased coloring	Color fastness
Crystalline iodine -1g,	Swab	Different shades of brown	Unstable
potassium iodide - 2 g, distilled water 40 ml	-//-	-//-	-//-
Fuchsin basic - 1.5 g, ethyl alcohol 70% - 25 g	15 drops in 1/4 cup of water, rinse 30 sec.	Red	Persistent
Erythrosine tablets	Chew	-//-	-//-
1% methylene blue solution	Swab	Blue	-//-

Determination of the hygienic state of the oral cavity

Hygienic Index	Methodology	Assessment, points	Index calculation
Fedorova-Volodkina
A) quantitative assessment		1 point - no staining 2 points - Dyeing up to 1/4 of the tooth crown 3 points - up to 1/2 of the tooth crown 4 points - up to 3/4 of the tooth crown 5 points - more than 3/4 of the tooth crown	IG = 1.1 - 1.5 - good 1.6 - 2.0 - satisfactory 2.1 - 2.5 - unsatisfactory 2.6 - 3.4 - bad 3.5 - 5.0 - very bad
B) qualitative assessment	Schiller's solution - Pisarev's vestibular surface 31, 32, 33, 41, 42, 43 teeth	1 point - no staining, 2 points - weak staining, 3 points - intense coloring	IG =
Pakhomova	Staining with Schiller's solution - Pisarev of the vestibular surfaces of 11, 16, 21, 26 and 31, 32, 33, 36, 41, 42, 43, 46 teeth.	1 - no staining, 2 - staining 1/4 of the tooth crown, 3 - up to 1/2, 4 - up to 3/4, 5 - more than 3/4 of the surface of the tooth crown	IG =
Green-Vermillion (plaque)	Staining of the vestibular surfaces of the 11, 16, 26, 31 and lingual surfaces of the 36, 46 teeth.	0 - no staining, 1 - staining up to 1/3 of the tooth crown, 2 - up to 2/3, 3 - more than 2/3 of the tooth crown	IZN =
Simplified Green-Vermillion Hygiene Index ( IGR-U) or (OHI - S)	Evaluation of dental plaque (ZN) and calculus (TC) is carried out visually or by staining with special solutions the vestibular surfaces of 11, 16, 26, 31 and lingual surfaces of 36, 46 teeth.	Plaque Index ( IZN) 0 - absence; 2 - from 1/3 to 2/3; Tartar index ( FROM TO ) 0 - absence; 1 - plaque covers no more than 1/3 of the surface of the tooth crown; 2 - from 1/3 to 2/3; 3 - more than 2/3 of the tooth crown surface.	IGR-U =
Silnes Lowe	The thickness of the dental plaque is taken into account with a probe without staining	0 - the plaque at the neck of the tooth is not detected by the probe, 1 - plaque is not visible with the eye, but at the tip of the probe, if you hold it near the neck of the tooth, a lump of plaque is visible, 2 - plaque is visible to the eye, 3 - intensive plaque deposition on the tooth surface, in the interdental spaces and above the gingival margin.	GI =

Green-Vermillion Index

Plaque assessment codes and criteria (ZN):

0 - no plaque detected;

1 - plaque covering up to 1/3 of the tooth crown;

2 - plaque coveringfrom 1/3 to 2/3 of the tooth crown surface;

3 - plaque covers more than 2/3 of the tooth crown surface.

Index interpretation:

IH indicator	Hygiene level
0,0 - 0,6	good
0.7 - 1.8	satisfactory
1,9 -3,0	bad

Simplified Green-Vermillion Index (IGR-U or OHI-S)

Evaluation of dental plaque (ZN) is carried out visually or by staining with special solutions the vestibular surfaces of 11, 16, 26, 31 and lingual surfaces of 36, 46 teeth.

Plaque assessment codes and criteria (ZN):

0 no plaque detected;

1 - plaque covers no more than 1/3 of the surface of the tooth crown;

2 - plaque covers from 1/3 to 2/3 of the surface of the tooth crown;

3 - plaque covers more than 2/3 of the surface of the tooth crown.

Determination of supra- and subgingival calculus is carried out using a dental probe.

Codes and criteria for the assessment of dental calculus (CC):

0 - tartar was not detected;

1 - supragingival calculus covers 1/3 of the surface of the tooth crown;

2 - supragingival calculus covers from 1/3 to 2/3 or the presence of separate deposits of subgingival calculus;

3 - supragingival calculus covers more than 2/3, the presence of subgingival calculus.

The calculation of the individual index value is carried out according to the formula:

IGR-U =

Values:

∑ЗН - the sum of the plaque value;

∑ZK - the sum of calculus values;

6 - the number of examined teeth.

Index interpretation:

IGR-U indicator	Hygiene level
0,0 - 1,2	good
1.3 - 3.0	satisfactory
3.1 - 6.0	bad

(Kuzmina E.M. Prevention of dental diseases. / Textbook // E.M. Kuzmina, S.A. Vasina, E.S.Petrina and others - M., 1997 - S. 39-40.)

Test questions to identify the initial knowledge of students:

Tell us about the classification of the acquired structures (according to Pakhomov).
What is the origin of the pellicle, composition and clinical significance.
What is dental plaque.
Tell us about soft plaque. How is it different from dental plaque?

The outline of the indicative basis of action -

recognition, assessment and removal of dental plaque

Non-mineralized dental plaque
1. Food leftovers	Visible on examination	They are located in retention places, can be easily removed by moving the lips, tongue, cheeks, rinsing.
2. Soft dental plaque	Visible on examination
a) color		Yellow or grayish white
b) consistency		Sticky
c) localization		It is deposited on the surface of teeth, fillings, stones, gums. Can be washed off with a stream of water, completely removed when brushing teeth, with a cotton swab with antiseptics.
3. Dental plaque	On examination, it is not visible, it can only be detected with special staining (Schiller-Pisarev solution, erythrosine, methylene blue, basic fuchsin).
a) color		colorless formation
b) consistency		soft, does not wash off and is practically not removed when brushing your teeth, it can be scraped off with an excavator or trowel.
c) localization		accumulates above the gum and below the gum on the surfaces of teeth, dentures, on tartar, mainly in places of retention.
4. Tooth pellicle	Visible when stained with erythrosine solution	Thin organic film,covering the entire tooth can only be removed withstrong abrasives.

Situational tasks

Patient B., when stained with Lugol's solution, crowns 43, 42, 33, stained 1/4; crowns 41, 31 by 1/2. Calculate the hygiene index.
Patient S. has a hygiene index of 3.0 points, assess the hygienic state of the oral cavity.
The hygiene index according to Fedorov-Volodkina is 2.3 points. Assess your oral hygiene.

List of literature for preparation for classes by section

"Prevention and Epidemiology of Dental Diseases"

Department of Pediatric Dentistry, Omsk State Medical Academy ( IV semester).

Educational and methodological literature (basic and additional with the stamp of UMO), including those prepared at the department, electronic textbooks, network resources:

Preventive section.

A. BASIC.

Children's therapeutic dentistry. National leadership: [with adj. on CD] / ed .: VK Leontiev, LP Kiselnikova. - M .: GEOTAR-Media, 2010 .-- 890s. : ill.- (National project "Health").
A.P. Kankanyan Periodontal disease (new approaches in etiology, pathogenesis, diagnosis, prevention and treatment) / A.P. Kankanyan, V.K. Leontiev. - Yerevan, 1998 .-- 360p.
Kuryakina N.V. Prophylactic dentistry (guide to the primary prevention of dental diseases) / N.V. Kuryakina, N.A. Saveliev. - M .: Medical book, N. Novgorod: Publishing house of the NGMA, 2003. - 288 p.
Kuryakina N.V. Pediatric therapeutic dentistry / ed. N.V. Kuryakina. - M .: N. Novgorod, NGMA, 2001 .-- 744s.
Lukinykh L.M. Treatment and prevention of dental caries / LM Lukinykh. - N. Novgorod, NGMA, 1998 .-- 168p.
Primary dental prophylaxis in children. / V.G. Suntsov, V.K. Leontiev, V.A. Distel, V. D. Wagner. - Omsk, 1997 .-- 315p.
Prevention of dental diseases. Textbook. Manual / E.M. Kuzmina, S.A. Vasina, E.S. Petrina and others - M., 1997 .-- 136s.
Persin L.S. Pediatric dentistry / L.S. Persin, V.M. Himarova, S.V. Dyakov. - Ed. 5th revised and enlarged. - M .: Medicine, 2003 .-- 640s.
Handbook of Pediatric Dentistry: trans. from English / ed. A. Cameron, R. Widmer. - 2nd ed., Rev. And add. - M .: MEDpress-inform, 2010 .-- 391p .: ill.
Dentistry of children and adolescents: Per. from English / ed. Ralph E. McDonald, David R. Avery. - M .: Medical Information Agency, 2003. - 766s .: ill.
V.G. Suntsov The main scientific work of the Department of Pediatric Dentistry / V.G. Suntsov, V.A. Distel and others - Omsk, 2000 .-- 341p.
V.G. Suntsov The use of therapeutic gels in dental practice / ed. V.G. Suntsova. - Omsk, 2004 .-- 164p.
V.G. Suntsov Dental prophylaxis in children (a guide for students and doctors) / V.G. Suntsov, V.K. Leontiev, V.A. Distel. - M .: N. Novgorod, NGMA, 2001 .-- 344s.
Hamadeeva A.M., Arkhipov V.D. Prevention of major dental diseases / A.M. Hamdeeva, V.D. Arkhipov. - Samara, SamSMU - 2001 .-- 230p.

B. ADDITIONAL.

Vasiliev V.G. Prevention of dental diseases (Part 1). Study guide / V.G. Vasiliev, L.R. Kolesnikova. - Irkutsk, 2001 .-- 70s.
Vasiliev V.G. Prevention of dental diseases (Part 2). Study guide / V.G. Vasiliev, L.R. Kolesnikova. - Irkutsk, 2001 .-- 87p.
Comprehensive program of dental health of the population. Sonodent, M., 2001 .-- 35p.
Methodological materials for doctors, educators of preschool institutions, school accountants, students, parents / ed. V.G. Vasilieva, T.P. Pinelis. - Irkutsk, 1998 .-- 52p.
Ulitovskiy S.B. Oral hygiene is the primary prevention of dental diseases. // New in dentistry. Specialist. release. - 1999. - No. 7 (77). - 144p.
Ulitovskiy S.B. Individual hygienic program for the prevention of dental diseases / S.B. Ulitovsky. - M .: Medical book, N. Novgorod: Publishing house of the NGMA, 2003. - 292p.
Fedorov Yu.A. Oral hygiene for all / Yu.A. Fedorov. - SPb, 2003 .-- 112s.

The staff of the Department of Pediatric Dentistry published educational and methodological literature with the stamp of UMO

Since 2005

Suntsov V.G. Guide to practical exercises in pediatric dentistry for students of the pediatric faculty / V.G. Suntsov, V.A. Distel, V.D. Landinova, A.V. Karnitskiy, A.I. Mateshuk, Yu.G. . Khudoroshkov. - Omsk, 2005.211s.
V.G. Suntsov A guide to pediatric dentistry for students of the pediatric faculty / V.G. Suntsov, V.A. Distel, V.D. Landinova, A.V. Karnitskiy, A.I. Mateshuk, Yu.G. Khudoroshkov. - Rostov on Don, Phoenix, 2007 .-- 301s.
The use of therapeutic and prophylactic gels in dental practice. A guide for students and doctors / Edited by Professor V.G. Suntsov. - Omsk, 2007 .-- 164p.
Dental prophylaxis in children. A guide for students and doctors / V.G. Suntsov, V.K. Leontiev, V.A. Distel, V.D. Wagner, T.V. Suntsova. - Omsk, 2007 .-- 343p.
Distel V.A. The main directions and methods of prevention of dentoalveolar anomalies and deformities. A guide for doctors and students / V.A. Distel, V.G. Suntsov, A.V. Karnitsky. - Omsk, 2007 .-- 68p.

Electronic tutorials

The program for the current control of students' knowledge (preventive section).

Methodical developments for practical training of 2nd year students.

"On increasing the efficiency of dental care for children (draft order of 11.02.05)."

Requirements for sanitary-hygienic, anti-epidemic regimes and working conditions of those working in non-state health care facilities and offices of private practicing dentists.

The structure of the Dental Association of the Federal District.

Educational standard for postgraduate professional training of specialists.

Illustrated material for state interdisciplinary examinations (04.04.00 "Dentistry").

Since 2005, the staff of the department has published electronic teaching aids:

Tutorial Department of Pediatric Dentistry, Omsk State Medical Academyunder the section "Prevention and Epidemiology of Dental Diseases"(IV semester) for students of the Faculty of Dentistry / V.G. Suntsov, A.Zh. Garifullina, I.M. Voloshina, E.V. Ekimov. - Omsk, 2011 .-- 300 Mb.

Videos

Colgate training cartoon on teeth cleaning (children's dentistry, prevention section).
"Tell the Doctor", 4th scientific and practical conference:

G.G. Ivanova. Oral hygiene, hygiene products.

V.G. Suntsov, V.D. Wagner, V.G. Bokaya. Problems of prevention and treatment of teeth.

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The Dental Index is a method for determining the effectiveness of hygiene procedures and the overall health of the oral cavity. The article discusses the main types of indices, assessment criteria, diagnostic procedures used.

What is the Dental Oral Hygiene Index?

The hygiene index is indicators that reflect oral hygiene, the degree of pollution, determining the presence of signs of bacterial infection, indicating the number of teeth that are affected by caries.

The hygiene index allows the specialist to determine the causes of tooth decay, gum disease, and also to prescribe effective prophylactic agents.

With their help, they determine:

The patient's dental health;
The severity and stage of caries;
Number of teeth pulled out;
The quality of hygiene procedures;
The presence of curvature of the bite;
The degree of effectiveness of therapy.

Important to remember! Each diagnostic criterion for different types of lesions is reflected in an individual index.

KPU index

It is the most common indicator used in modern dentistry. The presented indicator reflects the nature of the course of caries. The index is used in the diagnosis of both temporary and molars.

The KPU index reflects:

Taken together, this data allows the dentist to determine the severity and intensity of caries.

There are these types of KPU indices:

KPU teeth (reflects how many teeth are affected by caries or filled);
KPU surfaces (reflects on how many teeth an early stage of caries is found);
KPU cavities (reflects the number of cavities caused by tissue softening against the background of caries or loss of filling).

When examining milk teeth, the number of torn or dropped units is not taken into account. The index includes only indicators K - the number of caries affected, and P - the number of filled teeth.

Using the KPU index, the prevalence of caries is assessed. The number of all caries patients must be divided by the number of subjects and then multiplied by 100. The result will indicate the prevalence percentage.

Prevalence levels:

1% - 30% - low;
31% - 80% - average;
81% - 100% high.

The degree of caries intensity is calculated taking into account the number of diseased teeth:

The intensity of the pathological process	Evaluations for children (12 years old)	Evaluations for adults (35 years old)
Very low	Below 1.1	Below 1.5
Low	1.2 – 2.6	1.6 – 6.2
Average	2.7 – 4.4	6.3 – 12.7
High	4.5 – 6.4	12.8 – 16.2
Very high	6.5 and up	More than 16.2

Important to remember! The dental index of the KPU is very effective, but it does not allow you to give absolutely reliable information about the nature of the course of caries. This is due to the fact that the general clinical picture is affected by previously cured or extracted teeth.

Green-Vermillion (OHI-S)

The method is a simplified hygienic indexing method by which the volume of plaque is determined without the application of auxiliary dyes.

A dental examination is used to determine contamination. During the examination, the condition of 6 teeth is examined.

Examined teeth:

Vestibular surface: 11, 31;
Buccal surface: 16, 26;
Lingual surface: 36, 46.

The evaluation criteria for Green Vermillion (Vermillion) are presented in the table:

To calculate the index, the estimates of plaque and tartar are summed up, and the resulting number is divided by 6.

The interpretation of the results is presented in the table:

Fedorova-Volodkina

The presented technique is carried out in order to determine the level of contamination by plaque. During the procedure, a solution containing potassium and iodine is applied to the vestibular surface of the lower anterior teeth. Drying from saliva is done beforehand.

The index is determined based on the intensity of staining:

The Fedorov-Volodkin index is determined as follows: the sum of the indices of each stained tooth is divided by 6.

Interpretation of results:

Silnes Lowe

A method for assessing oral hygiene without the application of staining materials.

The dentist examines the mouth using a probe for plaque.

Based on the amount of plaque detected, an appropriate assessment is made:

0 - no plaque;
1 - a thin layer of deposits, invisible without the use of a probe;
2 - visually noticeable plaques;
3 - plaque covers the crown.

The Silnes-Lowe method calculates the hygiene index of an individual unit, a group of several teeth or the entire oral cavity.

Pakhomova

Provides for the application of Lugol's solution to the examined teeth. The procedure involves 6 anterior teeth of the lower jaw, all 1st molars, 11 and 21 teeth.

Hygiene quality is assessed according to the degree of staining:

Grade	Coloration degree
1	Lack of color when applied
2	Staining 1/4 of the crown
3	Staining 1/2 crown
4	Staining 3/4 crown
5	Staining the entire tooth surface

The total score is calculated by summing the scores for each examined tooth and dividing them by 12.

Plaque assessment in young children (Kuzmina's indicator)

During the examination, the child is examined for the erupted units

The assessment of the hygienic state of the oral cavity is carried out after the eruption of deciduous teeth.

During the examination, the child is examined for the erupted units. Inspection is carried out visually or using a probe.

The condition of the oral cavity is assessed depending on the presence of plaque.

No deposits corresponds to a score of 0, and any amount of plaque corresponds to 1 point.

To assess the plaque index in children, the score must be divided by the number of all erupted teeth. This allows you to determine the quality of hygiene procedures.

Indicators of the Kuzmina plaque index:

0 - optimal oral hygiene;
From 0.1 to 0.4 - hygiene is at a satisfactory level;
From 0.5 and higher - unsatisfactory hygiene.

Important to remember! Children's teeth are more susceptible to bacteria and are more likely to suffer from caries, which underlines the need for high hygiene standards.

Indicator Navi

The method involves examining the anterior incisors from the side of the lips. Before starting the procedure, the patient needs to rinse his mouth with a fuchsin solution. This substance stains soft deposits so that the degree of contamination can be assessed.

Hygiene assessment:

0 - no deposits;
1 - the presence of deposits in the area between the gum and the tooth;
2 - the presence of a noticeable plaque strip above the border of the tooth and gum;
3 - coating by 1/3 bloom;
4 - 2/3 bloom coating;
5 - the tooth is covered with deposits by more than 2/3.

To give an overall assessment, calculate the arithmetic mean for all examined teeth.

Tureski

When calculating the Tureski index, the entire dentition is examined. The procedure consists in applying a fuchsin solution, after which the appearance of deposits on the lingual and labial surfaces of the teeth is analyzed.

The score is calculated as follows:

The Turesky Index is calculated by adding the scores for each individual tooth and dividing them by the number of teeth examined.

Arnim

It is used primarily for research purposes. In dental practice, it is used extremely rarely, since the calculation is a laborious and time-consuming process. The procedure is aimed at determining the area covered with plaque.

Stages of calculating the Arnim index:

Coloring the front incisors (erythrosine)
Taking photographs of teeth that are stained
Enlarging photographs and transferring contours using a planimeter
Determination of the area of the contaminated surface

CPITN indicator

The CPINT index is also called the indicator of the need for periodontal therapy. The assessment method involves examining the gums in the 11, 16, 17, 26, 27, 36, 37, 46 and 47 teeth. The method allows you to determine the condition of the tissues on both jaws.

With the help of a probe, the degree of bleeding of the gums, the presence of a periodontal pocket, and tartar are determined.

The assessment is carried out as follows:

When determining the CPINT index, the condition of each of the above teeth is assessed.

After that, a general assessment is made, reflecting the condition of the soft tissues and the degree of need for therapeutic intervention.

An estimate of the need for treatment is calculated by adding the results for each tooth and dividing the resulting number by the number of units studied.

CPINT scores:

PMA indicator

It stands for papillary-marginal-alveolar index. It is used to assess the condition of the oral cavity with gingivitis (inflammation of the gums).

The assessment is based on the location and degree of the lesion:

1 - gingival papilla;
2 - edge area;
3 - alveolar area.

The PMA index is calculated using the formula: the sum of points for each tooth * 100 divided by 3 * the number of teeth.

PHP

Determines the degree of effectiveness of hygiene measures, including the thoroughness of daily cleaning. During the procedure, 6 teeth are examined: 16, 26, 11, 31, 36 and 46. The patient rinses his mouth with a special solution containing a dye.

The assessment is based on the presence of a reaction to the solution:

0 - no reaction
1 - staining of the tooth

If an indexed tooth is removed, the adjacent tooth is examined.

To calculate the result, the assessment of all examined teeth is adjusted, after which it is divided by 6. The code of an individual tooth is an assessment obtained during the examination of each site (medial, distal, occlusal, central, cervical).

Interpretation:

Oral Hygiene Performance Index (RHP) Podshadley, Haley, (1968)

CSI

Determination of the CSI index allows you to find out the amount of tartar and accumulated plaque in the area of contact between the teeth and the gums.

The condition of the anterior incisors is analyzed. Each tooth is examined from the lingual, medial and vestibular sides. The examination is carried out using a dental probe.

Each surface is rated by points:

0 - no deposits;
1 - deposits 0.5 mm wide;
2 - deposits 1 mm wide;
3 - plaque more than 1 mm.

To determine the index, it is necessary to add the sum of the scores for each examined surface and divide by the number of teeth. The maximum value is considered to be CSI 16.

Proximal Plaque Index (API)

The procedure involves the application of a dye

The proximal surface is the area of contact between the enamel and the posterior tooth.

The need to inspect the presented area is explained by the fact that it needs careful care, which can be difficult to provide through daily hygiene procedures.

In the event that the amount of plaque exceeds the permissible level, the patient is assigned a professional cleaning.

The procedure involves the application of a dye. After that, it is determined on how many teeth the color changes.

The API index score does not provide for the definition of contamination score. The presence of a reaction to the dye or its absence is used as an assessment.

To determine the index, it is necessary to divide the number of stained teeth by the number of all teeth in the patient's mouth. The resulting figure is multiplied by 100.

Evaluation of results:

Plaque rate by Quigey and Hein

Determination of the plaque index involves the application of a solution of fuchsin to 12 anterior teeth on both jaws. The survey involves numbers 12, 13, 11, 21, 22, 23, 31, 32, 33, 41, 42, 43.

After applying the solution, the vestibular surface is examined. The plaque index depends on the degree of surface coloration.

Results of the procedure:

0 - no changes when applying the solution;
1 - change in color in the area of the neck;
2 - color within 1 mm;
3 - deposits occupy from 1 mm to 1/3 of the surface;
4 - plaque 2/3;
5 - deposits cover more than 2/3.

To calculate the index, the set of points is summed up, and the resulting number is divided by the number of examined teeth (12).

Gingivitis score PMA (Parma)

It is used to determine the clinical state of the periodontium, reflecting the present symptoms of inflammation.

The assessment reflects the stage of the inflammatory process:

The difference between the Parma modification lies in the changed formula for calculating the index.

The indicator is calculated as follows: the total of points is divided by 3 * the number of examined teeth. The result is multiplied by 100.

Thus, the severity of gingivitis is assessed:

Less than 30% - light;
31% - 60% - average;
61% - 100% - heavy.

Complex Periodontal Index (CPI)

It is used for a comprehensive assessment of the condition of the gums and the periodontal canal. The procedure involves performing a standard dental examination using a probe and a mirror.

During the examination, the dentist notes the presence of certain symptoms, each of which corresponds to a specific assessment that reflects the state of the tissues.

Criteria for evaluation:

0 - no pathological signs;
1 - soft deposits;
2 - bleeding;
3 - tartar;
4 - expansion of the periodontal canal;
5 - loosening of the tooth in the affected area.

The KPI index is determined by dividing the sum of indicators by the number of examined teeth. The examination method depends on the patient's age.

Interpretation of KPI:

From 0.1 to 1 - the potential risk of developing periodontitis;
From 1.1 to 2 - a mild form of periodontitis;
From 2.1 to 3.5 - moderate severity;
From 3.6 and above - severe form.

Ramfiord

As well as KPI reflects the state of the periodontal and gums. During the procedure, the vestibular and lingual surfaces of 6 teeth are examined: 16th, 21st, 36th, 41st, 44th. The presence of plaque and tartar must be taken into account.

Inspection results:

0 - no pathological signs were found;
1 - inflammation of an insignificant area of the gums;
2 - pronounced inflammatory process;
3 - aggravated inflammatory process.

Such symptoms are typical for periodontitis and gingivitis. Further assessment reflects the condition of the periodontal pocket.

In the presence of periodontitis, the following values are possible:

0-3 - normal sizes;
4 - formation of a pocket up to 3 mm;
5 - formation of a pocket up to 6 mm;
6 - pocket deeper than 6 mm.

Pfri

The indicator reflects the rate of plaque formation. Allows you to evaluate the conditions and factors that affect the process of formation of soft deposits. The diagnostic value of the method lies in the fact that it allows you to assess the risk of caries.

The following factors affect the rate of plaque formation:

Professional cleaning is performed prior to assessing the rate of plaque formation.

The diagnostic procedure is performed 24 hours after cleaning. For this, a coloring solution is applied.

The following surfaces are examined:

Cheek;
Lingual;
Mesio-buccal;
Mesio-lingual;
Distal-buccal;
Distal-lingual.

The appearance of color is assessed as 1 point, while the lack of reaction to the solution is 0 points.

To calculate the PFRI, the score must be divided by the number of teeth and multiplied by 100. PFRI results are shown as a percentage.

Ratings:

0 to 10% - very low;
10% to 20% - low;
From 21% to 30% - average;
From 31% to 40% - high;
Over 40% is very high.

Survey stages

Determination of dental indices is a complex procedure that includes several main stages.

Survey stages:

Proposed in 1968. Fedorov Yu.A. and Volodkina V.The. and it is recommended to use it to assess the hygienic state of the oral cavity in children 5-6 years old.

To determine the index, it is necessary to examine the labial surface of the six lower anterior teeth: 43 (83), 42 (82), 41 (81), 31 (71), 32 (72), 33 (73).

The above teeth are stained using special solutions (fuchsin, erythrosine, Schiller-Pisarev) and the presence of plaque is assessed using the following codes.

1 dental plaque was not detected;

2-staining 1/4 of the tooth crown surface;

3-staining 1/2 of the tooth crown surface;

4-staining 3/4 of the surface of the tooth crown;

5-staining of the entire surface of the tooth crown.

The plaque code of each of these six teeth is determined, the results are summed up and divided by the number of teeth examined:

IG = sum of points / 6 teeth

Evaluation criteria:

1.1-1.5 is good;

1.6-2.0 - satisfactory;

2.1-2.5-unsatisfactory;

2.6-3.4-bad;

3.5-5.0 is very bad.

J.C. Green Oral Hygiene Index, J.R. Vermillion.

A simplified oral hygiene index was proposed in 1964. for separate assessment of the amount of dental plaque and tartar.

When determining the index, 6 teeth are examined:

16,11,26,31 - from the vestibular surface;

36.46 - from the lingual surface.

Plaque assessment can be carried out visually or using staining solutions (fuchsin, erythrosine, Schiller-Pisarev).

0 dental plaque was not detected;

1 soft dental plaque covers no more than 1/3 of the tooth surface;

2-soft plaque covers 1/2 of the tooth surface;

3-soft plaque covers more than 2/3 of the tooth surface.

The supra- and subgingival calculus is assessed using a dental probe.

Codes and criteria for the assessment of dental calculus:

0-tartar was not found;

1-non-gingival calculus covers no more than 1/3 of the tooth surface;

2-supragingival calculus covers 1/2 of the tooth surface, or the presence of subgingival calculus in the cervical region of the tooth;

3-supragingival calculus covers more than 2/3 of the tooth surface, or significant subgingival calculus deposits around the cervical area of the tooth.

The following formula is used for the calculation:

IGR-U = sum of plaque values / 6 +

Sum of stone values / 6.

Evaluation criteria for the level of oral hygiene:

0-0.6 is good;

0.7-1.6 - satisfactory;

1.7-2.5-unsatisfactory;

> 2.5 is bad.

Oral Hygiene Efficiency Index (RHP).

One of the hygiene indexes used to quantify plaque. To determine it, 6 teeth are stained:

* 16,26,11,31-vestibular surfaces;

* 36.46 lingual surfaces.

The examined surface of each tooth is conventionally divided into 5 sections:

1-medial;

2-distal;

3-mid-occlusive;

4-center;

5-mid-cervical.

Plaque assessment codes and criteria:

0-lack of staining;

1-staining detected.

To calculate the index, the code of each tooth is determined by adding the codes for each area.

If staining is detected in one area, the distal plaque code is 1.

If staining, for example, is detected at three sites - medial, distal and mid-cervical - the plaque code is 3 (1 + 1 + 1).

Calculation formula:

PHP = sum of codes of all teeth / 6

Index interpretation:

0 - excellent hygiene level;

0.1-0.6 is good;

0.7-1.6 - satisfactory;

> 1.7, unsatisfactory.

4. List of practical works, visual aids and TCO:

Educational and methodical literature.

Visual aids: tables, diagrams, dummies, simulators, posters, slides.

Practical work

Practical work title: examination, questioning and collection of anamnesis, filling out a survey card.

Purpose of work: learn to examine the patient

Execution method:

Required materials: survey card, ballpoint pen, gloves, mask.

The order of implementation: a survey with clarification of anamnesis and complaints; examination of the CLO and the oral cavity; filling out the survey card.

Results of work and evaluation criteria: correctly completed survey card.

6.List of questions to check the initial level of knowledge:

1.Classification of dental plaque.

2. Factors contributing to the formation of dental plaque.

3. Factors affecting the intensity and prevalence of caries.

7.List of questions to test the final level of knowledge:

1. The mechanism and timing of dental plaque formation.

2. Equipment and instruments used to assess the hygienic state of the oral cavity.

3. Hygienic indexes of Fedorov-Volodkina, Green-Vermillion.

8.Chronocard of the training session:

9. Independent work of students:

1. Sketch the mechanism of plaque formation.

2. Describe the methodology for assessing the hygienic state of the oral cavity using the Fedorov-Volodkina index.

3. Describe the methodology for the Green Vermillion Index.

4. Describe the method of the oral hygiene efficiency index.

10. List of educational literature:

1. Borovskiy E.V. Therapeutic dentistry - M. 2000

2. Kuzmina E.M. "Prevention of dental diseases" -M., 2001

3. Therapeutic dentistry. Maksimovsky Yu.M. Moscow, 2002

LESSON number 10

1. Topic of the lesson:

"Removal of dental plaque. Professional teeth cleaning. Equipment and tools for professional oral hygiene. Professional oral hygiene methods. Modern methods of removing dental plaque. Rules and methods of work with ultrasonic and sound scalers. Method of working with powder-jet devices ”.

2. Purpose of the lesson:

The student should know:

1. Methods for removing dental plaque.

2. Equipment and instruments for removing dental plaque.

3. Techniques for professional oral hygiene with ultrasonic and sound scalers.

4. Technique for working with powder-jet devices.

The student should be able to:

1.conduct a patient survey

2.conduct an examination of the oral cavity

3. Be able to fill out a medical record of a dental patient

The student should become familiar with:

With methods for removing dental plaque,

With professional oral hygiene,

With equipment and tools for professional oral hygiene,

With modern methods of professional oral hygiene,

With the rules and methods of working with ultrasonic and sound scalers,

With the method of working with powder-jet devices.

ORAL CAVITY INDICES

Methods for assessing dental plaque

Fedorov-Volodkina index (1968) until recently was widely used in our country.

The hygienic index is determined by the color intensity of the labial surface of the six lower frontal teeth with iodine-iodine-potassium solution, evaluated using a five-point system and calculated by the formula:

where To Wed... - general hygienic cleaning index; K u- hygienic index of cleaning one tooth; n- the number of teeth.

Staining the entire surface of the crown means 5 points; 3/4 - 4 points; 1/2 - 3 points; 1/4 - 2 points; lack of staining - 1 point.

Normally, the hygiene index should not exceed 1.

Green-Vermillion Index (Green, Vermillion, 1964) . The simplified oral hygiene index (OHI-S) is an assessment of the surface area of the tooth covered with plaque and / or tartar, does not require the use of special dyes. To determine OHI-S, the buccal surface 16 and 26, the labial surface 11 and 31, the lingual surface 36 and 46 are examined by moving the tip of the probe from the incisal edge towards the gum.

The absence of plaque is indicated as 0 , plaque up to 1/3 of the tooth surface - 1 , plaque from 1/3 to 2/3 - 2 , plaque covers more than 2/3 of the enamel surface - 3 ... Then calculus is determined according to the same principle.

Formula for calculating the index.

where n- the number of teeth, ZN- plaque, ZK- tartar.

Silnes-Low Index (Silness, Loe, 1967) takes into account the thickness of the plaque in the gingival region in 4 areas of the tooth surface: vestibular, lingual, distal and mesial. After drying the enamel with the tip of the probe, it is carried out along its surface at the gingival sulcus. If soft matter does not adhere to the tip of the probe, the plaque index on the tooth area is indicated as - 0 ... If plaque is not visually detected, but becomes visible after probe movement, the index is 1 ... Plaque thickness from a thin layer to moderate, visible to the naked eye is estimated by the indicator 2 ... Intense plaque deposition in the gingival sulcus and interdental space is referred to as 3 ... For each tooth, the index is calculated by dividing the sum of the points of the 4 surfaces by 4.

The general index is equal to the sum of indicators of all examined teeth, divided by their number.

Tartar Index (CSI) (ENNEVER "et al., 1961). The supra- and subgingival calculus on the incisors and canines of the lower jaw is determined. The vestibular, distal-lingual, central-lingual and medial-lingual surfaces are differentiated.

To determine the intensity of calculus, a scale from 0 to 3 is used for each surface to be examined:

0 - no tartar

1 - calculus is detected less than 0.5mm in width and / or thickness

2 - width and / or thickness of dental calculus from 0.5 to 1 mm

3 - the width and / or thickness of the calculus is more than 1mm.

Formula for calculating the index:

Ramfjord index (S. Ramfjord, 1956) as part of the periodontal index assumes the determination of plaque on the vestibular, lingual and palatal surfaces, as well as the approximal surfaces of the 11, 14, 26, 31, 34, 46 teeth. The method requires preliminary staining with a brown bismarck solution. The score is assessed as follows:

0 - no dental plaque

1 - dental plaque is present on some surfaces of the tooth

2 - dental plaque is present on all surfaces, but covers more than half of the tooth

3 - dental plaque is present on all surfaces, but covers more than half.

The index is calculated by dividing the total score by the number of teeth examined.

Navi index (I.M. Navi, E. Quiglty, I. Hein, 1962). The indexes of tissue color in the oral cavity, limited by the labial surfaces of the anterior teeth, are calculated. Before the examination, the mouth is rinsed with a 0.75% solution of basic fuchsin. The counting is carried out as follows:

0 - no plaque

1 - the plaque was stained only at the gingival border

2 - pronounced plaque line at the gingival border

3 - the gingival third of the surface is covered with plaque

4 - 2/3 of the surface is covered with plaque

5 - more than 2/3 of the surface is covered with plaque.

The index was calculated in terms of the average number per tooth per subject.

Turesky Index (S. Turesky, 1970). The authors used the Quigley-Hein scoring system on the labial and lingual surfaces of the entire row of teeth.

0 - no plaque

1 - individual spots of plaque in the cervical region of the tooth

2 - a thin continuous strip of plaque (up to 1 mm) in the cervical part of the tooth

3 - the strip of plaque is wider than 1mm, but covers less than 1/3 of the tooth crown

4 - plaque covers more than 1/3, but less than 2/3 of the tooth crown

5 - plaque covers 2/3 of the tooth crown or more.

Arnim Index (S. Arnim, 1963) When evaluating the effectiveness of various oral hygiene procedures, the amount of plaque present on the labial surfaces of the four upper and lower incisors stained with erythrosine was determined. This area is photographed and developed at 4x magnification. The outlines of the corresponding teeth and colored masses are transferred to paper and these areas are determined with a planimer. The percentage of the surface covered by the plaque is then calculated.

Hygiene efficiency index (Podshadley, Haby, 1968) requires the use of a dye. Then a visual assessment of the buccal surfaces of 16 and 26, labial - 11 and 31, lingual - 36 and 46 teeth is carried out. The surveyed surface is conventionally divided into 5 sections: 1 - medial, 2 - distal 3 - mid-occlusal, 4 - central, 5 - mid-cervical.

0 - no staining

1 - there is a staining of any intensity

The index is calculated using the formula:

where n is the number of examined teeth.

CLINICAL METHODS FOR ASSESSING THE STATE OF THE GUM

PMA Index (Schour, Massler ). Inflammation of the papilla (P) is assessed as 1, inflammation of the gingival margin (M) - 2, inflammation of the mucous membrane of the alveolar process of the jaw (A) - 3.

When summing up the assessments of the condition of the gums for each tooth, the PMA index is obtained. At the same time, the number of examined teeth of patients aged 6 to 11 years is 24, from 12 to 14 years old - 28, and from 15 years old - 30.

The PMA index is calculated as a percentage as follows:

PMA = (sum of indicators x 100): (3 x number of teeth)

In absolute numbers, PMA = sum of indicators: (number of teeth x 3).

Gingival index GI (Loe, Silness ). Four areas are differentiated for each tooth: the vestibular-distal gingival papilla, the vestibular marginal gum, the vestibular-medial gingival papilla, and the lingual (or palatal) marginal gum.

0 - normal gums;

1 - slight inflammation, slight discoloration of the gingival mucosa, slight swelling, no bleeding on palpation;

2 - moderate inflammation, redness, edema, bleeding on palpation;

3 - pronounced inflammation with noticeable redness and swelling, ulceration, a tendency to spontaneous bleeding.

Key teeth in which the gums are examined: 16, 21, 24, 36, 41, 44.

To evaluate the results of the examination, the sum of points is divided by 4 and by the number of teeth.

0.1 - 1.0 - mild gingivitis

1.1 - 2.0 - moderate gingivitis

2.1 - 3.0 - severe gingivitis.

V periodontal index PI (Russell) the condition of the gums and alveolar bone is calculated individually for each tooth. For the calculation, a scale is used in which a relatively low indicator is assigned to gingival inflammation, and a comparatively higher indicator is to resorption of the alveolar bone. The indices of each tooth are added together and the result is divided by the number of teeth in the mouth. The result shows the patient's periodontal index, which reflects the relative status of periodontal disease in a given oral cavity without regard to the type and causes of the disease. The arithmetic mean of the individual indices of the examined patients characterizes the group or population indicator.

Periodontal Disease Index - PDI (Ramfjord, 1959) includes an assessment of the condition of the gums and periodontium. The vestibular and oral surfaces of 16, 21, 24, 36, 41, 44 teeth are examined. Plaque and tartar are taken into account. The depth of the gingival pocket is measured with a graduated probe from the cement-enamel junction to the bottom of the pocket.

GINGIVIT INDEX

, ORGAN AND TISSUE TRANSPLANTATION.docx, 6. State of matter. ЛР №5 “Observation of various states of matter, PRELIMINARY ASSESSMENT OF THE STATE OF TRANSBOUNDARY RIVERS (pdf.io) .doc.
Index assessment of the state of periodontal tissues

Distinguish between reversible, irreversible and complex indices. At using reversible indices assess the dynamics of periodontal disease, the effectiveness of therapeutic measures. These indices characterize the severity of symptoms such as gum inflammation and bleeding, tooth mobility, and the depth of gingival and periodontal pockets. The most common of them are the PMA index, Russell's periodontal index, etc. Hygienic indices (Fedorov-Volodkina, Green-Vermilion, Ramfjord, etc.) can be included in the same group.

Irreversible indexes: X-ray index, gingival recession index, etc. - characterize the severity of such symptoms of periodontal disease as bone resorption of the alveolar bone, gum atrophy.

With the help of complex periodontal indices, a comprehensive assessment of the state of the periodontal tissues is provided. For example, when calculating the Komrke index, the PMA index, the depth of periodontal pockets, the degree of atrophy of the gingival margin, bleeding of the gums, the degree of tooth mobility, and the Svrakov iodine number are taken into account.

Oral hygiene index

To assess the hygienic state of the oral cavity, the hygiene index is determined by the method of Yu.A. Fedorov and V.V. Volodkina... As a test for hygienic cleaning of teeth, the coloring of the labial surface of the six lower front teeth with iodine-iodide-potassium solution is used (potassium iodide - 2 g; crystalline iodine - 1 g; distilled water - 40 ml).

The quantitative assessment is carried out according to a five-point system:

staining the entire surface of the tooth crown - 5 points;

staining 3/4 of the tooth crown surface - 4 points;

staining 1/2 of the tooth crown surface - 3 points;

staining of 1/4 of the tooth crown surface - 2 points;

lack of staining of the surface of the tooth crown - 1 point.

By dividing the sum of points by the number of examined teeth, an indicator of oral hygiene (hygiene index - IG) is obtained.

The calculation is made according to the formula:

IG = Ki (the sum of the ratings of each tooth) / n

where: IG - general cleaning index; Ki is the hygienic index of cleaning one tooth;

n is the number of examined teeth [usually 6].

The quality of oral hygiene is assessed as follows:

good IG - 1.1 - 1.5 points;

satisfactory IG - 1, 6 - 2.0 points;

unsatisfactory IG - 2.1 - 2.5 points;

bad IG - 2.6 - 3.4 points;

very bad IG - 3.5 - 5.0 points.

With regular and proper oral care, the hygiene index is in the range of 1.1–1.6 points; the IG value of 2.6 or more points indicates the lack of regular dental care.

This index is quite simple and available for use in any setting, including when conducting mass population surveys. It can also serve to illustrate the quality of dental cleaning in hygiene education. Its calculation is carried out quickly, with sufficient information content to draw conclusions about the quality of dental care.

Simplified hygienic index OHI-s [Green, Vermillion, 1969]

6 adjacent teeth or 1–2 from different groups (large and small molars, incisors) of the lower and upper jaws are examined; their vestibular and oral surfaces.

1/3 of the tooth crown surface - 1

1/2 of the tooth crown surface - 2

2/3 of the tooth crown surface - 3

no plaque - 0

If the plaque on the surface of the teeth is uneven, then it is assessed by a larger volume or, for accuracy, the arithmetic mean of 2 or 4 surfaces is taken.

OHI-s = Sum of indicators / 6

OHI-s = 1 reflects normal or ideal hygiene condition;

OHI-s> 1 - poor hygiene condition.

Papillary-marginal-alveolar index (PMA)

The papillary-marginal-alveolar index (PMA) allows one to judge the extent and severity of gingivitis. The index can be expressed in absolute numbers or as a percentage.

The inflammatory process is assessed as follows:

inflammation of the papilla - 1 point;

inflammation of the gum edge - 2 points;

inflammation of the alveolar gums - 3 points.

The condition of the gums of each tooth is assessed.

The index is calculated using the following formula:

PMA = Sum of indicators in points x 100 / 3 x number of teeth in the subject

where 3 is the averaging coefficient.

The number of teeth with the integrity of the dentition depends on the age of the subject: 6-11 years - 24 teeth; 12-14 years old - 28 teeth; 15 years and older - 30 teeth. Loss of teeth is based on their actual presence.

The value of the index with a limited prevalence of the pathological process reaches 25%; with a pronounced prevalence and intensity of the pathological process, the indicators approach 50%, and with the further spread of the pathological process and an increase in its severity - from 51% or more.

Determination of the numerical value of the Schiller-Pisarev sample

To determine the depth of the inflammatory process, L. Svrakov and Y. Pisarev suggested lubricating the mucous membrane with iodine-iodide-potassium solution. Staining occurs in areas of deep lesion of the connective tissue. This is due to the accumulation of large amounts of glycogen at the sites of inflammation. The sample is quite sensitive and objective. When the inflammatory process subsides or stops, the intensity of the color and its area decrease.

When examining the patient, the gums are lubricated with the specified solution. The degree of coloration is determined and areas of intense darkening of the gums are recorded in the examination card, for objectification it can be expressed in numbers (points): coloration of the gingival papillae - 2 points, coloration of the gingival margin - 4 points, coloration of the alveolar gums - 8 points. The total score is divided by the number of teeth in which the study was conducted (usually 6):

Iodine number = Sum of scores for each tooth / Number of examined teeth

mild inflammation process - up to 2.3 points;

moderately pronounced process of inflammation - 2.3-5.0 points;

intensive inflammatory process - 5.1-8.0 points.

Schiller-Pisarev test

The Schiller-Pisarev test is based on the detection of glycogen in the gums, the content of which increases sharply during inflammation due to the absence of keratinization of the epithelium. In the epithelium of healthy gums, glycogen is either absent or there are traces of it. Depending on the intensity of inflammation, the color of the gums when lubricated with a modified Schiller-Pisarev solution changes from light brown to dark brown. In the presence of a healthy periodontium, there is no difference in the color of the gums. The test can also serve as a criterion for the effectiveness of the treatment, since anti-inflammatory therapy reduces the amount of glycogen in the gums.

To characterize inflammation, the following gradation is adopted:

- staining of the gums in a straw-yellow color - negative test;

- staining of the mucous membrane in a light brown color - a weakly positive test;

- staining in dark brown color - positive test.

In some cases, the test is applied with the simultaneous use of a stomatoscope (magnification 20 times). The Schiller-Pisarev test is performed for periodontal diseases before and after treatment; it is not specific, however, if it is impossible to use other tests, it can serve as a relative indicator of the dynamics of the inflammatory process during treatment.

Periodontal index

The periodontal index (PI) makes it possible to take into account the presence of gingivitis and other symptoms of periodontal pathology: tooth mobility, the depth of the clinical pocket, etc.

The following estimates are used:

no changes and inflammation - 0;

mild gingivitis (inflammation of the gums does not cover the tooth

from all sides) - 1;

gingivitis without damage to the attached epithelium (clinical

pocket is not detected) - 2;

gingivitis with the formation of a clinical pocket, dysfunction

no, the tooth is motionless - 6;

pronounced destruction of all periodontal tissues, the tooth is mobile,

can be offset - 8.

The periodontal condition of each existing tooth is assessed - from 0 to 8, taking into account the degree of gum inflammation, tooth mobility and the depth of the clinical pocket. In doubtful cases, the highest possible rating is given. If an X-ray examination of the periodontium is possible, an assessment of "4" is introduced, in which the leading sign is the state of the bone tissue, manifested by the disappearance of the closing cortical plates at the tops of the alveolar process. X-ray examination is especially important for diagnosing the initial stage of development of periodontal pathology.

To calculate the index, the estimates obtained are added and divided by the number of teeth available using the formula:

PI = Sum of scores for each tooth / Number of teeth

The index values are as follows:

0.1–1.0 - initial and mild periodontal pathology;

1.5–4.0 - moderate degree of periodontal pathology;

4.0-4.8 - severe periodontal pathology.

Index of need for treatment of periodontal diseases

To determine the need index for the treatment of periodontal disease (CPITN), it is necessary to examine the surrounding tissues in the area of 10 teeth (17, 16, 11, 26, 27 and 37, 36, 31, 46, 47).

17/16	11	26/27
47/46	31	36/37

This group of teeth creates the most complete picture of the state of the periodontal tissues of both jaws.

The study is carried out by the sounding method. With the help of a special (bulbous) probe, bleeding of the gums, the presence of supra- and subgingival "tartar", and a clinical pocket are detected.

The CPITN index is assessed according to the following codes:

- there are no signs of the disease;

- gingival bleeding after probing;

- the presence of supra- and subgingival "tartar";

- clinical pocket 4–5 mm deep;

- a clinical pocket with a depth of 6 mm or more.

Only 6 teeth are registered in the corresponding cells. When examining the periodontium of teeth 17 and 16, 26 and 27, 36 and 37, 46 and 47, codes corresponding to a more severe condition are taken into account. For example, if bleeding is found in the area of tooth 17, and "tartar" in the area of 16, then a code is entered into the cell indicating "tartar", i.e. 2.

If any of these teeth is missing, then the tooth next to it in the dentition is examined. In the absence of a nearby tooth, the cell is crossed out diagonally and is not included in the summary results.
From the official website of the Department of Therapeutic Dentistry, St. Petersburg State Medical University