the periodontal probe presented by: mellissa boyd, rdh, bsdh
TRANSCRIPT
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
• Measurement
– Sulcus/pocket depths– Width of attached
gingiva– Bleeding – Exudate– Oral lesions– Furcations
A B C
DE
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 root at point apical of CEJ
Comparison MeasurementMarquis Probe (3 6 9 12)‐ ‐ ‐
Healthy Sulcus Diseased Pocket
Probing Depth? Probing Depth?
Need CPE to get the full story
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
– 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
Maxillary Posterior Technique
Walk all theway 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
Max vs. Mand – who wins?
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 quadrantstarting @ #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:1. GM apical to CEJ
(recession)2. GM coronal to CEJ
(hyperplasia)3. GM level with CEJ
Accuracy of MeasurementAffected 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
1. Mandibular right first molar, facial aspect (Nield p 233 –235)
2. Mandibular left canine, facial aspect (Nield pp 236-237)