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6PPC - Probing depth, clinical attachment loss and recession

KK

Kona Kon

Transcript

6PPC - Probing depth, clinical attachment loss and recession.

How is the 6 PPC performed?

  • Measure probing depth, recession and bleeding on probing at 6 sites on the tooth
  • Remember to use walking stroke and measure deepest reading in each of the 6 points.

Measuring mobility and furcation involvment

Probing depth

6 point pocket check

  • Tooth mobility is also considered.
  • Tested by using force with 2 instrument handles.
  • Check for lateral and vertical movements.
  • Class I - Up to 1mm horizontal mobility in facial - lingual direction
  • Class II Between 1-2mm horizontal mobility in facial - lingual direction
  • Class III - >2mm horizontal displacement and/or vertical displacement.

Definition - The distance between the gingival sulcus (junctional epithelium) and the gingival margin.

Gingival margin

Gingival sulcus

(junctional epithelium)

  • Gives a more detailed overview of the current periodontal state of the mouth
  • Performed when BPE score is 3 for a sextant
  • IF BPE score is 4 then the whole mouth is checked.

Furcation involvement

Williams probe

  • Remember to check for furcation involvement.
  • Nabers probe
  • Grade I - Concativity of root trunk can be felt with probe tip with no more than 3mm entry.
  • Grade II - Probe enters furcation more than 3mm without coming out opposite side
  • Grade III - In maxillary molars probe passes through mesiobuccal and distobuccal roots. In mandibular molars probe passes through mesial and distal roots.

Circumferential markings at 2, 3, 4, 7, 8, 9, 10mm.

Clinical attachment loss and recession

  • More representative of the histomorphology of periodontium.
  • Recession is the distance between the CEJ and the gingival margin.
  • Calculated by using:

Probing depth + recession (+ve or -ve)

Problems with probing depth

  • Position of gingival margin may vary.
  • Margin can be coronal to CEJ in the case of gingival hyperplasia (-ve recession)
  • Margin can be apical to CEJ in the case of ginigival recession(+ve recession)
  • Think of the number as how much you need to add or subtract to return to the CEJ

List of things to remember

  • Test 6PPC (Pocket depth, recession)
  • Bleeding on probing
  • Furcation involvement
  • Tooth mobility

Interpreting the full mouth periodontal chart

Example chart.

Here we will go through how to fill and interpret tart

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