Indices Used For Periodontal Disease Assessment

Dr.
Ali Fahad Al-Fatlawi COMMUNITY DENTISTRY LEC: 4
Indices used for periodontal disease assessment

There are 4 main areas in periodontal disease for which indices are required:
• Gingivitis: It is an inflammation of gingival tissue mainly caused by dental plaque.
• Periodontitis: It is an inflammation of periodontal ligament which mainly precede by untreated
gingivitis.
• Dental plaque: It is soft non-mineralized, bacterial deposit formed on the tooth surface.
• Calculus: It is a hard deposit that forms by mineralization of dental plaque.
Indices used for plaque and debris assessment

Plaque Index (PII): Which was introduced by Silness and Loe in 1964
-- Used together with GI.
-- Only 6 teeth used for scoring.
-- No substitution for any missing tooth.
-- Used on all surfaces (4) (M, D, B, L) or selected surfaces (M, O, L).
-- This index measures the thickness of plaque on the gingival one third.
-- The six index teeth are:
6 2 4 E B D
4 2 6 D B E
Score Criteria
0 No plaque
1 A film of plaque adhering to the free gingival margin and adjacent area of the tooth, which
cannot be seen with the naked eye. But only by using disclosing solution or by using
probe.
2 Moderate accumulation of deposits within the gingival pocket, on the gingival margin and/
or adjacent tooth surface, which can be seen with the naked eye.
3 Abundance of soft matter within the gingival pocket and/or on the tooth and gingival
margin.
Calculation:
1. Individual: 2. Population:
PII = Total scores PII = Total scores of individuals

No. of surfaces examined No. of individuals examined
PII
Indices used for gingival disease assessment

Gingival Index (GI): Which was introduced by Loe and Silness in 1963
-- GI could be used in all teeth or selected teeth and in all surfaces or selected surfaces.
1
-- The examination done by blunt probe.
-- Partially erupted teeth, retained roots, teeth with periapical lesion and third molars should be
excluded and there is no substitution.
Score Criteria
0 No inflammation.
1 Mild inflammation, slight change in color, slight edema, no bleeding on probing.
2 Moderate inflammation, moderate glazing, redness, bleeding on probing.
3 Severe inflammation, marked redness and hypertrophy, ulceration, tendency to spontaneous
bleeding.
0.1 ----------- 1 Mild gingivitis
1.1 ----------- 2 Moderate gingivitis
2.1 ----------- 3 Severe gingivitis
Calculation:
1. Individual: GI= Total scores 2. Population: GI= Total scores of all subjects
No. of surfaces examined No. of subjects examined
Indices used for calculus assessment

Calculus Surface Index (CSI): Which was introduced by Ennever et al. in 1961.
-- CSI assesses the presence or absence of supra and/or sub-gingival calculus by visual or tactile
examination, regardless the quantity of calculus.
- Criteria: 0 = Absence 1= Present
-- 4 or 6 mandibular anterior teeth are examined.
-- Each tooth divided into 4 areas.
Calculation:
facial lingual
CSI =Total number of scores 0 ----------- 16 or 0 ---------- 24
Indices used for periodontal disease assessment

Periodontal Disease Index (PDI): Which was introduced by Ramfjord in 1959
Which is composed of three components.
All the three components will be scored separately using six Ramfjord selected teeth.
6 1 4 E A D
4 1 6 D A E
1-Gingival and periodontal component
-- The criteria ranged from (0 = normal), (1 2 3 = gingivitis) and (4 5 6 = periodontitis)
-- All areas (M, D, B, L) is scored as a one unit.
-- Only fully erupted teeth are scored
-- There is no substitution for excluded teeth.
Calculation: Total sores
No. of teeth examined
2-Plaque component
-- The criteria ranged from 0 - 3.
2
Score Criteria
0 No plaque
1 Plaque present on some but not on all interproximal, buccal, and lingual surfaces of the
tooth.
2 Plaque present on all interproximal, buccal, and lingual surfaces, but covering less than one
half of these surfaces..
3 Plaque extending over all interproximal, buccal and lingual surfaces, and covering more
than one half of these surfaces.
-- All areas ( B , L , M , D ) are scored as one unit.
-- Only fully erupted teeth are scored.
-- There is no substitution for excluded teeth.
Calculation: Total scores
No. of teeth examined
3- Calculus component
-- The criteria ranged from 0 - 3 .
Score Criteria
0 Absence of calculus.
1 Supra-gingival calculus extending only slightly below the free gingival margin (not more
than 1 mm).
2 Moderate amount of supra-gingival and sub-gingival calculus or sub-gingival calculus alone.
3 An abundance of supra gingival and sub gingival calculus.
-- This index measured the extension of calculus.
-- Only facial and lingual surfaces are evaluated, and scored separately.
Calculation: Total scores
No. of surfaces examined
Community Periodontal Index of Treatment Needs (CPITN):

Which was introduced by WHO / FDI in 1982
The mouth is divided into six parts (sextants).
The examination done by special probe (WHO probe).
The score is identified by examination of specified index teeth or all teeth.
6 1 6
6 1 6
CPI
Score Criteria
0 No periodontal disease.
1 Bleeding on probing.
2 Calculus with plaque seen or felt by probing.
3 Pathological pocket 4 – 5 mm.
4 Pathological pocket 6 mm or more.
x When only 1 tooth or no tooth are present.
3
TN
Score Criteria
0 No need for treatment.
1 Personal plaque control (OHI). (1- 4).
2 Professional plaque control (scaling and polishing). (2- 4).
3 Deep scaling, root planning, surgical procedure. (3- 4).
Advantages of CPITN
1. Simplicity.
2. Speed.
3. International uniformity.
4. Record the common treatable conditions like periodontal pockets, gingival inflammation and
calculus.

Indices Used For Periodontal Disease Assessment

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Dr.

Ali Fahad Al-Fatlawi COMMUNITY DENTISTRY LEC: 4

Indices used for periodontal disease assessment

Indices used for plaque and debris assessment

PII = Total scores PII = Total scores of individuals

Indices used for gingival disease assessment

Indices used for calculus assessment

Indices used for periodontal disease assessment

Community Periodontal Index of Treatment Needs (CPITN):

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