<<
>>

2.2.1 Clinical methods

At clinical inspection of patients radiological data analyzed the anamnesis of a life and illness of the patients, the previous medical documentation, clinico-. Estimated level of individual hygiene and a condition of tissues parodonta.

Estimation of prevalence and intensity of diseases parodonta spent by means of an index of needs in treatment of diseases parodonta CPITN [144]. For definition of this index surveyed 10 teeth (1.7, 1.6, 1.1,

2.6, 2.7, 3.7, 3.6, 3.1, 4.6, 4.7). At inspection of each pair molar tooths considered

Only one code characterising the most unsatisfactory condition. Each sextant estimated at presence in it of two or more teeth which are not demanding excision. If in a sextant there was one tooth, it joined in the next sextant. Sounding spent in average, medial and distal zones of vestibular and lingual surfaces of a teeth.

Codes and criteria of an index:

0. The healthy gum, is not present pathology signs;

1. After sounding the gum staxis is observed;

2. By a probe it is defined poddesnevoj an odontolith; the black stria of a probe does not plunge in desnevoj a pocket;

3. The pocket of 4-5 mm is defined; the black stria of a probe partially plunges in zubodesnevoj a pocket;

4. The pocket more than 6 mm is defined; the black stria of a probe is completely shipped in desnevoj a pocket.

The code 0 testifies to absence of necessity of treatment.

The code 1 or above specifies in necessity of improvement of hygiene of a cavity


Mouth.

The code 2 or above demands improvement individual and carrying out

Professional hygiene of an oral cavity, elimination of the factors promoting a retention of a debris.

The code 3 testifies to necessity of carrying out of professional hygiene of an oral cavity and curettage carrying out.

The code 4 specifies in necessity of complex treatment of diseases parodonta.

Hygienic condition of an oral cavity defined Green - Vermilliona's method (OHI-S) (Simplified Oral Hygiene Index) [156]. The simplified index of hygiene of an oral cavity consists in an estimation of the area of a surface of a tooth, pruinose and-or an odontolith. By means of a probe investigated an index teeth: a buccal surface 1.6 and 2.6, a lingual surface 3.6 both 4.6 and a labial surface

1.1, 3.1. Probing movements made from cutting edge to a gum. Criteria of an estimation of results of research with use of a method of Green - Vermilliona are presented in table 2.

Table 2 – Criteria of an estimation of a method of Green - Vermilliona (OHI-S)

Quantity

Points

Debris Odontolith
1 2 3
0 No No

1

Soft debris

Covers to 1/3 crowns and-or any quantity dense pigmentirovannogo scurf

Naddesnevoj an odontolith to 1/3

Crowns

2

Scurf covers from 1/3 to

2/3 surfaces

Naddesnevoj an odontolith from 1/3

To 2/3 and-or poddesnevoj an odontolith in the form of separate islets

3

Soft scurf covers

More than 2/3 surfaces

Naddesnevoj an odontolith more

2/3 crowns and-or poddesnevoj an odontolith tsirkuljarno cover a tooth neck

Calculation of the simplified index of hygiene of an oral cavity spent under the formula:

Where n – quantity of a teeth;

ZN – a debris;

ZK – an odontolith.

Results for an index estimation:

0 – 1,2 point: low, good hygiene

1,3 – 3,0 point: average, unsatisfactory hygiene

3,1 – 6,0 point: high, bad hygiene

Depth measurement parodontalnogo a pocket (personal computer) and losses zubodesnevogo attachments (PZP) is spent.

At personal computer measurement estimated distance between edge of a gum and clinically probed bottom parodontalnogo a pocket or desnevoj sulcuses. For estimation PZP measured distance between emalevo - cement border of a tooth and clinically probed bottom parodontalnogo a pocket.

Definition of indexes was spent with the help parodontalnogo a firm probe «LM - Instruments» (Finland).

Staxis of gums estimated by means of an index of a staxis of gums on H.R. Muhleman under the following scheme:

0. The staxis is absent.

I.Кровоточивость Arises not earlier than in 30 seconds after sounding.

II.Кровоточивость Arises at once or within 30 seconds after sounding.

III.Кровоточивость Appears at food intake or cleaning of a teeth.

Mobility of a teeth defined on scale Miller (in updating T.J. Fleszar) [205].

Codes and index decoding:

0. The tooth steady, is available only physiological mobility.

I. Shift of a tooth concerning a vertical axis is a little bit more, but does not exceed 1 mm.

II. The Tooth is displaced on 1 ∑ 2 mm in a shchechno-LINGUAL direction, function is not broken.

III. Mobility is sharply expressed, thus the tooth moves not only in shchechnojazychnom a direction, but also on a vertical, its function is broken.

For revealing of the developed forms of a pathology parodonta used parodontalnyj an index (PI, Russel, 1956). It reflects a gum inflammation, presence zubodesnevyh pockets and rezorbtsiju an osteal tissue of an alveolar part, actual loss of function of a tooth. Registration limit to the expressed lesions which are obvious at survey (table 3).

Table 3 – Criteria of an estimation parodontalnogo an index (PI, Russel, 1956)

Point Mass researches The additional

X-ray inspections

1 2 3
0 There are no inflammation signs No
1 Easy inflammation of a gum, not

Surrounding a tooth around

X-ray pattern without

Changes

2 The ulitis round a tooth neck, but is not present

Disturbances of circular ligament

X-ray pattern without

Changes

4 This estimation is given only at

Radiological inspection

Initial degree rezorbtsii

Tops of interdental septums

6 Ulitis with formation desnevogo

Pocket, the epithelial attachment is damaged, but chewing function is not broken, the tooth is not displaced

Horizontal rezorbtsija

The alveolar interdental septum, the reaching l of length of a root of a tooth

8 The expressed destruction of tissues

parodonta with loss of chewing function, the tooth is easily mobile, can be displaced

Rezorbtsija l of length exceeds

Root, the intraosteal pocket can be defined

Estimate a condition parodonta each available tooth – from 0 to 8, taking into account degree of an inflammation of a gum, mobility of a tooth and depth clinical

Pocket. In doubtful cases put maximum of possible estimations.

At X-ray inspection possibility parodonta enter an estimation

«4» at which as a leading sign the condition of an osteal tissue shown by disappearance of closing cortical plates at tops of an alveolar process serves. The X-ray inspection is especially important for diagnostics of initial degree of development of a pathology parodonta.

For index calculation the received estimations put and divide into number of an available teeth under the formula:

PI = the Sum of estimations of each tooth / Number of a teeth.

Value of an index the following:

0,1 – 1,0 – initial and easy degree of a pathology parodonta.

1,5 – 4,0 – srednetjazhelaja pathology degree parodonta.

4,0 – 4,8 – serious degree of a pathology parodonta.

Gum recession on classification Miller P.D. (1985)

Gum recession is a pathological process at which there is an apical moving desnevogo edges to a partial denudation of a root of a tooth. Occurrence of recession of a gum is caused by a number of the reasons: presence of a tooth plaque, disturbance of position of a teeth in a tooth arch, wrong cleaning of a teeth, disturbance of technology of sealing of a teeth (table 4).

Table 4 – Criteria of an estimation of recession of a gum on classification Miller P.D. (1985)

Class The description of a condition of a gum
I Recession of a gum which does not reach border between the mucous

Cover and gum. There is no loss of soft tissues, an osteal tissue in interdental areas. 100 % root closing probably with predicted result

II Recession of a gum which reaches border between the mucous

Cover and gum or extends further. There is no loss of the soft

Tissues, an osteal tissue in interdental areas. 100 % root closing probably with predicted result

III Recession of a gum which reaches border between the mucous

Cover and gum or extends further. There is a moderate loss of soft tissues, an osteal tissue in interdental areas or shift of a teeth. The predicted result is impossible

IV Recession of a gum which reaches border between the mucous

Cover and gum or extends further. There is an expressed loss of soft tissues, an osteal tissue in interdental areas or the expressed shift of a teeth. Root closing is impossible

<< | >>
Scientific source YELISEYEVA Anna Fyodorovna. SOCHETANNOE LESION PARODONTA And CARDIOVASCULAR SYSTEM, CLINICO-MORPHOLOGICAL And MICROBIOLOGICAL RESEARCH. The dissertation on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg – 2014. 2014

Other medical related information 2.2.1 Clinical methods:

  1. immunologic methods of research of blood serum
  2. Methods of an estimation of a microbiocenosis
  3. Clinical features of current GER and constipations of a functional parentage at surveyed children
  4. 2.2. The organisation of epidemiological research («ISAAC») and tayobakokurenija among teenagers, a general characteristic of the surveyed groups of teenagers, clinico-functional and laboratory methods issledovayonija
  5. 2.2. Research methods
  6. research methods
  7. modern methods of diagnostics of infectious diseases: detecting of microorganisms on the structural, genetically determined fat acids in object of research by means of a method of a gas chromatography of mass spectrometry
  8. CHAPTER 5. RESULTS OF STUDYING OF MICROORGANISMS ON THE STRUCTURAL, GENETICALLY DETERMINED FAT ACIDS IN OBJECT OF RESEARCH BY MEANS OF THE METHOD OF THE GAS CHROMATOGRAPHY OF MASS SPECTROMETRY
  9. 5.1. Studying of microorganisms on the structural, genetically determined fat acids in a saliva (sputum) of children by means of a method of a gas chromatography of mass spectrometry and reconstruction of microbic community
  10. Chapter 2 the GENERAL CLINICAL CHARACTERISTIC of GROUPS of PATIENTS And RESEARCH METHODS.
  11. THE TABLE OF CONTENTS
  12. clinical methods of research
  13. the general clinical methods of research of children
  14. Chapter 2 Base, the program, a research technique
  15. research methods
  16. Chapter 2. The GENERAL CLINICAL CHARACTERISTIC of PATIENTS And RESEARCH METHODS
  17. INTRODUCTION
  18. THE CHAPTER II. THE MATERIAL AND RESEARCH METHODS
  19. HEAD SH. THE CLINICO-STATISTICAL ANALYSIS OF THE REMOTE RESULTS OF THE ART ROSKOPICHESKY PLASTY OF FORWARD CROSSWISE LIGAMENT OF THE KNEE JOINT THE AUTOGRAFT FROM WHIRLBONE LIGAMENT
  20. THE CONCLUSION