Oral hygiene. Hygiene indices. Hygienic assessment Dyes for the determination of dental plaque Quantitative assessment of oral hygiene. Hygiene indices Assessment of oral hygiene using indices

What is the Dental Oral Health Index?

KPU index

Green-Vermillion (OHI-S)

Fedorova-Volodkina

Silnes Low

Pakhomova

Assessment of plaque in young children (Kuzmina index)

Navi indicator

Tureski

Arnim

CPITN indicator

PMA indicator

PHP

CSI

Approximal Plaque Index (API)

Flying Rate by Quigey and Hein

Gingivitis score PMA (Parma)

Composite Periodontal Index (CPI)

Ramfiord

PFRI

Examination stages

O'Leary's Oral Hygiene Protocol (1972)

Turesky Oral Health Index (1970)

Silnes-Lowe Plaque Index PLI (1964)

Simplified Green and Vermilion Oral Health Index OHI-S (1964)

PHP Patient Oral Hygiene Performance Index (1968)

Axelsson Plaque Formation Rate Index PFRI (1987)

Medical practice

N a Yudina V and Azarenko basic and additional methods of examining a patient at a dentist’s appointment educational and methodological manual Minsk Belmapo

1. Qugley-Hein Plaque Index(1962) is determined after rinsing the mouth with a solution of basic fuchsin. The vestibular surfaces of the incisors and canines are examined. The following criteria are used:

0 - no plaque;

1 - individual areas of dental plaque in the cervical area;

2 - a continuous strip of dental plaque up to 1 mm wide in the cervical area;

3 - dental plaque covers more than 1 mm, but less than 1/3 of the tooth crown;

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

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

Plaque index = sum of scores for each tooth examined /

number of teeth examined

2. IG Fedorov-Volodkina(1971) is determined by the intensity of coloring of the vestibular surface of the six lower frontal teeth with Schiller-Pisarev solution (crystalline iodine - 1 g, potassium iodide - 2 g, distilled water - 40 ml.). In this case, the plaque turns dark brown. The hygienic condition is assessed using a five-point system:

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

4 points – 3/4 of the surface;

3 points – 1/2 surface;

2 points -1/4 surface;

1 point - no staining.

IG score: 1.1 -1.5 - good level of hygiene;

1.6-2.0 - satisfactory;

2.6-3.4 - bad;

3.5-5.0 - very bad.

Normally, IG = 1.1-1.5.

High quality Oral hygiene assessment is carried out using the following system: tooth surface staining

intensive - 3 points;

weak - 2 points;

absent - 1 point.

Normally, IG = 1.1-1.5.

3. Modified IG proposed by L.V. Fedorova (1982)

It differs from the one described above in that the study

carried out on 16 teeth:

6 321	123 5
5 321	123 6

IG score: 1.1 -1.5 - good level of hygiene;

1.6-2.0 - satisfactory;

2.1-2.5 - unsatisfactory;

2.6-3.4 - bad;

3.5-5.0 - very bad.

4. IG Green-Vermillion (1964) used to detect not only dental plaque, but also dental calculus (TC).

The study is carried out on the vestibular surface of the 16, 11, 26, 31 and lingual surface of the 46, 36 teeth

The following codes and criteria are used to evaluate dental plaque:

0 - no plaque;

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

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

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

IG = sum of points / number of teeth examined (6)

IG score: 0.0-0.6 - good

0.7-1.6 - average;

1.7-2.5 - bad;

2.6 - very bad.

The tartar index is determined in the same way as dental plaque, taking into account the following assessments:

0 - no stone;

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

2 - supragingival stone covers from 1/3 to 2/3 of the tooth surface:

3 - supragingival calculus covers more than 2/3 of the tooth surface.

The presence of subgingival calculus is scored as 2 and 3.

ZK index = sum of points/number of teeth examined

Green-Vermillion Index = IG+IZK.

5. Silnes-Lowe Index (1964) designed to determine the thickness of dental plaque in the cervical area. Either all teeth or a group of teeth are examined. Staining is not carried out; a mirror, probe and air are used for drying. Fillings and dentures are not examined. Each tooth has distal, vestibular, medial and lingual surfaces. The tooth is dried and the tip of the probe is passed into the gingival area. The following codes and criteria are used:

0 - no plaque;

1 - a layer of dental plaque on the free gingival margin or in the cervical area of the tooth is determined only when the probe moves along the surface;

2 - moderate accumulation of plaque in the gingival sulcus, on the surface of the gum and (or) tooth, visible to the naked eye without probing;

3 - plaque in excess in the area of the gingival margin and the adjacent surface of the tooth.

Plaque index of one tooth - the sum of points for each of the 4 tooth surfaces is divided by 4 (surfaces).

Plaque index of a group of teeth - the sum of the plaque index of each tooth is divided by the number of teeth in the group (incisors, molars, etc.).

Individual plaque index - the sum of the plaque index of each tooth is divided by the number of teeth examined.

6. IG Ramfjord (1956) serves to determine plaque on the buccal, lingual and lateral surfaces of 6 teeth (14, 11, 26, 34, 31, 46).

It is part of the Ramfjord periodontal index, but can be used independently to assess the area of plaque on the surface of the teeth.

For staining, use a brown Bismarck solution. The assessment is carried out according to the following codes and criteria:

0 - no dental plaque;

1 - dental plaque is present on some, but not all, proximal, buccal and lingual surfaces of the tooth;

2 - dental plaque on all approximal, buccal and lingual surfaces, but covers no more than half of the tooth;

3 - dental plaque on all proximal, buccal and lingual surfaces and covers more than half of the tooth.

IG = sum of points/number of teeth examined

7. Hygiene Performance Index (Podshadley, Haley, 1968) assessed after applying the dye and rinsing the mouth with water. The vestibular surfaces of the 16, 11, 26, 31 teeth and lingual surfaces of the 36, 46 teeth are examined. The tooth surface is conventionally divided into 5 sections - medial, distal, mid-occlusal, central and mid-cervical.

0 - no staining in a separate area;

1 - staining in a separate area.

Tooth index = total points / 5

Individual index = total points / number of teeth

IG score: 0 - excellent oral hygiene;

0.1-0.6 - good hygiene;

0.7-1.6 - satisfactory hygiene;

more than 1.7 - unsatisfactory hygiene.

Periodontal indices are intended for an objective assessment of the condition of periodontal tissues. They are divided into reversible, irreversible and complex.

1. REVERSIBLE INDICES. They evaluate the dynamics of periodontal disease. They are based on clinical signs such as inflammation, tooth mobility, bleeding, which change during the development of the disease and under the influence of treatment.

1) Papillary-marginal-alveolar (PMA) the index serves to assess the severity of gingivitis. Mild gingivitis - inflammation of the papillae in 1-4 teeth, and the gingival margin in 0-2 teeth; moderate severity - with 4-8 inflamed papillae and inflamed gingival margins of 2-4 teeth. If inflammation covers more than 9 papillae on the jaw and the gingival margin of more than 4 teeth, then gingivitis is considered severe.

Parma suggested assessing the condition of the gums of each tooth. Inflammation of the papilla - 1 point, gingival margin - 2 points, attached gum - 3 points.

RMA = sum of points x 100% / 3 x number of teeth

at 6-11 years old the number of teeth is 24

12-13 years -28 teeth

from 15 years - 30 teeth

2) Schiller-Pisarev test used to identify the inflammatory process in the gums. It is based on intravital staining of glycogen with iodine-containing Lugol's solution, the amount of which increases in the epithelium during inflammation. As glycogen accumulates, the color intensity increases. The gingival margin is treated with a cotton swab moistened with Lugol's solution or Schiller-Pisarev solution. The inflamed part of the gum instantly turns into transitional tones from light brown to dark brown, depending on the degree of inflammation.

The test can be used to determine the extent of inflammation and the extent of surgical intervention during gingivectomy, papillotomy, curettage of periodontal pockets, and can serve as an objective test for assessing the effectiveness of treatment, for differential diagnosis.

3) Gingival index Loe and Silnes. Determines the condition of the gums from the vestibular, lingual, medial and distal surfaces. Each of the 4 sides is scored in points:

0 - normal gum;

1 - mild inflammation, slight discoloration, slight swelling, no bleeding when touched;

2 - moderate inflammation, the gums are hyperemic, swollen, and bleed when touched;

3 - severe inflammation, severe hyperemia and edema, ulceration, tendency to spontaneous bleeding.

GI = total points / 4

This index can be determined for any group of teeth.

Index score: 0.1-1 - corresponds to mild gingivitis;

1.1 - 2 - moderate gingivitis;

2.1 - 3 - severe gingivitis.

4) Russell's periodontal index (PI) designed to identify developed forms of pathology. It reflects inflammation of the gums, pocket formation with subsequent resorption of alveolar bone, and the actual loss of tooth function. When determining the index, all teeth except wisdom teeth are examined. The condition of the gums around each tooth is assessed on a scale from 0 to 8.

PI evaluation criteria:

0 - no signs of inflammation;

1 - mild inflammation of the gums that does not surround the tooth circularly:

2 - gingivitis around the neck of the tooth, but there is no disruption of the circular ligament (epithelial attachment);

4 - this assessment is given only during x-ray examination;

6 - gingivitis with the formation of a gum pocket. The epithelial attachment is damaged, but the function is impaired, the tooth is not displaced;

8 - pronounced destruction of periodontal tissue with loss of chewing function, the tooth is easily movable and can be displaced.

PI index = sum of points / number of teeth examined

With clinically normal gums, it ranges from 0 to 0.1-0.2.

Index 0.1-1.0 corresponds to the initial and I stages of the disease

1.5-4.0 - stage II

4.0 -8.0 - Stage III of the disease (developed and terminal)

5) Ramfjord index. In cases where x-ray examination of the patient is contraindicated or is difficult, the Ramfjord index is of particular importance. It is based on two indicators: gum inflammation of varying degrees and the depth of the periodontal pocket.

Periodontal tissues in the area of 16, 21, 24, 36, 41, 44 teeth are examined. They are assessed according to the following indicators:

1) mild gingivitis of any one surface of the gum, not spreading around the tooth:

2) moderate gingivitis;

3) severe gingivitis, but the epithelial attachment is not impaired.

The depth of periodontal pockets can be up to 3 mm, 3-6 mm and more than 6 mm.

Index = sum of scores / number of teeth examined (6)

IRREVERSIBLE INDICES

1. X-ray index. Fuchs index.

Index evaluation criteria:

absence of resorption of the alveolar process - 4;

bone resorption up to 1/3 of the length (grade 1) - 3:

resorption up to 2/3 of the root length (II degree) - 2;

resorption of more than 2/3 of the root length (III degree) - 1;

absence of a tooth caused by periodontal pathology - 0.

Index = total points / number of teeth according to WHO

Normal =1.

An index in the range from 1 to 0 characterizes various manifestations of periodontal pathology, the degree of which is higher as the index approaches 0.

2. Gingival atrophy index, or gingival recession index, is determined by the number of teeth in which the enamel-cementum boundary is exposed, and is expressed as a percentage of the total number of teeth present in the oral cavity. This index is easy to calculate, but it is not informative enough.

3. Kötschke index takes into account a large number of parameters, including RMA according to Parma, depth of gingival pockets, atrophy of the gingival margin, bleeding gums, degree of tooth mobility, Svrakov’s iodine number.

Evaluation criteria:

RMA Index: inflammation of the gingival papilla - 1 point; gingival margin - 2 points; alveolar gum - 3 points.

Pocket depth: 1 -2 mm - 2 points; 2-3 mm - 4 points, more than 3 mm - 6 points.

Bleeding: I degree (rarely) - 2 points; II degree (during brushing teeth) - 4 points; III degree (during meals or spontaneously) - 8 points.

Gum recession: up to 1 mm - 1 point: 1-2 mm - 2 points; more than 3 mm - 6 points.

Mobility: physiological - 1 point, obvious mobility not felt by the patient - 2 points, with impaired articulation - 8 points: with pressure from the tongue or lips - 16 points.

Svrakov iodine number depends on the staining of the gums (Schiller-Pisarev test):

pale yellow color - 0 points; brown color of the papilla - 2 points; gingival margin -4 points; alveolar gum - 8 points. To calculate the index, six lower anterior teeth are examined.

Kötschke index = sum of points (obtained by examining 6 teeth) x 100% / 6 x 55 (this is the maximum sum of points that can be obtained by examining one tooth)

Normally it is equal to 0.

4. Index of the degree of periodontal damage (Sandler. Staht. 1959) is found by the ratio of the number of teeth with periodontal damage to the number of teeth present in a given patient, and it is expressed as a percentage. The dental periodontium is considered affected if inflammation, hyperplasia and ulceration are noted, a pocket more than 3 mm deep, tooth mobility of more than 1 mm in any direction, bone resorption of more than 3 mm from the level of the enamel-cementum border is determined by x-ray.

5. Index of need for treatment of periodontal diseases (CP1TN) is intended to determine the prevalence and intensity of periodontal diseases in epidemiological studies, as well as to justify the placement of medical personnel.

It is proposed to distinguish three sextants on each jaw: frontal and lateral. The border between them runs between the canine and premolar. 10 teeth are examined (17, 16.11.26, 27.31, 36, 37, 46.47), but in each sextant the periodontal condition of only one tooth is recorded, fixing the tooth with a more severe clinical condition for the molars.

Clinical signs such as bleeding gums, dental plaque, and pocket depth are noted. For examination, a special periodontal probe is proposed, which has a dark part at the level of 3.5-5.5 mm and a weight of 25 g. Probing is carried out without pressure, immersing the probe until an obstacle is felt from the bottom of the pocket and moving it along the perimeter of the tooth. If the dark part of the probe sinks under the gum, then the pocket depth is more than 6 mm and the sextant receives a score of 4 points. If the marking is slightly visible from under the gum, the pocket is 4-5 mm - this corresponds to 3 points. If the markings are fully visible and there is supra- and subgingival calculus, the score will be 2 points. Score 1 point - bleeding with a pocket depth of up to 3 mm, which is determined after 30-40 s. 0 points - absence of these signs.

The scope of necessary measures is assessed as follows:

0 points - no treatment required;

1 point - instructions on oral care are provided and teeth brushing is taught with the determination of IG.

2-3 points - removal of dental plaque (professional hygiene) and hygiene training.

4 points - comprehensive treatment of periodontal diseases.

6. Combined periodontal index (CPI) according to T.V. Nikitina includes the condition of the gums and pockets in the assessment.

The condition of the gums depends on the resistance of capillaries according to Kulazhenko:

0 - time of hematoma formation within normal limits (if there is no device, this corresponds to the absence of bleeding from the gingival margin);

1 - reduction in time by ½, but not more than 3 times, or mild bleeding;

2 - reduction in time by 3 times, but not more than 4 times, or significant bleeding;

3 reduction in time by 4 times or more, or spontaneous bleeding.

The second component is the depth of the periodontal pocket, which the authors consider an indicator of bone loss:

0 - no pocket;

2 - the distance from the cement-cement border to the bottom of the pocket is no more than 2 mm;

4 - from 2 to 4 mm;

6 - from 4 to 6 mm;

8 - more than 6 mm.

The depth of the pocket is measured from four sides and the largest value is taken into account.

The periodontal condition is assessed for each tooth, the scores are summed up and divided by the number of teeth examined.

KII index = sum of received data = (V+D) R,

where P is the prevalence of the process,

B - degree of inflammatory process,

During epidemiological surveys, one can limit oneself to a group of teeth: 17, 12, 21, 26, 32, 37, 41, 46. But to calculate the index, another assessment of the prevalence of the process is introduced. It is calculated by dividing the number of teeth with visually detectable signs of periodontal pathology by the total number of teeth. It ranges from 0.03 to 1.

When examining the condition of periodontal tissues in only 8 teeth, the index value is multiplied by the assessment of the prevalence of the process and the KPI value is obtained.

7. Diagnostic periodontal index (DPI) according to T.V. Nikitina

DPI = V / V + D,

where B is the degree of the inflammatory process

D - indicator of bone tissue loss

For gingivitis, DPI = 1; in the presence of bone tissue destruction, it is less than 1, and the less, the more pronounced the destruction.

1. Danilevsky N.F., Borisenko A.V. Periodontal diseases. Kyiv. "Health", 2000.

2. Ivanov B.S. Periodontal diseases. M.: Medical Information Agency, 2001.

3. Ivanov B.S., Barannikova I.A. Using indices to assess periodontal condition // Dentistry. 1978. No. 3. pp. 88-93.

4. Ivanov V.S., Barannikova I.A., Balashova A.N. Diagnosis of periodontal condition using standard indicators: Proc. allowance. M., 1982.

5. Ivanov V.S., Lasovsky I.I. On the methodology for examining patients with periodontal disease // Dentistry. 1971. No. 1. P. 48-52.

6. Kutsevlyak V.F. ,Lakhtin Yu.V. Index assessment of periodontal status: Educational and methodological manual. - Sumy: GDP "Mriya-1" LTD, 2002. - 80 p.

7. Pakhomov G.N., Kulazhenko T.V. The use of WHO periodontal indices in the study of periodontal morbidity in individuals aged 15-25 years // Dentistry. 1985. No. 6. pp. 34-39

8. Rybakov A.I., Nikitina T.V. Comprehensive examination and treatment of patients with periodontal diseases: Method, recommendations. M., 1975.

9. Yakovleva V.I., Trofimova E.K., Davidovich T.P., Prosveryak G.P. Diagnosis, treatment and prevention of dental diseases. Minsk, 1994.

Security questions:

1. List the main methods of clinical examination of a patient with periodontal diseases.

2. Features of interviewing patients with periodontal diseases.

3. Changes in the gums characterizing the pathological state of periodontal tissues.

4. PMA index, its definition. Assessment of the condition of the mucous membrane of the gingival margin depending on the index value.

5. Periodontal index (PI), its definition and interpretation.

7. Detection of subgingival calculus

8. Epithelial ulceration test, procedure.

Minimum manipulations:

1. The ability to draw up a plan for examining a patient with periodontal diseases.

2. The ability to clinically assess the condition of the gums.

3. Ability to determine the hygiene index.

4. The ability to determine the degree of gum inflammation using the PMA, Ramfjord, and Schiller-Pisarev indices.

5. Ability to calculate the periodontal index PI.

6. The ability to determine the depth of the gingival sulcus and periodontal pockets.

7. The ability to determine the presence and nature of exudate in the periodontal pocket.

9. The ability to determine the condition of periodontal tissues using the CPITN index.

List of knowledge:

3. KPI and DPI.

4. CPITN index (index of need for treatment).

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

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

Where TO Wed. – general hygienic cleaning index; TO u– hygienic index of cleaning one tooth; n– 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; absence of staining – 1 point.

Normally, the hygiene index should not exceed 1.

Green-Vermillion index (Green, Vermillion, 1964) . The Oral Health Index Simplified (OHI-S) evaluates the area of tooth surface covered by plaque and/or tartar and does not require the use of special stains. To determine OHI-S, examine the buccal surface 16 and 26, the labial surface 11 and 31, and the lingual surface 36 and 46, moving the tip of the probe from the cutting edge towards the gum.

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

Formula for calculating the index.

Where n– number of teeth, ZN– dental plaque, ZK– tartar.

Plaque:		Stone:

	1/3 crown		supragingival stone on 1/3 of the crown
	for 2/3 crowns		supragingival stone on 2/3 of the crown
	> 2/3 crowns		supragingival calculus > 2/3 of the crown or subgingival calculus surrounding the cervical portion of the tooth

Silnes-Lowe Index (Silness, Loe, 1967) takes into account the thickness of plaque in the gingival region in 4 areas of the tooth surface: vestibular, lingual, distal and mesial. After drying the enamel, the tip of the probe is passed along its surface at the gingival sulcus. If no soft substance adheres to the tip of the probe, the plaque index on the tooth area is indicated as - 0 . If the plaque is not visually detected, but becomes visible after moving the probe, the index is equal to 1 . A plaque with a thin to moderate thickness, visible to the naked eye, is assessed by 2 . Intensive deposition of dental plaque in the area of the gingival sulcus and interdental space is designated as 3 . For each tooth, the index is calculated by dividing the sum of the points of 4 surfaces by 4.

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

Tartar index (CSI) (ENNEVER" et al., 1961). Supra- and subgingival tartar is determined on the incisors and canines of the lower jaw. The vestibular, distal-lingual, central-lingual and medial-lingual surfaces are differentially examined.

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

0 - no tartar

1 - tartar is determined to be less than 0.5mm in width and/or thickness

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

3 - width and/or thickness of tartar more than 1 mm.

Formula for calculating the index:

Ramfjord index (S. Ramfjord, 1956) as part of the periodontal index involves the determination of dental plaque on the vestibular, lingual and palatal surfaces, as well as the proximal surfaces of the 11, 14, 26, 31, 34, 46 teeth. The method requires preliminary staining with a Bismarck brown solution. Scoring is done as follows:

0 - absence of dental plaque

1 - dental plaque is present on some tooth surfaces

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.

Navy index (I.M.Navy, E.Quiglty, I.Hein, 1962). The color indices of tissues in the oral cavity limited by the labial surfaces of the front teeth are calculated. Before the examination, the mouth is rinsed with a 0.75% solution of basic fuchsin. The calculation 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 area of the tooth

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

3 - plaque strip is wider than 1 mm, 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.

Index Arnim (S. Arnim, 1963) in assessing the effectiveness of various oral hygiene procedures, determined the amount of plaque present on the labial surfaces of four upper and lower incisors stained with erythrosine. 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 surface area covered by plaque is then calculated.

Hygiene Performance Index (Podshadley, Haby, 1968) requires the use of dye. Then a visual assessment of the buccal surfaces of 16 and 26 teeth, labial surfaces of 11 and 31 teeth, and lingual surfaces of 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 - staining of any intensity is available

The index is calculated using the formula:

G
den is the number of teeth examined.

The dental index is a method for determining the effectiveness of hygiene procedures and the general condition of the oral cavity. The article discusses the main types of indices, evaluation criteria, and diagnostic procedures used.

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

The hygiene index allows a specialist to determine the reasons why tooth decay occurs, gum disease occurs, and also prescribe effective preventive measures.

With their help they determine:

The level of dental health of the patient;
The severity and stage of caries;
Number of teeth pulled out;
Quality of hygiene procedures;
Presence of malocclusion;
The degree of effectiveness of therapy.

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

The KPU index reflects:

The combination of this data allows the dentist to determine the severity and intensity of caries.

There are the following types of KPU indexes:

KPU of teeth (reflects how many teeth are affected by caries or filled);
KPU of surfaces (reflects how many teeth the early stage of caries was found on);
KPU of cavities (reflects the number of cavities caused by softening of tissues due to caries or loss of fillings).

When examining baby teeth, the number of pulled out or fallen out 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 patients with caries must be divided by the number of subjects, and then multiplied by 100. The result obtained will indicate the percentage of prevalence.

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:

Intensity of the pathological process	Grades for children (12 years old)	Estimates 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 higher	Over 16.2

Important to remember! The dental index KPU is very effective, but does not allow us to provide absolutely reliable information about the nature of the course of caries. This is due to the fact that the overall clinical picture is influenced by previously treated or extracted teeth.

The method is a simplified method of hygienic indexing, with 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.

Teeth examined:

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

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

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

A breakdown of the results is presented in the table:

The presented method is carried out to determine the level of plaque contamination. During the procedure, a solution containing potassium and iodine is applied to the vestibular surface of the lower front teeth. Drying from saliva is done first.

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:

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

The dentist examines the oral cavity using a probe to determine the amount of plaque.

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

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

Using the Silnes-Low method, the hygiene index of an individual unit, a group of several teeth or the entire oral cavity is calculated.

Involves applying Lugol's solution to the teeth being examined. The procedure involves 6 frontal teeth of the lower jaw, all 1st molars, 11 and 21 teeth.

The quality of hygiene is assessed according to the degree of staining:

Grade	Staining degree
1	Lack of color upon application
2	Staining 1/4 crown
3	Staining 1/2 crown
4	Staining 3/4 crowns
5	Staining the entire surface of the tooth

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

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

An assessment of the hygienic condition of the oral cavity is carried out after the eruption of primary teeth.

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

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

The absence of deposits corresponds to a score of 0, and any amount of plaque corresponds to a score of 1.

To assess the plaque index in children, it is necessary to divide the number of points by the number of all erupted teeth. This allows you to determine the quality of hygiene procedures.

Kuzmina plaque index indicators:

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

Important to remember! Children's teeth are more susceptible to bacteria and more often suffer from caries, which emphasizes the need to maintain high levels of hygiene.

The method involves examining the anterior incisors from the lips. Before starting the procedure, the patient is required to rinse his mouth with a fuchsin solution. This substance colors soft deposits, allowing you to assess the degree of contamination.

Hygiene rating:

0 – no deposits;
1 – presence of deposits in the area between the gum and tooth;
2 – the presence of a noticeable strip of plaque above the border of the tooth and gum;
3 – 1/3 coating;
4 – 2/3 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.

When calculating the Turesky index, the entire dentition is examined. The procedure involves 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 by the number of teeth examined.

It is used primarily for research purposes. It is used extremely rarely in dental practice, since the calculation is a labor-intensive and time-consuming process. The procedure is aimed at determining the area covered by plaque.

Arnim index calculation steps:

Application of a dye to the front incisors (erythrosine)
Taking photographs of teeth that have stained
Enlarging photos and transferring contours using a planimeter
Determination of contaminated surface area

The CPINT index is also called the periodontal therapy need index. The assessment method involves examining the gums in the area of 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.

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

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

CPINT ratings:

Stands for papillary-marginal-alveolar index. Used to assess the condition of the oral cavity in case of gingivitis (inflammation of the gums).

The assessment is made depending on the location and extent of the lesion:

1 – gingival papilla;
2 – marginal area;
3 – alveolar area.

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

Determines the 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 rating is based on the presence of a reaction to the solution:

0 – no reaction
1 – tooth staining

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

To calculate the result, the score of all examined teeth is combined, after which it is divided by 6. The code for an individual tooth is the score obtained from the examination of each area (medial, distal, occlusal, central, cervical).

Interpretation:

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

Determining the CSI index allows you to find out the amount of tartar and accumulated plaque in the area where the teeth come into contact with 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 scored according to:

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 up the sum of ratings for each examined surface and divide by the number of teeth. The maximum value is considered to be CSI 16.

The procedure involves applying a dye

The approximal surface is the area of contact between the enamel and the tooth located behind it.

The need to inspect the area presented is due to the fact that it requires careful care, which can be difficult to achieve through routine hygiene procedures.

If the amount of plaque exceeds the permissible level, the patient is prescribed professional cleaning.

The procedure involves applying a dye. After this, it is determined how many teeth the color changes.

The API index rating does not provide a pollution rating. The assessment is the presence of a reaction to the dye or its absence.

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

Evaluation of results:

Determining the plaque index involves applying a fuchsin solution to 12 front teeth on both jaws. The survey includes 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 staining.

Results of the procedure:

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

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

Used to determine the clinical condition of the periodontium, reflecting the present symptoms of inflammation.

The score reflects the stage of the inflammatory process:

The difference between the Parma modification is the modified formula for calculating the index.

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

This is how the severity of gingivitis is assessed:

Less than 30% – light;
31% – 60% – average;
61% – 100% – severe.

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

During the examination, the dentist notes the presence of certain symptoms, each of which corresponds to a specific score reflecting the condition of the tissues.

Evaluation criteria:

0 – absence of 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 method of examination depends on the age of the patient.

Interpretation of the CRPD:

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

Like the KPI, it reflects the condition of the periodontium 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 identified;
1 – inflammation of a small area of the gum;
2 – pronounced inflammatory process;
3 – aggravated inflammatory process.

Such symptoms are characteristic of 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.

The indicator reflects the rate of plaque formation. Allows you to evaluate the conditions and factors that influence the 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 rate of plaque formation is influenced by the following factors:

Before assessing the rate of plaque formation, professional cleaning is performed.

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

The following surfaces are examined:

Buccal;
Lingual;
Mesio-buccal;
Mesio-lingual;
Distobuccal;
Distal-lingual.

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

To calculate the PFRI, the total score should be divided by the number of teeth and multiplied by 100. The PFRI results are expressed as a percentage.

Ratings:

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

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

Examination stages:

Important to remember! The diagnostic results obtained must be entered into the patient’s medical record.

Oral hygiene can be assessed using different indicators and criteria. Dental indices provide detailed information about the condition of teeth and gums and reflect the likelihood of developing diseases.

Hygiene indices are determined through a dental examination, which is absolutely painless and does not cause discomfort to the patient.

28917 0

The protocol is very useful for systematic training in oral hygiene for a particular patient, as it allows us to identify not only the patient’s attitude towards oral hygiene, but also to detect shortcomings in cleaning certain surfaces of all groups of teeth.

To complete the protocol, all surfaces (except the chewing surface) of each tooth are painted with a permanent dye.

Determine the presence of dental plaque on 4 tooth surfaces (on the vestibular, oral, distal and medial) or on 6 surfaces (on the distal-vestibular, vestibular, medial-vestibular, distal-oral, oral and medial-oral). Using a dental mirror, the presence or absence of staining in the area of the crowns of all teeth is recorded. The data is entered into a modified schematic “formula” of the dentition (see diagram for registering the CPUP), shading the sector of the square corresponding to the contaminated tooth surface. The number of painted surfaces is counted and what proportion (%) of all tooth surfaces is contaminated and which, accordingly, is free from dental plaque.

The result is recorded in the patient's chart and used for comparison with the results of subsequent oral hygiene studies.

The index is used for individual clinical work and is often used for comparative research of the quality of products intended for oral hygiene.

After staining, the oral and vestibular surfaces of all teeth are examined. Rating scale for each surface:
0—no staining;
1 - staining in the form of a thin line at the border with the gum;
2 - the line at the gum is wider;
3 - the gingival third of the surface is painted;
4 — 2/3 of the surface is painted;
5 - more than 2/3 of the surface is painted.

The result is taken into account as the sum of all points, evaluated over time and when comparing different objects.

The index allows you to examine all teeth or only some teeth selected at the request of the researcher. Without staining, the presence of soft dental deposits on the four surfaces of the tooth is examined visually or with a probe. The probe is directed to the gingival groove.

The amount of plaque on one tooth surface is assessed on a scale:
0 points - no plaque in the gingival area;
1 point - a thin film of plaque in the gingival area is determined only by a probe;
2 points - plaque is visible to the eye in the gingival groove and cervical area;
3 points - there is excess plaque on most of the tooth surface and in the interdental space.

PLI of a tooth is calculated using the formula:

PLI = (Sum of points of four surfaces)/4

Oral PLI is calculated as the average of the PLI of all teeth examined.

OHI-S was created by the authors on the basis of the Oral Hygiene Index (OHI), which they proposed in 1960, which involved a quantitative assessment of supra and subgingival dental plaque on the buccal and lingual surfaces of all permanent teeth, with the exception of third molars, with an assessment of the result by segments (quadrants).

OHI-S is proposed for assessing oral hygiene only by the surface condition of six indicator teeth: all first molars of the upper and lower jaws (16, 26, 36 and 46, if they are absent - the adjacent second molars) and two central incisors (11 and 31, in the absence - the central incisors of the other side). Only one surface of the teeth is examined: for the molars of the upper jaw and all incisors - the vestibular surface, for the molars of the lower jaw - the lingual. In this case, these surfaces should not be affected by caries and hypoplasia.

Each surface is examined using a probe for the presence of soft plaque and tartar. On the surface under study (lingual, buccal), the probe is placed parallel to the axis of the tooth and, starting zigzag movements from the occlusal surface of the tooth to the neck, the level of the crown from which dental plaque accumulates on the probe is noted.

OHI-S is calculated as the sum of two indices - plaque index and calculus index.

Debris Index (DI-S):
0 points - no plaque or pigment;
1 point - soft plaque occupies no more than 1/3 of the crown height, or there is extradental pigmentation without visible soft plaque (Priestley plaque) on any surface area;
2 points - soft plaque covers more than 1/3, but less than 2/3 of the crown height;
3 points - soft plaque covers more than 2/3 of the tooth surface.

Calculus Index (CI-S):
0 points - no stone;
1 point - supragingival calculus, occupying no more than 1/3 of the examined surface;
2 points - supragingival calculus, occupying more than 1/3, but less than 2/3 of the examined surface or the presence of individual fragments of subgingival calculus;
3 points - supragingival calculus, covering more than 2/3 of the surface or subgingival calculus, encircling the neck of the tooth.

The DI-S and CI-S data for each tooth are entered into a special table with six cells, each of which is divided in two diagonally. To calculate OHI-S, the DI-S and CI-S of all teeth are summed up:

OHI-S = (DI-S + CI-S)/6

The state of oral hygiene according to the OHI-S is assessed as follows:
with OHI-S no more than 0.6 - good hygiene; 0.7—1.6—satisfactory; 1.7—2.5—unsatisfactory; > 2.6 - bad.

The index is used to control the quality of teeth brushing during training. The presence of plaque is recorded on the same surfaces of the same teeth as in OHI-S (vestibular surfaces 16 and 26, 11 and 31, lingual surfaces 36 and 46), but at the same time the contamination of several areas (sectors) of the examined surface of the tooth crown is taken into account ( Fig. 5.24).

Rice. 5.24. Scheme of dividing the vestibular surface of the tooth into sectors.

The presence of soft plaque is determined after rinsing with dye. If there is no staining in the sector, 0 points are given; if there is any coloring in the sector - 1 point. The scores of five sectors of one surface are summed up and the tooth’s RHP is obtained. RNR for the oral cavity is calculated as the average of all six indicators:

RNR = (sum of RNR of teeth)/(n teeth)

Oral hygiene assessment using PHP:
O - excellent oral hygiene;
0.1-0.6 - good;
0.7—1.6—satisfactory;
>1.7 – unsatisfactory.

The free (without hygienic interventions) formation of dental plaque is assessed within 24 hours after professional oral hygiene on all surfaces (except occlusal) of all teeth. After staining, the number of all contaminated surfaces is noted, then the proportion of those examined (%) is calculated. The result is assessed on a scale (Table 5.8).

Table 5.8. PFRI Rating Scale

Studies of the microflora of oral fluid and dental plaque make it possible to give a more complete and accurate description of their cariogenicity and clarify the degree of risk of caries development.

T.V. Popruzhenko, T.N. Terekhova

12.1. Determination of the oral hygiene index (Yu.A. Fedorov - V.V. Volodkina, 1971)

As a test for hygienic cleaning of teeth, coloring of the labial surface of six lower frontal teeth with an iodine-iodide-potassium solution (potassium iodide - 2.0; crystalline iodine - 1.0; distilled water - 40.0) is used.

Quantitative assessment is made using a five-point system:

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

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

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

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

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

The calculation is made using the formula:

Where ISIS- general hygienic cleaning index, TO And- hygienic index of cleaning one tooth, n - number of teeth examined (usually 6).

By dividing the sum of points by their number, an indicator of oral hygiene (hygiene index) is obtained. When determining the quality of oral hygiene, the studied indicator is assessed as follows: 1.1–1.5 points - good hygiene index; 1.6–2.0 points - satisfactory; 2.1–2.5 points - unsatisfactory; 2.6–3.4 - bad; 3.5–5.0 points - very poor hygiene index. With regular and proper oral care, the hygiene index varies between 1.1–1.6 points. A hygiene index reaching 2.6 points or more indicates a lack of regular dental care.

Using the hygiene index, you can determine the quality of teeth cleaning and determine the cleansing effect of various hygiene products. The proposed hygienic index for teeth cleaning is quite simple and accessible for use in any conditions, including when conducting mass surveys of the population. This index can also serve to illustrate the quality of tooth cleaning during hygiene education. Its calculation is carried out quickly with sufficient information content to draw conclusions about the quality of dental care.

12.2. Definition of the simplified oral hygiene index - OHI-S (Green, Vermillion, 1964)

Method of determination: simplified index of oral hygiene Green, Vermillion (1964) is determined visually, without staining. Six key teeth are examined using a dental probe, moving its tip towards the gum: buccal surface 16 and 26; labial surface 11 and 31; lingual surface 36 and 46.

Formula for calculating the index:

OHI-S = () + (
),

Where ∑ - sum of values; ZN- dental plaque; ZK- tartar; n - number of teeth examined (usually 6).

Interpretation

12.3. Determination of the plaque index - PLI (Silness–Loe, 1964)

Designed to determine the thickness of plaque in the gingival area of the tooth. All or selected teeth are examined, dividing the tooth into 4 parts: distal-vestibular, vestibular, medial-vestibular and lingual surfaces.

A mirror, probe and air are used to dry the tooth. The study does not exclude dentures or fillings.

Codes	Criteria
	no plaque in the gum area
	film of plaque adhered to the free gingival margin or adjacent surface of the tooth, which is recognized when the probe is moved over the surface
	moderate accumulation of soft plaque in the gingival groove, on the gingival and/or adjacent tooth surfaces, which can be visible to the naked eye without a probe
	Excessive plaque in the gingival pocket area and/or on the gingival margin and adjacent tooth surface

12.4. Determination of gingival index - GI (Loe, strength, 1963)

Intended to determine the location and severity of gingivitis. Used for clinical and epidemiological studies.

Each tooth is examined in four areas:

gingival papilla from the medial and distal surfaces of the tooth;

marginal gums from the vestibular and lingual surfaces of the tooth.

To determine bleeding, the gums are probed with a blunt instrument.

The gums are examined in all teeth or selectively by segments, sextants. Key teeth are 16, 21, 24, 36, 41, 44. The GI value for a site is determined by summing the codes around the examined tooth. The sum of the site codes divided by 4 indicates the GI of the tooth. To obtain the GI values of an individual examined, all GI values of the teeth must be summed and divided by the number of teeth examined.

Formulas for calculating the index:

GI tooth =	∑ points	Interpretation:
GI tooth =		0.1–1.0 - mild gingivitis;
		1.1–2.0 - moderate gingivitis;
		2.1–3.0 - severe gingivitis.

Individual's GI =	GI teeth
Individual's GI =	n teeth

Inspection and subsequent calculation of the index require certain knowledge and manual skills. GI is the most accurate in assessing the effectiveness of the anti-inflammatory effects of drugs.

12.5. Determination of the gingival index - PMA (M. Massler,
J. Shour, C. Parma, 1960)

The papillary-marginal-alveolar index 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 gum - 3 points. The condition of the gums of each tooth is assessed. The index is calculated using the following formula:

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 - 28 teeth; 15 years or more - 30 teeth. When teeth are lost, they are based on their actual presence.

In practical work, the PMA index can be used in a number of cases:

a) during preventive examinations in order to identify the disease at early stages of development of the process;

b) examination of periodontal disease in dental patients;

c) treatment of patients with gingivitis to assess the severity of gingivitis and the effectiveness of treatment;

d) in the treatment of patients with periodontitis to evaluate the results of treatment.

It is advisable to combine the PMA index with indices that take into account bone tissue damage. The index values with a limited prevalence of the pathological process reach 25%, with a more significant spread and intensity of the pathological process the indicators approach 50%, and with the spread of the pathological process and an increase in its severity - from 51% or more.

12.6. Determination of the Schiller-Pisarev test and Svrakov’s iodine number (1963)

To determine the intensity of the inflammatory process, D. Svrakov and Yu. Pisarev (1963) used treatment of the oral mucosa with an iodine-iodide-potassium solution. Staining occurs in areas where there is deep damage to the connective tissue. It is associated with the accumulation of large amounts of glycogen in areas of inflammation. The test is quite sensitive and objective: when the inflammatory process subsides or stops, the color intensity and its area decrease.

Methodology: when examining a patient, the gums are treated with the specified solution. The degree of coloration is determined and areas of intense darkening of the gums are recorded in the examination chart. The Schiller-Pisarev test for objectification can be expressed in numbers (points), assessing the color of the papillae as 2 points, the color of the gingival margin as 4 points and the color of the alveolar gum as 8 points.

The resulting total score should then be divided by the number of teeth examined (usually 6) using the formula:

Thus, it is possible to determine the digital value of the sample or the Svrakov iodine number in points.

Assessment of Svrakov’s iodine number values: mild inflammatory process - up to 2.3 points, moderately expressed inflammatory process - from 2.67 to 5.0 points, intense inflammatory process - from 5.33 points to 8.0 points.

12.7. Determination of the complex periodontal index - KPI (P.A. Leus, 1988)

The examination is carried out in a dental chair under adequate artificial lighting. A standard set of dental instruments is used. A dental probe is used to determine signs of periodontal damage (bleeding, tartar, pathological pocket), as well as dental plaque; to determine pathological mobility of teeth - a dental probe or tweezers. Registration of indicators is carried out in any card that has a dental formula. In adolescents and adults they study: 17/16, 11, 26/27, 31, 36/37, 46/47. The following criteria are used:

Codes for recording	Signs	Criteria
	healthy	dental plaque and signs of periodontal damage are not detected during examination
	plaque	any amount of soft white plaque detected by a probe on the surface of the crown, interdental spaces or subgingival area
	bleeding	bleeding visible to the naked eye upon slight probing of the periodontal groove (pocket)
	tartar	any amount of hard deposits (tartar) in the subgingival area of the tooth
	pathological pocket	pathological periodontal pocket determined by a probe
	tooth mobility	pathological tooth mobility grade 2–3

If several signs are present, a more severe lesion is recorded (higher score). In case of doubt, preference is given to underdiagnosis.

The KPI of an individual is calculated using the formula:

KPI =	Σ codes
	teeth (usually 6)

The average CPI of the surveyed population group is calculated by finding the average number of individual CPI values:

Evaluation criterion for the intensity of periodontal diseases according to the KPI index:

12.8. Determination of periodontal index - PI (A.L. Russel, 1956, 1967)

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

The following estimates are used:

0 - no changes and inflammation;

1 - mild gingivitis (gum inflammation does not cover the entire tooth);

2 - gingivitis without damage to the attached epithelium (pathological pocket is not detected);

6 - gingivitis with the formation of a periodontal pocket, no dysfunction, the tooth is not mobile;

8 - pronounced destruction of all periodontal tissues, the tooth is mobile and can be displaced. The periodontal condition is assessed for each existing tooth from 0 to 8, taking into account the degree of gum inflammation, tooth mobility and the depth of the periodontal pocket.

In doubtful cases, the highest possible rating is given.

If an X-ray examination of the periodontium is possible, a score of “4” is entered, where the leading sign is the condition of the bone tissue, manifested by the disappearance of the closing cortical plates at the apexes of the alveolar ridge. This is especially important for diagnosing the initial stage of development of periodontal pathology.

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

Index values are evaluated as follows:

0.1–1.0 - initial and mild degree of periodontal pathology;

1.5–4.0 - moderate degree of periodontal pathology;

4.0–8.0 - severe periodontal pathology.

12.9. Determination of the gingival recession index - IR (S. Stahl, A. Morris, 1955)

The gum recession index is irreversible and records gum recession.

Periodontal damage is assessed based on the index, which is calculated in units or percentages by dividing the number of teeth with the cervical part of the tooth exposed by the number of teeth in the subject using the formula:

The index value ranges from 0 to 100%.

A mild degree of periodontal pathology corresponds to digital index values of up to 25%, a moderate degree of severity - from 26% to 50%, and a severe degree - more than 51%.

12.10. Determination of a vacuum test for the resistance of gum capillaries (V.I. Kulazhenko, 1960).

A vacuum test for the resistance of gum capillaries (V.I. Kulazhenko, 1960) characterizes the functional state of peripheral blood circulation in the gum. This is a response of the gum capillaries to exposure to low pressure, which leads to the formation of “drain extravasates - hematomas”.

The optimal option for determining the resistance of gum capillaries is the correct choice of four parameters: low pressure (720–740 mm Hg), the diameter of the vacuum cuvette (7 mm), the beginning of registration of the formation of a vacuum hematoma, the area of gum examination (frontal, premolar and molar areas ).

Any vacuum device that produces 20–30 mm Hg can be suitable for vacuum procedures. Art. (26.6–53.2 GPa) residual pressure.

In recent years, serial production of a vacuum device for the treatment of periodontal diseases (ALP) and its modification (ALP-M) has been launched. Each of the devices consists of a vacuum pump, a receiver, and a vacuum gauge, enclosed in a housing and connected by rubber hoses.

Diagnostic and therapeutic procedures of focal dosed vacuum are carried out as follows. A glass cuvette with a diameter of 7 mm is applied to the gum or mucous membrane of the alveolar process of the jaw in the area of projection of the roots of the teeth. Turn on the vacuum apparatus. By means of a connecting rubber tube, air is sucked out of the glass cuvette and the gums or mucous membrane of the alveolar process are drawn into the cuvette, on which extravasates are first formed, then draining extravasates and, finally, a vacuum hematoma. The time of hematoma formation depends on the degree of damage to the connective tissue structures of the periodontium. What determines the functional state of the periodontium.

Determination of the resistance of gum capillaries is carried out at 40 mm Hg. Art. (53.2 GPa) in a vacuum system. Simultaneously with ensuring the specified vacuum in the tube, the stopwatch is turned on. The time of formation of extravasates is a measure of the resistance of the gingival capillaries of the studied area.

It has been established that in practically healthy people, aged 20–40 years, who have not suffered from diseases affecting the resistance of capillaries, vacuum hematomas are formed on average in 50–80 seconds in the area of the front teeth, in the area of premolars on the upper and lower jaws in 10– 20 seconds slower, and in the molar area the formation of vacuum hematomas occurs in 60–100 seconds.

The vacuum treatment procedure is carried out at 20–40 mmHg. Art. (26.6–53.2 GPa) residual pressure in the vacuum cell. It is under this influence, according to V.I. Kulazhenko (1960), the optimal therapeutic effect from vacuum exposure is achieved: differentiated damage to the gum capillaries occurs. Predominantly only pathologically altered microvessels are damaged. Along with this, according to our data, there is an increase in diapedesis of blood cells through the wall of the microvessel. In one session, 6–8 vacuum hematomas are formed on each jaw. Subsequent procedures are carried out after 3–4 days (the time for the reverse development of hematomas). Hematomas form in those areas of the alveolar process that were not involved in the previous session. In total, a course of 5–7 procedures is carried out depending on the dynamics of the disease, the main criterion of which is this indicator of the resistance of the gum capillaries.

... ; coloring; X-ray. Methods diagnostics complications of caries. Methods diagnosticsdiseasesperiodontal. Methods diagnosticsdiseases oral mucosa...

Explanatory note

Filling root canals. DiseasesperiodontalDiseasesperiodontal: methods diagnostics. Plan for examining patients with diseases periodontal. Diagnosticsdiseasesperiodontal: stages, criteria...

to calculate the index:

Tooth PLI =

∑ points

Individual PLI =

PLI teeth

n teeth

Educational and methodological manual

Palpation. ADDITIONAL: X-ray diagnostics, thermal test, EDI. DISEASESPERIODONTAL BASIC: inspection, probing, percussion... recommendations. – Mn., 2004. – 24 p. Dedova L.N. Diagnosticsdiseasesperiodontal: Method. recommendations. – Mn., 2004. – 70 ...