Ch. 20: The Periodontal Probe and Explorer

distance from gingival margin to the base of the sulcus

probing depth

The periodontal probe helps to determine…

classification of disease (gingival or periodontal)

distance between the gingival margin and CEJ

determines recession and clinical attachment levels

uses of the probe

determine relationship of…

gingival margin

attachment level

mucogingival junction

frenum attachments

width of attached gingiva

BOP

exudate/suppuration

consistency of gingival tissues

BOP

bleeding on probing

exudate/suppuration

pus

What are some signs of health revealed by probing?

less than 10% of sites exhibit BOP, reduced probing depth, and firmness and stippling of tissues

The COL area is typically a ______ reading.

higher

Why is it important to get probing measurements of the COL?

because it is non-keratinized and infections frequently begin here

What anatomic features effect probe accuracy?

concave surfaces, anomalies, shape of cervical third, and position of furcations 

During movement of probe, its possible to feel…

calculus and irregularities

Why might you have to reprobe after cleaning?

if there is severe calculus 

What factors effect probe accuracy?

stage and extent of periodontal disease, probe being used, placement issues, and clinician technique

normal healthy tissue

probe at the base of the sulcus (coronal end of junctional epithelium)

gingivitis and periodontitis

probe passes through the junctional epithelium to reach attached CT fibers

may overestimate attachment loss

calibration

accurately marked

thickness

thinner probes slips into a narrow pocket with more ease

readability

markings and color coding

What anatomic variations affect probing?

tooth contours, furcations, contact areas, and crowding

What interferences affect probing? 

calculus, irregular margins, and fixed dental prostheses

What accessibility/visibility issues affect probing? 

bleeding, biofilm, limited opening, and macroglossia 

What type of tissue is harder to insert probe?

healthy and firm tissue

What characteristics does spongy/soft tissue have? 

loose and flappy gingival margin, destruction of gingival fibers, easy insertion, and BOP

side of probe on enamel

gingival pocket

side of probe is on cementum or dentin when inserted below CEJ

periodontal pocket

uses walking motion to read measurements so the probe remains in the sulcus 

circumferential probing 

How many measurements are recored for each tooth?

6 (3 facial and 3 lingual)

What are the uses of explorers?

detect texture/character of tooth surfaces (ex. calculus)

define the extent of instrumentation needed

evaluate the completeness of treatment (see if calculus is removed)

11/12 explorer

used for subgingival calculus detection

TU-17

used for subgingival calculus detection

shepherd’s hook

supragingival instrument:
pits and fissures
smooth surfaces
margins of restorations

pigtail or cowhorn

proximal surfaces:
detects calculus, caries, margins of restorations

types of stimuli used when exploring

tactile, auditory, and visual

clean smooth enamel sounds _____.

quiet

rough cementum or calculus sounds ______.

scratchy and noisy

metallic restorations may ______.

squeak or ring

What does supragingival calculus look like when it’s dried?

usually chalky white or brownish-yellow in contrast to tooth color