Periodontal examination.

With the exception of gingival indices, it is evident that there have not been great changes in the methods used in clinical practice. Rather, the changes made are in the categories of integration of methods and interpretation of data. We know that the extent of periodontal disease cannot be ascertained from any single diagnostic aid alone. The date obtained from the many diagnostic methods described must be evaluated together before an accurate diagnosis can be achieved. A periodontal examination should include a periodontal probing, a radiographic analysis, a gingival index, mobility charting, and an evaluation of the amount of attached gingiva. These clinical exercises require simple instrumentation and a minimal amount of clinical calibration on the part of the examiner. These exercises, however, do not eliminate the need for a general examination that includes the location of caries, plaque index, and medical and dental history. Probing is still considered the single most important examination method in detecting periodontal disease and evaluating therapy. However, probing becomes a great deal more meaningful when combined with data from a gingival index and radiographic analysis. Because the significance of the pocket depth depends not only on the height of the alveolar bone but also on the degree of gingival inflammation, a gingival index should be used as an integral part of a routine examination. A radiographic examination supplements probing by providing information on root length and shape and width of the periodontal ligament space, and aids in determining the configuration of a bony defect. Yet radiographic analysis is of little value without the knowledge of the pocket depths, position of the gingival margin, and mobility patterns. Many forms of sophisticated instrumentation and indices for a periodontal examination have been introduced in the past decade. Unfortunately, many of these new instruments are not practical for clinical practice in their present form. Future trends will no doubt be directed toward simplifying these instruments and indices so that they can be more easily adapted to the clinical practice of periodontics, by both the general dentist and the specialist.