jacopastorius
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Hi all, I have a question about probing and periodontal charting, do you agree with the following considerations?
Let's say we have a patient with periodontal tissues apparently healthy. I go to tooth 2.1 and I notice that the CEJ is not visible because it is covered by the gum. Such a situation is possible in a healthy patient, because the gingival margin can also be positioned coronally to the CEJ, not necessarily in correspondence with it. Probing, I find 3mm of ppd. At this point there may be 3 possibilities:
1- CEJ at the connective tissue attachment: sound groove. In this case it is likely that the CEJ cannot hear with the probe because its tip stops penetrating a little bit in that 1mm of junctional epithelium.
2- CEJ at the connective tissue attachment: pseudo-pocket. But in this case unlikely because the gum does not show signs of inflammation and maybe I would have probed more than 3mm. I can perhaps hear the CEJ because the tissues a little more lax for inflammation allow the probe to penetrate beyond the junctional epithelium.
3- Coronal CEJ with respect to the connective tissue attachment: there was a loss of clinical attachment, therefore a probable periodontal pocket if the loss of attachment occurred due to periodontal causes. The CEJ can be heard.
So I thought that when filling out a periodontal chart, but also when doing a quick probing, one should always try to understand where the CEJ is (when covered by the gum, when there is a recession it is easy to evaluate it); this to understand if we are in the presence of a healthy groove or not.
Recording the position of the CEJ with respect to the gingival margin is also important to understand, in the phase of re-evaluation after non-surgical periodontal therapy, if the PPD has been reduced because there has been gain of clinical attack, or only for effect of recession following reduction of inflammation.
Let's say we have a patient with periodontal tissues apparently healthy. I go to tooth 2.1 and I notice that the CEJ is not visible because it is covered by the gum. Such a situation is possible in a healthy patient, because the gingival margin can also be positioned coronally to the CEJ, not necessarily in correspondence with it. Probing, I find 3mm of ppd. At this point there may be 3 possibilities:
1- CEJ at the connective tissue attachment: sound groove. In this case it is likely that the CEJ cannot hear with the probe because its tip stops penetrating a little bit in that 1mm of junctional epithelium.
2- CEJ at the connective tissue attachment: pseudo-pocket. But in this case unlikely because the gum does not show signs of inflammation and maybe I would have probed more than 3mm. I can perhaps hear the CEJ because the tissues a little more lax for inflammation allow the probe to penetrate beyond the junctional epithelium.
3- Coronal CEJ with respect to the connective tissue attachment: there was a loss of clinical attachment, therefore a probable periodontal pocket if the loss of attachment occurred due to periodontal causes. The CEJ can be heard.
So I thought that when filling out a periodontal chart, but also when doing a quick probing, one should always try to understand where the CEJ is (when covered by the gum, when there is a recession it is easy to evaluate it); this to understand if we are in the presence of a healthy groove or not.
Recording the position of the CEJ with respect to the gingival margin is also important to understand, in the phase of re-evaluation after non-surgical periodontal therapy, if the PPD has been reduced because there has been gain of clinical attack, or only for effect of recession following reduction of inflammation.