Fernando Suarez - Periodontics

The absence of PDL space around dental implants also determines the lack of vascularization from this structure. Consequently, the blood vessels that irrigate the periimplant mucosa are terminal branches from the periosteum. On the other hand, both natural dentition and dental implants present with a vascular plexus adjacent to the junctional epithelium. 37

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Clinical attachment level: The distance from the cementoenamel junction (CEJ) to the tip of a periodontal probe during periodontal diagnostic probing. The health of the attachment apparatus can affect the measurement. 1

Furcation: The anatomical area of a multirooted tooth where the roots diverge. 1

Furcation involvement: Pathologic resorption of bone within a furcation. The degree of interradicular bony destruction of a multirooted tooth. It is characterized by factors such as root trunk length, root concavities, and the extent of root separation. 2

Recession: The migration of the marginal soft tissue to a point apical to the CEJ of a tooth or the platform of a dental implant. 1

A thorough and comprehensive clinical and radiographic examination is the critical first step for establishing a proper periodontal diagnosis before a treatment plan can be developed. The objective of this chapter is to review the main components of a periodontal examination and interpretation of these parameters to aid in developing a periodontal diagnosis. The second part of this chapter is an overview of the different classifications for periodontal diseases and conditions that have been proposed and developed over the years.

To determine a proper periodontal diagnosis, clinicians should perform a periodontal examination that includes but is not limited to the following parameters 2,3:

Probing depth (PD)

Gingival recession

Clinical attachment level (CAL)

Width of keratinized gingiva (KG) and attached gingiva (AG)

Signs of gingival inflammation (ie, bleeding on probing [BOP], suppuration, gingival color and texture)

Tooth mobility

Degree of furcation involvement

Extent, distribution, and pattern of radiographic bone loss

Patient’s medical and dental history 3