RU2435505C1 - Method of determining periodontium state - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used for determination of periodontium state. For this purpose amount of gingival fluid in dentogingival groove or periodontal recess in area of all present teeth is determined, obtained values are compared with determined regularity for each tooth. After conclusion about severity and spread of pathologic process therapeutic measures are taken and conclusion about impact of taken measures on patient's periodontium is made.

EFFECT: method makes it possible to determine periodomtium state both in patients with complete dentitions and those with defect of dentition integrity, characterising state of tissues of dentition periodontium in general and of each tooth separately, being available and of low cost.

2 ex, 3 tbl

Description

The invention relates to medicine, namely to dentistry, and can be used to determine pre-nosological changes in the state of periodontal disease, the severity and prevalence of its diseases, study the dynamics of the course, control the quality of individual treatment measures, as well as plan and control the adaptation and rehabilitation period.

The study of transition states between health and illness means the study of the process of such a transition, the knowledge of those stages, stages, which, as steps, lead from health to illness. The practical implementation of the ideas of functional diagnostics in dentistry requires the development of a clear and understandable methodology for calculating functional states that take into account new approaches to ideas about health and disease based on adaptation theory.

It is known that for the early diagnosis of periodontal conditions determine the amount of gingival fluid (W. Harzer. The collection and evaluation of sulcus fluid in the juvenile periodontium. // Stomat. DDR. - 1978. - Vol.28. - P.164-170 N.Brill, B. Krasse // Acta odont. Scand. - 1958 - Vol.16. - P.232-245). Gingival fluid for quantitative studies is obtained according to the so-called intra-fissure method of N.Brill and B.Krasse using 15 × 4 mm filter paper strips.

Known works on the formulation of the Barera index, which determines the severity of the periodontal condition as a whole. Before examining teeth 1.6; 1.1; 2.4; 3.6; 3.1; 4.4 and the gum adjacent to them are thoroughly cleaned of plaque, insulated from saliva with cotton rolls and dried. At the mouth of the gingival groove, the pointed end of the paper strip is inserted so that it does not reach the bottom, to prevent mechanical tissue stimulation and subsequent increase in fluid flow. Paper strips are inserted into the groove in the area of the interdental gingival papillae. The time for obtaining gingival fluid is set to 3 minutes. (Barer G.M., Kocherzhinsky V.V., Halitova E.S., Lukinykh L.M. // Dentistry - 1986. - No. 5. - P.24-26 .; Barer G.M., Kocherzhinsky V. .V., Halitova E.S., Lukinykh L.M. // Dentistry - 1987. - No. 1. - P.28-30).

The amount of gingival fluid was determined by weighing or measuring the area (in square millimeters) of the portion of the paper strip soaked with it. To identify the impregnation zone, coloring was performed with a 0.2% alcohol solution of ninhydrin.

The disadvantage is that this method does not make it possible to establish locally forming pathological changes in a single periodontal complex. It is not possible to determine how changes that occur during the course of the disease or with ongoing treatment in the periodontium of a tooth (group of teeth) affect the condition of periodontal tissues in the area of other teeth.

A known method for predicting complications after prosthetics with secondary partial adentia. The method is as follows. After a periodontal treatment, the patient determines the amount of gingival fluid in the teeth that limit the defect, and then determine the convergence angle of each of these teeth, equal to the difference between the values of the angle of inclination of the studied tooth and the same tooth of the opposite jaw. If the amount of gingival fluid corresponding to the intact periodontium and the angle of convergence of the teeth is up to 5 degrees, the risk of complications is excluded (Kopytov A.A. Dynamics of changes in gingival fluid during rehabilitation of patients with bridges with different inclination of the abutment teeth: Dis .... k.m Science / MGMSU. - 2008. - 151 pp. RF Patent No. 2289358, published December 20, 2006)

Lack of work: the study of quantitative criteria for the exudation of gingival fluid in the region of the second molars of the upper jaw, planned supporting, while restoring the integrity of the dental arch. There are no studies regarding other groups of teeth. In this study, the severity of periodontal pathology was determined according to the data proposed by G.M.Barer. For all groups of teeth, this algorithm was not possible to apply due to lack of data.

A known method for quantifying the state of periodontal tissues is the gingival fluid index.

In all examined individuals, in this work, gingival fluid was measured in gingival sulci in 20 teeth. Determining the amount of gingival fluid in such a number of teeth requires a significant investment of time. In order to reduce the time of examination of the patient in order to more conveniently use the gingival fluid indicators in the clinic, it was proposed to determine the gingival fluid in the following 6 teeth:

1.6; 1.1; 2.4; 3.6; 3.1; 4.4

The choice of these teeth was based on data on the unequal amount of gingival fluid secreted from the gingival grooves in various groups of teeth, as well as on data on a certain symmetry of the level of gingival fluid secretion in the same teeth on the right and left half of the upper and lower jaw.

The gingival fluid index reflects the average amount of gingival fluid per patient. The calculation of the index is as follows:

In order to find out whether the indices of the proposed index correspond to the average indices of the gingival fluid per examined, obtained using 20 teeth, a comparative study of these indices was carried out in 50 people with an intact periodontium and in 50 people with chronic catarrhal gingivitis. It was found that with an intact periodontium in 80.57% of the examined, the quantitative indices of the gingival fluid index were in the range of 0-0.05 mg. In chronic catarrhal gingivitis in 74.98% of cases, the index values ranged from 0.1 mg to 0.3 mg or more.

In addition, in order to clarify the intervals of quantitative indicators of gingival fluid depending on the clinical condition of periodontal tissues, we studied the relative frequencies of individual values of the amount of gingival fluid as a percentage of the total number of examined teeth in the area of which the gingival fluid was taken.

The interval of quantitative gingival fluid indices for an intact periodontium was determined based on the analysis of gingival fluid indices in the area of the examined teeth in the 1st group of individuals with an intact periodontium.

In order to identify the range of gingival fluid quantitative indicators characteristic of the alleged preclinical changes in periodontal tissues, we studied the relative frequencies of individual values of the gingival fluid in percent of the total number of teeth examined in the 2nd group of individuals with an intact periodontium and in areas with apparently intact gum with chronic catarrhal gingivitis.

The interval of quantitative indicators of gingival fluid in the presence of inflammation in the periodontal tissues was determined based on the analysis of gingival fluid values in areas where there was inflammation of the gum tissue in chronic catarrhal gingivitis and in patients with periodontitis. As a result of the studies, it was found that with intact periodontal disease in 80.39% of cases from the gingival grooves from 0 to 0.05 mg of gingival fluid is released. With presumptive preclinical changes in periodontal tissues in the 2nd group of individuals with an intact periodontium and in areas without visible gum inflammation in chronic catarrhal gingivitis, quantitative gingival fluid values ranged from 0.05 mg to 0.1 mg in 54.32% and 41 , 59% of cases, respectively.

In chronic catarrhal gingivitis in areas with an inflamed gum, 73.89% of the gingival fluid ranged from 0.1 mg to 0.3 mg. In patients with periodontitis in 66.47% of cases, quantitative gingival fluid values ranged from 0.3 mg and higher.

Based on the studies conducted in order to use the proposed gingival fluid index in the clinic, the following indicative intervals of quantitative gingival fluid indicators are recommended depending on the condition of periodontal tissues:

(0-0.05 mg) - intact periodontium,

(0.05-0.1 mg) - there may be preclinical changes,

(0.1-0.3 mg) - chronic catarrhal gingivitis,

(0.3 mg and above) - periodontitis.

Halitova E.S. Quantitative and qualitative indicators of gingival fluid in the norm and in the pathology of periodontal tissues: Dis .... k.m.s. / Order of the Red Banner of Labor Moscow Dental Institute named after N.A.Semashko. - 1989. - 173 p.

The disadvantages of this work are:

- The study of patients only with complete dentitions (a similar category of persons is extremely rare in clinical practice) without taking into account the fact of the severity and (or) violation of approximate contacts, which reduces the reliability.

- Gingival fluid exudation parameters are presented selectively.

- The criterion for evaluating exudation is weighted, which crosses out one of the main advantages of the diagnostic system under consideration - its low budget, i.e. availability. This approach stipulates the mandatory availability of high-precision scales, and the implementation of the relevant requirements creating the conditions for their work. Increases the time for one study.

The objectives of the invention are the development of low-budget and, therefore, an affordable way to determine periodontal conditions in patients with complete dentition, and with a defect in the integrity of the dentition characterizing the condition of periodontal tissues of the dentition as a whole, and each tooth individually.

The solution of the tasks is achieved due to the fact that the proposed method for determining periodontal conditions, including determining the amount of gingival fluid in the periodontal groove of the teeth, and determine the amount of gingival fluid in the periodontal groove or periodontal pocket in the area of all available teeth, compare the obtained values with the following indicators:

tooth 11: 0.167 0.02 intact periodontium (hereinafter referred to as IP), 0.474 ± 0.02 periodontium in which preclinical changes are possible (hereinafter referred to as CI), 0.617 ± 0.03 catarrhal gingivitis (hereinafter referred to as CH); tooth 12: 0.149 ± 0.02 PI, 0.419 ± 0.02 CI, 0.545 ± 0.05 KG; tooth 13: 0.184 ± 0.02 PI, 0.448 ± 0.02 CI, 0.681 ± 0.05 KG; tooth 14: 0.227 ± 0.03 PI, 0.484 ± 0.05 CI, 0.733 ± 0.05 KG; tooth 15: 0.309 ± 0.04 PI, 0.541 ± 0.04 CI, 0.792 ± 0.05 KG; tooth 16: 0.406 ± 0.05 PI, 0.933 ± 0.05 CI, 1.395 ± 0.07 KG; tooth 17: 0.386 ± 0.05 PI, 0.928 ± 0.05 CI, 1.377 ± 0.08 KG;

tooth 21: 0.165 ± 0.02 PI, 0.435 ± 0.02 CI, 0.623 ± 0.03 KG; tooth 22: 0.175 ± 0.02 PI, 0.401 ± 0.02 CI, 0.556 ± 0.04 KG; tooth 23: 0.186 ± 0.02 PI, 0.458 ± 0.02 CI, 0.638 ± 0.04 KG; tooth 24: 0.201 ± 0.02 PI, 0.465 ± 0.03 CI, 0.742 ± 0.05 KG; tooth 25: 0.278 ± 0.04 PI, 0.517 ± 0.03 CI, 0.740 ± 0.05 KG; tooth 26: 0.454 ± 0.05 PI, 0.965 ± 0.05 CI, 1.398 ± 0.08 KG; tooth 27: 0.440 ± 0.05 PI, 0.949 ± 0.05 CI, 1.378 ± 0.08 KG;

tooth 31: 0.099 ± 0.02 PI, 0.297 ± 0.02 CI, 0.560 ± 0.03 KG; tooth 32: 0.103 ± 0.02 PI, 0.290 ± 0.02 CI, 0.541 ± 0.03 KG; tooth 33: 0.117 ± 0.02 PI, 0.351 ± 0.02 CI, 0.602 ± 0.03 KG; tooth 34: 0.195 ± 0.02 PI, 0.452 ± 0.02 CI, 0.644 ± 0.04 KG; tooth 35: 0.272 ± 0.03 PI, 0.501 ± 0.03 CI, 0.706 ± 0.05 KG; tooth 36: 0.386 ± 0.05 PI, 0.768 ± 0.05 CI, 1.083 ± 0.07 KG; tooth 37: 0.379 ± 0.05 PI, 0.737 ± 0.05 CI, 1.022 ± 0.08 KG;

tooth 41: 0.113 ± 0.02 PI, 0.282 ± 0.02 CI, 0.596 ± 0.03 KG; tooth 42: 0.123 ± 0.02 PI, 0.276 ± 0.02 CI, 0.501 ± 0.04 KG; tooth 43: 0.150 ± 0.02 PI, 0.375 ± 0.03 CI, 0.656 ± 0.04 KG; tooth 44: 0.197 ± 0.03 PI, 0.465 ± 0.03 CI, 0.722 ± 0.05 KG; tooth 45: 0.250 ± 0.03 PI, 0.498 ± 0.03 CI, 0.728 ± 0.06 KG; tooth 46: 0.358 ± 0.05 PI, 0.673 ± 0.05 CI, 1.161 ± 0.07 KG; tooth 47: 0.349 ± 0.05 PI, 0.651 ± 0.05 CI, 1.095 ± 0.07 KG;

and make a conclusion about the severity and prevalence of the pathological process as a whole and (or) in the area of a tooth, after which the indicated therapeutic measures are carried out and the amount of gingival fluid in the area of existing teeth is re-determined, the obtained values are compared with the initial data, and then a conclusion the impact of the event on the periodontium of the patient, a change in the prevalence and severity of the disease.

Studies of the patterns of inflammatory-dystrophic processes in periodontal tissues, taking into account the listed disadvantages, made it possible to identify a pattern adapted to newly emerging views on etiopathogenesis (Table 1):

1. A study of the periodontium of individuals with impaired integrity of aksximal contacts along the dental arches was carried out.

2. Full data on the parameters of the exudation of gingival fluid in the area of all groups of teeth are presented.

3. The presented material allows not only to study the dynamics of processes in the periodontium of a single tooth, but also to determine the interdependent changes in various parts of the periodontal complex.

4. The severity of periodontal pathology is determined by the area of impregnation. It is based on the phenomenon of capillarity (wetting of filter paper).

The revealed pattern, reflected in table 1, is recommended to be considered as a program-evaluation scale for the diagnosis of intermediate and final results of both individual and complex treatment and rehabilitation measures. We also consider its rational use in:

- calibration of special processes of other scientific studies;

- selection of methods and development of research methods;

- the formulation of preliminary conclusions, their testing and clarification;

- substantiation of final conclusions and practical recommendations.

The developed method for determining pre-nasological changes in periodontal conditions, the severity of its diseases and the dynamics of the quality of the treatment allows, based on the newly obtained data, regarding the exudation of the gingival fluid of each tooth, to compile a complete picture of the patient’s periodontal status. It is possible to build diagnostic algorithms “from particular to general” and “from general to particular”.

It is also possible to monitor how the change in the periodontal status of a single tooth, which has arisen as a result of the influence of any type of damage, or the treatment performed, affects the periodontal status of the interested teeth and the condition of the entire masticatory apparatus.

Diagnosis of the periodontal condition as a “periodontium in which preclinical changes are possible” and the implementation of preventive measures in this condition, gives dentistry a preventive orientation that makes it possible to avoid the development of various forms of diseases. Using the proposed method is a reliable tool that enables reliable monitoring of the dynamics of periodontal conditions.

The proposed method is carried out in the following way: in patients with any periodontal condition, from "intact", characterized by a complete absence of clinical manifestations of pathological changes, to "periodontitis", characterized by an expanded clinical picture, determine the amount of gingival fluid in the area of any tooth or the area of all teeth, carry out any procedure shown, in the absence of a visible clinical effect, re-conduct a quantitative study of the gingival fluid, to reduce or increase th area impregnating judge the impact of the procedure on how periodontal tooth in respect of which the intervention, and the whole complex of the periodontal patient.

Clinical example 1.

Patient A. 24 years old. I went to the clinic with complaints of bleeding gums when brushing my teeth. After a comprehensive periodontal treatment, she asked me to individually select from the spectrum of toothpastes offered by trade organizations the one that is clinically suitable for her. Previously, the patient preferred products of the Italian-Russian company Premier Product. After obtaining informed consent, it was proposed to study the effects on the periodontal tissues of President Exclusive and President Classic toothpastes.

No complaints at the time of admission.

Objectively: The mucous membrane of the oral cavity is pale pink. The gum fills the interdental spaces and tightly covers the neck of the teeth, forming a gingival sulcus; the depth of sounding of the gingival sulcus does not exceed 2.5 mm; enamel-cement border is covered. Colorimetric indices are negative. The dentitions are full. Approximate contacts are expressed.

Preliminary diagnosis: condition after periodontal treatment. Sanitized periodontium.

In order to clarify the clinical situation, a quantitative study of the gingival fluid was performed (Table 2; p. 3, 5). The obtained values of the areas of impregnation characterized the patient’s periodontium as "periodontal disease in which preclinical changes are possible."

Clinical diagnosis: Periodontium, in which preclinical changes are possible

Research technique: The patient was asked to purchase two identical toothbrushes and brush her teeth in the usual mode for a month with President Exclusive paste, and then come for a diagnostic examination. After inspection, change the paste to President Classic and perform hygiene measures using the following brush. A follow-up inspection was also planned in a month.

After using President Exclusive paste during the examination of the oral cavity, clinically inflammatory and dystrophic processes in the oral cavity did not appear. Having determined the amount of gingival fluid in the area of all groups of teeth by the standard method, we compared with the developed revealed pattern reflected in Table 1. After making the appropriate calculations, they revealed a significant increase in exudation in the area of chewing teeth. The obtained results of filter paper impregnation are given (Table 2; p. 2, 7).

The following month, President Classic toothpaste was used for hygiene events. After the agreed period, the patient appeared for examination again. Signs of inflammatory-dystrophic processes in the oral cavity were not detected. Exudation of gingival fluid in the area of chewing teeth decreased (table 2; p. 1, 8). We turned to the developed revealed pattern, which is reflected in Table 1, compared the area of impregnation after applying each of the two pastes for a month, and it was concluded that the patient was using President Classic paste.

Clinical example

Patient B., 31 years old, came to the clinic with complaints of increased tooth sensitivity from temperature irritants, bleeding gums when brushing your teeth. Twice a year, she undergoes anti-inflammatory therapy with a periodontist. Observes the rules for oral care. Bleeding during treatment disappears and resumes within a week after the end of treatment. During pregnancy and lactation, 16, 26 teeth were lost. Last tooth extraction 26 - 4 months ago. It claims that after the last removal, a one-sided chewing type has formed.

Objectively: 17, 27 stable. The mobility according to T.S. Flezar is 0. On intraoral images in the area of 17, 27 teeth medially, there are no trailing cortical plates. The sounding depth of the periodontal pocket in the region of 17, 27 is 3.5 mm. There is no bleeding during sounding.

In the cervical areas 13, 14, 23, 24, 25, 33, 34, 35, wedge-shaped defects. Left-sided sharply expressed.

The mucous membrane of the oral cavity is pale pink. In the area of premolars and the frontal group of teeth, the gum fills the interdental spaces and tightly covers the neck of the teeth, forming a gingival sulcus; the depth of sounding of the gingival sulcus does not exceed 2.5 mm; enamel-cement border is covered. RMA - 9%. Hygienic index - 1 - absence of inflammation. The lower dentition is complete. Approximate contacts are expressed.

Preliminary diagnosis: Localized periodontitis in the area of 17, 27 teeth. Wedge-shaped defects of 13, 14, 23, 24, 25, 33, 34, 35 teeth. Hypersthesia of the teeth.

In order to clarify the periodontal status, a quantitative study of the gingival fluid was performed (Table 3; p. 2, 6). Correlating the obtained values with the revealed regularity, they received confirmation of the patient's statement about a one-sided type of chewing. The amount of gingival fluid obtained in the area of the teeth of the lower jaw gradually increases from the incisors to the molars. There is a lack of symmetry in the allocation of the amount of gingival fluid in the teeth of the same name on the right and left half of the lower jaw. This pattern is observed in individuals with the recently developed unilateral type of chewing on one of the sides. On the right half of the lower jaw, the increase in the amount of gingival fluid is more pronounced. If on the left half of the lower jaw the amount of gingival fluid is in the middle of the interval “periodontal period in which preclinical changes are possible”, then on the right half, the amount of gingival fluid secreted in a larger volume approaches the border of this interval. Realized chewing load, in the absence of pathological processes in the periodontium of antagonist teeth, causes an identical clinical response. In our case, this is not observed. In the area of teeth located on the right half of the upper jaw, the amount of gingival fluid increases significantly, in accordance with the physiology of chewing of the patient, without going beyond the interval "periodontal, in which preclinical changes are possible." In the area of teeth located on the left half of the upper jaw, the amount of gingival fluid is allocated in volumes close to the volumes characterizing catarrhal gingivitis. The absence of other clinical evidence of developing periodontal pathology suggested a clearly defined local effect of the pathogenic factor.

Clinical diagnosis: Mechanical trauma to marginal gums. Localized periodontitis in the area of 17, 27 teeth. Wedge-shaped defects of 13, 14, 23, 24, 25, 33, 34, 35 teeth. Hypersthesia of the teeth.

It was suggested that bleeding during brushing is not associated with localized periodontitis in the area of 16, 26 teeth. Bearing in mind the above and the fact that wedge-shaped defects develop due to the mechanical effect of the toothbrush, the patient was asked to change the brush used by her to a treatment-and-prophylactic one, with a flexible arm (rubber insert) and bristles sensitive (very soft) and or soft (soft) . Control examination - after two weeks.

Two weeks later, the patient complained of increased tooth sensitivity from temperature irritants. Complaints of bleeding during brushing did not show.

Objectively: no signs indicating the development of inflammatory-dystrophic periodontal diseases have been identified. The application of the developed database allowed us to draw a number of conclusions. The area of soaking with gingival fluid decreased in all teeth located both on the upper jaw and on the lower. Moreover, the amount of gingival fluid obtained in the area of 23, 24, 25 teeth decreased and was determined in the middle of the interval characterizing periodontal disease as “periodontal period in which preclinical changes are possible”. This directly indicates the cessation of mechanical damage to the gums with a brush when brushing your teeth and confirms the correctness of the selected algorithm of action (table 3; p. 1, 7).

The study of quantitative criteria for the gingival fluid exudation allows one to reliably determine both the quality of preclinical periodontal conditions and the severity of pronounced clinical changes, as well as the effect of therapeutic measures on the dynamics of the course of diseases.

Table 1 Impregnation area (cm ² ) of standard strips with gingival fluid, characterizing the different status of periodontal tissues. Catarrhal Ingivitis 1.377 ± 0.08 1.395 ± 0.07 0.792 ± 0.05 0.733 ± 0.05 0.681 ± 0.05 0.545 ± 0.05 0.617 ± 0.03 0.623 ± 0.03 0.556 ± 0.04 0.638 ± 0.04 0.742 ± 0.05 0.740 ± 0.05 1.398 ± 0.08 1.378 ± 0.08 Periodontal period in which preclinical changes are possible 0.928 ± 0.05 0.933 ± 0.05 0.541 ± 0.04 0.484 ± 0.05 0.448 ± 0.02 0.419 ± 0.02 0.474 ± 0.02 0.435 ± 0.02 0.401 ± 0.02 0.458 ± 0.02 0.465 ± 0.03 0.517 ± 0.03 0.965 ± 0.05 0.949 ± 0.05 Intact Periodontium 0.386 ± 0.05 0.406 ± 0.05 0.309 ± 0.04 0.227 ± 0.03 0.184 ± 0.02 0.149 ± 0.02 0.167 ± 0.02 0.165 ± 0.02 0.175 ± 0.02 0.186 ± 0.02 0.201 ± 0.02 0.278 ± 0.04 0.454 ± 0.05 0.440 ± 0.05 Tooth formula 17 16 fifteen fourteen 13 12 eleven 21 22 23 24 25 26 27 47 46 45 44 43 42 41 31 32 33 34 35 36 37 Intact Periodontium 0.349 ± 0.05 0.358 ± 0.05 0.250 ± 0.03 0.197 ± 0.03 0.150 ± 0.02 0.123 ± 0.02 0.113 ± 0.02 0,099 ± 0,02 0.103 ± 0.02 0.117 ± 0.02 0.195 ± 0.02 0.272 ± 0.03 0.386 ± 0.05 0.379 ± 0.05 Periodontal period in which preclinical changes are possible 0.651 ± 0.05 0.673 ± 0.05 0.498 ± 0.03 0.465 ± 0.03 0.375 ± 0.03 0.276 ± 0.02 0.282 ± 0.02 0.297 ± 0.02 0.290 ± 0.02 0.351 ± 0.02 0.452 ± 0.02 0.501 ± 0.03 0.768 ± 0.05 0.737 ± 0.05 Catarrhal gingivitis 1,095 ± 0,07 1.161 ± 0.07 0.728 ± 0.06 0.722 ± 0.05 0.656 ± 0.04 0.501 ± 0.04 0.596 ± 0.03 0.560 ± 0.03 0.541 ± 0.03 0.602 ± 0.03 0.644 ± 0.04 0.706 ± 0.05 1,083 ± 0,07 1,022 ± 0,08

table 2 The area of impregnation (cm ² ) of standard strips with gingival fluid obtained from the patient’s gingival grooves in the process of determining the appropriateness of the use of toothpastes. President classic 0.926 0.910 0.526 0.467 0.454 0.431 0.463 0.433 0.399 0.449 0.456 0.521 0.944 0.930 President exclusive 1,097 1,078 0,607 0.538 0.504 0.439 0.491 0.454 0.430 0.513 0.516 0.583 1,051 1,052 initial situation 0.907 0.898 0.519 0.458 0.442 0.407 0.463 0.425 0.389 0.435 0.444 0.502 0.937 0.916 Tooth formula 17 16 fifteen fourteen 13 12 eleven 21 22 23 24 25 26 27 47 46 45 44 43 42 41 31 32 33 34 35 36 37 initial situation 0.720 0.754 0.476 0.442 0.351 0.266 0.271 0.289 0.279 0.332 0.433 0.473 0.768 0.713 President exclusive 0.817 0.856 0.542 0.615 0.399 0.279 0.285 0.331 0,304 0.384 0.496 0.543 0.866 0.809 President classic 0.733 0.771 0.485 0.450 0.367 0.267 0.270 0.293 0.284 0.344 0.445 0.463 0.779 0.725 An increase in the amount of gingival fluid compared to the initial state by more than 10% An increase in the amount of gingival fluid compared with the initial state by less than 10%,

Table 3 The area of soaking (cm) of standard strips with gingival fluid obtained from the gingival grooves of patient B in the process of diagnostic measures and treatment. Follow-up inspection after toothbrush change 1,118 0.629 0.525 0.520 0.449 0.489 0.487 0.452 0.518 0.524 0.633 0.955 The amount of gingival fluid received in the first visit 1,156 0.642 0.547 0.531 0.453 0.504 0.498 0.483 0.602 0.671 0.701 0.973 Periodontal period in which preclinical changes are possible 0.928 ± 0.05 0.933 ± 0.05 0.541 ± 0.04 0.484 ± 0.05 0.448 ± 0.02 0.419 ± 0.02 0.474 ± 0.02 0.435 ± 0.02 0.401 ± 0.02 0.458 ± 0.02 0.465 ± 0.03 0.517 ± 0.03 0.965 ± 0.05 0.949 ± 0.05 Tooth formula 17 16 fifteen fourteen 13 12 eleven 21 22 23 24 25 26 27 47 46 45 44 43 42 41 31 32 33 34 35 36 37 Periodontal period in which preclinical changes are possible 0.651 ± 0.05 0.673 ± 0.05 0.498 ± 0.03 0.465 ± 0.03 0.375 ± 0.03 0.276 ± 0.02 0.282 ± 0.02 0.297 ± 0.02 0.290 ± 0.02 0.351 ± 0.02 0.452 ± 0.02 0.501 ± 0.03 0.768 ± 0.05 0.737 ± 0.05 The amount of gingival fluid received in the first visit 0.860 0.881 0.562 0.547 0.431 0.319 0.337 0.313 0,304 0.399 0.491 0.517 0.823 0.811 Follow-up inspection after toothbrush change 0.846 0.861 0.551 0.526 0.424 0,303 0.320 0,305 0.297 0.385 0.483 0.504 0.801 0.792 Lost teeth An increase in the amount of gingival fluid within the "periodontal period in which preclinical changes are possible" Increased gingival fluid to catarrhal gingivitis

Claims (1)

A method for determining periodontal conditions, including determining the amount of gingival fluid in the gingival groove of the teeth, characterized in that the amount of gingival fluid in the gingival groove or periodontal pocket in the area of all available teeth is determined, and the obtained values are compared with the following indicators:
tooth 11: 0.167 ± 0.02 intact periodontium (hereinafter referred to as IP), 0.474 ± 0.02 periodontium in which preclinical changes are possible (hereinafter referred to as CI), 0.617 ± 0.03 catarrhal gigivitis (hereinafter referred to as CG); tooth 12: 0.149 ± 0.02 PI, 0.419 ± 0.02 CI, 0.545 ± 0.05 KG; tooth 13: 0.184 ± 0.02 PI, 0.448 ± 0.02 CI, 0.681 ± 0.05 KG; tooth 14: 0.227 ± 0.03 PI, 0.484 ± 0.05 CI, 0.733 ± 0.05 KG; tooth 15: 0.309 ± 0.04 PI, 0.541 ± 0.04 CI, 0.792 ± 0.05 KG; tooth 16: 0.406 ± 0.05 PI, 0.933 ± 0.05 CI, 1.395 ± 0.07 KG; tooth 17: 0.386 ± 0.05 PI, 0.928 ± 0.05 CI, 1.377 ± 0.08 KG;
tooth 21: 0.165 ± 0.02 PI, 0.435 ± 0.02 CI, 0.623 ± 0.03 KG; tooth 22: 0.175 ± 0.02 PI, 0.401 ± 0.02 CI, 0.556 ± 0.04 KG; tooth 23: 0.186 ± 0.02 PI, 0.458 ± 0.02 CI, 0.638 ± 0.04 KG; tooth 24: 0.201 ± 0.02 PI, 0.465 ± 0.03 CI, 0.742 ± 0.05 KG; tooth 25: 0.278 ± 0.04 PI, 0.517 ± 0.03 CI, 0.740 ± 0.05 KG; tooth 26: 0.454 ± 0.05 PI, 0.965 ± 0.05 CI, 1.398 ± 0.08 KG; tooth 27: 0.440 ± 0.05 PI, 0.949 ± 0.05 CI, 1.378 ± 0.08 KG;
tooth 31: 0.099 ± 0.02 PI, 0.297 ± 0.02 CI, 0.560 ± 0.03 KG; tooth 32: 0.103 ± 0.02 PI, 0.290 ± 0.02 CI, 0.541 ± 0.03 KG; tooth 33: 0.117 ± 0.02 PI, 0.351 ± 0.02 CI, 0.602 ± 0.03 KG; tooth 34: 0.195 ± 0.02 PI, 0.452 ± 0.02 CI, 0.644 ± 0.04 KG; tooth 35: 0.272 ± 0.03 PI, 0.501 ± 0.03 CI, 0.706 ± 0.05 KG; tooth 36: 0.386 ± 0.05 PI, 0.768 ± 0.05 CI, 1.083 ± 0.07 KG; tooth 37: 0.379 ± 0.05 PI, 0.737 ± 0.05 CI, 1.022 ± 0.08 KG;
tooth 41: 0.113 ± 0.02 PI, 0.282 ± 0.02 CI, 0.596 ± 0.03 KG; tooth 42: 0.123 ± 0.02 PI, 0.276 ± 0.02 CI, 0.501 ± 0.04 KG; tooth 43: 0.150 ± 0.02 PI, 0.375 ± 0.03 CI, 0.656 ± 0.04 KG; tooth 44: 0.197 ± 0.03 PI, 0.465 ± 0.03 CI, 0.722 ± 0.05 KG; tooth 45: 0.250 ± 0.03 PI, 0.498 ± 0.03 CI, 0.728 ± 0.06 KG; tooth 46: 0.358 ± 0.05 PI, 0.673 ± 0.05 CI, 1.161 ± 0.07 KG; tooth 47: 0.349 ± 0.05 PI, 0.651 ± 0.05 CI, 1.095 ± 0.07 KG;
and make a conclusion about the severity and prevalence of the pathological process as a whole and (or) in the area of a tooth, after which they take therapeutic measures and re-determine the amount of gingival fluid in the area of existing teeth, compare the obtained values with the initial data, and then conclude that the effect of the event on the periodontium of the patient, a change in the prevalence and severity of the disease.