Charting Parodontal

[Amelie Robertos]

Periodontalcharting refers to a chart utilized by a dental care professional (periodontist, dentist, registered dental hygienist) to write and record gingival[1] and overall oral conditions relating to oral and periodontal health or disease.

The dental professional with the use of a periodontal probe can measure and record a numerical value for various areas on each tooth. These numbers, often referred to as probe measurements, can be assigned to the depth of the gingival sulcus, the location and depth of root furcations, the size and length of oral pathology, the loss of periodontal fiber, the clinical attachment loss (CAL), alveolar bone loss, and help in assessing and determining a periodontal disease classification associated and classified by the American Academy of Periodontology (AAP).

En cliquant sur le numro de n'importe quelle dent, celle-ci sera visuellement barre et toutes ses valeurs seront correspondantes seront supprimes ou inaccessibles. Maintenez la touche SHIFT enfonce et cliquez sur le numro pour rinitialiser toutes les valeurs de la dent.

Les donnes saisies dans le status parodontal en ligne peuvent tre tlcharges sous forme de fichier directement dans le dossier des tlchargements du navigateur.Le status parodontal en ligne peut galement tre sauvegard sous forme de fichier PDF. En cliquant sur le bouton "Imprimer", la bote de dialogue d'impression s'ouvre et permet de slectionner le format Adobe PDF. En cliquant sur OK, l'utilisateur peut slectionner un nom de fichier et un emplacement pour le fichier PDF.

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All information is for internal use only and is kept confidential.

Florida Probe Corporation has been the industry leader in computerized probing and charting for over 20 years. We are proud of our history, longevity and innovation in this field. The Florida Probe Handpiece (computerized probe) was invented at the University of Florida in 1985 in response to a request by the National Institutes of Health and received FDA approval in 1987. Soon after, a computer program was added to organize and track changes in patients' periodontal health. This was the beginning of the Florida Probe System. read more >

In 2009, we are pleased to announce a major upgrade to our FP32 perio charting software, Version 9, which features E-pad digital signature capture and storage for Patient Diagnosis Sheets/informed consent; Live Chat feature within the actual software; SQL database management and support for our new wireless keypad (part of the GoProbe System).

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Dental and periodontal charting provide a graphic description of the conditions in a patient's mouth, including caries (i.e., decay), restorations, missing or malposed teeth, clinical attachment levels, furcation (root) involvement, mobility, pocket depths, bleeding sites, and other deviations from normal. Other conditions that may be charted include erosion, abrasion, developmental anomalies and use of prostheses.

Thorough charting of both visual and radiographic findings allows dental practitioners to collate information needed to assess the patient's level of dental and periodontal health or disease. Charting should be updated with each visit to follow the patient's progress with home care, monitor disease progression, and to track completed dental procedures.

Charting begins with tooth naming and numbering. The maxillary, or upper arch, and the mandibular, or lower arch, each contain 16 teeth in a full adult dentition. Teeth are paired right and left by size, shape, and function. Beginning at the midline, each arch includes two central incisors side by side. Continuing outward to right and left are pairs of lateral incisors, canines (cuspids), first premolars (first bicuspids), second premolars (second cuspids), first molars, second molars, and third molars (wisdom teeth).

In a primary, or deciduous, dentition there are no premolars or third molars. From the midline, pairs are central incisors, lateral incisors, canines, first molars, and second molars. As the adult dentition erupts, first and second primary molars are replaced by adult premolars. Adult molars erupt behind the primary molars in space created by the lengthening maxilla and mandible.

The widely used universal system, adopted in 1974, assigns the permanent teeth numbers from 1 to 32. Primary teeth are assigned letters from a to t, regardless of their position in the mouth. In the permanent dentition, 1 is the third molar of the maxillary (upper jaw) right quadrant. Numbering continues sequentially around the upper arch to 16, the third molar of the maxillary left quadrant. Number 17 is the third molar of the mandibular (lower jaw) left quadrant, and numbering again continues sequentially around the lower arch to 32, the third molar of the mandibular right quadrant. Teeth may drift due to factors including other missing teeth, malocclusion, malpositioning, or congenital abnormalities.

Lettering of primary teeth is similar. An a is assigned to the second molar of the maxillary right quadrant, and lettering continues sequentially around the upper arch to j, the second molar of the maxillary left quadrant. The letter k is the second molar of the mandibular left quadrant, and lettering continues sequentially around the lower arch to t, the second molar of the mandibular right quadrant.

An older system, sometimes used by orthodontists, is Palmer's Notation. In that system, teeth are numbered 1 through 8 or lettered a through e by quadrant, beginning at the midline. Permanent maxillary canines, for instance, would be referred to as "upper right 3" and "upper left 3" instead of 6 and 11. Primary mandibular first molars would be referred to as "lower right d" and "lower left d" instead of s and l. When written down, the numbers or letters are enclosed in half boxes to denote upper or lower, left or right.

A dental chart can be anatomically correct, showing several views of each tooth, or it can be stylized, showing two rows of 16 circles each. Small boxes are usually placed above and below the rows to allow coded notations for each tooth. Each circle represents a tooth, and is divided to show a smaller round center and four outside surfaces. The round center represents the occlusal (i.e., biting surface) of posterior teeth, or the incisal (i.e., biting edge) of anterior teeth. The four surfaces surrounding the center, noted clockwise from the top, are buccal (i.e., outside surfaces of posterior teeth) or facial (i.e., outside surfaces of anterior teeth); mesial (i.e., proximal surface of a tooth closest to the midline); lingual (i.e., inside surface of a tooth); and distal (i.e., proximal surface of a tooth farthest from the midline).

For the purposes of communication, tooth surfaces are referred to by their first initial. For instance, a restoration on the mandibular left first molar that covers the mesial and occlusal surfaces would be called an MO on 19. A carious lesion that extends from mesial to facial to incisal surface of the maxillary right lateral incisor would be an MFI on 7.

Missing teeth are normally charted first, marked out with an X or a single vertical line. Unerupted teeth may be completely circled, with the circle altered if necessary to show partial eruption. Both carious lesions and restorations are marked by coloring the portion of the tooth affected, usually in different colors. For more precise charting, shadings, colors or coded letters may be used to differentiate between types of restorations. Amalgam (i.e., silver) restorations might be colored blue, for instance, while composite (i.e., white) restorations might be outlined in blue. Gold crowns might be marked with a "G" (or designated with a blue outline and oblique lines), and porcelain crowns with a "P." Additionally, full-coverage crowns are usually marked by circling just the crown of the tooth on the chart in blue. Areas of decay or defective restorations are marked in red.

Endodontic (i.e., root canal) restorations can be marked with a black line extending up the length of the tooth root. A periapical abscess (i.e., infection of the tooth nerve) is marked with a small circle at the apex of the root. Conditions such as erosion, abrasion, and congenital abnormalities can be identified with boxed notes. The directions of malpositioned, drifted, and super-erupted teeth can be indicated with arrows.

When a single clinician writes and draws findings on a dental chart, there are concerns about time, accuracy, and cross-contamination. Charting by hand is most efficient with two people, one performing the exam and the other recording the findings on the chart. If a computer is available in the treatment area, a clinician can use a headset microphone and voice-activated charting software for ease and convenience.

Once the teeth themselves have been charted, periodontal charting is indicated. The periodontium, or support structure for teeth, includes gingiva (i.e., gums), periodontal ligaments and membranes, and bone.

Baseline data, recorded as part of the initial examination, is a resource for treatment planning. During treatment, the chart offers direction for instrumentation, alerting the clinician to complex pocketing, mobility, and root furcation involvement. Later, periodically updated charts evaluate the success of home care and professional treatment. Further uses for periodontal charting are as legal evidence, to support a diagnosis and justify treatment, and as forensic evidence. The best defense in a malpractice suit is complete and accurate documentation.

For a periodontal chart, the clinician measures and records pocket depths surrounding the teeth. In a healthy mouth, each tooth is surrounded by a free collar of marginal gingiva. At a depth of 0-3 millimeters, the gingiva is attached to the cementum, the surface of the tooth root. The surrounding 0-3-mm space within the free collar is referred to as the sulcus. In an unhealthy condition, sulcus depths can be much greater because of loss of attachment and are referred to as periodontal pockets.

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