dental

1. EXTENT AND SEVERITY INDEX (ESI) carlos
et al 1986
 The ESI index is an attempt to preserve the maximum
amount of information from a clinical examination
consistent with the need to achieve a reasonable degree
of data reduction

2. EXTENT INDEX
 The extent index describing the proportions of tooth sites
of a subject examined showing signs of destructive
periodontitis
 For an individual the extent score is the percentage of sites
examined that have attachment loss greater than 1mm

3. SEVERITY INDEX
 The severity index describing the amount of
attachment loss at the diseased sites and
expressed as a mean value
 The severity score for an individual is the
average loss of attachment per sites among the
disease sites

4. ADVANTAGE
 Gives information about extent and severity of the
disease
 Doesnt asses gingival inflammation but estimates the
periodontal attachment loss
 Used to summarize data rather than a true index
 ESI is expressed as a bivariate statics

5.  EXTENT INDEX
localized : < 30% of sites affected
generalized : > 30% of sites affected
 SEVERITY INDEX
Either entire dentition or individual teeth/site examined
Slight =1-2mm CAL
Moderate =3-4mm CAL
Severe =5mm CAL

6. NATIONAL INSTITUTE OF DENTAL AND
CRANIOFACIAL RESEARCH (NIDCR)
 NIDCR workshop underwent quantitative evaluation of periodontal
diseases by physical measurement techniques
 Also computerization offers the entire dental team the ideal potential
to achieve examiner standardization ,so that future comparison of
health and disease becomes simpler and more precise and remains
cost effective

7. NIDCR protocol for periodontal disease
assessment
 Attachment loss, pocket depth , furcation involvement
 Examination of mesiobuccal , midbuccal, and disto facial by
using NIDCR probe
 Partial furcation involvement (grade 1)
 Complete furcation involvement ( grade 2)

8. LIMITATIONS OF CONVENTIONAL
PERIODONTAL PROBING
 Lack of sensitivity and reproducibility
 Discrepancy between measurement depends on
probing technique , probing force , angle of insertion of probe , size of
probe, precision of calibration , presence of inflammation
 Readings of clinical pocket depth measured with probe does not coincide
with the histologic pocket depth
 All these variable contribute to the large standard deviation (0.5-1.3mm) in
clinical probing results

9. NIDCR CRITERIA FOR OVERCOMING LIMITATIONS OF CONVENTIONAL PERIODONTAL
PROBING (parakkal P.F. 1979)
Precision 1mm 0.1mm
range 12mm 10mm
Probing force Non standardized Constant & standardized
applicability Non invasive and easy to
use
Non invasive , light
weight and easy to use
reach Easy to access any
location around all teeth
Easy to access any
location around all teeth
angulation subjective A guidance system to
ensure proper angulation
security Easily sterilized
Simple stainless steel
instrument
Complete sterilization of
all the portions entering
the mouth
No biohazard from
materials or electric
shock
readout Depending upon voice
dictation and recording in
writing
Direct electronic reading
and digital output
LIMITATIONS CONVENTIONAL PROBING NIDCR CRITERIA