Post on 14-Apr-2017
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Probing Concepts
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Probing: the act of walking the tip of a probe along the base of a sulcus or pocket for the purpose of assessing the health status of the periodontal tissues
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Walking Stroke
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Probe Walking Stroke
• Walking stroke: a series of bobbing strokes that are made within the sulcus or pocket while keeping the probe tip against the tooth surface
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Production of Walking Strokes
1. Insert the probe and lightly run the tip along the tooth surface until it encounters the soft tissue base of the sulcus or pocket.
• The junctional epithelium that forms the base of a sulcus or pocket feels soft and flexible when touched with the probe tip.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Production of Walking Strokes
2. Create a walking stroke by moving the probe tip up and down in short bobbing strokes.
3. Move forward in 1 mm increments.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Production of Walking Strokes
• The probe is NOT removed from the sulcus with each stroke.
• Repeatedly removing the probe can traumatize the tissue.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Stroke Pressure
• A pressure exerted with the probe tip against the soft tissue base of the sulcus or pocket should be between 10 and 20 grams.
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Calibrate with a Scale
• Standardize your probing pressure by practicing on a scale that measures weight in grams.
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Adaptation of Probe Tip
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Probe Tip
• The Probe tip is 1 to 2 mm of the side of the probe.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
• The probe tip is kept in contact with the tooth surface throughout the walking stroke.
Adaptation of Probe Tip
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Incorrect Adaptation
• The probe tip should NOT be held away from the tooth.
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Parallelism
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• The probe is positioned as parallel as possible to the tooth surface.
• The probe must be parallel in the mesiodistal dimension and the faciolingual dimension.
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Probe Parallel to Long Axis
• This probe is correctly positioned parallel to the long axis of the tooth.
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Incorrect Technique
• This probe is incorrectly positioned.
• It is not parallel to the long axis of the tooth.
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Walk Around the Entire Tooth
Bob along that soft tissue base all around the tooth.
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• Walking strokes with the probe should cover the entire circumference of the sulcus or pocket base.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Depths Vary in a Single Area
• It is common for the depth of a pocket to be deeper in one place.
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Walk the Entire Circumference
• Walk around the entire circumference to avoid missing a deeper area.
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Measurements
How are measurements recorded?
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Measurements Recorded
• Measurements are recorded for 6 specific sites on each tooth.
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Record the Deepest Measurement
• In this example, the deepest reading would be recorded for the facial reading.
• That reading is the one taken at point C.
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Taking Readings on the Mesial and Distal Surfaces
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
• When two teeth are in contact—side by side—a special technique is used to probe the area directly beneath the contact area.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Interproximal Readings
• It is impossible to probe the base of the sulcus that is directly under the contact area.
• The probe cannot fit between two adjacent teeth.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
• A two step technique is used to probe the mesial and distal surfaces.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Step 1: Touch the Contact Area
• Walk the probe between the teeth until it touches the contact area.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Slant the probe slightly so that the tip reaches under the contact area.
• In this position, gently press downward to touch the soft tissue base.
Step 2: Tilt the Probe
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Probing Maxillary MolarsA tight fit!
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Mandible Gets in the Way
• It can be difficult to probe the distal surfaces of the maxillary molars because the mandible gets in the way.
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• Reposition the instrument handle to the side of the patient’s face to reach the distal surfaces of the maxillary molars.
Solution
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Recap
• A very careful, precise technique is used to assess the depths of a sulcus or pocket.
• Use of the walking stroke, correct adaptation, and parallelism are all important.