DENTISTRY
Index used for
gingival disease
assessment
The gingival index was introduced by Loe and
Silness in 1963. 1
• The gingival index can be used in all teeth or
selected teeth and in all surfaces or selected
surfaces.
• The examination is done by using a blunt probe.
• Partially erupted teeth, retained roots, teeth with
periapical lesions and third molars should be
excluded, and there is no substitution.
Figure 8C. Gingival enlargement in a Shih Tzu secondary to cyclosporine.
Score and criteria
0: No inflammation
1: Mild inflammation, slight change in color, slight
edema, no bleeding on probing
2: Moderate inflammation, moderate glazing,
redness, bleeding on probing
3: Severe inflammation, marked redness and
hypertrophy, ulceration, tendency to spontaneous
bleeding
Reference
1. The gingival index, the plaque index and
the retention index systems. J Periodontol
1967;38:610-616.
Figure 8D. The appearance two weeks after medication cessation and
laser treatment.
Gingival recession
Figure 8A. Gingival enlargement surrounding the mandibular incisors in a
boxer.
Gingival recession results in the exposure of the root
surface by apical migration of the gingival margin.
The periodontal attachment level (PAL) is an accurate
measurement of periodontal destruction in cases of
gingival recession where little or no pocketing exists.
The PAL is measured from the base of the gingival
sulcus/periodontal pocket to the cementoenamel
junction. The clinical pocket depth plus recession
(measured from the cementoenamel junction to the
gingival margin) equals the total periodontal attachment
loss (Figure 9).
Figure 8B. Gingival enlargement secondary to amlodipine.
Issue 02 | APRIL 2017 | 31