Labsan, Hilario M.Jung, Young-Min

• The GPI is a modification of the PDI of the Ramfjord for the purpose of screening individuals to determine who needs periodontal treatment.

• The GPI assesses three components of periodontal disease:– gingival status– periodontal status (crevice depth)– collectively material alba, calculus and

overhanging restorationIrritation Index

• To monitor patient progress

• For epidemiologic surveys

• Timothy J. O’Leary• And his following associates:

– Gibson W.A.– Shannon I.A.– Schuessler C.F.– Nabers C.L.

• (1959) after the Periodontal Disease Index of Ramfjord has been founded, Prof. O’Leary formulated a modification of the PDI.

• Periodontal Screening Examination (1963)• Gingival-Periodontal Index (excludes the

calculus and overhanging restoration)

Irritation Index

• Scoring is done on all teeth present.• The assessment is done segment wise. • The primary objective in using the index is

to determine the tooth or its surrounding tissues, with the severest condition within each segment.

• The Dentition is divided into six segments:– (According to FDI notation)18 to 14 13 to 23 24 to 28

38 to 3433 to 4344 to 48

The specific criteria for the gingival status component of the GPI are as

follows:

score criteria

0 • Gingival tissue tightly adapted to the teeth; firm consistency with physiologic architecture

1 • Slight to moderate inflammation; as indicated by changes in color and consistency involving one or more teeth in the same segment but not completely surrounding any one tooth

2 • Inflammatory changes encircling the tooth

3 • Marked inflammatory or gingival contour changes indicated by loss of surface continuity (ulceration), spontaneous hemorrhage, loss of facio-lingual continuity or any interdental papilla, marked deviation from normal contour (such as gross thickening or enlargement covering more than one-third of one anatomic crown), recession, and clefts.

• The area with the highest score determines the gingival score for the entire segment, and the gingival status for the mouth is obtained by dividing the sum of the gingival scores by the number of segments.

sum of gingival scores of all the segments

Total #. of segment

= Gingival score of the mouth

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

Gingival Score

3 0 0 0 1 1 1 0 0 1 1 0 1 0 1 1

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

Gingival Score

0 1 1 3 0 2 1 0 0 1 0 0 1 1 2 3

Upper right post. Upper Anterior Upper left post.

Lower right post. Lower anterior Lower left post

GSM=3+1+1+3+2+3

6

=13

6

= 2.16 Poor gingival health status

Ways of measuring the crevice depth

• Beginning in segment one, the mesiofacial line angle of every tooth erupted to the occlusal plane is probed with a Merritt type probe. (1) (It is round, single bend to shank)

• In probing, the distance from the gingival margin to the Cemento Enamel Junction (CEJ) is noted. Then the probe is advanced to the depth of the pocket and this depth from the gingival margin is noted. Subtracting the first reading from the second one gives the amount of loss of periodontal attachment.

The recording is made at the mesiofacial or buccal line angle with the probe directed in the long axis of the tooth. The probe tip is directed along the crown toward the CEJ at a 45° angle until the junction is located.

Criteria of scoring Periodontal status

score Criteria

0 Probe doesn’t extend 1mm apical to the CEJ of any tooth in the segment & no exposure of CEJ.

4 Probe extends up to 3 mm apical to CEJ of any tooth in segment

5 Probe extends from 3mm to 6mm apical to CEJ of any tooth in

segment

6 Probe extends from 6mm or more apical to CEJ of any tooth in segment

The highest score found on any tooth in a segment is recorded as the periodontal score for the segment.

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

Periodontal score

0 0 5 0 4 0 0 0 0 0 4 0 0 0 6 4

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

Periodontal score

0 0 0 0 0 5 0 0 0 5 0 0 0 0 0 6

Crevice Score

• Periodontal Score of the MouthPSM= sum of crevice scores of all the segments Total # of segments

= 5+4+6+0+5+6 6

= 26 6

= 4.33 Poor health status of epithelial attachment

Compiling the Gingival Periodontal Index

The highest score (either gingival or periodontal) found for each dentulous segment is recorded and the sum is divided by the number of segments to give the GPI score for the individual.

Upper Right Posterior Teeth

Gingival Score = 3Crevice Score = 5Segment Score =

5

Upper Anterior Teeth

Gingival Score = 1Crevice Score = 4Segment Score =

4

Upper Left Posterior Teeth

Gingival Score = 1Crevice Score = 6Segment Score =

6

Lower Right Posterior Teeth

Gingival Score = 3Crevice Score = 0Segment Score =

3

Lower Anterior Teeth

Gingival Score = 2Crevice Score = 5Segment Score =

5

Lower Left Posterior Teeth

Gingival Score = 3Crevice Score = 6Segment Score =

6

GPS = sum of all the segment scores Total # of segments

GPS = 5+ 4 + 6 + 3 + 5 +6 6

= 29 3

= 4.83Patient has relatively high periodontal

treatment needs and has a poor periodontal health status