📌 POINTS TO PONDER
🔹Periodontal pocket is pathologically deepened gingival sulcus.
🔹Periodontal pocket is a soft-tissue change, thus can not be detected during radiographic examination.
🔹Biologic/histologic depth is the distance between the gingival margin and base of the pocket (coronal end of the junctional epithelium).
🔹 Clinical/probing depth is the distance between the gingival margins to the base of the probeable crevice up to which probe penetrates into the pocket.
🔹It is bordered by the tooth on one side, by ulcerated epithelium on the other and has the junctional epithelium at its base.
🔹A periodontal pocket is an area that is inaccessible for plaque removal, resulting in the establishment of the following feedback mechanism for further plaque buildup:
plaque → gingival inflammation → periodontal inflammation → periodontal pocket formation → more plaque buildup.
🔹Classification of periodontal pocket:
▪️ Can be pseudo or true pockets
▪️ Simple, compound or complex pockets
▪️ Suprabony or infrabony pockets.
📌 VIVA VOCE
Q1. How Infrabony pocket can be differentiated clinically from suprabony pocket?
Ans. Infrabony pocket can be differentiated clinically from suprabony pocket by inserting the probe parallel to the long-axis of the tooth and pulling it towards the gingiva, if bony resistance is felt the pocket is said to be infrabony. Bony resistance felt is the bony wall of the infrabony pocket, as the base of the pocket is apical to the alveolar crest.
Q2. Which types of pockets are found in furcation defects?
Ans. Spiral/complex pockets are found in furcation defects.
Q3. What is the relative volume of PMNs, when junctional epithelium loses its cohesiveness and detaches from tooth surface?
Ans. The relative volume of PMNs is approximately 60% or more when junctional epithelium loses its cohesiveness and detaches from tooth surface.
Q4. What is the most reliable clinical method to detect a periodontal pocket?
Ans. The most reliable clinical method to detect a periodontal pocket is by using a periodontal probe.
Q5. What is the significance of pus in pocket?
Ans. It is the common feature of periodontal disease but is only a secondary sign. It reflects the nature of inflammatory changes in pocket wall. It is not an indication of depth of pocket or severity of destruction of supporting tissues.
Q6. What is the basic difference between an active and inactive pocket?
Ans. Active pocket consists of more of the inflammatory content and is marked by spontaneous bleeding or bleeding on slight provocation. Inactive pocket contains less inflammatory contents and shows no signs of attachment loss or bone loss.
Q7. What kind of bone loss is found in suprabony pocket?
Ans. Horizontal bone loss.
Q8. What kind of bone loss is found in infrabony pocket?
Ans. Vertical bone loss.
Q9. What are the contents of periodontal pockets?
Ans. Microbial colonies and their products (enzymes, endotoxins and other metabolic products), gingival crevicular fluid, salivary mucin, food debris, desquamated epithelial cells and leukocytes.
Q10. What is probing depth?
Ans. It is the distance between the gingival margin to the base of the probeable crevice upto which probe penetrates into the pocket.
📌 MULTIPLE CHOICE QUESTIONS MCQs
💡 A pseudopocket (or gingival pocket) is formed by the:
A. Coronal migration of the gingival margin
B. Coronal migration of the epithelial attachment
C. Apical migration of the gingival margin
D. Apical migration of the epithelial attachment
Answer : A
💡 Periodontal pockets can BEST be detected by
A. Radiographic detection
B. The color of the gingival
C. The contour of the gingival margin
D. Probing the sulcular area
Answer : D
💡 A compound periodontal pocket is:
A. Spiral type of pocket
B. Present on two or more tooth surfaces
C. Infrabony in nature
D. All of the above
Answer : B
💡 Periodontal pocket wall between tooth and bone is:
A. Infrabony pocket
B. Suprabony pocket
C. Gingival pocket
D. Pseudo pocket
Answer : A