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 Release 22.0, Sept. 2008
 
Chapter : ch9. Dentistry & Oral Medicine Section : Indices for Evaluating Dental Health Status
  The Periodontal Disease Index (PDI) of Ramfjord

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Copyright (c) 2008-2010, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

The Periodontal Disease Index (PDI) is a modification of Russell's Periodontal Index developed by Ramfjord. It is intended to give an accurate assessment of a person's periodontal status. It can be used as a guide in assessing the need for treatment and for evaluation of the results following treatment. The author was from the University of Michigan.

 

Teeth examined:

(1) maxillary right first molar (tooth #3)

(2) maxillary left central/medial incisor (tooth #9)

(3) maxillary left first bicuspid (tooth #12)

(4) mandibular left first molar (tooth #19)

(5) mandibular right central/medial incisor (tooth #25)

(6) mandibular right first bicuspid (tooth #28)

 

If any of the teeth are missing or unerupted, then only the teeth present are examined.

 

Parameters measured (only gingivitis is used in the PDI):

(1) gingivitis

(2) calculus

(3) plaque

(4) depth of the gingival crevice

 

NOTE: In the original description Ramfjord also monitored mobility and lack of contact between teeth. However, the index does not consider whether the periodontal support has been lost (from periodontitis, atrophy or other cause).

 

Parameter

Finding

Points

gingivitis

no signs of inflammation

0

 

mild to moderate inflammatory gingival changes, not extending around the tooth

1

 

mild to moderately severe gingivitis extending all around the tooth

2

 

severe gingivitis characterized by marked redness, swelling, tendency to bleed and ulceration

3

calculus

none

0

 

supragingival calculus, extending only slightly below the free gingival margin (not more than 1 mm)

1

 

moderate amount of supra and subgingival calculus or subgingival calculus alone

2

 

an abundance of supra and subgingival calculus

3

plaque

none

0

 

present on some but not on all interproximal, buccal and lingual surfaces

1

 

plaque present on all of the interproximal, buccal and lingual surfaces, but covering less than half of these surfaces

2

 

plaques extends over all interproximal, buccal and lingual surfaces, and cover more than one half of these surfaces

3

 

 

Gingival Crevice

Gingivitis Score

PDI Score

does not extend apically to the cementum-enamel junction at any of the measured areas

0

0

 

1

1

 

2

2

 

3

3

extends apically to the cementum-enamel junction but not more than 3.0 mm

NA

4

extends apically to the cementum-enamel junction with a distance of 3.1 – 6.0 mm

NA

5

extends apically to the cementum-enamel junction with a distance of > 6.0 mm

NA

6

 

PDI =

= AVERAGE(PDI scores for the teeth scored)

 

Interpretation:

• minimum index: 0

• maximum index: 6

• The higher the score, the more severe the periodontal disease.

 

  References:

Orban JE, Stallard RE, Bandt CL. Evaluation of indexes of periodontal health. J Am Dental Assoc. 1970; 81: 683-687.

Ramfjord SP. Indices for prevalence and incidence of periodontal disease. J Periodontol. 1959; 30: 51-59.

Ramfjord SP. The Periodontal Disease Index (PDI). J Periodontol. 1967; 38: 602-610.

 

 

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