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  • Modelo Periograma

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    odalisiofilho-1
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    This document is a periodontal chart used to record periodontal examination findings for 28 teeth. It includes sections to record mobility, furcation involvement, bleeding on probing, plaque, probing depth and gingival margin levels for facial, lingual, mesial and distal tooth surfaces. Examination findings are recorded numerically for each tooth surface. There are also sections to record average probing depth, clinical attachment level, percentage of sites with plaque and bleeding and treatment modalities.

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    MODELO_PERIOGRAMA

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    This document is a periodontal chart used to record periodontal examination findings for 28 teeth. It includes sections to record mobility, furcation involvement, bleeding on probing, plaque, probing depth and gingival margin levels for facial, lingual, mesial and distal tooth surfaces. Examination findings are recorded numerically for each tooth surface. There are also sections to record average probing depth, clinical attachment level, percentage of sites with plaque and bleeding and treatment modalities.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    20 views1 page

    Modelo Periograma

    Uploaded by

    odalisiofilho-1
    This document is a periodontal chart used to record periodontal examination findings for 28 teeth. It includes sections to record mobility, furcation involvement, bleeding on probing, plaque, probing depth and gingival margin levels for facial, lingual, mesial and distal tooth surfaces. Examination findings are recorded numerically for each tooth surface. There are also sections to record average probing depth, clinical attachment level, percentage of sites with plaque and bleeding and treatment modalities.

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    of 1

    MODELO DE PERIOGRAMA

    18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28
    MOBILIDADE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    IMPLANTE
    FURCA
    SANGRAMENTO À SONDAGEM
    PLACA
    MARGEM GENGIVAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    PROFUNDIDADE DE SONDAGEM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

    VESTIBULAR

    PALATINA
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    MARGEM GENGIVAL
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    PROFUNDIDADE DE SONDAGEM
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

    PLACA
    SANGRAMENTO À SONDAGEM
    FURCA
    NOTA
    MÉD. DA PROF. DE SONDAGEM: mm MÉD. DE NÍVEL DE INSERÇÃO: mm % PLACA % SANGRAMENTO À SONDAGEM

    NOTA
    FURCA
    SANGRAMENTO À SONDAGEM
    PLACA
    MARGEM GENGIVAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    PROFUNDIDADE DE SONDAGEM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

    LINGUAL

    VESTIBULAR

    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    MARGEM GENGIVAL
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
    PROFUNDIDADE DE SONDAGEM
    0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

    PLACA
    SANGRAMENTO À SONDAGEM
    FURCA
    IMPLANTE
    0 0 0 0 0 0 0 0
    MODALIDADE
    0 0 0 0 0 0 0 0

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

    OBSERVAÇÕES:

    DATA DA CONSULTA: ASSINATURA DO BENEFICIÁRIO: ASSINATURA DO CREDENCIADO:

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