How do I set the Periotron to zero? 1. Turn power on about 10 minutes before use. 2. Open a sterile packet of PerioPaper strips and mount the enclosed sheet of strips on the PerioPaper holder usually attached to the top of the Periotron instrument. 3.
Remove a strip with cotton pliers. Place this dry strip between the sensors of the Periotron meter and adjust the instrument to read “00″ with the large adjustment wheel at the front of the instrument . The Periotron 8000 will give you 16 seconds to adjust the 00 following closure of the sensors on the strip.
4. Remove and discard the dry strip; commence GCF measurements.
How do I clean the electrodes?
Water and/or ethyl alcohol are the fluids commonly used to clean the electrodes. A few drops of distilled water from a distilled water bottle onto the middle of a paper tissue (Kleenex) that has been very loosely rolled up works well. The two ends act as handles. This can be gently drawn between the electrodes in their open position. Then the electrodes can be dried by moving a dry portion of the paper tissue between the electrodes. By closing the upper jaw loosely onto the paper tissue, the electrodes are easily dried.
A repeat of the opening and closing of the jaws on another dry part of the tissue will make sure. After a high reading (over a 100 or so) or after a series of readings where some residual GCF has or may have been left, an alcohol swab is a simple means of cleaning the electrodes. Place the swab between the electrodes. Bring the upper jaw to where the swab can be loosely moved back and forth a few times between the electrodes. This should simultaneously clean both electrodes. Then, open the jaws and dry as above with paper tissue.
What are the effects of residual moisture on zero adjustment?
The electrodes should be dried first to ensure that any zero shift is not due to moisture left beforehand on the electrodes. Use paper tissue for drying as above, as this is quite effective. A shift of 1 or 2 units from zero does not warrant re-adjusting the zero. The major cause of instability of the zero is loss of integrity of the special insulation coating on the electrodes that enable them to work as two plates of a capacitor. A common cause of coating damage results from scratching with cotton pliers during careless handling of collection strips.
How do I measure with the Periotron? 1. Using cotton rolls, isolate the gingival site or sites to be measured. 2. Place a saliva aspirator in the patient’s mouth. 3. With an air syringe, gently dry the area around the gingival crevice where GCF is to be measured. Blow air from the syringe across but not into the crevice or pocket. 4. Using cotton pliers, grasp the orange plastic handle of a Periopaper® strip and pull a fresh strip from its clear plastic support mounted on the Periopaper® strip holder. 5. With the other hand, adjust the strip between the beaks of the pliers so that the ends of the beaks close on the white portion of the strip about 1/3 of its length from the orange handle. This will make it easier to place the strip into the crevice and to feel when the strip reaches the base of the crevice. 6. Insert the strip into the gingival crevice; then release the grip of the pliers on the strip and allow the strip to remain in place on its own for 5 seconds. It is simplest to count off the 5 seconds as one-one thousand, two-one thousand etc. 7. Next remove the strip by grasping the orange handle with the cotton pliers. 8. Transfer the strip to the Periotron meter for GCF measurement. Position the strip on the lower sensor so that all but about 1 mm of the white part of the strip ends up between the sensors when they are brought together. Close the movable upper sensor arm and record the reading. 9. When making a large number of GCF measurements, as for example, doing a whole mouth ‘survey’, a “four-handed” technique may be used. The dentist or hygienist isolates and dries the measurement site. The assistant simultaneously performs step 4, then hands the cotton pliers and strip to the dentist or hygienist who then performs steps 5 to 7 inclusive. The cotton pliers and strip are then handed back to the assistant who performs step 8. The whole process takes less than one minute. Repeat until the survey is completed. 10. At all times, the sensors of the instrument should be handled with care. The special coatings on their surfaces are essential for proper operation. When placing strips between the sensors and when bringing the sensors together, do so with care. To do otherwise may damage them and the meter. 11. If residual crevicular fluid or debris is left on the sensors, the meter may not zero with a fresh dry strip. Consequently, the sensors should be gently wiped with a paper tissue (e.g. Kleenex) wetted with a small amount of 70% ethyl alcohol. Dry the sensors with a dry paper tissue and then proceed. Check Periotron “00″ setting with a dry filter paper strip. 12. Check Periotron “00″ periodically (usually after a whole series of readings) and readjust if necessary. 13. A reading of 0 – 20 on the Periotron meter indicates that the tissue is healthy and shows little or no inflammation. Readings increase with increase in the severity of inflammation. A reading between 20 and 60 indicates mild inflammation but not periodontitis; 60 – 150 indicates moderately severe condition and > 150 very severe inflammation. Above a reading of about 60, one can expect the bacterial activity and level of putrefaction to be a severe enough risk factor for periodontitis to proceed. In other words, one can expect at these levels with time to see clinical evidence of epithelial attachment loss and periodontal pocket development which in due time may be measurable upon periodontal probing. The more and the longer that the GCF is above this level, the greater the chance that the relatively insensitive method of periodontal probing will indicate periodontium damage. Just as elevated blood pressure is a high risk factor for cardiovascular disease, elevated GCF levels should be considered to denote a risk of periodontal disease.
How do I calibrate the Periotron using PerioCol Paper?
1. A blank PerioCol strip is placed between the sensors of the Periotron fluid meter, and the zeroing dial on the face of the instrument is adjusted until “zeros” (00) appear on the display. This blank strip is then removed from between the sensors and discarded.
2. Using a microliter syringe which can accurately deliver 0.1 to 1.0 ml of fluid, the readings on the meter are related to the volume in ml as follows:
3. The syringe is filled to capacity (1.0-5.0 ml, depending on the model of syringe selected) with the test fluid (distilled water, saliva or serum; the results are basically the same) making sure that the loaded syringe contains no air bubbles. The plunger is carefully depressed in the barrel to deliver 0.25 ml which appears as a minute droplet at the end of the syringe tip. Without delay, the end of a PerioCol strip is carefully brought into contact with the droplet of test fluid which is immediately absorbed onto the PerioCol strip. Again without delay, the strip is placed between the Periotron sensors, and the score is automatically recorded. This procedure is repeated three (3) more times with this volume (0.25 ml), and the average score is recorded.
4. The procedure is repeated with each of the following (or similar) known volumes: 0.5, 1.0 and 1.25 ml, and the Periotron Score at each volume is again recorded.
5. The Periotron computer program computes a standard curve relating the volume of fluid (ml) on the “x” axis to the Periotron Score on the “y” axis (Click here to see article on standard curve).
6. A strip containing an unknown volume of fluid (e.g. GCF) is then placed between the sensors, the Periotron Score is automatically recorded, and the volume of fluid is determined by interpolation from the standard curve. Values obtained are converted to volumes in ml by Periotron Professional.
