*01/30 - Evaluation of Initial Therapy

Question 1

What are the objectives of initial therapy?

Answer 1

• reduce or eliminate gingival inflammation by removing plaque retentive factors
• reduce or eliminate periodontal pockets produced by edematous enlargement of inflamed gingiva
• achieve surgical manageability

Question 2

What are the purposes of PR-E?

Answer 2

• response to initial periodontal therapy (review systemic health; reassess initial diagnosis)
• residual problems (reassess prognosis)
• treatment plan to improve health for “areas of concern” (review treatment plan)

Question 3

When should re-evaluation of periodontitis be performed? Gingivitis? What if the provider is doing full-mouth SRP divided into several appointments?

Answer 3

• minimum of 4 weeks (to allow tissues time to sufficiently heal)
• maximum 12 weeks (don’t want plaque and deposits to return)
• gingivitis: 2 weeks
• the PR-E is done 4-12 weeks after the LAST quadrant is completed

Question 4

What is the primary goal of periodontal treatment planning? Do this include local or systemic conditions?

Answer 4

• elimination of gingival inflammation and correction of conditions that cause and/or perpetuate it
• includes both local and systemic conditions

Question 5

The decision to extract a tooth is based on what 3 factors?

Answer 5

• mobility
• abscess with already severe CAL
• position

Question 6

What are the phases of periodontal therapy in order?

Answer 6

• initial preparation (etiotrophic phase; diet control, SRP, removal of caries, ill-fitting restorations, antimicrobial therapy, occlusal adjustment, minor ortho, provisional splinting, and prosthesis)
• re-evaluation
• surgical phase (perio/implant/endo)
• restorative phase
• maintenance phase

Question 7

True or false: The initial treatment plan is definitive.

Answer 7

FALSE: it can change after re-evaluation (?)

Question 8

What 4 things should be kept in mind when presenting the treatment plan?

Answer 8

• be specific
• begin with a positive note
• present the entire treatment plan as a unit
• do not hold onto hopeless teeth

Question 9

True or false: If you know that your patient’s finances are tight, you may choose not to include the more expensive treatment in the treatment plan.

Answer 9

FALSE: patient has the right to know different treatment options

Question 10

What is the active phase of periodotnal treatment?

Answer 10

• evaluation and treatment plan
• initial therapy (extractions, if any + periodontal + caries control)
• re-evaluation (do we need to refer for surgeries? are we ready to place patient in perio maintenance?)

Question 11

What occurs first (periodontal surgery or restorations) when surgery is needed? When no surgery is needed?

Answer 11

• SURGERY NEEDED: periodontal surgeries first and then restorations
• NO SURGERY: start restorations, place patient in perio maintenance, but know that sometimes periodontal surgery is needed for restorative needs

Question 12

True or false: Perform 3 different plaque scores to show whether the patient is improving.

Answer 12

true