Comprehensive Treatment Planning Flashcards
What are the aims of periodontal therapy?
To maintain the health, function, comfort and aesthetics of all supporting and surrounding tissues of teeth and dental implants
Attainment of sustained high levels of achievement in personal plaque control reflected as sustained full-mouth bleeding on probing scores around 10% of teeth.
Absence of an increase in attachment loss and/or bone loss
Probing pocket depths of no greater than 5mm, including horizontal probing in furcations of less than 5mm.
Tooth hypermobility should be such that it does not impair the patient’s plaque control efforts and allows the patient to function to an acceptable level in comfort.
What are the goals of periodontal therapy?
Preserve, improve, and maintain natural dentition, implants and surrounding structures
Obtain a healthy periodontium/peri-implant tissues: Absence of inflammation and progressive attachment/bone loss
What does a comprehensive periodontal evaluation consist of?
Anamnesis (recollection)/history general and oral disease
Risk characteristics
Current health status
What classification is used for diagnosis?
AAP/EPP 2018
How are clinical findings, diagnosis and prognosis used to understand necessary treatment?
Clinical findings together with the diagnosis and prognosis
should be used to develop a logical plan of treatment to
eliminate signs and symptoms of periodontal and peri-implant
diseases.
What should the treatment plan contain as a result of the clinical examination, diagnosis and prognosis?
Should be used to establish methods and sequence of delivering appropriate periodontal treatment which may include:
Non-surgical
Surgical
Regenerative
Cosmetic
Dental implant placement procedure
What are the phases of periodontal treatment?
Emergency care phase
Risk management phase
Fundamental phase
Re-assessment/re-evaluation phase
Surgical phase
Maintenance care phase
What should be done in the emergency care phase?
Treat any acute condtions
Extract teeth that are problematic and cannot be saved.
What happens during the risk management phase?
Evaluation of the patient’s systemic status to assess the presence of conditions that may contribute to the periodontal condition observed or may require modification of the plan of treatment.
Addresses all modifiable risk factors associated with periodontal diseases.
Patient education, training in OHI, and counselling on control of risk factors with medical referral where appropriate.
What are possible risk factors to address during risk management phase?
Smoking cessation
Diabetes
Stress management
Plaque control
Other systemic factors (Other diseases, use of medications, need for antibiotics prophylaxis)
What happens during the fundamental phase?
Reinforcement of biofilm control measures, diet orientation when appropriate.
Disrupt biofilms and remove all biofilm retentive factors, provisional sealing of cavities, etc
Treat halitosis and dentine hypersensitivity
Rational use of fluoride: Caries activity and hypersensitivity.
What criteria should be used for determining priority selection of areas for treatment?
Urgency
Severity
Convenience
Experience of the operator and approval of specialist tutor
How should number of sessions be determined in fundamental phase?
Available appointment time
Case severity
Any specific condition and the experience of the operator.
What happens during re-assessment phase?
Comparison of pre-treatment and post-treatment clinical parameters to assess healing responses and determine stability or need for further treatment.
Review and reinforce personal OHI when appropriate.
Update anamnesis
Review initial prognosis
Referral for specialist if needed.
When should re-assessment phase be done?
6 - 8 weeks after fundamental phase.
What happens during the surgical phase?
Antibiotics are given
Surgical debridement and reassessment.
What is done if patient is stable after surgical phase?
Regenerative procedures
Periodontal plastic surgery
Preprosthetic periodontal procedures
Implant surgery.
What is the purpose of the restorative phase of treatment?
If the periodontium is stable, this phase includes a more definitive restorative diagnosis and treatment planning.
This includes orthodontics, restorative, and prosthodontic treatment.
What happens during the maintenance care phase?
Aim of this treatment is to maintain the periodontal treatment results via recall appointments and assessment of periodontal health.
THIS IS MANDATORY.
What should be done in the maintenance care phase?
Update medical and dental histories
Evaluation of current extra and intraoral, periodontal and peri-implant soft tissues as well as dental hard tissues and referral when indicated
Assessment of the oral hygiene status with reinstruction when indicated.
Mechanical tooth cleaning to disrupt/remove dental plaque, biofilms, stains, calculus, etc.
Elimination or mitigation of new or persistent risk and etiological factors with appropriate treatment
Identification and treatment of new, recurrent, or persisting areas of periodontal disease.
Establishment of an appropriate, individualized interval for periodontal maintenance treatment.
What should patient be informed of during treatment?
Areas of persistent, recurrent and persistent, or new periodontal disease
Changes in the periodontal prognosis
Advisability of further periodontal treatment or re-treatment of indicated sites.
Other oral health problems noted that may include caries, defective restorations, and non-periodontal mucosal diseases or conditions and peri-implant diseases
