Exam 3 - Tx & Diagnosis Flashcards
T or F, Only in emergencies can you treat a patient before a treatment plan has been established and accepted by the patient.
True
What must occur first before the treatment and sequence is planned?
A diagnosis and prognosis has been determined
Describe the Urgent phase of care
Begins with a thorough review of the patient’s medical condition and history. This initial emergency appointment is to establish patient’s comfort and it may include:
- eliminate pain and/or abscess
- Address emergency concern
Describe things that may occur during the Control Phase of care
- Control active pathological lesions
- Control general caries and initial tooth preparation and provisional for diagnostic purposes
- Provisional restoration for esthetic and/or functional reason
- Control plaque and initial periodontal therapy
- Oral surgery procedures
- Initiation of endodontic treatment
What is the Re-evaluation phase
Phase of treatment plan is to determine the response to our initial therapy before our definitive phase begins.
Describe the Definitive phase of treatment
After reassessing the initial treatment, the patient enters the corrective or definitive phase of treatment.
This phase includes all therapies that restore function after the patient’s disease has been controlled.
- Orthodontics
- Implant restoration
- Fixed and removable prosthodontics
Describe Maintenance phase
Includes regular re-care examinations such as reassessment of occlusion, etc.
Clinical Presentation for Gingivitis
- Inflammation is soft tissue only (superficial)
- Bleeding on provocation
- Probing depth may range from 1-4 mm and present as pseudo pockets
- No loss of attachment or radiographic evidence of bone loss
- No tooth mobility
- No furcation involvement
Initial therapy (Phase I) of Gingivitis
- Medical consult if indicated
- Oral Hygiene instructions
- Full-mouth scale and polish
- Re-evaluation in 4-6 weeks
- Prophylaxis every 6 months if disease is resolved.
Clinical Presentation of Mild Chronic Periodontitis
- Inflammation extending to bone
- Bleeding on provocation
- Attachment loss of 1-2 mm from CEJ
- Probing depths of 3-4 mm
- Radiographic bone loss of
Initial therapy (Phase I) of Mild Chronic Periodontitis
- Medical consult if indicated
- Oral Hygiene Instructions
- Quadrant or half-mouth scaling and root planing with anesthesia
- Requires 2-4 appointments
- Re-evaluation (4-6 weeks)
- 3-4 month maintenance interval (depending on OH)
Clinical presentation of Moderate Chronic Periodontitis
- Inflammation extending to bone
- Bleeding on provocation
- Attachment loss of 3-4 mm from CEJ
- Probing depths 5-6 mm
- Radiographic bone loss of 20%-40%
- Class I and II furcation involvement
- Class I and II tooth mobility
Initial therapy (Phase I) of Moderate Chronic Periodontitis
- Medical consult if indicated
- Oral Hygiene Instructions
- Quadrant or half-mouth scaling and root planing with anesthesia
- Requires 2-4 appointments
- Re-evaluation (4-6 weeks)
- Locally delivered antimicrobials in 5-6 mm residual pockets
- Referral to periodontist
Clinical Presentation of Advanced Chronic Periodontitis
- Inflammation extending to bone
- Bleeding on provocation
- Attachment loss of >5 mm from CEJ
- Probing Depths of >7mm
- Radiographic bone loss > 40%
- Class I, II or III furcation involvement
- Class I, II or III tooth mobility
Initial Therapy (Phase I) of Advanced Chronic Periodontitis
- **Same as Moderate Chronic Periodontitis
1. Medical consult if indicated
2. Oral Hygiene Instructions
3. Quadrant or half-mouth scaling and root planing with anesthesia
4. Requires 2-4 appointments
5. Re-evaluation (4-6 weeks)
6. Locally delivered antimicrobials in 5-6 mm residual pockets
7. Referral to periodontist
Diagnostic Prognosis
Prognosis without treatment
Therapeutic Prognosis
What effect will periodontal treatment have on the course of the disease?
Prosthetic Prognosis
Given the anticipated results of periodontal treatment, what is the forecast for the success of the prosthetic restoration?