examination, diagnosis & treatment planning Flashcards
What must you have before formulating a treatment plan?
diagnosis
if a patient has some gingival issues but no crestal bone loss….. do they have periodontits or gingivitis?
no bone loss = gingivitis
how to tell healthy tissue vs gingivitis?
gingivitis= no bone loss but BOP
How are pseudopockets treated?
by regular cleanings
Requirements to start treatment for gingivitis
healthy crestal bone levels with healthy probing depths
6 month maintenance
if bone levesl are healthy but psuedopockets are present, what might you consider for treatment?
prophylaxis with anesthesia
what classification system does dr. yoon like for diagnosing periodontology?
American academy of periodontology. ( ADA system is complex)
what are the diagnostic criteria for perio disease?
localized/generalized
chronic/aggressive
mild-moderate-severe
If disease effects less than 30% of sites it is….
localized
more than 30% is generalized
remember there are 6 sites per tooth
chronic and aggressive is all based off of what?
time,
chronic is more than 1 year
aggressive is less than 1 year
mild-moderate-severe is all based off what?
CAL
1-2mm of loss is mild
3-4 mm of loss is moderate
5+ mm is severe
2 things to remember to be considered periodontitis it must have…
radiographic bone loss
inflammation
what if there is attachment loss but no etiologic factors?
its not periodontitis, consider the following mucogingival deformities, trauma, or periodontal healht after a surgery
treatment planning phases
phase 1- disease control
phase 2- surgery
phase 1 includes….
oral hygiene instructions prophylaxis 6 month maintenance SRP based on probing depths extraction of hopeless teeth restoring carious lesions
after phase 1 how long must you wait to re-evaluate the tissue condition
4-6 weeks if pockets are still present move on to phase 2
phase 2 includes….
surgical phase, recalcitrant probing depths. 5mm with bleeding or 6+ need to see a periodontist
SRP includes….
removing calculus, bacterial toxins, and etiological agents that cause inflammation
goal of SRP
eliminate the problem without having to have surgery
SRP should only be done on teeth that exhibit…..
bone loss( CAL)
whats the critical probing depth for surgery? SRP?
4mm -surgery
3mm SRP
if a pt has no bone loss ( less than 2mm) you can move onto what
maintenance
if bone loss you must diagnose a periodontal condition
Final numbers
if probing depth is greater than 4.2 you should do what?
scale and rooth plane
if probing depth is 2.9 or lower you should do what?
scale
in conclusion clinical diagnosis is based on…..
treatment is based on …..
attachment levels
probing depths
