Perio Prognosis, Treatment Planning And Maintenance

Question 1

Stages of perio

Answer 1

Stage 1. Stage/mild: less than 15% bone loss (worst site) or 2 mm attachment loss from CEJ

Stage 2. Moderate: bone crest -coronal 1/3rd of root

Stage 3. Severe: bone crest -mid 1/3rd of root

Stage 4. Very severe: bone crest- apical 1/3rd of root

*Normal health is up to 2 mm from CEJ to bone crest

Stage represents severity of disease at presentation
It explains anticipated complexity of case management
Describes the extent and distribution of disease in the dentition

Question 2

Grades of perio

Answer 2

Grade A: less than 0.5 (slow rate of progression)

Grade B: 0.5-1 (moderate rate of progression)

Grade C: more than 0.1 (rapid rate of progression)

It is %bone loss divided by pt age

Grade provides supplemental information about the biologic features of the disease

Question 3

Periodontal diagnosis- status

Answer 3

Currently stable:
BoP less than 10%
PPD 4mm or less
No BoP at 4 mm

Currently in remission:
BoP more than 10%
PPD 4mm or more
No BoP at 4 mm sites

Currently unstable:
PPD more than 5mm or
PPD of 4 mm or more AND BoP

Question 4

EFP stage 1 therapy

Answer 4

The first step in therapy is qimee at guiding behavior change by motivating the pt to undertake successful removal of supragingival dental biofilm and risk factor control

Improved OH, PMPR, risk factor control

Question 5

EFP stage 2 therapy

Answer 5

It is cause related therapy
Aimed at controlling (reducing/eliminating) the subgingival biofilm and calculus by subgingival instrumentation

Question 6

EFP stage 3 therapy

Answer 6

Usually surgical treatment that is effective but frequently complex. Should be done by a specialist or dentist with additional specific training

Question 7

Supportive periodontal care

Answer 7

Following the completion of active periodontal therapy, successfully treated periodontitis pt may fall in one of two diagnostic categories:

Periodontitis pt with a reduced but healthy periodontium

Or

Periodontitis pt with gingival inflammation

Both remain at high risk for periodontitis recurrence/ progression and require specifically designed supportive periodontal care, consisting of combination of preventative and therapeutic interventions rendered at different intervals which should include:

• appraisal and monitoring of systemic and periodontal health
  -reinforced OHI
  -pt motivation towards continuous risk fastor control
  -PMPR
  -localized subgingival instrumentation at residual pockets

Supportive care should be scheduled at intervals of 3 to a maximum of 12 months