Periodontal diagnosis/prognosis and treatment planning

Question 1

what factors may affect the patients prognosis?

Answer 1

systemic health and immune status
hereditary factors
aetiology
age of patient related to LOA
smoking status
attitude and co operation of pt

Question 2

what are some local prognostic factors?

Answer 2

plaque
organisms
pocket depth and location
distribution and severity of LOA
presence/severity of furcation
restorative condition
endodontic condition
activity of disease
root length and shape
tooth position
calculus

Question 3

what are the 5 stages of treatment planning?

Answer 3

1. initial exam and pain relief
2. initial cause related therapy
3. re exam and definitive/corrective tx plan
4. definitive/correct tx
5. maintenance

Question 4

what is the goal of non surgical therapy?

Answer 4

To render the roots biologically compatible with soft tissue by eliminating calculus and altered cementum and reducing periodontal pathogenic microorganisms

Question 5

what is non surgical therapy?

Answer 5

ohi
supragingival debridement
subgingival debridement
re evaluate 6-8 weeks

Question 6

if a patient has deeper pocketing than normal but with no BOP how do you manage this?

Answer 6

don’t attempt to re RSD - could worsen LOA or make an inactive site active
put pt on frequent recall and see if pockets shrink further

Question 7

healing occurs because of a combination of what 3 things?

Answer 7

formation of long JE
shrinkage of gingivae
tightening and formation of gingival cuff

Question 8

what is a long junctional epithelium?

Answer 8

epithelial cells multiply quickly producing a long JE = new attachment by hemidesmosomes
at base of pocket = small amount of connective tissue reattachment or connective tissue new attachment

Question 9

why does shrinkage of the gingivae occur?

Answer 9

inflammation is lost

Question 10

what is tightening and formation of the gingival cuff?

Answer 10

tightening and formation of new collagen fibres around the tooth as inflammation is lost

Question 11

what are the 4 types of gingival fibres?

Answer 11

circular
dentogingival
dentoperiosteal
alveogingival

Question 12

what makes a patient periodontally stable and suitable for maintenance?

Answer 12

no BOP

pockets under and equal to 3 mm

Question 13

when devising a maintenance plan what should be considered?

Answer 13

any systemic conditions that will effect = shorter recall time
anything has been added intra orally = shorter recall time
patients ability to attend