Prognosis

Question 1

prognosis

Answer 1

prediction of the course , duration, and outcome of a disease based on the patho of the disease and the presence of risk factors for the disease

Question 2

when is prognosis established

Answer 2

after dx is made and before tx plan is established

Question 3

overall prognosis

Answer 3

• pt age
• severity of disease
• systemic factors
• smoking
• plaque, calculus, other
• pt compliance
• pros possibilities

Question 4

individual tooth prognosis

Answer 4

• determined after the overall prognosis and affected by it
• mobility
• probe depth
• bone loss
• furcation involvement
• local factors

Question 5

mcguire and nunn - good prognosis

Answer 5

• 25% AL and/or class 1 FI
• adequate remaining bone support
• adequate pt cooperation
• non systemic environmental factors or well controlled systemic factors

Question 6

mcguire and nunn - fair prognosis

Answer 6

• 25-50% AL
• class 1 or 2 FI
• adequate maintenance possible
• few systemic complications

Question 7

mcguire and nunn - poor prognosis

Answer 7

• > 50% AL
• class 2 mobility
• inaccessible class 2 FI, class 3
• difficult to maintain areas, doubtful pt cooperation
• presence of systemic/environmental factors

Question 8

mcguire and nunn - hopeless prognosis

Answer 8

• > 75% AL
• mobility 2+
• class 2 and 3 FI
• difficult to maintain areas, doubtful pt cooperation
• root proximity

Question 9

overall clinical factors

Answer 9

• pt age (older generally better px - younger is aggressive)
• disease severity (measured by CAL, radio exam)
• plaque control
• pt compliance

Question 10

systemic/environmental factors

Answer 10

• smoking

- systemic disease/condition

Question 11

local factors

Answer 11

• plaque control (microbial challenge is most important local factor)
• anatomic factors (short tapered roots and large crowns = poor px)
• tooth mobility (reversible if caused by inflam and trauma from occlu)

Question 12

common places for root concavitites

Answer 12

• max 1st premolar

- MB root of max 1st molar

Question 13

prognosis for drug induced gingival enlargement

Answer 13

• plaque control alone doesnt prevent lesions

- surgical intervention usually necessary

Question 14

px for chronic periodontitis

Answer 14

• slowly progressive disease with well known local env factors
• in slight-moderate, px is usually good if inflam can be controlled

Question 15

px for aggressive periodontitis

Answer 15

• can be local or generalized
• rapid AL and bone destruction in otherwise healthy pt
• familial aggregation
• AA or PG present
• poor px

Question 16

PD as a manifestation of systemic disease

Answer 16

both classifications (assoc w hematologic disorders and genetic disorders) have fair-poor px

Question 17

hypophosphatasia

Answer 17

• decreased levels of circulating alkaline phosphatase, severe alveolar boneloss, premature loss of primary and secondary teeth, CT disorder
• fair-poor px

Question 18

NUG px

Answer 18

• primary predisposing factor is bacterial plaque
• px is good
• repeated episodes may make px fair

Question 19

NUP px

Answer 19

many pts are immunocompromised thru systemic conditions (HIV)
-px dependent upon reduction of local and secondary factors AND control of systemic disease