Prognosis of Periodontitis

Question 1

5 types of prognosis by (McGuire, 1996)

GFPQH

Answer 1

Good prognosis: Control of etiologic factors and adequate periodontal support ensure the teeth will be easy to maintain by both the patient and clinician.

Fair prognosis: Approximately 25% attachment loss and/or Class I furcation involvement (location and depth allow proper maintenance with good patient compliance).

Poor prognosis: 50% attachment loss, Class II
furcation involvement (location and depth make maintenance possible but difficult).

Questionable prognosis: >50% attachment loss, poor root form, Class II furcation (location and depth make access difficult) or Class III furcation involvements, poor crown-to root ratio; root proximity; >2+ mobility.

Hopeless prognosis: Inadequate attachment to maintain comfort, health and function.

Question 2

McGuire, 1996 system prognosis
limitations

Answer 2

1. Utilization regeneration therapy around
   teeth was not performed.

Question 3

Kwok, 2007
prognosis system

Answer 3

Favorable prognosis: complete periodontal therapy and follow up will stabilize the status of the teeth. Future loss of periodontal support is unlikely.

Questionable prognosis: systemic and/or local factors influencing the periodontal status of the teeth may or may not be controllable. If controlled, the periodontal status can be stabilized with complete periodontal therapy. If not, future periodontal deterioration may occur.

Unfavorable prognosis: local and/or systemic factors influencing the periodontal status cannot be controlled. Comprehensive periodontal therapy and follow up are unlikely to prevent future periodontal breakdown.

Hopeless prognosis: the teeth need to be extracted. Because periodontal maintenance is assessed on a regular basis using clinical parameters, it may be more useful in making therapy decisions and prognosis predictions than trying to determine the probability that the teeth will be lost.

Question 4

periodontal prognostic results rely on:

Answer 4

• Compliance
• Motivation
• Oral hygiene practices
• Individual’s risk factors.

Question 5

Kwok, 2007 system VS McGuire, 1996 system

Answer 5

The favorable prognosis in Kwok, 2007 system is consistent with good and fair prognosis of McGuire, 1996 system because:

Both prognoses are expecting if the
1. etiologic factors are controlled
2. The periodontal support is adequate
3. The clinical attachment loss not excessed 25% that ensures the teeth will be easy to maintain.

Question 6

Questionable prognosis

Answer 6

When the Local and/or Systemic factors can be controlled but the furcation involvement is class II and/or the clinical attachment loss is not excessed 50% of the root surface, that ensure the periodontal status can be stabilized with comprehensive periodontal therapy,

Question 7

Indications for extraction

Answer 7

1. Inadequate attachment to maintain health, comfort and function.

Question 8

AAP 8 Classifications

Answer 8

1. Gingival disease
2. Chronic periodontitis
3. Aggressive periodontitis
4. Periodontitis as a manifestation of systemic disease
5. Periodontal Abscess
6. Necrotizing periodontitis
7. Periodontitis associated with endodontic lesions
8. Developmental/Acquired deformities and conditions

Question 9

Chronic
Periodontitis Prognosis

Answer 9

Clinical attachment loss is not very severe (slight-to-moderate periodontitis), the prognosis is GOOD - IF- inflammation can be controlled through the removal of local plaque-retentive factors and good oral hygiene.

Question 10

Aggressive periodontitis prognosis

Answer 10

Poor prognosis

Localized aggressive periodontitis when diagnosed early, it can be treated conservatively with:
1. Oral hygiene instruction
2. Systemic antibiotic therapy resulting in an excellent prognosis

Generalized aggressive periodontitis usually
have a fair, poor, or questionable prognosis

Question 11

Periodontitis as a manifestation of systemic diseases

Answer 11

Periodontitis as a manifestation of systemic diseases such as
neutropenia, hypophosphatasia and Ehlers-Danlos syndrome
have a fair to poor prognosis.

Answer 12

Stage I periodontitis has Good prognosis

Stage II periodontitis has fair prognosis

Stage III periodontitis
1. Poor prognosis when the radiographic bone loss [33% to 50%] and/or the furcation involvement is class II
2. Questionable prognosis when the bone loss exceeds 50% and the furcation involvement is class III

Stage IV periodontitis
Hopeless prognosis due to
-Mobility ≥ grade 2 and/or the
-Bone loss exceed 50% and/or
-Systemic factors are uncontrolled