Prognosis, Re-Evaluation, & Maintenance Flashcards
What is our objective with perio therapy?
- predictable plan
- stable perio health
- long-term outcome
A prediction of the course, duration and outcomes a disease based on a general knowledge of the risk factors for the disease:
Prognosis
List the steps required in order to deliver a predictable and long term stable comprehensive treatment plan:
- comprehensive examination (clinical/radiographic findings)
- diagnosis
- prognosis
- treatment plan
An evaluation of the course of the disease WITHOUT treatment:
Diagnostic prognosis
An evaluation of the course of the disease WITH treatment:
Therapeutic diagnosis
The anticipated result of the periodontal therapy with anticipated prosthetic treatment:
Prosthetic prognosis
When viewing the DIAGNOSTIC prognosis study, it evaluated 30 patients with moderate to advanced periodontitis with NO TREATMENT at an average of 3.72 years after initial examination, the average tooth loss was:
0.36 teeth per patient per year
When viewing the THERAPEUTIC prognosis study, it evaluated 44 patients with moderate to advanced periodontitis WITH TREATMENT but NO MAINTENANCE over a 5-year period, the average tooth loss was:
0.22 teeth per patient per year
When viewing the THERAPEUTIC prognosis study, it evaluated 95 patients with moderate to advanced periodontitis WITH TREATMENT and REGULAR MAINTENANCE at an average of 6.5 years, the average tooth loss was:
0.11 teeth per patient per year
When viewing the PROSTHETIC prognosis study, ____% of the bridges failed due to loss of retention, fracture of bridgework, or fracture of abutment teeth.
Severe reduction of periodontal support around the abutment teeth and difference in the bridgework ______ influence periodontal status.
8%
did NOT
Factors to consider with individual tooth prognosis include:
- percentage of bone loss
- deepest probing depth
- horizontal or vertical bone loss
- anatomical factors (furcation involvement, root form, mobility, etc.)
- crown-to-root ratio
- caries or pulpal involvement
- tooth malposition
- fixed or removable abutment
Factors to consider with overall prognosis of perio disease include:
- age
- medical status
- smoker and/or diabetic
- family history of perio disease
- oral hygiene
- compliance
- maintenance interval
- parafunctional habits with/without guard
- individual tooth prognosis
When determining the prognosis of a periodontal patient, you should consider both:
- individual tooth prognosis
- overall prognosis
According to the prognosis assignment, the overall prognosis is concerned with:
the dentition as a whole
According to the prognosis assignment, the individual tooth prognosis is:
modified and affected by overall prognosis
With individual tooth prognosis, what is the MOST IMPORTANT determinant:
Amount or percentage of attachment loss
Why is the amount or percentage of attachment loss considered the most important determinant for individual tooth prognosis?
Because it influences mobility and crown/root ratio
List the factors affecting individual tooth prognosis:
- amount or percentage of attachment loss
- bony defect topography
- pocket depth (needs to related to the attachment loss)
- rate of attachment loss
- systemic/environmental factors
- patients compliance and oral hygiene control
When determining the pocket depth effects on the individual tooth prognosis, this needs to be related to:
attachment loss
What are some systemic/environmental factors that affect individual tooth prognosis?
- smoking
- diabetes
- stress
- genetics
- medications inducing gingival enlargements
- systemic disease affecting perio
What are the anatomical factors that affect individual tooth prognosis?
- excessive occlusal forces
- overhang or defective subgingival restorations
- cervical enamel projections (CEP’s)/enamel pearls
- developmental/palatogingival grooves
- root concavities
- root forms and lengths
- furcation and intermediate bifurcation ridges
- accessary canals
- root proximity
- tooth mobility
Defective subgingival margins & overhand are examples of:
Anatomical factors affecting individual tooth prognosis
What can be seen in the following image that affects individual tooth prognosis?
Defective subgingival margin/overhang
(anatomical factors affecting individual tooth prognosis)
CEP’s:
Cervical enamel projections
CEP in which the enamel projection extends from the CEJ of the tooth toward the furcation entrance:
Grade 1
CEP in which the enamel projection approaches the entrance to the furcation (not entered yet):
Grade 2
CEP in which the enamel projection extends horizontally into the furcation:
Grade 3
When CEP’s are present, it extends into furcation areas of _____ of molars
20-30%
The most common locations for a CEP is the:
buccal surface of 2nd mandibular molars
Classify the grade of the following CEP’s:
A: Grade 1
B: Grade 2
C: Grade 3
