Prognosis, Re-Evaluation, & Maintenance

Question 1

What is our objective with perio therapy?

Answer 1

1. predictable plan
2. stable perio health
3. long-term outcome

Question 2

A predication of the source, duration, and outcome of a disease based on a general knowledge of the risk factors for the disease:

Answer 2

prognosis

Question 3

List the steps involved in delivering a predictable and long term stable comprehensive treatment plan:

Answer 3

1. comprehensive exam (clinical & radiographic findings)
2. diagnosis
3. prognosis
4. treatment plan

Question 4

An evaluation of the course of disease WITHOUT treatment:

Answer 4

diagnostic prognosis

Question 5

An evaluation of the course of the disease WITH treatment:

Answer 5

therapeutic prognosis

Question 6

The anticipated result of the periodontal therapy with anticipated prosthetic treatment:

Answer 6

Prosthetic prognosis

Question 7

When viewing the DIAGNOSTIC prognosis study, it evaluated 30 patients with moderate to advanced periodontitis with NO TREATMENT at an average of 3.72 yeasrs after initial examination, the average tooth loss was:

Answer 7

0.36 teeth per patient per year

Question 8

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:

Answer 8

0.22 teeth per patient per year

Question 9

When viewing the THERAPEUTIC prognosis study, it evaluated 95 patients with moderate to advanced periodontitis WITH TREATMENT and REGULAR MAINTENACE at an average of 6.5 years. The average tooth loss was:

Answer 9

0.11 teeth per patient per year

Question 10

When viewing the PROSTHETIC prognosis study, ___% of 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 bridgework ____ influence periodontal status.

Answer 10

8%; did not

Question 11

Factors to consider with individual tooth prognosis include:

Answer 11

1. percentage of bone loss
2. deepest probing depth
3. horizontal or vertical bone loss
4. anatomical factors (furcation involvement, root form, mobility etc.)
5. crown-to-root ratio
6. caries or pulpal involvement
7. tooth malposition
8. fixed or removable abutment

Question 12

Factors to consider with overall prognosis of perio disease include:

Answer 12

1. age
2. medical status
3. smoker and/or diabetic
4. family hx of periodontal disease
5. oral hygiene
6. compliance
7. maintenance interval
8. parafunctional habits with/without guard
9. individual tooth prognosis

Question 13

When determining the prognosis of a periodontal patient, you should consider both:

Answer 13

1. individual tooth prognosis
2. overall prognosis

Question 14

According to prognosis assignment, the overall prognosis is concerned with:

Answer 14

the dentition as a whole

Question 15

According to prognosis assignment, the individual tooth prognosis is:

Answer 15

modified and effected by overall prognosis

Question 16

With individual tooth prognosis, what is the MOST IMPORTANT determinant:

Answer 16

amount or percentage of attachment loss

Question 17

Why is the amount of percentage of attachment loss considered the most important determinant for individual tooth prognosis?

Answer 17

because it influences mobility and crown/root ratio

Question 18

List factors affecting individual tooth prognosis:

Answer 18

1. amount or percentage of attachment loss
2. bony defect topopgraphy
3. pocket depth (needs to relate to the attachment loss)
4. rate of attachment loss
5. systemic/ environmental factors
6. patients compliance and oral hygiene control

Question 19

When determining the pocket depths effects on the individual tooth prognosis, this needs to be related to:

Answer 19

attachment loss

Question 20

What are some systemic/environmental factors that affect individual tooth prognosis?

Answer 20

1. smoking
2. diabets
3. stress
4. genetics
5. medications inducing gingival enlargements
6. systemic disease affecting perio

Question 21

What are some anatomical factors that affect individual tooth prognosis?

Answer 21

1. excessive occlusal forces
2. overhand or defective subgingival restorations
3. cervical enamel projections (CEP’s)/ enamel pearls
4. Developmental/ Palatogingival grooves
5. Root concavities
6. Root form and lengths
7. Furcation and intermediate bifurcation ridges
8. Accessory canals
9. Root proximity
10. Tooth mobility

Question 22

Defective subgingival margins and overhands are examples of:

Answer 22

anatomical factors affecting individual tooth prognosis

Question 23

What can be seen in the following image that affects individual tooth prognosis?

Answer 23

Defective sub G margin/overhang

(anatomical factors affecting individual tooth prognosis)

Question 24

CEP’s:

Answer 24

Cervical Enamel projections

Question 25

CEP In which the enamel projection extends from the CEJ to the tooth toward the furcation entrance:

Answer 25

Grade 1

Question 26

CEP in which the enamel projection approaches the entrance to the furcation (not entered yet):

Answer 26

Grade 2

Question 27

CEP in which the enamel projection extends horizontally into the furcation:

Answer 27

Grade 3

Question 28

When CEPs are present, they extend into furcation areas of ____% of molars

Answer 28

20-30%

Question 29

The most common locations for a CEP is the:

Answer 29

buccal surface of 2nd mandibular molar