Reassessment after Fundamental Phase Periodontal Therapy Flashcards
What is the aim of periodontal therapy?
Maintenance of health, function, comfort, and aesthetics of all supporting and surrounding tissues of teeth and dental implants
Attachment sustained at high levels of achievement in personal plaque control reflected as sustained full-mouth bleeding on probing scores around 10% of eeth
Absence of increase in aattachment loss and/or bone loss
Probing pockets <5mm including horizontal probing in furcations of <5mm
Tooth hypermobility should be such that it does not impair patient’s plaque control efforts and allows the patient to function to an acceptable level in comfort.
What happens during the re-assessment phase of treatment?
Post-treatment evaluation
Comparison of pre-treatment and post-treatment clinical parameters to assess healing responses and determine stability or need for further treatment.
Review and reinforcement of personal daily oral hygiene when appropriate
Update anamnesis
Review the inital prognosis
If a periodontitis case, review the disease grade.
Refer to periodontal specialist if needed.
When should reassessment be done?
In general 60 - 90 days following treatment.
120 days for grade C and systemically modified subtypes.
What clinical parameters are used for re-assessment?
Supragingival: Plaque, marginal bleeding, and supragingival calculus
Subgingival: PD, CAL, BOP/supp
What should be done in a supragingival assessment when there is less than 10% visible plaque and BOP?
This is ideal and healthy. Nothing needs to be done
What should be done in a supragingival assessment when there is less than 10% visible plaque and >10% BOP?
Motivate patients to do better job
What should be done in a supragingival assessment when there is >10% visible plaque and BOP?
OHI
What should be done in a supragingival assessment when there is >10% visible plaque but <10% or no BOP?
Consider other factors such as smoking.
What does a reduced pocked depth indicate?
Oedema reduction
Possible recession
Long JE formation
What does an increase in pocket depth indicate?
Persistent inflammation/oedema
Continuing apical migration of the JE
What does an absence of BOP mean?
Resolution of inflammation and periodontal stability.
What should be done if re-assessment shows decreased PD and and BOP?
Stability
Ideal
Maintenance
What should be done if re-assessment shows decreased PD but increased BOP?
Remission is favourable
Maintenance
Close monitoring
What should be done if re-assessment shows increased PD and and BOP?
Instability. Further treatment is needed
Critical analysis should be done of:
Grade
Systemic modifiers
Type teeth/furcations
Type of bone defects
Subgingival calculus
Other root conditions
What further treatments can be done if normal scaling/root planing doesn’t work?
Antibiotics (depending on age, severity, and systemic involvement)
Surgical flap access for debridement (Deep and tortuous pockets, type teeth/furcations, type of bone defects, subgingival calculus and other root conditions)
