Risk assesment/prognosis Flashcards
Define Prognosis, Risk, and Prognostic factors
- Prognosis is a prediction of course and outcome of disease
- Risk is likelihood that an individual will develop a disease in a given time
- Prognostic factors and risk factors can be the same: Diabetes, smoking etc.,
Describe the McGuire and Nunn classification of prognosis:
Based on tooth mortality
Good-fair-poor-questionable-hopeless
Describe each prognosis category for McGuire and Nunn:
- Good: Control of etio factors, adequate support, easily maintained
- Fair: 25% CAL/Grade I fur- maintenance possible w compliance
- Poor: 50% CAL/Grade II fur - maintenance possible but difficult
- Questionable >50% CAL; (poor crown/root ratio); C II or III fur; >2+ mobility; root proximity
- Hopeless: Inadequate attachment to maintain health, comfort, fxn
Describe the Kwok and Caton prognosis classification system?
probability of obtaining stability
Describe the 4 classes of Kwok and Caton:
- Favorable: Tx and Maintenance will stabilize tooth, future loss is unlikely
- Questionable: local/systemic factors may or may not be controllable
- Unfavorable: factors cannot be controlled
- Hopeless: tooth must be ext
Which type of defect has a better prognosis?
Angular because it is graftable
How is age a prognosis factor?
Younger patients have greater reparative capability BUT if the pt is young that means it is more aggressive.
Is a combined perio-endo lesion a good or bad for prognosis?
If it is combined, both endo and perio will result in better prognosis.
Which is better: a center of rotation more apically or coronally?
More coronal is best
Name systemic/environmental factors related to perio dz:
smoking; DM; incapacitating conditions limiting OH; genetic factors: IL-1 genotype/serum IgG2 levels/etc.; stress, substance abuse
How long does a person have to stop smoking for them to have the same response as a nonsmoking individual?
11 years
What are the local factors that can effect perio dx prognosis?
cementoenamel projections; plaque, calculus, sub-G restorations, tooth mobility
What are the issues of tooth mobility?
mobility lowers response to therapy; ability to restore stability is inversely proportional to mobility caused by loss of supporting bone; plaque control may result in equal healing for hyper mobile teeth
List the anatomic feature of a tooth that hurt the prognosis:
- cervical enamel projections
- Root concavities
- Developmental grooves
- Access to furcations
In aggressive periodontitis, does the patient have a lot of plaque?
No- limited plaque but high in P. gingivalis and A.A.
What is the prognosis for pt with perio dz due to hematological disorders or genetic disorders?
fair to poor
What is the prognosis for NUG/NUP?
NUG: controlled plaque= good but repeated episodes is fair. NUP: usually has systemic factors and variable prognosis depending on systemic factor control
Systemic Risk factors for periodontitis? (3)
Smoking, Diabetes (7 or less), bacterial plaque
Genetic risks for perio dz?
IL genotype, neutrophil deficiency
Tools for perio prognosis:
PRC= periodontal risk calculator; function diagram program; Darcey and Ashley
PRC records?
Age, smoke, dm, pockets, BOP, furcation, sub-g calculus or restorations, bone height, vertical lesions
PRA with functional diagrams assess?
bop, pockets, loss of teerth, age/loss of support, systemic and genetic areas, environment (smoker).
Study show which as being better predictor - periodontist or computer?
calculator
