Risk Assesment/Treatment Planning Flashcards
What is a risk determinant?
A substitute term for risk factor - but cannot be modified
What are some risk determinants in the periodontium?
- Genetic factors
- Age (older > younger)
- Gender (men > women)
- Socioeconomic status
What is a risk indicator?
A probable risk factor - but has not been confirmed in longitudinal studies
What are some risk indicators in the periodontium?
- Microbiota
- Inflammation
- HIV/AIDS
- Osteoporosis
What are risk predictors?
May not be part of the causal chain - but are associated with elevated risk for disease
T/F: Risk predictors are useful in identifying likely interventions.
False
Good for identifying who is at risk
What are some risk predictors in the periodontium?
- Hx of PD
- BoP
- Fewer teeth
- Periodontal support in relation to age
- Calculus
- Furcations
What is a prognostic factor?
An environmental, behavioral or biological factor that directly effects the outcome of therapy
What are some prognostic factors in the periodontium?
- Extent and severity of disease
- Level of oral hygiene
- Infrequent dental visits
- Smoking
T/F: Once risk assessment is complete, you should immediately modify the treatment plan.
False
Risk assessment -> prognosis -> treatment plan -> patient education
Compare an etiologic factor with a risk factor.
Etiologic - contributes to cause of disease
Risk - associated with increased change of developing disease
What is a mucogingival defect?
When sulcus depth is at or apical to the mucogingival junction
Differentiate between Class I️, II, and III furcation involvements.
I️ - catch with no radiolucency
II - catch with radiolucency
III - through and through
Differentiate between class I️, II, and III mobility.
I️ - 1mm
II - 2mm or in two directions
III - 3mm or in three directions
T/F: All craters are two walled defects.
True
But all two walled defects are not craters
What determines if tissue regeneration will work in a vertical bone loss?
Number of remaining walls
T/F: If a patient has a reduced periodontia then they are always diagnosed with periodontitis.
False
Can be healthy/gingivitis on top of stable but reduced periodontia
What are the three requirements in order to move forward with a treatment plan?
- Data collection (initial exam)
- Diagnosis
- Prognosis
What are the short and long term goals of a periodontal treatment plan?
Short - eliminate bacterial plaque, and eliminate infectious/inflammatory processes
Long - reconstruction of healthy dentition that is functional and esthetic
Goals of treatment are to have BoP be less than _____ and to have no probe depths greater than or equal to _____.
25%; 5mm
What are the major goals in treatment for control of risk factors?
- Proper plaque control
- Smoking cessation
- Proper control of diabetes
What are the four phases of therapy?
- Systemic phase
- Initial (hygiene phase)
- Corrective phase
- Maintenance phase
After initial treatment during the initial phase, how long should you wait before reevaluation?
4-6 weeks
45 days for collagen regrowth and 2 weeks for JE regrowth
At what phase of therapy would periodontal surgery, implant surgery, endo, or restorative work be completed?
Corrective phase
What phase of therapy involves patient education and oral hygiene instruction?
Initial phase
Extraction of hopeless teeth, scaling and root planing, and antibiotic therapy are all part of the __________ phase of treatment.
Initial
What would the recall schedule be like for a typical PD patient in the maintenance phase?
Every 3 months
When is the prognosis established?
After diagnosis and before treatment plan
T/F: Individual tooth prognosis can be determined before the overall prognosis.
FALSE
Overall prognosis must be determined first!
T/F: Age, systemic factors, patient compliance all fall into factors affecting individual tooth prognosis.
False
Overall
What are the five possible prognosis classifications in the McGuire and Nunn system?
Very good, good, fair, poor, hopeless
Give prognosis for 25% attachment loss and/or class I️ Furcation involvement.
Good
Give prognosis for 50% attachment loss.
Fair
Give prognosis for easily accessible Grade II Furcation involvement.
Fair
If there is over 75% attachment loss the prognosis is _________.
Hopeless
If there is over 50% attachment loss the prognosis is _________.
Poor
If tooth mobility is class II+ and there are grade II/III Furcation involvements the prognosis is ___________.
Hopeless
A patient with slightly under 50% attachment loss but has many systemic/environmental complications would have a prognosis of ________.
Poor
Root proximity gives a prognosis of _______.
Hopeless
In patients with similar clinical features, a prognosis is normally better in (older/younger) patients?
Better in older patients
Likely not aggressive
T/F: Pocket depth is less important in prognosis than level of attachment.
True
T/F: More walls = a worse prognosis in vertical defects.
False
More walls = better prognosis
T/F: If a tooth has a vertical defect effecting only one side (ex. just mesial but not distal) the bone height of the unaffected side should be used when determining prognosis.
True
T/F: Smoking cessation can effect prognosis.
True
T/F: Prognosis is poor for teeth with shorter roots and larger crowns.
True
What are some anatomic factors that can cause a worse prognosis?
CEPs, enamel pearls, bifurcation ridges, root concavities, short roots
T/F: Aggressive periodontitis would have a fair prognosis.
Poor
Patients with periodontitis as a manifestation of systemic disease present with a ___________ prognosis.
Fair-poor
T/F: NUG patients have a good prognosis unless _________.
There are repeated episodes - downgraded to fair
