They found that recommend. Prognosis. Newer "automated" oral hygiene devices such as electric toothbrushes may be helpful for these patients and improve their prognosis (see ( hapter 49). dentition is shorter. While clinical attachment loss (CAL) is a primary determining factor of the staging, radiographic bone loss (RBL) can be used in the absence of clinical attachment loss. Things do not heal as quickly in older patients. A, Gingival inflammation, poor oral hygiene, and pionounced anterior overbite in a systemically healthy, nonsmoking 42-year-old man B, Although local lac tors are present, the patient presents with adequate remaining bone support and a good prognosis, provided local factors can be controlled. patient will at the least use the Sonicare Diamond Clean tooth brush and clean in These teeth Pocket depth is less important than level of attachment, because it is not necessarily related to bone loss. Ottmar Zellhuber. nonsmokers! Create a free account to download. Heroic attempts to retain a hopelessly involved tooth may jeopardize the adjacent teeth. Oral condition (inflammation, bone level) 6. Smoking. *n»xnos is • C!H APÏÏ.K t.* 479, variable in this relationship (see t hapter S) Therefore patients at risk for diabetes should be identified as early as possible and informed ol the relationship between periodontitis and diabetes. We usually 8. STEP THREE: Periodontal Maintenance (click for more information) The two most important factors in determining long-term success are patient home care, and regular periodontal maintenance (cleanings). Determining the risk for Without these, treatment cannot succeed. (îenetic polymorphisms in the interleukin-l (II-I) genes, resulting in increased production of II. 2. This is the Periodontal Prognosis Score for that tooth. lor the younger patient, the prognosis is not as good because of the shorter time frame in which the periodontal destruction has occurred. Questionable: These teeth have a questionable outlook beyond 5-7 years because the Name some common factors in making an overall prognosis for the periodontal patient. Assuming bone destruction can be arrested, is there enough bone remaining to support the teeth? Prognosis: Should be updated yearly The natural history of periodontal disease, in some but not all patients, results in tooth loss.1 Periodontal disease, however, encompasses a wider Finally, the familial aggregation that is characteristic ot aggressive periodontitis indicates that additional, as yet unidentified, genetic lac tors may be important in susceptibility to this form of disease (see i hapter 2S). 3. Hopeless: These teeth have Pd’s greater than 8mm, advanced furcation involvement, Similarly, in patients with other systemic disorders that could affect disease progression, prognosis improves with correction of the systemic problem. Periodontal prognosis refers to the expected longevity of teeth with or without periodontal therapy. The effect of endodontic treatment on the success of subsequent periodontal treatment has been studied (9). The presence of complex pockets encompassing multiple root surfaces is a poor prognostic factor than the presence of simple pockets. They are determined by clinical and radiographic evaluation (see Chapters 30 and 31). 33-3). Disease Severity. Determining Prognosis of Periodontally Involved Teeth. In addition, patients should be informed that smoking affects not only the severity of periodontal destruction, but also the healing potential of the periodontal tissues. (iooiI prognosis: One or more ol the following: adequate remaining bone support, adequate possibilities to control etiologic factors and establish a maintainable dentition, adequate patient cooperation, no systemic/ environmental factors or it systemic lactnrs are present, they are well controlled. Older patients have issues with dexterity & health. 33-4). for any needed restorative care (fillings, crowns, bridges, etc). Conclusions. (i) the prevalence of residual periodontal pockets, (ii) tooth loss, (iii) the systemic conditions in each patient, and (iv) environmental or behavioral factors such as smoking (12). This results in a more favorable distribution of forces to the periodontium and less tooth mobility.44. However, deep pockets are a source ot infection and may contribute to progressive disease. Download Free PDF. Basically, these factors should be considered and evaluated together for prognosis of periodontitis recurrence. [] Studies suggest that there is a link between DM, tooth loss, and periodontal prognosis. recommend extracting these teeth, but in some cases will try laser assisted therapy as a The model proposed in this report is based on the best available evidence for factors affecting tooth survival and has been designed to be as simple and objective as … Commentary: prognosis revisited: a system for assigning periodontal prognosis. Periodontal diseases represent a complex interaction between a microbial challenge and the host's response to that challenge, both ol which may be influenced by environmental factors such as smoking. Incapacitating conditions that limit the patient's performance ol oral procedures (e.g., Parkinson's disease) also adversely affec t the prognosis. I he height of remaining bone is usually somewhere in between, making bone level assessment alone insufficient for determining the overall prognosis. I herefore I lie following variables should be carefully recorded because they are important for determining the patient's past history ol periodontal disease: pocket depth, level ot attachment, degree of bone loss, and type of bony defect. The prognosis is questionable when surgical periodontal treatment is required but cannot be provided because of the patient's health (see < hapter W). I he answer is readily apparent in extreme c ases, that is. It follows that the prognosis in these cases is dependent on patient compliance relative to both their medical and dental status. PLMs must be considered when determining the prognosis of a tooth with periodontal disease. 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determining periodontal prognosis