Dental Prosthetics and Restorative Factors

Study Notes

Prognosis of Tooth Mobility

Tooth mobility caused by inflammation and trauma from occlusion may be correctable.
Tooth mobility resulting from loss of alveolar bone is not likely to be corrected.

Prognosis for Patients with Gingival Disease

Biofilm-induced gingivitis is a reversible disease that occurs when bacterial biofilm accumulates at the gingival margin.
The prognosis is good for patients with biofilm-induced gingivitis.
Systemic factors, such as endocrine changes, blood dyscrasias, and medications, can influence the inflammatory response and affect the prognosis.
The long-term prognosis depends on control of bacterial biofilm and correction of systemic factors.

Biofilm-Induced Gingival Diseases Modified by Medications

Medications, such as phenytoin, cyclosporine, and nifedipine, can cause drug-influenced gingival enlargement.
The long-term prognosis depends on whether the etiology of the inflammation can be eliminated or the patient's systemic problem can be treated with an alternative medication.

Non–Biofilm-Induced Gingival Lesions

Non-biofilm-induced gingivitis can be caused by bacterial, fungal, and viral infections.
The prognosis depends on elimination of the source of the infectious agent.
Dermatologic disorders, such as lichen planus, pemphigoid, and lupus erythematosus, can manifest in the oral cavity as atypical gingivitis.
The prognosis is linked to management of the associated dermatologic disorder.

Prognosis for Patients with Periodontitis

Chronic periodontitis is a slowly progressive disease associated with local environmental factors.
The prognosis is generally favorable for patients with slight to moderate periodontitis, provided the inflammation can be controlled through good oral hygiene and removal of local biofilm-retentive factors.
Patients with severe periodontitis, furcation invasion, and tooth mobility may have a questionable or unfavorable prognosis.
Aggressive periodontitis can present in a localized or generalized form, and the prognosis may be poor to hopeless.
Smoking cessation can affect the treatment outcome and improve the prognosis.

Systemic Disease or Condition

The patient's systemic background affects overall prognosis, and the prevalence and severity of periodontitis is significantly higher in patients with diabetes.
Well-controlled diabetics with slight-to-moderate periodontitis who comply with their recommended periodontal treatment should have a good prognosis.
Conditions that limit the patient's performance of oral procedures, such as Parkinson's disease, can adversely affect the prognosis.

Genetic Factors

Genetic factors may play an important role in determining the nature of the host response in periodontal diseases.

Plaque and Calculus

The microbial challenge presented by bacterial plaque and calculus is the most important local factor in periodontal diseases.

Subgingival Restorations

Subgingival margins may contribute to increased plaque accumulation, increased inflammation, and increased bone when compared with supragingival margins.
Discrepancies in these margins, such as overhangs, can negatively impact the periodontium.
Subgingival margins have a poorer prognosis than teeth with well-contoured, supragingival margins.

Description

This quiz covers the factors affecting tooth mobility and the overall prognosis in dentistry, including bone levels, attachment levels, and the possibility of saving teeth. It touches on the impact of inflammation, trauma, and loss of alveolar bone on tooth mobility.