28 Questions
What is the primary focus of the short term goal of periodontal treatment?
comfort and aesthetics
What is the main objective of the long term goals of periodontal treatment?
to establish occlusal stability and function
What is the primary purpose of the preliminary phase of periodontal treatment planning?
to treat emergencies and extract hopeless teeth
What is a determining factor of a hopeless prognosis tooth?
bone loss that involves the apex of the tooth
Why is it important to extract hopeless teeth in the preliminary phase?
to reduce the risk of further periodontal attachment loss
What is involved in the preliminary phase of periodontal treatment planning?
treating emergencies and extracting hopeless teeth
What is the ultimate goal of periodontal treatment planning?
to save as many teeth as possible
What is the purpose of patient education in the preliminary phase of periodontal treatment planning?
to instruct patients on proper oral hygiene techniques
What is the purpose of the maintenance phase in periodontal therapy?
To evaluate and maintain the patient's oral hygiene and periodontal tissues
How often is periodontal maintenance performed in the first year?
Every 3 months
What is a risk factor in periodontal disease?
A thing that is causally associated with the disease
What is a risk determinant in periodontal disease?
A unchangeable background characteristic
What is an example of a risk indicator in periodontal disease?
Osteoporosis
What is the purpose of distinguishing between risk factors, risk determinants, risk indicators, and risk markers?
To help clinicians assess a patient's risk of getting periodontal disease
Why are patients who have had scaling and root planing on periodontal maintenance for life?
Because they are at a higher risk of getting disease
What is an example of a risk marker in periodontal disease?
Previous history of periodontal disease
How often can patients who are doing well in periodontal maintenance move to?
Twice a year schedule
What is the initiating factor and direct cause of periodontal disease?
Plaque
What is the primary focus of Phase One therapy?
Conservative plaque control and oral hygiene instruction
What is the purpose of periodontal reevaluation?
To reaffirm the importance of oral hygiene and assess improvements in periodontal health
When should the periodontal reevaluation take place?
Four to eight weeks after completion of Phase One therapy
What is the term for the area where the epithelium contacts the enamel directly?
Junctional epithelium
What is the primary goal of Phase Two therapy?
To reduce or eliminate periodontal pockets and correct soft and hard tissue defects
What is the significance of stronger Hemi desmosomes attachment to the enamel?
Sign of healing towards a shallower pocket
What is the term for the phase of therapy that involves restorative treatment with crowns and final restorations?
Phase Three therapy
What is the primary goal of Phase Zero therapy?
To take care of immediate concerns and extract hopeless teeth
Why is patient compliance crucial in periodontics?
Because patients need to be motivated to improve their oral hygiene and situation
What is the purpose of scaling and root planing?
To remove local factors and improve oral hygiene
Study Notes
Short-term and Long-term Goals of Periodontal Treatment
- Short-term goals: reduce gingival inflammation, focused on comfort and aesthetics
- Long-term goals: eliminate pain, arrest hard and soft tissue destruction, establish occlusal stability and function, reduce tooth loss, prevent recurrence of periodontal disease
Five Phases of Periodontal Treatment Planning
Preliminary Phase (Phase 0)
- Treat emergencies (endodontic or periodontal abscess)
- Extract hopeless teeth (official category of tooth prognosis, e.g., bone loss involving the apex of the tooth)
- Focus on plaque control and patient education
- Involves cleaning, scaling, and root planing, oral hygiene instruction, and removal of local factors (plaque, calculus, etc.)
Phase One Therapy
- Focus on conservative plaque control
- In-office and at-home plaque control
- Periodontal reevaluation 4-8 weeks after completion of Phase One therapy to assess improvements in periodontal health and reaffirm importance of oral hygiene
Phase Two Therapy (Surgical Phase)
- Reduce or eliminate periodontal pockets
- Correct soft and hard tissue defects, regenerate periodontal tissue, or place implants
- Involves periodontal and endodontic therapy to restore teeth with endodontic problems
- May require flapping open gums for better access and vision
Phase Three Therapy (Restorative Phase)
- Focus on restorative treatments (crowns, bridges, partials) after periodontal disease is under control
Phase Four Therapy (Maintenance Phase)
- Ongoing evaluation of oral hygiene and periodontal tissues
- Periodic maintenance (every 3 months for the first year, then possibly twice a year) to assess pocket depths, inflammation, and overall periodontal health
- Patients who have had scaling and root planing will require periodontal maintenance for life due to increased risk of future disease
Risk Elements
- Risk factors: causally associated with disease (e.g., smoking, diabetes, pathogenic bacteria, microbial tooth deposits)
- Risk determinants: unchangeable background characteristics (e.g., gender, genetics, socio-economic status) that increase the likelihood of disease
- Risk indicators: not causally associated with disease, but may point to a higher risk (e.g., stress, osteoporosis, HIV/AIDS)
- Risk markers: quantitative association with disease (e.g., previous history, bleeding on probing, clinical attachment loss)
Learn about the short-term and long-term goals of periodontal treatment, including the five phases of treatment planning. Understand the preliminary phase, emergency treatment, and long-term goals of periodontal care.
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