Podcast
Questions and Answers
What is the primary focus of the short term goal of periodontal treatment?
What is the main objective of the long term goals of periodontal treatment?
What is the primary purpose of the preliminary phase of periodontal treatment planning?
What is a determining factor of a hopeless prognosis tooth?
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Why is it important to extract hopeless teeth in the preliminary phase?
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What is involved in the preliminary phase of periodontal treatment planning?
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What is the ultimate goal of periodontal treatment planning?
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What is the purpose of patient education in the preliminary phase of periodontal treatment planning?
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What is the purpose of the maintenance phase in periodontal therapy?
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How often is periodontal maintenance performed in the first year?
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What is a risk factor in periodontal disease?
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What is a risk determinant in periodontal disease?
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What is an example of a risk indicator in periodontal disease?
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What is the purpose of distinguishing between risk factors, risk determinants, risk indicators, and risk markers?
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Why are patients who have had scaling and root planing on periodontal maintenance for life?
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What is an example of a risk marker in periodontal disease?
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How often can patients who are doing well in periodontal maintenance move to?
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What is the initiating factor and direct cause of periodontal disease?
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What is the primary focus of Phase One therapy?
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What is the purpose of periodontal reevaluation?
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When should the periodontal reevaluation take place?
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What is the term for the area where the epithelium contacts the enamel directly?
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What is the primary goal of Phase Two therapy?
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What is the significance of stronger Hemi desmosomes attachment to the enamel?
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What is the term for the phase of therapy that involves restorative treatment with crowns and final restorations?
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What is the primary goal of Phase Zero therapy?
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Why is patient compliance crucial in periodontics?
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What is the purpose of scaling and root planing?
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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)
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Description
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.