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Chapter 22- Periodontal Maintenance Therapy (Components of the Periodontal…
Chapter 22- Periodontal Maintenance Therapy
Periodontal maintenance also has been referred to as periodontal recall, supportive periodontal care and continuing care
Refractory periodontal disease occurs in treated periodontal patients who fail to respond to periodontal treatment including maintenance therapy.
Patients may be refractory because of inadequate treatment, presense of systemic disease, deficient immune response, or persistence of periodontal pathogens
Recurrent periodontal disease occurs in patients who previously responded well to periodontal therapy but later showed signs of disease reactivation.
Objectives of Periodontal Maintenance
to prevent or minimize the recurrence of periodontal diseases in patients by controlling risk factors known to contribute to the disease process
to prevent or reduce the incidence of tooth or implant loss by monitoring the dentition and prosthetic replacements of the natural teeth
to increase the probability of locating and treating other conditions or disease found in the mouth
to preserve the health, comfort, and function of the teeth
Components of the Periodontal Maintenance Visit
An update of medical and dental histories
EOIO
Dental examination and gingival and periodontal assessment
Radiograph review
Oral hygiene evaluation
Review of the patient's biofilm-control efficacy
Removal of dental biofilm from the supra and subgingival areas, root debridement where indicated, teeth polishing, and adjunctive chemotherapy if necessary
Treatment: recurrent periodontal disease vs. a well-maintained periodontium
Recurrent periodontal disease occurs when signs and symptoms of disease return after having subsided during active treatment
In well-maintained patient in whom inflammation is not present(no bleeding on probing) and for whom soft tissue attachment loss or bone loss is minimal.
Chemotherapeutics agents may be beneficial in certain patients as an adjunct to standard oral hygiene procedures, nut they do not replace brushing and flossing.
Frequency of intervals are determined on an individual basis according to periodontal disease severity, type of treatment performed, adequacy of oral hygiene self care, presence of orthodontic and prosthetic appliances, systemic health , and patient adherence